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Aim: To evaluate the efficacy and tolerability of mexiB 6 and vinpotropil 10/800 in patients with chronic cerebral ischemia., Material and Methods: The study included 30 outpatients with chronic cerebral ischemia, 1-2 stages. The average age was 55,2±10,04 years. All patients underwent clinical/neurological examination. To assess the efficacy of therapy, the Visual-Analog Scale, the Test of feeling, activity and mood, the Montreal Cognitive Evaluation Scale, the Asthenia Scale, the Hospital Anxiety and Depression Scale were used. All patients were treated with mexicB 6 (1 tablet 3 times a day for 1 month), then vinpotropil 10/800 (1 tablet 3 times a day) was used in addition to mexiB 6. The total duration of follow-up was 2 months., Results and Conclusion: Treatment with mexiB 6 led to a significant regression of patients' complaints starting from the second week of therapy, the improvement in well-being was noted in all patients. Inclusion of vinpotropil in the therapy resulted in the additional symptom regression in 19 (63,3%) patients. At the end of combined therapy, there was a significant improvement on all the scales that indicated improvements in cognitive functions, asthenic and anxiety-depressive disorders. An increase in Mg in the blood (0,91±0,05 mmol/l), which did not change after 2 months of therapy (0,94±0,05 mmol/l) was observed. Undesirable phenomena during treatment were not recorded. MexiB 6 and vinpotropil were well-tolerated in both monotherapy and combined use. The proposed therapy scheme is effective and safe.

Objective: To determine the dynamics of immunometabolic characteristics in patients with chronic ischemia of the brain (discirculatory encephalopathy - DE) under the influence of various combinations of neuroprotective and antioxidant drugs and on this basis to identify the most effective therapeutic combinations., Material and Methods: Authors analyzed the results of treatment of 57 patients with DE, stage II, comorbid to hypertension, stage II, which were divided into 3 groups that received comprehensive basic and advanced therapy with paired combinations of neuroprotective and antioxidant drugs. Clinical examination and assessment of neuropsychiatric status were performed. Immune disorders were assessed by the level of plasma cytokines (TNF, IL-1β, IL-6, IL-8, IL-18, IL-4, IL-10 receptor antagonist IL-1 (RAIL), INF-γ, IL-2, IL-17), components of complement (C3, CA, C4, C5, CA), inhibitors (factor H, C1-inhibitor), immunoglobulin classes IgM, IgG, IgA, metabolic changes (concentrations of acylhydrazines, malondialdehyde, ceruloplasmin), C-reactive protein, neopterin concentrations, stable metabolites of nitric oxide, the activity of catalase, superoxide dismutase, total antioxidant activity of blood serum., Results and Conclusion: Laboratory and clinical efficacy of the combinations of neuroprotective and antioxidant drugs in DE reduced in the following order: actovegin and cereton → emoxipine and piracetam → cerebrolysin and mexidol.

Authors assume that super-refractoriness is probably characterized by the specific pathophysiological mechanisms of status epilepticus development and can't be treated using standard treatment schemes. By the example of two clinical cases, we have analyzed the efficacy of complex treatment of super-refractory nonconvulsive and myoclonic status using intravenous valproate, central anesthetics (thiopental sodium, propofol), levetiracetam and cortexin. Preliminary results suggest that cortexin and levetiracetam as add-on to standard treatment may be vitally important drugs for the patients.

Objective: To assess the severity of asthenic syndrome (AS) in chronic brain ischemia (CBI) in primary health care settings., Material and Methods: The study included 1170 patients with brain ischemia, aged 45-65 years, treated with phenotropil in dose 100 mg during 2 and 3 months. Clinical examination and MFI-20 subscales were administered. RESULTS AND СONCLUSION: The high incidence of asthenic syndrome was observed across all MFI-20 subscales. The decrease in asthenic syndrome severity was significant already in the end of the first month of treatment with phenotropil. Such dynamics maintained to the end of the second and third month of treatment. More than 2-fold decrease in the severity of asthenia symptoms was achieved in all subgroups 3 months after treatment. More rapid and apparent decrease in asthenic syndrome was observed in younger patients.

