Malware, Trojans, bugs - all these words strike fear into the heart of each of us, imagining the breakdown of code, skull and bones. All these malicious programs from the Internet, unfortunately, only prove that for every useful technology there is an equal amount of garbage, which can sometimes have a negative impact on your computer.

Potentially unwanted programs(PUPs) fully justify their name: they are programs cluttering up your computer that you want to get rid of. PUPs are similar to malware in that once downloaded and installed, they begin to cause various problems on your computer. Distinguishes PNP from malware only the fact that their downloading occurs with your consent.

The term PUP was first coined as a definition for downloadable adware or junkware, which is different from malware. software. PUPs often consume a huge amount of system resources and are a common cause of slow operating systems. However, they are not harmful or cause harm. However, they often annoy PC users themselves by creating new toolbars in the web browser for some online stores, changing the search engine from Google to Bing without warning, constantly opening pop-up advertising windows, or regularly informing the user about the weather in Swaziland. Some PUPs even behave aggressively, deliberately slowing down your computer in order to later sell you wonderful tools/settings to speed up the system.

Why do PNPs exist? So that "free" software developers make a profit. For example, for every toolbar successfully installed in a browser, a free software developer receives about $2. Some PUPs exist just to make money without even providing you with anything useful.

So, how do you get one potentially unwanted program (or ten at once)?
The behavior of PUPs is usually outlined in the User Agreement: this is the long document that appears as you work your way through all the installation windows, clicking “Agree” and “Accept” to finally get to the end. But this seemingly useless legal section actually lists the intent of the program. For their installation, PUPs require your approval through this “Agree” button. They count on this consent. This protects software developers from any legal recourse. They rely on you to speed through the installation process and expect you not to read the User Agreement, but to immediately scroll down and click the long-awaited “AGREE” button.

So how do they get into your computer?

Imagine what you get New Year's gift, beautifully wrapped in gift paper. So are PUPs, which are “nicely packaged” in a free download of the free program you want. And this applies not only to small providers of free software. Many big brands are also associated with PUPs, for example:

Another way for PUPs to penetrate your computer is through download portals. You visit these sites to update Adobe products or find a convenient media player. Most portals promise “clean and secure boot" However, it has become dangerous to trust any download portal, because PUPs are already included with software reviews on the site, which is not entirely legal.

We examined how many PUPs were built into the installation of the 50 most popular applications on Download.com. We found that PUPs are included in the installation 31 out of 50 tested apps on Download.com. Cm.:

Still shocked by these results, we decided to look into how the ten most popular download portals (besides Download.com) work to see if any of them were safe to use. We downloaded the ten most popular apps and calculated how much clutter was downloaded along with them. We found that almost every portal contains at least one or more PUPs. Cm.:

Problem with the bright green button.

You have finally decided to sort all the photos on your computer. Now they are in different folders, and it is impossible to find a specific photo when you need it. That's why you download special program, which can sort your photos for you and even edit them if you want. Download.com has a list of programs right on the main page. You select the program you need, and a bright green “DOWNLOAD NOW” button appears, separating you from all your photo organization problems. You press the button! Great! There is no more chaos on your desktop. Except that in addition to the photo program, you also downloaded three PUPs.

There are many players involved in the distribution of potentially unwanted programs. As a result, you may encounter what is best described as “Cascading PUPs.” During installation, you may receive not one, but several PUPs in a row - one after the other.

This happens when PUPs are bundled with other PUPs. When you download and install the program you want, you agree to the installation of the PUP toolbar, without even paying attention to it. As a result, one PUP is installed, which will subsequently install other PUPs without your knowledge.

Beware of fake software updates. Most often this happens through temporary websites that have been designed for Adsense. These sites have built-in downloaders that will tell you when it's time to update your Flash player or Java. There are companies that create hundreds of websites every day with only one goal - to mislead you and lead you to their site.

There are quite a few ways how your computer can acquire PUPs. We have collected all the main methods for you. Cm.:

So who benefits from PUP?

Software providers: With each installation, the software provider (seller) receives money from the PUP developers (creators of adware). We provide examples in this article.

Download Portal: this resource, like other portals for downloading software, receives money for embedding PUPs into its setup files(bright green “Download Now” button). The software vendor typically has no part in this and does not benefit from it.

PNP: Some PUP developers work together, installing each other's products and paying each other.

But here it’s already creepy.

