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In this paper, various neuromuscular manifestations of coronavirus infection are considered and methods of damage to the nervous system are highlighted. These include the "cytokine storm", impaired hemostasis, neurotropicity and neurovirulence of SARS-CoV-2. The persistence of the virus in the body affects the course of comorbid diseases, which requires a systematic approach to patient treatment. In this paper we discuss the data from modern research papers and clinical cases both from updated international literature and from our own clinical practice: it is the most frequently met condition - Guillain-Barré syndrome – acute inflammatory demyelinating polyneuropathy. We present both rare and common neuro-muscular conditions, their clinical onset, possible pathogenesis, variants of manifestation. According to the data from current publications, the evaluation and management of patients suffering from Guillain-Barré syndrome associated with new coronaviral infection SARS-CoV-2 is does not have major differences with the classical ones, that are not associated with the pandemic. Our patient that we present as our own case, was hospitalized, and observed as an in-patient. She was treated using plasma exchange in the algorithm of management. The outcome of this case was positive. We conclude that neuromuscular manifestation of new coronaviral infection SARS-CoV-2 could be new and possibly associated with this disease, but also could be described as worsening of the premorbid disorders. For instance, inherited neuromuscular diseases could have different variants during the period of pandemic caused by novel coronavirus SARS-CoV-2 infection.

In the Republic of Bashkortostan, a new original study of sleep-in patients in the recovery period of cerebral stroke is planned. One of the goals will be to improve the algorithms of sleep disorders management in complex post-stroke rehabilitation using rhythmic transcranial magnetic stimulation (rTMS). In this paper, we present the design of this study using modern instrumental and clinical technologies for the diagnosis of sleep disorders and rehabilitation. The work will be of practical importance in rehabilitation medicine and neurology for improving the quality of life of patients who have suffered acute cerebral circulatory disorders. We plan to study sleep disorders in patients in the early recovery period of stroke using clinical and polysomnographic techniques, to evaluate the safety and clinical effectiveness of rTMS in the studied patients with sleep disorders, to study the duration of the effects of rTMS on sleep normalization. The successful completion of the study will help to add to algorithms for correcting sleep disorders in post-stroke rehabilitation using transcranial magnetic stimulation.

Cognitive deficiency is often present and recognized in patients – stroke-survivors in different stages of strokes. This is a huge problem of the modern society because patients with cognitive decline have less rehabilitation capacities, less motivation, more risks of the second vascular event. We analyzed the results of our clinical tests in a small number of patients who were hospitalized for medical-and-psychological rehabilitation. We performed several assessments for evaluating cognitive and psychological deficiency in them. The mean age of our patients was 63 years, and more than 75% of them had strokes in carotid arteries. We diagnosed mild (60%) and moderate (33.4%) cognitive impairment in this cohort. The group was asked to give their opinion about the quality of life that they had. The mean number was 5.7 out of 10 using visual analogues scale. The lower were the cognitive functions, the less obvious were emotional problems and affective disorders in the patients of this study. Cognitive rehabilitation is one of the modern and promising directions in rehabilitation medicine. Research papers published worldwide and some results of this pilot study indicate the better prognosis for patients with less cognitive impairment.