Objective: To study the efficacy of neurometabolic treatment in dependence of different variants of speech delay (SD), general underdevelopment of speech (GUDS) type, in preschool children., Material and Methods: The study included 130 children, aged 4-6 years, with SD, GUDS type, Most of children were boys (74%). Clinical and psychological characteristics and efficacy of neurorehabilitation were studied in 3 parallel groups. RESULTS AND СONCLUSION: The results demonstrate the heterogeneity of disorders of speech development depending on the clinical and neurological SD variant. Authors have identified characteristics that allow to determine the amount of corrective actions for children with associated pathology and improve rehabilitation actions.

We examined 76 children and adolescents (45 boys (59.2%), 31 girls (40.8%), aged from 6 to 17 years (mean age 14.31 ± 0.3), with the diagnosis of refractory epilepsy using a clinical/psychopathological method and psychometric scales. Marked non-psychotic mental disorders of varying severity were observed in all patients. The patients were treated with levetiracetam in a dose of 60 mg/kg/day during one year. The reduction in the frequency of epileptic seizures was achieved in 77.6% of patients. The significant (p<0.01) improvement in cognitive functions and speech were found in 81.6% cases. The treatment reduced stress and improved mood in 63.1% of patients.

The neuroleptic (antipsychotic) activity of phenotropil was studied in an experimental animal model. Phenotropil had a marked neuroleptic activity in models of positive (apomorphine-induced verticalization test) and negative (5-HTP-induced hyperkinesis test) symptoms of psychoses as well as in the m-cholinergic pathway hyperactivation (arecoline-induced tremor test). The compound markedly antagonized haloperidol catalepsy. Used in a single dose or as a course treatment, phenotropil did not provoke aggression nor intensify it. In contrast to typical and atypical antipsychotics, phenotropil had no sedative action and other adverse effects. It exhibited a positive effect on exploratory behavior and motor activity, had anxiolytic and antidepressant action.

To study the possibility of application of nootropics and antioxidants in the complex antiepileptic therapy, we examined 75 patients with symptomatic focal posttraumatic epilepsy. A statistically significant reduction in the number of epileptic seizures, improvement of cognitive function and quality of life of the patients as well as a decrease in the severity of depression and epileptic changes in the EEG were identified. The potentiation of antiepileptic activity of basic drugs, normalization of brain's electrical activity and reduction in EEG epileptiform activity, in particular coherent indicators of slow-wave activity, were noted after treatment with the antioxidant mexidol. A trend towards the improvement of neuropsychological performance and quality of life was observed. There was a lack of seizure aggravation typical of many nootropic drugs. Thus, phenotropil and mexidol can be recommended for complex treatment of symptomatic posttraumatic epilepsy.

Sixty patients were randomized to treatment with cytoflavin (n=30) or nootropil (n=30). Patients of the main group received cytoflavin along with standard treatment for correction of hemodynamics. The treatment scheme was as follows: intravenous injections during 10 days, tablets - from 11 to 35 days. The same scheme of treatment was used in the comparison group. The total duration was 35 days. Patients were assessed with NIHSS, the Rankin scale, the Barthel index, MMSE. MRI was used to verify ischemic lesions. The therapeutic efficacy of cytoflavin was significantly higher compared to nootropil in respect to the restoration of neurological functions and self-service abilities as well as to the reduction of cognitive deficit.

Therapeutical action of mexidol as compared to piracetam was evaluated in groups of patients with tick borne encephalitis in the acute period of disease. Mexidol was administered as add-on to antiviral treatment in 72 patients while 89 patients received piracetam. The drugs were introduced intravenously during the first 10 days and then were given as tablets during 2 months. Based on these results, we can recommend the inclusion of mexidol in the pathogenetic treatment (fever symptoms) of tick born encephalitis. The use of mexidol as compared to piracetam led to more pronounced positive changes, higher percentage of favorable outcomes and lower frequency of residual signs.

This review summarizes the data of Russian and foreign authors as well as the results of original studies on etiology pathogenesis, and differential treatment of ulcer disease (UD). The author's original concepts of UD pathogenesis and relations between man and Helicobacter pylori are discussed. The pathogenetic role of disturbances in the system of gastroduodental self-regulatory function and psychosomatic mechanisms as well as immune deficiency and impaired antioxidatve protection is considered. Peculiarities and results of UD eradication therapy intended to eliminate H. pylori infection are described. The importance of the choice of the UD treatment strategy on an individual basis is emphasized as opposed to the use of universal standards and therapeutic modalities influencing only local pathogenic factors, such as acidopeptic ones and H. pylori infection.