Recent developments of PUPs use rootkits - infections that hide themselves, their own data and other files, so that neither the user nor the operating system can notice them. By intercepting and receiving messages from your computer, they forward all the information and reports whenever they want. The use of rootkits in the creation and distribution of adware blurs the line between simply unnecessary junk and active malware.

This is even more clearly seen in the new PUP known as “More fast internet", which after installation will create a fingerprint of your computer. This information is then sent to the developer's server along with screenshots of your PC's active display and your IP address. Such adware grossly violates your privacy and borders on spyware.

But wait! I see a popup trying to help me! An interactive PUP is starting to scare us by showing online advertisements that try to trick us into thinking that our PCs have serious problems. This is done so that you call the specified number Support services so that they scare you even more and force you to buy their services.

Unfortunately, every day there are more and more ways to become infected. And while adware installers remain unregulated, their developers remain unregulated.

PUPs and the antivirus industry
The most frightening thing is that after such large vendors as Oracle (Java) and Microsoft (Bing and Skype) began to include PUPs in their software, ethics in the software industry seemed to be completely lost, because even manufacturers of antivirus programs that include PUPs in their software. We examined free programs from several antivirus vendors. The results are worrying. We found that 7 out of 8 tested free antiviruses went along with the PNP. Cm.:

Emsisoft vs PUPs
The threat situation has changed significantly over the past few years. When the Emsisoft team checked the latest infection statistics, we found that 3/4 of all objects found by Emsisoft Anti-Malware today were PUPs. In recent years, their number has increased significantly. Cm.:

But where there is a problem, there is a solution. We at Emsisoft support high ethical standards, which determine how we handle all threats: we always keep our users in mind. While many antivirus products are unable to detect even the most common PUPs and, even worse,

PNPs account for 79% of infections

And although we do effectively combat PUPs, it is equally important that the user himself can recognize PUPs before downloading them and avoid problems.

So, to summarize:

• PNPs want to make money from you. The most common form is to hijack your browser so they can show you advertisements, monetize or sell your search queries and/or browser behavior, or redirect your home page.
• PUPs use aggressive distribution methods to get onto your computer. In the vast majority of cases, you simply will not know that you are installing a potentially unwanted program.
• Most PUPs do not provide any value or benefit. PUP developers manage to get around this by paying a reward for each new installation of your software to suppliers or distributors of other programs.
• PUPs often end up on your computer through free software providers because they come bundled with some kind of free program. While you are installing this program, you are also installing one or more PUPs without even knowing what you have done. For this, the free software provider receives money from the PUP manufacturer.

So, now you know what potentially unwanted programs are and how they get onto your PC. How to avoid PUP?

• Be careful, use common sense and take your time. Please read the terms or notes carefully before installation. Do not click “Accept” / “Agree” until you are sure that you are really ready to install everything that is mentioned in the User Agreement.
• Use only reliable resources to download: for example, the official website of the product you want to download.
• Avoid downloading from free portals and never download or install an application if it seems suspicious or malicious to you.
• Install, update and run only recognized antivirus programs, such as Emsisoft Anti-Malware, which offers real-time PUP protection.
• Clean up your computer periodically with our free toolkit Emsisoft Emergency Kit.

Happy (PUP-free) day!
Your Emsisoft team

13:15 — REGNUM Ulyanovsk region is ready to cooperate with universities of the Volga Federal District “in breakthrough areas” innovative development" This was stated by Governor Sergei Morozov at a meeting of the Council of Rectors of universities in the Volga region, which was held in the Ulyanovsk region, they reported IA REGNUM in the press service of the head of the region.

The event was attended by the President of the Russian Union of Rectors, the Rector of Moscow State University named after M.V. Lomonosov Victor Sadovnichy, his deputy and chairman of the Council of University Rectors of the Volga Federal District R Oman Strongin, heads of higher educational institutions in the regions of the Volga Federal District.

Addressing the meeting participants, Governor Sergei Morozov stated the pattern that “ it was the Ulyanovsk region that became a platform for discussing the tasks of our country’s innovative breakthrough", which the president put Vladimir Putin. The head of the region recalled that the Ulyanovsk region is among the top ten innovative regions of Russia: at the end of 2017, the region took eighth place in the ranking. Also, for several years, the Ulyanovsk region has remained one of the leaders in attracting investment. Sergey Morozov thanked the professional community of university rectors in our region “ for his invaluable contribution to this success».

