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Objective: To evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) for the treatment of patients with dystonia., Material and Methods: Authors treated 66 patients with segmental and generalized forms of dystonia, writer's cramp and oromandibular dystonia. The degree of dystonia severity was assessed using the Burke--Fahn--Marsden scale., Results and Conclusion: rTMS treatment of the motor cortex region decreased dystonic hyperkinesis severity. There was a significant decrease in scores on the Burke--Fahn--Marsden scale (p<0.05). This method was well-tolerated. No side-effects were observed, with the exception of one patient, who wished to discontinue treatment because of the twitching of facial muscles during rTMS. The results of the study allow to recommend wider adoption of this method in complex treatment and rehabilitation of patients with rare forms of dystonia.

Article presents the pathogenesis aspects and clinical data of adolescents with syndrome of vegetative dysfunction. The authors observe the structure of different clinical forms, reflect on conditions and situation, when adolescents needs a stable complex of etiopathogenetic therapy to control autonomic nervous system dysfunction.

Bright white light therapy was applied to 51 patients with syndrome of autonomic dysfunction of neurotic origin (1 hour of light exposure every day in the morning, during 2 weeks, 60 sm from the lamp, 3300 lux). Improvement occurred in 52% of the patients (responders--group 1, nonresponders--2). Changes occurred in nearly all symptoms: neuroendocrine, motivation, psychoautonomic, pain, psychopathologic. After the treatment in group 1 there was an increase of power of EEG spectrum, intensification of manifestations of the slow activity and decrease of the fast one from the two sides, an approach of the coefficient of asymmetry to the control levels as well as elevation of the urine excretion of metabolites of both catecholamines and serotonin. Initially higher power of EEG spectrum in group 2, became still more increased due to intensification of manifestations of theta and beta-2 rhythms from the two sides. Meanwhile coefficient of asymmetry was sharply decreased as well as general secretory activity inhibited. There were such symptoms and indices which had changed either negatively or positively under the influence of phototherapy.

26 patients with psychovegetative disorders of neurotic origin (vegetative dystonia syndrome, hyperventilation syndrome, panic attacks, headache, insomnia, motivation disorders) were treated. Light therapy (LT) was carried out every day during 2 weeks. The light of 4500-5000 lux was applied during 1 hour (the distance-60 cm). As a result positive effect was revealed in 11 patients while there was no effect in 15 individuals. The positive effect was observed as a decrease of clinical manifestations. Patients with positive treatment results were characterised by short disease duration, weak hypothalamus dysfunction, astheno-depressive disorders prevalence. Negative effect of LT was observed in patients with longer duration of disease, more severe hypothalamic dysfunction together with anxious and astheno-hypochondriac syndrome. The conclusion a made that LT effect is associated with the character and the degree of psychovegetative disorders, but not with presence or absence of hypothalamic dysfunction.

35 patients with vegetocirculatory dystonia and hyperventilation syndrome, but without the signs of organic lesion of nervous system were treated. The complex treatment included the breathing exercises with feedback mechanisms, the correction of psychovegetative and neurovascular disturbances, the massage of neck region and a head, psychotherapy, angioprotective, vegeto- and psychotropic drug therapy. The disappearance of acute vascular attacks and paroxysms of migrainous headache, the normalization of all breathing parameters and the improvement of vegetative status were observed in all patients.

The suggested mode of treatment combines the intravascular laser-light irradiation of blood with the visual analyzer exposure to light the brightness of which changes evenly and rhythmically with a frequency of 7-8 vibrations per minute (0.13 Hz). The combined use of the aforementioned exposures is justified due to the fact that exposure to both ionizing radiation and psychogenic factors play an important role in the pathogenesis of vegetovascular dystonia developing in the liquidators of the Chernobyl Atomic Power Plant breakdown. Change of lighting makes for the evolution of the inhibitory process in the cortex, has a sedative effect, attenuates the influence of psychotraumatizing factors. Intravascular laser-light irradiation of blood has a beneficial effect upon the organism's reactivity and immune system. Under the influence of the therapy adopted, all patients in present series (n = 67)--liquidators of the Chernobyl APP breakdown, suffering from VVD, demonstrated beneficial shifts both in the vegetovascular reactions and immune status, as evidenced by the analysis of the results of the presented mode of treatment in this patient population.

Effect of artificial mountain climate (AMC) on functional mobility of nerve processes (FMNP) was studied in a group of 46 patients with vegetovascular dystonias. The most essential physiologically significant parameters of the mountain climate were simulated on the unit "Orotron", the general atmospheric pressure remaining unchanged. It is shown that the course of AMC sessions tends to increase the working efficiency of the brain and functional mobility of the nervous processes in patients with vegetovascular dystonias. The pattern and degree of FMNP changes depend on individual characteristics of this property of the patients' nervous system. AMC may be recommended for use in clinical settings as a nonmedicamentous method of correction of functional disturbances in the central nervous system.

The paper is concerned with the results of therapy of the climacteric syndrome: the 1st group--typical CS with predominant emotional-vegetative dystonia of vagoinsular nature, skin sensitivity to a certain fraction of estrogens was increased, the 2nd group--CS complicated by hypertension, skin reaction to progesterone; the 3rd group--CS with emotional-vegetative dystonia of mixed type, skin sensitivity to estrogens and progesterone. Intracutaneous administrations of fractions of estrogens (E) and progesterone (P) were at a ratio of E:P = 4:1 for the 1st group, E:P = 1:1 for the 2nd and 3rd groups, causing a complete convalescence of 77 of 94 patients and a partial convalescence of 17 patients. In case of a partial therapeutic effect diet- and balneotherapy was recommended.

As many as 18 patients with a history of military service in Afghanistan, who suffered (7.2 years before on the average) commotion due to the explosion wave were examined. The vegetative status was studied by different methods including cardiointervalography, as was the patients' emotional and personality sphere. The data obtained were compared to those obtained in three control groups (practically healthy subjects; those who suffered a mild home craniocerebral injury; healthy subjects who fought in Afghanistan and were not victims to craniocerebral injury). The main group patients demonstrated noticeable changes in the vegetative tone, vegetative reactivity and vegetative supply to physical activity as well as a high level of anxiety, which forms vegetodystonia. Attempts were made to correct the psychovegetative syndrome by central electroanalgesia in the tranquilization mode (9-10 daily sessions). The lowering of the tension of regulatory body systems functioning and the reduction of anxiety and depression tendencies were recorded.

Results are reported of a study of 55 males with disorders of sexual potency with an objectively registered manifestation of vegetative dystonia. It was shown that sexual disorders in these patients have a psychogenic character. All of them showed neurosis and neurosis-like symptoms. With the purpose of finding effective treatment psychotherapy, phallic stimulation and physiotherapy were tried. Most effective was individual psychotherapy with elements of hypnotic suggestion and phallic vascular stimulation by local negative pressure.