A combination of valproates in dose 15-25 mg per day and levetiracetam in dose 20-25 mg per day was used in the treatment of 23 patients with different forms of epilepsy (juvenile myoclonic epilepsy, juvenile absence epilepsy, convulsive idiopathic generalized epilepsy and children absence epilepsy). The use of these drugs was effective in all forms of epilepsy. There were positive changes in the frequency of seizures and epileptic activity in the EEG.

We studied 279 women, aged 18-40 years old, with epilepsy. The study included the evaluation of anamnesis, clinical and neurological examination, routine EEG and/or video-EEG-monitoring, MRI of the brain. The period of observation was 6 months - 8 years. Idiopathic generalized epilepsy (IGE) was diagnosed in 85 cases, cryptogenic focal epilepsy in 107 cases, symptomatic focal epilepsy in 51 cases, unclassified epilepsy in 32 cases. In the end of study, remission was achieved in 70.8% of patients of the IGE group, the substantial reduction in the number of seizures was identified in 13.8%, no effect was seen in 15.4%. Adverse events were found in 22 of 63 (34.9%) patients treated with valproates, 9 of 25 (36%) patients treated with topiramate, 5 of 39 (1.8%) patients treated with carbamazepine, 3 of 7 (42.9%) patients treated with levetiracetam and in 2 of 5 (40%) patients treated with lamotrigine. The aggravation of absences with carbamazepine was diagnosed in 2 cases, myoclonic seizures - in 2 cases. Therapeutic strategies of young women with juvenile forms of IGE were described and analyzed.

The objective was to retrospectively study the efficacy and safety of levetiracetam (keppra) as an add-on treatment of pharmacoresistant forms of epilepsy in children. We have analyzed medical histories of 192 patients with pharmacoresistant epilepsy admitted to a neurological department of the Research and Treatment Center of Children's Medical Care over the period of 2008-2011. The patient's age varied in the range from 6 months to 19 years (mean age 5.7 years). The results of the study revealed the high efficacy of levetiracetam as an add-on treatment of pharmacoresistant epilepsy in children. The efficacy of > 50%, including patients in the remission, was found in 60.2%, the remission of more than 6 months was observed in 20.3% of patients. The efficacy of levetiracetam was higher in the treatment of the following variants of pharmacoresistant epilepsy: seizures caused by brain defects (the efficacy of > 50% was seen in 66.7% of patients), atypical rolandic epilepsy (the efficacy of > 50% was seen in 100% of patients). The efficacy of levetiracetam was not correlated with the priority of prescription of the drug that might be explained by the unique mechanism of the action of this anticonvulsant. Levetiracetam is well tolerated in the children age. Side-effects that were not life threatening were noted only in 6.2% of patients and the retention rate was 75.5%. The aggravation of seizures and EEG abnormalities, regardless of the epilepsy form, type of seizure, drug dose or the combination of anticonvulsants were seen in 5.7% of patients.

Forty-four patients with rolandic epilepsy (32 boys, 12 girls), aged from 5 to 14 years, were examined in the prospective study during 5 years. Before the antiepileptic treatment, most of patients had transitory cognitive disturbances. There were the impairment of verbal functions, especially verbal intellect, while non-verbal intellect remained intact; dyspraxia, impairment of auditory-speech memory, disturbances of arbitrary regulation and optical-motor coordination. The cognitive impairment was not severe and did not impact on learning of school program. No significant correlations were found between the lateralization of regional EEG changes and the character of cognitive dysfunction though the age-related lateralization of the focal epileptiform activity was shown: the right-side localization of central-temporal EEG spikes predominated in children at the age of 6.29 +/- 0.9 years, the left-side localization - in children at the age of 8.4 +/- 1.4 years. The clinical remission was achieved 4-5 years earlier than the recovery of cognitive functions. Valproates used as monotherapy or in the combination with ethosuximidum and levetiracetam were drugs of choice.

The effects of GABA derivatives phenotropil (25 mg/kg), phenibut (25 mg/kg), and baclofen (2 mg/kg) on the process of lipid peroxidation (LPO), as manifested by the initial level of malonic dialdehyde, velocity of spontaneous and ascorbate-dependent LPO, and the catalase activity in the homogenates of thymus and spleen, have been studied on rats of the Wistar line with cyclophosphamide (CPHA) immunodepression and lipopolysacharide (LPS) immune stress. It is established that, under the action of CPHA and LPS, activation of the LPO processes takes place in the immune organs. Under these conditions, changes of the catalase activity exhibited some specific features: in the animals under LPS action, the catalase activity increased in the spleen, while being decreased in the thymus; under the influence of CPHA, the activity of this enzyme decreased in both organs. An analysis of the antioxidant activity of GABA derivatives under the conditions of CPHA-induced immunodepression showed that all substances upon intraperitoneal introduction for 5 days favored the elimination of disturbances by suppressing the LPO processes and increasing the antioxidant protection activity. On the background of LPS-induced immune stress, all the tested substances showed a correcting action with respect to indicated biochemical processes in the thymus, while only phenibut activated the antioxidant system in the spleen.