“Including thanks to technical, classical, and agricultural universities, we managed to attract about a trillion rubles of investment into the regional economy, creating 20-25 thousand jobs annually. Today we face new challenges. The Ulyanovsk region is actively developing such industries as aircraft manufacturing, new materials, renewable energy, wind industry. It would be great if today we all looked at what breakthrough areas our region can be useful for the country, and began to develop them in cooperation with universities of the Volga Federal District," - said Sergei Morozov.

The meeting participants discussed issues of increasing the innovative component of universities. Viktor Sadovnichy noted the important role of the flagship university of the Ulyanovsk region. According to him, today serious national projects are planned, the implementation of which requires the solution of certain tasks.

"Ulyanovsky State University was founded as a branch of Moscow State University, and I am glad that now the university is actively developing and is one of the leading ones, including thanks to the competent leadership of the region by Governor Sergei Morozov. This is pride for Moscow University too,” - said Viktor Sadovnichy.

He also outlined the main directions of work of Russian universities in the context of the tasks set by Vladimir Putin. In particular, he touched upon the issue of creating consortia of Russian universities under the Vernadsky program. Viktor Sadovnichy addressed Governor Sergei Morozov and the meeting participants with the initiative to form a similar unified space in the Volga Federal District.

According to Roman Strongin, the best experience of the district’s universities will be accumulated at the Ulyanovsk site.

“A breakthrough is, first of all, a qualitative leap. If we leave everything as it is, then something will improve, but there will be no leap. This means that our very actions must be different. Previously, there was industrial science, industrial institutes, and every idea was brought to metal, to a machine, to a device, to a model. Now the university must do it itself - from idea to factory. The generation of mature scientists did not do this; they worked with industrial science. But it is necessary for them to carry out such activities, and for young people to be able to do this; these are large-scale educational tasks. And it is not true to say that someone already fully knows its solution,” - said Roman Strongin.

He emphasized that today it is important to collect the best practices of universities in the Volga region and see what happens, so that others can use and develop them. And Ulyanovsk University is one of these sources of experience. It was emphasized that one university is not enough - a consortium needs to be formed. The expert noted that career guidance work with schoolchildren and kindergarten students is also an important area.

“This should be a whole system together with the university. Some experience already exists in a number of regions, including the Ulyanovsk region,” — added Roman Strongin.

Let us remind you that currently at the federal level, “Science” and “Education” are among the priority national projects. The Council of University Rectors outlined the importance of developing scientific and industrial cooperation, including the creation of world-class scientific and educational centers. In addition, issues of updating the infrastructure of universities for conducting research and development in the Russian Federation, as well as supporting young scientists, were touched upon.

“Ulyanovsk talents have repeatedly become recipients of grants from the President of the Russian Federation. In 2018, the results of the competitive selection conducted jointly with Russian Foundation basic sciences. As a result, 100 million rubles will be allocated for the implementation of 85 scientific projects,” — commented the Minister of Education and Science of the Ulyanovsk region Natalia Semyonova.

The term "PUP"

POP is the abbreviated name for the bottomhole formation zone. The bottomhole formation zone is a section of the formation that is adjacent to the wellbore and within which the filtration properties of the productive formation change during construction, operation and repair of the well. The reasons that lead to changes in the characteristics of the near-wellbore zone of the formation include the following: redistribution of stress in the near-wellbore part, various physical and chemical effects of various process fluids, as well as various processes that are caused by operating modes and conditions. The dimensions, configuration, as well as the hydrochemical properties of the bottomhole zone of the formation change during the entire period of the well's existence. They affect the hydraulic connection of the well with the EOR and very often affect its productivity.

The configuration of the formation zone with changed characteristics in the near-wellbore part does not have any geometric shape. Its morphology is very diverse and complex, especially for fractured-pore and fractured reservoirs. Thanks to hydrodynamic studies of wells, it is possible to obtain a quantitative and qualitative assessment of the properties of the bottomhole formation zone, as well as determine hydraulic resistance. In the course of such studies, data is obtained on the size of the equivalent, rather than actual, circular zone. Thus, the dimensions of the formation zone are measured from fractions to several tens of meters. Sometimes you can observe the separation of the formation and the well, both during construction, as well as during repairs and operation. As a result, when tested, such objects may not produce products. To prevent a reduction in the filtration properties of the bottomhole formation zone, a number of measures are carried out that reduce the pressure on the formation during drilling, as well as during well casing and repair. Process fluids or compositions that are compatible with the formation rock or fluids saturating it can also be used. When influencing the bottom-hole zone, various methods increase or restore its filtration properties. The maximum effect can be achieved with a complex effect on PNP.

