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The aim of the present work was to assess the state of brain bioelectrical activity in children during the acute period of bacterial purulent meningitis, with quantitative mathematical analysis of the changes found. The studies included 31 children on days 1 and 6 from onset of illness: 16 children (8.9 ± 2.4 years) admitted to the Pediatric Scientific Clinical Center for Infectious Diseases with laboratory confirmation of diagnoses of purulent meningitis (due to

The aim of the present work was to evaluate changes in brain bioelectrical activity using electroencephalography (EEG) data in children with acute viral encephalitis. A total of 26 children were studied at the Pediatric Scientific Clinical Center for Infectious Diseases, Russian Federal Medical Biological Agency, with clinically confirmed diagnoses of “viral encephalitis.” Boys dominated the sex ratio of 18:8; mean age was 12 ± 2.1 years. All patients were in the acute period (first 14 days). The reference group for EEG analysis consisted of 10 healthy children. The groups were uniform in terms of sex and age. EEG recordings were made in all patients using a Neuron Spectrum 3 encephalograph (Ivanovo, Russia), with visual analysis of the EEG and spectral frequency analysis. Spectral power was evaluated in the α, θ, and δ frequency ranges, and the α/θ, α/δ ratios were also determined. Visual analysis of the EEG showed that 100% of children in the acute period of viral encephalitis showed diffuse slowing with recording of δ and θ frequencies. Focal changes in the form of sharp waves were recorded in 85% of cases (21 patients). Periodic activity was not recorded in even a single case in the study group of patients. Quantitative analysis of the results of statistical processing identified statistically significant decreases in the α/θ ratio (p = 0.035), maximum α (p = 0.046) and minimum θ (p = 0.044) in encephalitis patients as compared with the healthy children group. These data lead to the conclusion that pediatric patients during the acute period of viral encephalitis show significant impairments to the normal α/θ EEG power ratio. This impairment was apparent as a reduction in the power of the α and θ rhythms. It can be suggested that the cause of this reduction is suppression of the functional activity of the thalamus and thalamocortical pathways, as well as the reticular formation of the brain.

Objectives. To assess the value of using different treatment schemes in chronic migraine by comparing clinical results and the economic burdens of disease in real clinical practice. Materials and methods. The study included 66 patients attending the Academician Aleksandr Vein Headache and Autonomic Disorders Clinic: 60 women and six men aged 28–51 years with diagnoses of chronic migraine. The patients were divided into three groups: group 1 (n = 22) consisted of patients who received three months of oral prophylactic therapy with topiramate at doses of up to 100 mg/day; patients of group 2 (n = 20) received 12 sessions of acupuncture with three procedures per week; patients of group 3 (n = 24) received injections of botulinum toxin type A (Botox, BTA) at a dose of 155–195 U. The observation period was three months. Treatment efficacy was assessed using the following methods: clinical-neurological assessment, the Headache Impact Test HIT-6 questionnaire, and a subjective points questionnaire assessment for treatment satisfaction and tolerance. Results. BTA was the most effective of the three treatment methods studied in patients with chronic migraine. As compared with oral prophylactic therapy and acupuncture, BTA produced the fastest and strongest actions on the frequency of headache, promoting regression of chronic migraine and recovery of the episodic nature of headache (the numbers of headache days in group 1, 2, and 3 were 16.1 ± 0.1, 18.0 ± 0.02, and 13.9 ± 0.3, respectively, at one month). BTA also produced significantly faster and more effective recovery of quality of life and was better tolerated (good in 51%, 75%, and 85% in groups 1, 2, and 3, respectively; satisfactory in 35%, 25%, and 15% in groups 1, 2, and 3, respectively; poor in 14% in the oral prophylaxis group). Most patients in the BTA group achieved satisfactory treatment results more quickly. Despite the greater direct costs as compared with topiramate, the direct costs associated with the use of BTA (29931.51 and 32085.87 rubles, respectively, the predicted cost per non-headache day in the BTA group was the lowest, at 652.15 rubles (692.86 and 1017.60 rubles in the oral prophylaxis and acupuncture groups, respectively). Conclusions. The efficacy and cost data obtained here for the different methods of prophylaxis of chronic migraine may help specialists and patients select the most optimal therapeutic approaches.

Recommendations for the diagnosis and treatment of migraine based on the principles of evidence-based medicine are presented. The latest edition of the International Classification of Migraine is provided. Diagnostic methods and criteria are oriented to discriminating different types of migraine. Recommendations are given on the basis of data on the epidemiology and pathophysiological mechanisms of migraine. The most effective medication-based and non-medication-based approaches to the management of migraine patients are discussed.

Questions of the neurorehabilitation of strokes patients are addressed. The importance of the phenomenon of neuroplasticity, which underlies recovery processes after brain lesions, is emphasized. Particular attention is paid to the question of sensorimotor integration in health and CNS pathology, as well as to the role of afferentation in the processes underlying the recovery of motor impairments. The principles of rehabilitation therapy for stroke patients are discussed.

This study was conducted to address the clinical and neurophysiological features of pyramidal syndrome in patients with lateralized hemispheric lesions. A total of 52 patients were studied, all with hemiparesis following acute cerebrovascular accidents of the ischemic type in the right (24 patients) or left (28 patients) hemispheres of the brain. Clinical neurological analysis was performed, along with transcranial magnetic stimulation, evoked abdominal reflexes, movement-associated motor potentials, and somatosensory evoked potentials. Lesions of the right hemisphere resulted in significant weakening of activatory influences at both the hemisphere level and on descending motor structures, with marked impairment of the afferent flow from both sides of the body and excessive disorganization of activity in the left, “presumptively healthy,” side. Left-sided pathology impaired efferent control not only of the contralateral, but also of the ipsilateral side of the body. These data identify different neuroanatomical and neurophysiological features of the cerebral hemispheres not only in healthy people, but also in pathological conditions, this probably accounting for the polymorphism and heterogeneity of pyramidal syndrome in patients with lateralized cerebral lesions.

This study was conducted to address the clinical and neurophysiological features of pyramidal syndrome in patients with lateralized hemispheric lesions. A total of 52 patients were studied, all with hemiparesis following acute cerebrovascular accidents of the ischemic type in the right (24 patients) or left (28 patients) hemispheres of the brain. Clinical neurological analysis was performed, along with transcranial magnetic stimulation, evoked abdominal reflexes, movement-associated motor potentials, and somatosensory evoked potentials. Lesions of the right hemisphere resulted in significant weakening of activatory influences at both the hemisphere level and on descending motor structures, with marked impairment of the afferent flow from both sides of the body and excessive disorganization of activity in the left, "presumptively healthy," side. Left-sided pathology impaired efferent control not only of the contralateral, but also of the ipsilateral side of the body. These data identify different neuroanatomical and neurophysiological features of the cerebral hemispheres not only in healthy people, but also in pathological conditions, this probably accounting for the polymorphism and heterogeneity of pyramidal syndrome in patients with lateralized cerebral lesions.