We studied 52 patients with electric status epilepticus in slow sleep (EESSS) during 3-5 years. Age-dependent peculiarities of clinical course of the disease, risk factors for EESSS and rational approaches to antiepileptic treatment for these cases were singled out. Symptomatic and idiopathic EESSS variants were revealed. Combinations of valproates, levetiracetam and ethosuximidum were the most effective antiepileptic drugs in the treatment of EESSS.

We studied 1036 children with epileptic seizures, aged from 1 to 18 years, during 2004-2008. One hundred and six patients were diagnosed with idiopathic focal epilepsy (IFE). The following forms of IFE were singled out: benign seizures of infancy (familial and non-familial) - Watanabe--Vigevano syndrome - 5,7%, occipital epilepsy of childhood with early manifestation (Panayiotopoulos syndrome) -26,4%, occipital epilepsy of childhood with late manifestation (Gastaut syndrome) - 12,3%, benign epilepsy of childhood with central-temporal spikes (rolandic epilepsy) - 51%, benign focal epilepsy with affective symptoms - 4,7%. The efficacy of the first monotherapy was significantly worse in rolandic epilepsy compared to the other IFE forms. Prescription of valproate or the combination of valproate, ethosuximidum and levetiracetam, in case of resistant course, as a starting therapy was found optimal.

The novel antiepileptic drug levetiracetam (keppra, 80 mg/kg, i.p.) produces a pronounced anticonvulsant effect on all parameters of the audiogenic locomotion response in Wistar rats, leading to the prevention of acoustic seizures approximately in 50% animals. Keppra injection also led to a decrease in the intensity of single audiogenic convulsive episode, a twofold prolongation of the latency of motor reaction, and a change in the pattern of seizure reaction toward increasing number of rats with "one-wave" response. In contrast, a lack of sound resistant animals and the change from one- to two-wave audiogenic response were observed in Krushinsky-Molodkina strain rats.

To assess objectively a dynamics of brain functional state, EEG spectral power and peak latency of the P300 component of cognitive auditory evoked potentials have been analyzed in adolescents during the course of nootropic therapy of residual asthenic consequences of traumatic brain injury (ICD-10 F07.2). The study included 76 adolescents, aged 12-18 years, who have undergone severe closed head trauma with brain commotion 1/2--5 years ago. Patients have been divided into 3 groups treated during one month with cerebrolysin, piracetam or magne-B6, respectively. After the end of the nootropic therapy, 77% of patients treated with cerebrolysin as well as 50% of patients treated with piracetam and magne-B6 have demonstrated the positive dynamics of their brain functional state that manifested itself in the appearance of occipital EEG alpha rhythm or in the increase of its spectral power; in the normalization of alpha rhythm frequency; in the decrease in the spectral power of slow wave (theta and delta) EEG activity, in the amount (up to the disappearance) of paroxysmal EEG activity, in the EEG response to hyperventilation and in the shortening of the P300 peak latency. Such positive changes of neurophysiological parameters have been associated with the improvement of clinical conditions of patients and correlated significantly with the dynamics of psychometric scores of attention and memory.

One hundred and forty-three patients with partial epilepsy, aged 16-73 years, were treated with levetiracetam (keppra) during 3 years. Group 1 included 71 patients who received the drug as the first monotherapy, group 2 consisted of 72 patients who received levetiracetam as the second or the third monotherapy due to the insufficient efficacy/poor tolerability of the initial therapy with AED. Percent of retention of patients on the drug is an integral index of the total efficacy of treatment (remission or >50% decrease of seizure frequency) minus the percent of drug withdrawal due to different reasons for a certain period. In group1, the percent of retention was 90,1% for the first year, 87,3% for the second year and 83,1% for the third year; in group 2-75% for the first year, 70,8% for the second year and 69,4% - for the third year. The drug was well-tolerated. The drug withdrawals due to side effects was 5,6% in group 1 and 8,2% in group 2. The results of the study suggest high efficacy of levetiracetam in treatment of partial epilepsy.