The monitor is the most important component of any computer. It is he who provides the user with visual information. A high-quality display is especially important if a person works at a computer for a long time. The decisive role here is played by screen resolution and flicker frequency, which is measured in hertz. However, it must be clearly understood that even the most best monitor will not work well in the operating system if the appropriate drivers are not installed. Usually the lack of drivers is not noticeable. And you can understand that they are not there only by the inscription “Universal PnP monitor”. What does this mean and how to fight it? We will talk about this in the article.

What does this phrase mean?

Essentially, the phrase: “Universal PnP monitor” means that the device being connected (in this case, the monitor) belongs to the Plug And Play category. This means that for the initial connection and configuration of the device you do not need special drivers from the manufacturer. Often such devices work quietly without drivers at all at their native resolution. But it is not possible to change the flicker frequency of the screen. And this is very bad for those who use a computer for their main work. And gamers will not be particularly happy, since the quality of picture display in games will suffer greatly.

It is possible to fix the problem, but it does not always work out. However, you need to look at all the ways to solve this problem, since the monitor must be configured completely, and not just in parts. Let's figure out how to force universal PnP the monitor should be called by its proper name, and not hide behind faceless words. But first, some interesting information.

What does a monitor without PnP mean?

There is such a thing as a “universal non-PnP monitor”. What does it mean? This means that when you connect this device to a computer, it will generally refuse to work normally. The resolution will be extremely low, and it’s better not to think about the flicker frequency at all. For such devices, installation is required necessary drivers. Sometimes they are on Microsoft servers, and then the situation is corrected. But they are unreliable. Therefore, you should replace them with drivers from the official manufacturer at the first opportunity. To do this, you just need to go to the official website of the manufacturer. There are plenty of drivers there.

Now it’s clear what a “universal non-PnP monitor” is and what it means. One has only to add that only old monitors released before 2005 belong to this category. They do not support Plug And Play. Often CRT displays are just that. However, we got carried away. It's time to move on to ways in which you can force the monitor to be called by its own name.

Method number 1. Installing the necessary drivers

If the monitor is defined as a universal PnP monitor, then you must install drivers from the device manufacturer. You can download them on the official website. If they are not there, then drivers from Microsoft will do. What needs to be done to install them? You need to open the "Device Manager", which is located in the "Control Panel", and find the "Monitors" item there. Click on universal device and select "Update driver". The system will start searching the servers, and if it finds it, it will install required driver automatically, after which you will need to restart your computer. You have to agree. It’s not a fact that after this the monitor will be called by its real name, but it will work much better.

Method number 2. Understanding the inf file

So, we have already figured out why it says “universal PnP monitor”. Now we present ways to solve the problem. One of them is to manually rename the title by adding the inf file from the manufacturer to the system. This method should be used if the monitor is working normally, but you want everything to be displayed beautifully. Just click right click inf file and select "Add to registry". After rebooting the computer in place former device PnP will display the proud name of the monitor model. In this way you can artificially force operating system display what is supposed to be displayed. However, this method does not work in all cases. And not everyone has an inf file. Therefore, it is better to simply install the necessary drivers.

Understanding Windows 10

The "Universal PnP Monitor" sign in Windows 10 does not pose any danger to the user. The fact is that in the top ten this concept refers to the standard driver from Microsoft. The tenth version of Windows installs drivers automatically when connecting to the Internet. So there are no problems here. Only discomfort from the wrong name. But it can be corrected using the inf file. In this regard, the latest OS from Microsoft is very convenient. In the "seven" it was necessary to update the drivers manually. And here they update themselves without problems. But sometimes this can also play a cruel joke. For example, in the case when new drivers do not fit your old hardware. So you need to be extremely careful here too.

Where can I find the inf file?

But this is a good question. If you are already tired of the words “universal PnP monitor”, then you can search for the required inf file on the Internet. To do this, just type the name and model of the monitor into Google search. Often these types of files are included in driver packages. But then you can just install the driver. There are such files on the disk with outdated drivers from the manufacturer. Even a relatively old inf file may be suitable. In general, such files are always located on the disks that come with the monitor. Therefore, you should not throw away the CD. Even though they are already outdated.

You can also dig around on computer forums. The old-timers there will definitely have something suitable. The chances of success will increase if you have a modern monitor model. Although inf for older models can be found on the same forums. The main thing is not to forget that the system must work, and not just beautifully display the name of the connected equipment. So there’s no need to worry too much about the display. It works - and that's fine. Because, out of ignorance, you can do such a thing that you will have to reinstall the operating system. But this is a long and tedious task.

