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Background. Inflammatory polyneuropathies (IPNP) are diseases caused by an immune response against antigens in the peripheral nervous system. Epidemiological research is essential for health resource planning.Objective: to assess the clinical and epidemiological characteristics of acute and chronic IPNP in adults in the Leningrad region.Materials and methods. We analyzed the incidence of acute and chronic IPNP the Leningrad region for the last 24 years.Results. A gradual increase in the incidence rate since 2003 with slight fluctuations has been shown. A particularly significant increase was recorded in 2015 from 14 (2014) to 22 patients, while in previous years fluctuations ranged from 4 to 10 people. In 2016 and 2017, the number of cases increased even more to 26–27 per year (there are 1 600 000 residents over 18 years of age in the region). At the same time, an increase in the incidence of both Guillain–Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) was noted. The incidence of GBS in the last 10 years was 0.18–0.88, the incidence of CIDP was the same 0.18–1.0 per 100 000 population. With GBS, women were more likely to get sick, with CIDP – men. With GBS, the debut was more often in winter (35 %), in summer and autumn, 25 % each, less often in spring – 17 %. The average age of GBS development in our study was 50.3 years. CIDP also fell ill at all age periods from 19 to 84 years (average age 55.6 years). The most common GBS triggers were acute respiratory viral infections in 36 % and enterocolitis in 13 %. Respiratory disorders requiring mechanical ventilation were observed in 8 % of patients with GBS.Conclusions. The incidence of IPNP in adults, both acute and chronic in the Leningrad region, is growing with some fluctuations. This should be taken into account for health resource planning.

Objective: description of a clinical case of the development of longitudinally spread transverse myelitis in a young woman suffering from nonHodgkin’s lymphoma (follicular, 1 degree, IIIA stage, complete remission from February 2017). This is a rare, significant case in clinical practice for both residents and neurologists, and the case is under discussion. It requires certain scientific studies in the search for specific antionkoneural antibodies or a more detailed study of the already known. It is necessary to introduce these studies into laboratory practice in Russia, which would help to accelerate the diagnosis of paraneoplastic myelitis.Materials and methods. Patient B., 30 years old, has been suffering non-Hodgkin’s lymphoma since February 2016 (follicular, I degree, IIIA stage, complete remission from February 2017), receives infusions of Rituximab with a dose of 600 mg once in 2 months, the subacute developed pronounced lower spastic paraparesis. In November 2018, suddenly, against the background of complete well-being, weakness and numbness of the legs appeared. The patient asked for help at the Center for Multiple Sclerosis on 11.17.2018, then she was hospitalized and examined. Patient B. received a pulse therapy with methylprednisolone 1000 mg intravenously № 5. Discharged with positive dynamics with a diagnosis of Demyelinating CNS disease, unspecified. Acute protracted transverse myelitis (LETM), EDSS = 3.5 points. On December 13, due to the increase in spacity and leg weakness, she was urgently hospitalized in the neurological department of the Clinical Hospital.Results. After the completion of laboratory and instrumental examination, the condition was regardedby us as paraneoplastic myelitis. Relapse of lymphoma was ruled out. The treatment was carried out: pulse therapy with methylprednisolone, Plasmapheresis and intravenous administration of IgG (Privigen) with a distinct positive dynamics.Conclusion. This clinical observation allowed us to become more familiar with paraneoplastic syndromes and, in particular, with paraneoplastic myelitis. In the clinical situation previously described, we encountered a number of features: longitudinally extensive transverse myelitis developed without relapse of lymphoma, progressed rapidly, there was no response to treatment (glucocorticosteroids, plasmapheresis, Rituximab). All these signs and MRI data of the cervical and thoracic spine (a symmetric hyper-intensive signal from level CII to level ThXI, mainly involving the central spinal cord T2 MRI mode) testified in favor of the paraneoplastic etiology of longitudinally extensive transverse myelitis.