The study aimed at the evaluation of clinical efficacy and safety of the neurotrophic medication omaron, a combination of piracetam and cinnarizin, in the early restoration period of ischemic stroke. One hundred and twenty post stroke patients were examined. A diagnosis was confirmed by the brain MRI and CT examination. Neurological and mental status of patients was assessed with a number of scales. The omaron therapy reduced significantly the neurological deficit and improved health status and functioning of patients. The drug was well-tolerated by patients.

To assess objectively a dynamics of brain functional state, EEG spectral power and peak latency of the P300 component of cognitive auditory evoked potentials have been analyzed in adolescents during the course of nootropic therapy of residual asthenic consequences of traumatic brain injury (ICD-10 F07.2). The study included 76 adolescents, aged 12-18 years, who have undergone severe closed head trauma with brain commotion 1/2--5 years ago. Patients have been divided into 3 groups treated during one month with cerebrolysin, piracetam or magne-B6, respectively. After the end of the nootropic therapy, 77% of patients treated with cerebrolysin as well as 50% of patients treated with piracetam and magne-B6 have demonstrated the positive dynamics of their brain functional state that manifested itself in the appearance of occipital EEG alpha rhythm or in the increase of its spectral power; in the normalization of alpha rhythm frequency; in the decrease in the spectral power of slow wave (theta and delta) EEG activity, in the amount (up to the disappearance) of paroxysmal EEG activity, in the EEG response to hyperventilation and in the shortening of the P300 peak latency. Such positive changes of neurophysiological parameters have been associated with the improvement of clinical conditions of patients and correlated significantly with the dynamics of psychometric scores of attention and memory.

A study included patients, aged from 30 to 70 years, with a verified diagnosis of compensated diabetes mellitus type 1 or type 2, diabetic polyneuropathy (DPN) or the syndrome of moderate cognitive disorders (MCD). Patients with DPN were stratified into two groups: 30 patients of the main group received the antioxidant drug tiolepta in tablets (600 mg) once a day during 60 days; 30 patients of the control group received only basic (sugar-reducing) therapy. Twenty patients with MCD were treated with the combined nootropic and vasoactive drug vinpotropil in dose 2 capsules, 3 times a day during 2 months in addition to the basic therapy (sugar-reducing, antihypertensive, antiaggregate drugs). To the end of treatment, the severity of DPN was lower in the main group treated with tiolepta that reflected in the normalization of NDS scores in 50% of patients compared to 30% in the controls and in the disappearance of neurological symptoms on the TSS in 30% of patients while these symptoms were present in the control group. The electroneuromyographic study showed the statistically non-significant trend (p>0,05) to the higher velocity of impulse conduction along the sensory and motor nerves as well as higher amplitudes of motor and sensory responses in the main group. To the end of the treatment, positive dynamics in the number of complaints and neurological status was found in patients with MCD. The neuropsychological study revealed the significant (p< or =0,05) improvement on the MMSE scale and in the delayed recall of words (the ten words test). Adverse effects that led to discontinuation of treatment were not found for both drugs.

We studied the efficacy of akatinol memantine compared to that of piracetam in the treatment of 41 patients with posttraumatic cognitive disturbances (20 patients were treated with akatinol memannine and 21 patients with piracetam) during 24 weeks. Ten patients had a severe traumatic brain injury (TBI) and 11 patients had mild TBI. Treatment efficacy was assessed during 6 months using the data of clinical examination, neuropsychological testing, CT and MRI. Akatinol exerted a distinct positive, stable and continuously effect on a broad spectrum of cognitive disturbances while the effect of piracetam was observed only for some cognitive functions and was short-term (during 1 month). Both drugs were well-tolerated by patients.

We studied 400 patients with ischemic stroke, including 200 patients (the main group), who received 3 courses of phenotropil in the complex rehabilitation treatment in dosage 400 mg/day during 1 year after stroke. The extent of restoration of neurologic functions and daily living activities was assessed with Barthel, Lindmark, Scandinavian scales and Merton and Sutton scale. The restoration of neurologic and daily living activities was significantly (p < 0.0001) better in the main group compared to the control one.