Finally

So, we have figured out what the inscription “universal PnP monitor” means and how to remove it (if necessary). This inscription does not necessarily mean that there are no monitor drivers, but it may be so. In order for the real name of the monitor to be displayed, it is often enough to simply install the latest drivers. But sometimes this is not enough. Then you can work with inf file. But if everything is fine, and the discrepancy in the names doesn’t bother you at all, then you don’t need to touch anything. Let perfectionists struggle to correct the name in Device Manager. It will be quite normal for the average user to work with a universal PnP monitor.

Polyneuropathy– a clinical syndrome that occurs as a result of the influence of various etiological factors on peripheral nerves and is characterized by heterogeneous pathogenetic mechanisms.

Polyneuropathy(PNS) occupy second place in the structure of diseases of the peripheral nervous system, second only to vertebrogenic pathology, but significantly exceeding it in the severity of clinical manifestations and disabling consequences.

Currently, three leading pathomorphological mechanisms underlying the formation of PSP have been established:
Wallerian degeneration
primary demyelination
primary axonopathy

There are several pathogenetic theories of the development of the disease:
1.Vascular theory is based on the involvement of the vasa nervorum in the process, which provides blood supply to the peripheral nerves, as well as a change in blood rheology, which leads to their ischemia.
2.Oxidative stress theory explains the development of PSP from the standpoint of disturbances in the metabolism of nitric oxide, which changes the potassium-sodium mechanisms underlying the formation of excitation and conduction of impulses along the nerve.
3.The theory of decreased activity of nerve growth factors suggests a deficit in axonal transport with subsequent axonopathy.
4.Immunological theory explains the development of PSP as a result of cross-production of autoantibodies to PNS structures with subsequent autoimmune inflammation and necrosis.

The causes of the development of PSP are varied and numerous, but even modern research allows us to establish the etiological factor of the disease only in 40-75% of patients.

Nevertheless, the most common systematization of PSP is based on etiological principles.

Classification of polyneuropathies

Autoimmune:
Acute inflammatory demyelinating PSP
Chronic inflammatory demyelinating PSP
Multifocal motor PSP
Paraneoplastic PSP
PNP for systemic diseases
Inflammatory:
Diphtheria PNP
Leprosy PNP
Lyme borreliosis PNP
HIV-associated PSP
Dysmetabolic:
Diabetic PNP
Nutritional PNP
Alcoholic PNP
PNP critical illness
Hereditary:
Sensorimotor PSP type I
Sensorimotor PSP type II
Dejerine-Sottas disease
Refsum disease
PSP with a tendency to pressure paralysis.
Toxic(medicinal or due to intoxication with household or industrial poisons).
PSP caused by exposure to physical factors.

Autoimmune polyneuropathies

1. Acute inflammatory demyelinating PSP(AIDS, Guillain-Barré syndrome) occurs with a frequency of 1-2 cases per 100 thousand population, more often in men, and has two peaks of incidence: at 20-24 and 70-74 years.
It is characterized by the appearance of acute (or subacute) progressive symmetrical weakness in the limbs with loss of tendon-periosteal reflexes. In 70% of cases, ARDP is preceded by various infections suffered the previous day (1-3 weeks before). In other cases, the disease develops for no apparent reason.
Typically, AIDP begins with pain in the calf muscles (cramps) and paresthesias in the fingers and toes, which are then quickly replaced by the development of flaccid paresis of the limbs.

Weakness and wasting of muscles predominate in the proximal sections, pain in the nerve trunks on palpation and positive symptoms of radicular tension (Lasegue, Neri symptoms) are noted.

An early decrease in the Achilles and knee reflexes is an obligatory sign of the disease.

In 25% of cases, there is a disorder of superficial types of sensitivity in the form of “gloves” and “socks”. Less commonly, deep sensitivity is impaired with the development of sensitive ataxia. In 30% of patients, the disease is ascending in nature with damage to the cranial nerves (most often VII, IX, X), with impaired swallowing and breathing.

Pelvic disorders are not typical for AIDP.

There are options for OVDP in the form:
pandysautonomia (heart rhythm disturbances, blood pressure instability)
with exclusively motor impairments in the limbs
Miller Fisher syndrome (manifested by ataxia, areflexia and ophthalmoplegia).

