Search

In this literature review and our own data, we provide information about navigational transcranial magnetic stimulation (TMS). At present, a significant amount of knowledge has been accumulated about the use of TMS, both diagnostic and therapeutic, in real clinical practice. Diagnostic TMS has been studied and developed maximally. Nevertheless, despite the undoubted clinical effect of therapeutic TMS, the question of the need for the most accurate target designation for the greatest effectiveness of treatment remains controversial. A number of publications emphasize and justify the need for such target designation, but others report a positive clinical effect of stimulation regardless of the exact location of the inductor. This undoubtedly makes further research in this area relevant with an assessment of the comparative effectiveness of the most accurate rhythmic TMS with other protocols for its use.

The purpose. The article is devoted to chronic pain (CP) in elderly patients and the possibilities of various therapeutic strategies for this category of patients.Basic provisions. Chronic pain and the biological aging process have similar pathophysiological (cellular and molecular) mechanisms of development. However, chronic pain is not an inevitable component of the aging process, however, it is much more common in older people, the diagnosis and therapy of which is associated with atypical clinical manifestations of pain in elderly patients and the need for a more attentive, balanced approach when assessing pharmacokinetic and pharmacodynamic changes associated with the aging process. To ensure adequate pain relief, a multidisciplinary approach and appropriate therapies are used.Conclusion. The final result of CP treatment (reduction in pain intensity, restoration of functional activity, autonomy, etc.) depends on polymorbidity, geriatric status and cognitive capabilities of the patient; therefore, it is necessary to take into account all available factors for adequate and complete pain therapy.

Tertiary care centers in Russia were subdivided on two categories during recent COVID-19 outbreak and counter infection measures, undertaken by the government. In the first category were the centers, providing medical care solely to the COVID-19 cases; in second hospitals worked with all other cases, excluding COVID-19 ones. COVID-19-oriented centers are taking strict protective measures against the infection, with medical and other staff working in the individual biohazard protection suits, full disinfection at the border between the clean and unclean zones, thorough medical supervision over the health of all the employees. In the second category centers observation regime was implemented, with the obligatory medical masks and disposable lab coats. wearing, as well as thorough medical supervision over the health of all the employees. These different regimes determine some features of clinical neurophysiology in these centers. In the case of electroencephalography (EEG) main point is the real need of the procedure in the certain clinical situation. In COVID-19 cases all functional tests should be excluded from the protocol; procedure have to be performed in shortest time possible. EEG is performed according to good clinical practice and consensus protocols with thorough and strict disinfection of the devise and all cables, caps etc. If the patient was in the prone position during the procedure, this should be noted for the neurophysiologist. Conduction studies may be performed in the possible coronavirus-associated Guillain–Barré syndrome or critical illness polyneuropathies. Needle myography may be needed only in the rare cases of coronavirus-associated acute myelitis, in all other cases conduction studies are more than enough.

Chronic pain syndromes represent a significant socio-economic problem for health care and society as a whole due to the insufficient effect of the treatment, a pronounced decrease in the quality of life and a significant degree of maladjustment of this category of patients. Treatment of chronic pain syndromes with first-line drugs from the group of anticonvulsants (gabapentin, pregabalin, carbamazepine, valproic acid and topiramate) does not always give the expected effect, and various side and undesirable effects are often observed. This implies the search for opportunities and prospects for the use of other new generation anticonvulsants, one of which is lamotrigine, as a means of pharmacological action. The article discusses a wide range of effective and safe use of Lamitor for various diseases accompanied by chronic pain.

Our aim was to determine parameters of motor evoked potential (MEP) from the tongue in healthy persons.Methods. 25 healthy individuals (average age 22.4 ± 6.2 years, range 18–41 years, 12 females & 13 males) were enrolled. All underwent diagnostic TMS, single-pulse protocol, 90-sm round coil, Neiro-MS-D device. Coil was placed on Fz point, registration was performed by the surface electrode on the middle line of the tongue.Results. MEP was registered in all cases, its average latency was 7.14 ± 0.63 ms, average amplitude — 1.79 ± 1.09 μV. There were no gender & age differences.Conclusion. In healthy people aged 18–41 years MEP from the tongue may be registered in 100% of the cases; its average latency is 7.14 ± 0.63 ms, average amplitude — 1.79 ± 1.09 μV; there are no significant age & gender differences. TMS of the tongue according to this protocol is relatively simple, not time-and efforts-consuming & may be widely implemented in clinical neurophysiology.