We conducted an open study on efficacy and safety of vinpotropile in patients with initial signs of chronic brain ischemia. Twenty patients, aged from 50 to 78 years, were examined. Seven patients had the diagnosis of discirculatory encephalopathy (DE), I stage, and 13 patients were diagnosed with DE, II stage. Vinpotropile was prescribed in 2 capsules tree times per day during 30 days. At the end of the study (the 30th day), the results of the therapy were assessed as very good or good in 75% of patients. Also, positive changes were seen in the performance on neuropsychological tests: MMSE scores were improved in average by 1,9 point, the mean score in the group being corresponded to normal values. Patients performed better on the Isaac speech activity test. The higher performance on the task and less errors were seen in the proof test that reflected the increase of attention/concentration. Patients showed the significant improvement on a scale that assessed self-rated health, activity and mood. The emotional state was normalized in 50% of patients during the treatment with vinpotropile. No adverse effects were observed.

We studied efficacy and tolerability of the combined drug omaron (25 mg of cinnarizine and 400 mg of piracetam in one tablet) in patients with multiple sclerosis. The dosage of the drug was 1 tablet 3 times a day during 12 weeks in 33 patients (mean age 35.3±4.2 years) of the index group. A comparison group consisted of 27 patients matched for demographic and clinical characteristics who did not receive nootropics during the study. None of patients included in the study received disease modifying drugs. The significant (p<0.05) decrease in the severity of chronic fatigue syndrome (by 28.6% compared to baseline), improvement (p<0.05) of cognitive functions (increase of MMSE scores by 9.4%) were found in the index group compared to the comparison one. The statistically significant changes in the severity of disability assessed by EDSS were not observed. Omaron was well-tolerated with no serious adverse-effects.

Forty children with dyslexia, aged 7-12 years, have been randomized into two groups in an open controlled study: 18 of them received Nootropil (piracetam) in the dose of 100 mg/kg daily for 2 months and 22 were examined as a control group. Nootropil exerted positive effects on reading and spelling skills in 56% of children with dyslexia who demonstrated the improvement of fluency and accuracy of reading along with a significant decrease of specific errors (dysphonemic and visuospatial) in dictation. In the control group, the improvement was seen only in 10% of children. These data corresponded to the results of neuropsychological testing that demonstrated the improvement of automatic lexical retrieval, phonological skills and sustained attention in dyslexic children treated with nootropil as compared to the control group. The dynamics of interhemispheric asymmetry in EEG alpha-theta-subbands (4-13 Hz) during the performance of incomplete figures recognition test in the nootropil treatment may be indicative of the formation of compensative mechanisms linked with the functional activation of the right hemisphere structures and associative anterior left hemisphere areas which contributed to the progress in reading and spelling skills.

Efficacy of omaron (a combination of piracetam 400 mg and cinnarizin 25 mg) has been studied 3 months after stroke in 90 post-stroke patients. Forty-five patients receiving the basic therapy (antihypertensive and antithrombotic drugs, statins) have been included in the control group and 45 patients of the main group received in addition omaron (1 pill 3 times daily during 2 months). Intensity of neurologic disturbances, degree of disability, cognitive functions assessed by neuropsychological tests (the Mini-Mental State Examination, the Frontal Assessment battery, the Five words test, the Clock drawing test, the Schulte test) and emotional state (the Centre for Epidemiologic Studies Depression scale, the Spilberger scale) have been measured. During the period of the study, none of the patients had stroke or myocardial infarction. The improvement of indices of neurological status, decrease of disability degree and normalization of arterial pressure were found in both groups after 2 months of treatment. The significant improvement (p<0,05) of performance on tests for neurocognitive functions and parameters of emotional state was noted in patients treated with omaron compared to those of the control group. The good tolerability of omaron, absence of serious side-effect in combination with other drugs used for prevention of secondary stroke were reported.

One hundred and thirty-eight patients (76 women and 62 men, aged from 16 to 65 years) with symptomatic partial epilepsy (n=128) and idiopathic generalized epilepsy (n=10) have been studied. All patients received keppra on regiments of monotherapy (n=30) and polytherapy (n=108). The study included evaluation of anamnesis, clinical and neurophysiological examination, routine EEG and/or video-EEG-monitoring, MRI of the brain, assessment of effectiveness, tolerability and quality of life (QUALIE-31, version 1). The period of observation was 1-4 years (on average 2,5 years). The high effectiveness and tolerability, good characteristics of therapy duration, the early appearance of clinical effect after the therapy has been started and positive cognitive effect are noted. The effectiveness, tolerance and clinical features of keppra treatment in different epileptic syndromes are analyzed.