In the majority of patients (80-90%), the disease proceeds benignly with complete or almost complete recovery, and restoration of lost functions always occurs in reverse order: dysfunction of the cranial nerves regresses first, then the upper and lower extremities. In 18% of patients, motor deficits or sensory impairments that limit ability to work persist.

In the diagnosis of ARDP it is important:
Detection of protein-cell dissociation in the cerebrospinal fluid, which is detected in 60-90% of patients 7-10 days after the onset of the disease.
The results of electroneuromyography (ENMG) indicate the demyelinating nature of the lesion, which is manifested by a significant (>80%) decrease in the speed of impulse conduction in at least two motor nerves.
The modern approach to diagnosing ARDP is to conduct enzyme immunoassays to detect an increased titer of antibodies to gangliosides GM1 and GQ1b in Miller Fisher syndrome.

2. Chronic inflammatory demyelinating PSP(CIDP) is characterized by slow (more than 2 months) development of motor and sensory disorders in the extremities.

Men suffer 3-4 times more often than women. The disease occurs with a frequency of 1-2 cases per 100 thousand population. There are two peaks of the disease: 40–50 years (more pronounced) and over 70 years.

The most consistent symptoms of CIDP are:
hypo- or areflexia
muscle hypotonia
hypotrophy in the limbs

Also typical:
Frequent signs of the onset of the disease are numbness or paresthesia in the limbs
Every third patient has cramps in the calf muscles at the onset of the disease

1. Patients with distal tetraparesis predominate (40%).
2. In 80% of patients, sensitive polyneuritic and autonomic (sympathetic) disorders in the limbs are detected.
3. In 20% of cases, the clinical picture of CIDP contains signs of damage to the central nervous system (pyramidal, pseudobulbar, cerebellar symptoms).
4. In 17% of patients, the cranial nerves are involved in the process (usually the facial or caudal group).

Pelvic and respiratory disorders are not typical.

The course of CIDP can be:
monophasic progressive
monophasic regressive
recurrent

After a year, 50% of patients have signs of partial or permanent disability.

In diagnostics diseases are helped by:
detection of protein-cell dissociation in the cerebrospinal fluid (in 40-60% of cases)
high titer of antibodies to myelin associated with glycoprotein
ENMG reveals a decrease or partial block of conduction in two or more motor nerves
with a biopsy of the sural nerve, the identification of a pattern of demyelination or remyelination, endoneurial edema, proliferation of Schwann cells with the formation of “onion heads” in 4 out of 5 nerve fibers is of diagnostic significance.

3. Multifocal motor PNP (MMP) with conduction blocks(Sumner-Lewis syndrome) occurs in a wide age range, predominant in men.

The onset of the disease is subacute or chronic, often without visible reasons.

The neurological picture consists of:
distal asymmetric paresis, mainly in the arms
crumpy
fasciculations
rapid formation of pronounced amyotrophies
the lower extremities are affected later and to a lesser extent
tendon reflexes decrease, but may be normal

Sensitive, bulbar, respiratory, pelvic, pyramidal, and autonomic symptoms are not typical.

The course of MMP is progressive.

Diagnostics:
ENMG results - detection of conduction blocks outside the zones of typical nerve compression
cerebrospinal fluid often does not change
in some patients, an increase in the titer of antibodies to gangliosides GM1, GA1, GD1b is possible

4. Paraneoplastic PSP(Denny-Brown syndrome) can develop with different localization of the tumor process (usually in lung cancer), which often precedes (several years) the manifestation of the oncological process.

1) Sensory variants of the disease predominate, which are manifested by numbness, paresthesia, dysesthesia and pain in the distal extremities. Usually all types of sensitivity are affected, but disorders of vibration and deep muscle sense dominate, up to severe sensory ataxia.
2) Deep reflexes gradually decrease.
3) Orthostatic hypotension and other autonomic disorders are often observed.

The course of the disease is slowly progressive with the transition to a plateau phase.

Diagnostics:
identification of the primary oncological process
detection of antibody titer to ANNA1, Hu
ENMG - characterized by an axonal type of damage to peripheral nerves, which is manifested by a significant decrease in the amplitude of the M-response at normal impulse conduction speed

5. PNP for systemic rheumatic diseases nyahs occur when:
polyarteritis nodosa
scleroderma
dermatomyositis
Wegener's granulomatosis
Sjögren's disease
antiphospholipid syndrome
primary and secondary vasculitis

Variants of the disease:
1) simultaneous or sequential damage to individual nerves in different limbs
2) symmetrical sensorimotor PSP

