2018, volume 14

The aim is to study the relationship between the parameters of neurological status and quality of life of patients who first underwent ischemic strokes in the carotid basin to predict the outcome of an acute cerebrovascular accident. Material and Methods. 73 patients with ischemic stroke in the carotid artery basin were examined. Analyzed indices of the scales, reflecting the severity of motor deficit (NIHSS, Rankin, Rivermead, Fugl-Meyer), the initial evaluation and parameters of quality of life using the questionnaire SF-3624-36 months after inpatient treatment. Patients were divided into groups of favorable and unfavorable outcome according to the questionnaire SF-36. Results. A direct correlation between the level of physical and psychological health and indicators Of the Fugl-Meyer scale and a negative correlation between the level of psychological health and the severity of stroke on the NIHSS scale in a group with an adverse outcome was revealed. Conclusion. Indicators scales Fugl-Meyer, and NIHSS obtained in the acute period of ischemic stroke can be used to build a predictive model of outcome of stroke.

The aim of the study was to examine multimodal evoked potential in patients with or without relapse
multiple sclerosis during 12 month. Material and Methods. The study included 32 patients with
established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS
score was evaluated. All patients underwent a study of multimodal evoked potential. All examined
patients were divided into 2 groups depending on the relapse multiple sclerosis by the end of the year.
Results. Multimodal evoked potentials show ambiguous data on the activity of multiple sclerosis. The
greatest correlation with subsequent activity of multiple sclerosis is shown by stem evoked potentials.
Conclusion. This study is the initial stage in the search for a tool for predicting the course of the disease
in patients with multiple sclerosis. An increase in the group of subjects and inclusion in the analysis of
structural changes in the central nervous system according to magnetic resonance imaging probably will
increase the information content of predictions.

The article provides an overview of data on isolated demyelination syndromes that may precede multiple sclerosis, and on the peculiarities of the so-called "benign" form of multiple sclerosis. Clinical and anamnestic criteria for establishing the fact of a "benign" form of multiple sclerosis are presented, as well as trends in the number of these patients in the general population of patients with multiple sclerosis, including in connection with the improvement of treatment methods for this disease.

Purpose: to conduct an analysis of psychoemotional disorders in patients with multiple sclerosis, who are not receiving any treatment for these disorders. Material and Methods. A cohort of patients with a reliable diagnosis of multiple sclerosis, according to the criteria of С Poseur, consisting of 163 people, was selected for the research. A four-dimensional symptomatic questionnaire was used to assess distress, depression, anxiety and somatization (4DSQ) and a self-questionnaire for evaluating the symptoms of fibromyalgia with quantitative measures (WPI, SS, FS). Re-sults. Differences in the average values of the level of distress, depression, anxiety and somatization in patients with multiple sclerosis of different sex, age, with different type of course and duration of the disease are shown. Conclusion. The neuropsychological status of patients depends on the type of course of the disease, the level of distress — from age and sex, the level of somatization —from the age of this category of patients. In the complex treatment of this category of patients it is necessary to use symptomatic treatment in addition to pathogenetic therapy, which has not only neurotrophic and vasoactive effects, but also affects the psychoemotional background of patients.

Purpose: to evaluate the effectiveness of low-intensity helium-neon laser radiation in patients with trigeminal neuralgia. Material and Methods. With the help of low-intensity helium-neon laser radiation, 76 patients with trigeminal neuralgia were treated. For this purpose, helium-neon laser devices AFL-1 and AFDL-1 with a wavelength of laser radiation of 0.63 microns were used, the power flux was 20-25 mW. Results. It is shown that as a result of treatment with this type of radiation in most cases, both nociceptive and neuropathic components of the pain syndrome are stopped. Conclusion. For the management of pain syndrome in trigeminal neuralgia, it is advisable to use low-intensity laser radiation in complex treatment.

The aim: to evaluate the effect of complex restorative treatment on clinical manifestations and the state of oxidative homeostasis in patients with different variants of myasthenia gravis. Material and Methods. The analysis of indicators of biochemiluminescence, muscle strength according to the scales QMGS and MG-ADL, instrumental methods of research (ENMG and respiratory function) before and after treatment in 117 patients with myasthenia gravis is carried out. For comparative analysis of independent samples was used Mann — Whitney U-test, and for paired comparisons was used the Wilcoxon test. Results. The dynamics of oxidative homeostasis, clinical picture, indicators of instrumental methods of research (ENMG, respiratory function) in patients with myasthenia gravis, without thymoma and underwent thymectomy on the background of complex treatment with the use of antioxidant therapy is presented. In all studied groups against the background of complex treatment with application of antioxidant therapy increase in activity of antioxidant protection of organism and decrease in activity of free radical oxidation that correlates with clinical improvement in all groups of patients is noted. Conclusion. The use of antioxidant therapy in complex rehabilitation of patients with myasthenia gravis is pathogenetically justified, especially in patients without thymoma.