An open 6 month clinical trial of efficacy of acatinol has been carried out in patients with mild cognitive disorder (MCD). Forty patients received acatinol and 20 patients of comparison group were treated with piracetam. Mean age of patients was 67,7+/-7,2 years. Patient's state was assessed with a battery of scales, questionnaires and neuropsychological tests. Acatinol was prescribed in dosage 10 mg daily and piracetam in dosage 1200 mg daily at baseline, after 3 and 6 months of treatment. Thirty-eight (95%) of patients treated with acatinol and 18 (90%) of patients treated with piracetam have completed the treatment. In the acatinol group, worsening was seen in 5% of patients, no changes - in 20%, moderate improvement - in 35%, marked improvement - in 25%, substantial improvement - in 15%. Portion of patients with worsening or absence of changes was significantly lower and that with marked and substantial improvement was higher in the acatinol group compared to the piracetam group. The global assessment of cognitive functions on the MMSE scale was significantly increased to the end of 3rd month in both groups. However this improvement was maintained to the end of 6th month only in patients treated with acatinol. In the latter group, the positive changes of depressive symptoms, subjective symptoms and quality of life were shown. The positive dynamics was more pronounced in patients with dysregulation type of MCD compared to patients with amnesic type. The authors suggest a term <>. For this type of MCD the use of acatinol may be most necessary.

The duration and severity of cataleptic freezing after audiogenic seizures were investigated in rats of several genotypes with different predisposition to audiogenic epilepsy. These genotypes were the Krushinsky-Molodkina strain (KM--the audiogenic seizure prone strain), the Wistar and two new substrains selected from hybrids KM x Wistar for high ("4") and low ("0") audiogenic seizure susceptibility. The drug injections, which modulated the audiogenic fit severity, induced the changes in catalepsy too. It was found, that in intact animals cataleptic freezing developed after audiogenic seizures only and was more intense after severe seizures, the correlation coefficient being statistically significant. Levetiracetam (anticonvulsant drug) injections resulted in significant decrease of audiogenic fit severity and cataleptic state in Wistar and KM rats. Caffeine injections resulted in audiogenic seizures accompanied by cataleptic freezing in rats of the substrain "0", selected for audiogenic non-pronness.

The efficacy of piracetam in the treatment of the consequences of moderate and severe closed traumatic brain injury was assessed in 42 patients, aged 12-18 years, who suffered traumatic disorders 1,5-5 years before this study. Adolescents from the main group (20 patients) received piracetam in dosage of 40-50 mg/kg (or 1600-2400 mg daily) during one month. 22 patients of the second group were examined as controls. The positive therapeutic effects of piracetam on cognitive (memory, attention, executive functions) and motor (coordination) functions as well as the speed of cognitive and motor performance were demonstrated in this study.

The "new" antiepileptic drug levetiracetam has the unique mechanisms of antiepileptic activity. Various recent studies revealed its efficacy and safety in different forms of epilepsy both as a monotherapy and an additional therapy. The low frequency of side-effects and minimal interactions with other drugs allow to use levetiracetam in elderly patients and in patients with severe co-morbid diseases including AIDS and hepatitis C receiving the corresponding therapy. Moreover, the efficacy of levetiracepam in other neurological diseases: chronic headaches, i.e., migraine, neuropathic pain, including patients with cancer, movement disorders (myoclonus, dystonia and dyskinesia in Parkinson's disease, essential tremor, have been revealed.

Efficacy of keppra was studied in 52 patients, aged 10-55 years, after the surgical treatment of gliomas of the brain hemispheres. The medication was used (in combination with other anticonvulsant drugs and hormones) during the radiotherapy. In 30 (57,8%) of cases epileptic seizures were before the surgery. In 22 (42,2%) of patients they developed during the radiotherapy. Keppra was used in the regiment of "urgent aid" in relation to the appearance of seizures and increase of their frequency during the radiotherapy. Doses of keppra varied from 500 to 2500 mg (30-50 mg/kg/day) in a single dose. Then patients received the drug 2 times daily under the control of clinical and EEG presentations. A clinical effect, including the decrease of seizures frequency by 48,3% (p<0,001), positive changes of quality of seizures (more simple structure, reduced time of seizures), was observed for the first 24 h and in future the state of patients was stable. All patients have completed the course of radiotherapy. The choice of dose was depended on age, body mass and dynamics of clinical and EEG data.