Neurological manifestations are always combined with signs:
systemic damage to internal organs (kidneys, lungs, heart, gastrointestinal tract), skin, joints, ENT organs
weight loss
general intoxication manifestations

Diagnostics:
increased ESR
detection of C-reactive protein
increased titer of cardiolipin antibodies to lupus anticoagulant and antibodies to the cytoplasm of neutrophils (specific for Wegener's granulomatosis)

Inflammatory polyneuropathies

1. Diphtheria ANPs appear:
early (from the 3-4th day of illness) development of bulbar symptoms (dysphagia, dysphonia, dysarthria)
oculomotor disorders (diplopia, mydriasis, ptosis, limited mobility of the eyeballs, weakened pupillary reactions to light, accommodation paralysis) due to damage to the caudal and oculomotor nerves
after 1-2 weeks, peripheral paresis of the limbs usually appears, predominant in frequency and severity in the legs
Disorders of superficial types of sensitivity of the distal type are characteristic

These symptoms are often accompanied by general intoxication symptoms.

Restoration of lost functions occurs in the reverse order: Bulbar and oculomotor disorders regress first over several weeks, then gradually (over the course of a year) motor and sensory disorders in the limbs, which rarely leave a motor deficit.

Diagnostics based on:
epidemic data
bacteriological studies of the pharynx mucosa (isolation of Corinebacterium diphtheriae)

2. Leprosy PNPs.
Neurological manifestations diseases:
loss of superficial types of sensitivity (pain, temperature) in the areas of innervation of individual nerves (usually the ulnar and peroneal), as well as in places of skin manifestations of leprosy
soreness and thickening of individual nerves (usually the great ear)
limited muscle atrophy, predominant in the thenar, hypothenar, interosseous muscles and early development of contractures of the fingers
vegetative-trophic disorders: dryness and flaking of the skin, hypo- and anhidrosis, hair loss, hypo- and hyperpigmentation, striations and brittleness of the nail plates, cyanosis of the hands and feet, trophic ulcers and mutilation of individual phalanges
paresis of the facial muscles occurs, especially the upper part of the face (“St. Anthony’s mask”).

The course of the disease is progressive and ends with severe motor loss.

3. Lyme borreliosis ANPs are often neurological complications of the disease.
The most common are:
neuropathy of the facial nerves (possible diplegia facialis)
sensory PNP
sensorimotor PSP

Clinically they manifest are characterized by paresthesia and severe pain in the limbs, followed by amyotrophy. The upper extremities are always affected more often and more severely. Deep reflexes are lost on the hands while the knee and Achilles are preserved.
The course of the disease is regressive with frequent residual motor deficits.
IN diagnostics disease, a diagnostically significant increase in the titer of specific antibodies in the blood and cerebrospinal fluid is important.

4. HIV-associated PSP most often (30%) it manifests itself as distal symmetrical weakness in the limbs.

First signs- numbness and moderate pain in the legs. In 60% of cases, distal paresis develops in the legs, Achilles reflexes decrease (or fall out), pain, vibration, and rarely temperature sensitivity decreases. These symptoms develop against the background of other manifestations of HIV infection: weight loss, fever, lymphadenopathy, etc.
The course of the disease is slowly progressive.

Dysmetabolic polyneuropathies

1. Diabetic PNP occurs in 60-80% of patients with long-term diabetes mellitus and high hyperglycemia, more often in men.

1) The most common manifestation of the disease is the distal sensorimotor form.
2) The disease begins gradually, with paresthesias and dysesthesias in the distal parts of the extremities, like “gloves” and “socks”.
3) An early symptom is loss of Achilles reflexes.
4) As the disease progresses, pain appears in the legs, which occurs or intensifies at night, all superficial types of sensitivity (pain, temperature, tactile, vibration) are disrupted.
5) Subsequently, weakness of the foot muscles, typical deformities of the fingers (hammer, claw), trophic ulcers and osteoarthropathy develop.
6) Autonomic symptoms are characteristic: orthostatic hypotension, impotence, violation heart rate, gastroparesis, diarrhea, disorders of sweating and pupillary reactions.
7) Cranial nerves may be affected (usually III, VI, VII). The course of the disease is regressive and is clearly related to the level of glycemia in the blood. ENMG reveals the axonal nature of the lesion.