The aim of the study was to study medical and social and anxiodepressive disorders (ADR) in patients with little brain insult (LBI) in the early recovery period. Materials and Methods. 140 patients were examined, the mean age of which was 57.2±2.2 years. The patients were examined in the early recovery period. Among the 140 patients with LBI, 62% were men and 38% women. The level of anxiety and depression was assessed using the Hamilton psychometric scales (HPMS). Results. In 6% of patients there are relatives who have undergone an acute cerebrovascular acident. 50% of patients live with their families, 27.2% lived with relatives and 22.8% lived alone. Only 25.5% of patients had a daily monitor blood pressure (BP), 17.8% of patients — several times a week and 17.8% of people — several times a month. In addition, 16.4% of patients are forced to measure BP in the health facility, since they do not have a personal tonometer. 26.4% of patients did not measure their BP. 16.4% measure blood pressure once a year. A high level of depression occurred in 3.57% of patients, an average level in 27.86% of patients, mild depression in 33.57% of patients and absence of depressive symptoms in 35% of patients. A high level of anxiety was found in 17.50% of patients with Ml, moderate anxiety level in47.86% of patients, low anxiety level in 45.00%, no anxiety in 1.43% of patients. Conclusion. In patients with LBI in the early recovery period a rather high level of ADR severity was revealed. That causes as early as possible the identification and administration of specific therapy for ADR with LBI.

Purpose: identification of tendencies of development of incidence of a neurosyphilis and structures of clinical forms of a late neurosyphilis in Altai Territory. Material and Methods. Materials of forms of the state statistical overseeing of 1999-2016 across Altai Territory, official statistical materials of the Department of monitoring, the analysis and strategic development of health care, Federal State Budgetary Institution Central Research and Development Institute of the Organization and Informatization of Health Care, contemporary records of medical institutions of Altai Territory are analysed. Results. The carried-out retrospective analysis of incidence of a lues in Altai Territory for the 18-year period of observations revealed tendencies to decrease in primary incidence of a lues with simultaneous increase in structure of late forms, including a late neurosyphilis that completely confirmed the model of development of epidemic process constructed earlier by authors. In structure of forms of a late neurosyphilis without symptomless neurosyphilis, symptomless meningitis and meningovascular forms of neurosyphilis came to light more often. Conclusion. The clinical picture of late forms of a neurosyphilis is mainly without symptoms character now. Among demonstrative forms the meningovascular forms as a predictor of cerebrovascular pathology at working-age is registered more often.

Currently, much attention is paid to the search for laboratory diagnostic tests for Parkinson's disease, which can be used to create a screening diagnostic panel. The aim of the research was to study markers of oxidative status in blood plasma and to correlate these indicators with the main clinical characteristics of Parkinson's disease. Material and Methods. The study included 32 patients of the main group and 21 patients as a control group. Blood was collected for the evaluation of total oxidative activity and general antioxidant status of the organism (OOAand OAA): determination of the activity of catalase, superoxide dismutase (SOD), malonic dialdehyde (MDA) in the blood serum by spectropho- tometric method. Results. The parameters of SOD, catalase, ОАА, OOA in patients with early stage of Parkinson's disease significantly differed from those of the control group Conclusion. Reduction of oxidative activity could slow down the development of the disease.

The purpose of the study is to evaluate the symptomatology of multiple sclerosis (MS) and to evaluate the immune status in patients with reactivation of persistent herpes viral infection (PHVI). Material and Methods. We examined 56 patients with definite multiple sclerosis (MS) and 20 patients treated for other diseases of nervous system (radicu-iar syndrome caused by degenerative disease backbone) (comparison group). The MS patients were divided into 2 groups: patients without reactivation of PHVI (typical MS) and patients with reactivation of PHVI (virus-associated MS). The PHVI reactivation was registered in the case of presence of the appropriate clinical features and it was also verified by serological methods (ELISA). The symptomatology of MS was evaluated according to FS and EDSS scales. We performed the study of cell and humoral adaptive immunity. Results. Patients with reactivation of PHVI had more significant neurological symptomatology, more frequent relapses of MS, a higher speed of MS progression compared with typical MS patients. The immune status features in virus-associated MS patients can be estimated as a combination of secondary immunodeficiency (T-cell mediated) and active autoimmune process (the activation of B-cell component). Conclusion. It was revealed more significant neurological symptomatology, severer MS course and markers of secondary immunodeficiency in MS patients with reactivation of PHVI.