2. Nutritional ANP due to:
insufficient intake of vitamins B, A, E as a result of malnutrition or unbalanced nutrition or impaired absorption in the gastrointestinal tract
in patients with achylia or achlorhydria after gastrectomy operations
for diseases of the liver, kidneys, thyroid and pancreas, dysproteinemia

The clinical picture is dominated by:
paresthesia
dysesthesia
burning sensation in the lower extremities
knee and Achilles reflexes decrease or disappear
Amyotrophy is observed mainly in the distal limbs
movement disorders are not typical
more than 50% of patients develop heart pathology, including cardiomegaly and atrial fibrillation, swelling in the legs, orthostatic hypotension, weight loss, anemia, stomatitis, glossitis, cheilesis, dermatitis, diarrhea, corneal atrophy

3. Alcoholic PNS- a variant of nutritional PNP. Associated with a deficiency of vitamins B1, B2, B6, B12, B15, A, PP, E due to exposure to ethanol, as well as its direct toxic effect on metabolism in neurons.

The disease most often manifests itself as distal symmetrical vegetosensory PSP.

Characteristic:
pain in the legs of varying severity
crumpy
dysesthesia
vegetative-trophic disorders are represented by changes in skin color, hypo- or anhidrosis of the hands and feet, hair loss on the legs
symmetrical decrease in vibration, tactile, pain and temperature sensitivity in the distal parts of the legs, their moderate amyotrophy
loss of Achilles, less often knee reflexes
frequent combination with cerebellar ataxia expressed exclusively in the legs (Marie-Foy-Alajouanin syndrome), Gaye-Wernicke polyencephalopathy, Korsakoff syndrome, epileptic seizures, chronic hepatitis

Movement disorders occur rarely, cranial nerve damage not typical.

The course of the disease is regressive.
ENMG reveals the classic axonal type of nerve damage.

4. PNP critical conditions develops with severe infections, injuries or intoxications, accompanied by multiple organ failure. Prolonged loss of consciousness and significant severity of the patient’s condition masks the symptoms of PSP, which can be suspected in the case of:
loss of deep reflexes
early (after 1-3 weeks) development of amyotrophy and muscle contractures in the distal extremities
lack of spontaneous breathing when mechanical ventilation is stopped, which cannot be explained by existing pulmonary and cardiovascular pathology

In surviving patients, the disease manifests itself as nonspecific symptoms of severe asymmetric distal sensorimotor PSP.

The course of the disease is regressive, often with moderate residual effects.
ENMG records the axonal nature of the lesion.

Hereditary polyneuropathies

This is a heterogeneous group of diseases inherited in autosomal dominant, autosomal recessive and X-linked sex types.

1. Hereditary sensorimotor PSP(Charcot-Marie-Tooth disease).
There are two options of this disease:
1) Type I (demyelinating) occurs in 66.2% of patients
2) Type II (axonal) – in 23% of all cases

Clinically both options are similar and differ in ENMG results.
The disease begins at 10-16 years of age and is characterized by triad of symptoms:
1. atrophy of the hands and feet
2.disorder of superficial types of sensitivity
3.hypo- or areflexia

Patients often develop foot deformities (Friedreich's, hollow, equinovarus). Some patients experience a moderately progressive, ascending course. The arms are involved later and are less affected. Pronounced interfamilial and intrafamilial polymorphism is characteristic.

2. Dejerine-Sotta disease (type III) and Refsum disease (type IV) begin in the first years of life and are manifested by motor disorders in the limbs in combination with hypertrophy of peripheral nerves and ichthyosis.

3. Hereditary PSP with a tendency to pressure paralysis is a kind of recurrent focal PSP, inherited in an autosomal dominant manner. Begins at the age of 20-30 years with equal frequency in men and women.

Clinical picture is associated with the formation of painless acute mononeuropathies or multiple mononeuropathies with motor and sensory disorders in the extremities.

Nerves are most often affected in the areas of their most typical compression. after minor injuries and compressions:
fibular (35%)
elbow (20%)
radial (9%)

Neurological symptoms last from several days to several weeks. As the disease progresses, regression slows down with the formation of amyotrophies of the limbs.
ENMG reveals the demyelinating nature of the lesion.
Most patients have a favorable prognosis.

Toxic polyneuropathies develop due to:
taking a number of medications (vincristine, cisplatin, ethambutol, etc.)
intoxication with household or industrial poisons, such as lead, arsenic, thallium, carbon disulfide, nitric oxide, and manifest themselves as purely motor (for example, lead) or sensory (carbon disulfide, etc.) PNP

PSP caused by exposure to physical factors develops when:
general or local vibration
after frostbite, burns, electrical injuries
They are characterized mainly by sensory disorders in the extremities.