Migraine is one of the most common types of headache, which can lead to a significant decrease in quality of life. Researchers identify migraine with aura, migraine without aura, and chronic migraine that substantially reduces the ability of patients to work and is frequently concurrent with mental disorders and drug-induced headache. The complications of migraine include status migrainosus, persistent aura without infarction, migrainous infarction (stroke), and a migraine aura-induced seizure. The diagnosis of migraine is based on complaints, past medical history, objective examination data, and the diagnostic criteria as laid down in the International Classification of Headache Disorders, 3 rd edition. Add-on trials are recommended only in the presence of red flags, such as the symptoms warning about the secondary nature of headache. Migraine treatment is aimed at reducing the frequency and intensity of attacks and the amount of analgesics taken. It includes three main approaches: behavioral therapy, seizure relief therapy, and preventive therapy. Behavioral therapy focuses on lifestyle modification. Nonsteroidal anti-inflammatory drugs, simple and combined analgesics, triptans, and antiemetic drugs for severe nausea or vomiting are recommended for seizure relief. Preventive therapy which includes antidepressants, anticonvulsants, beta-blockers, angiotensin II receptor antagonists, botulinum toxin type A-hemagglutinin complex and monoclonal antibodies to calcitonin gene-related peptide or its receptors, is indicated for frequent or severe migraine attacks and for chronic migraine. Pharmacotherapy is recommended to be combined with non-drug methods that involves cognitive behavioral therapy; progressive muscle relaxation; mindfulness; biofeedback; post-isometric relaxation; acupuncture; therapeutic exercises; greater occipital nerve block; non-invasive high-frequency repetitive transcranial magnetic stimulation; external stimulation of first trigeminal branch; and electrical stimulation of the occipital nerves (neurostimulation).

When examining a patient with lumbosacral pain, it is necessary to rule out the specific cause of the disease. The diagnosis of discogenic lumbosacral radiculopathy (DLSR) is based on clinical examination; magnetic resonance imaging (MRI) is of informative value in excluding other causes of radiculopathy and in evaluating disk herniation. If the signs of cauda equina and spinal cord compression are absent, and no epidural glucocorticoid injection or urgent surgical treatment is scheduled, there is no reason for early (within the first 4 weeks) MRI.It is recommended to inform the patient with DLSR about the possibility of disk herniation regression and natural recovery and about the advisability of maintaining physical activity. Epidural administration of local anesthetics and glucocorticoids and use of non-steroidal anti-inflammatory drugs are advisable to relieve acute pain. Anticonvulsants (pregabalin and gabapentin), muscle relaxants, and B vitamins can be used as additional methods for acute DLSR; psychological therapies (cognitive behavioral therapy), antidepressants, therapeutic exercises (kinesiotherapy), manual therapy, and acupuncture are effective in chronic DLSR. Consultation with a neurosurgeon for possible microdiscectomy is indicated in the presence of cauda equina syndrome (urgently) and in the absence of medical therapy effects within 4–8 weeks.Therapeutic exercises (kinesitherapy) with an educational program for prevention of strenuous physical activity and static and uncomfortable positions for a long time, as well as for teaching how to lift weights properly, etc. are recommended for preventive purposes.

This article presents the results of our study of the nutritional status of patients after cerebral stroke who were hospitalized to the medical rehabilitation unit. Among all patients, 16 % had an increased risk of nutritional deficiency by all scales with the highest numbers in patients over 65 (44 % had a risk of nutritional deficiency on all scales). Among patients with swallowing disorders, 100 % of patients had a risk of nutritional deficiency. Out of all anthropometric indicators, only the circumference of the shoulder muscles was significantly lower in patients with nutritional deficiency. Assessment and correction of malnutrition during rehabilitation after stroke is recommended during the acute treatment and follow-up. Special clinical nutrition products can be a good support for balanced feeding for more rapid rehabilitation.

The article discusses the first results of studies of coping strategies of servicemen of the structure of Rosgvardia.The purpose of the study was to study the specifics and to analyze the coping strategies of the rank and file and the command structure of mobile special forces units (OMON) of the Federal service of troops Rosgvardia.Materials and methods. Underwent questionnaire survey 65 members of OMON of the Federal service troops Rosgvardia. The working activity of the presented group of people is associated with the frequent impact of stress factors. The questionnaire of coping with stress in adaptation of Rasskazova-Gordeeva-Aspen was used as a method. Results. After analyzing the data, we determined the frequency of choice of riot police coping strategies in difficult or problematic situations for them. Conclusion. The data collected can be useful for the development of rehabilitation programmes for military personnel, as well as help to expand the database of existing data in the study of coping strategies.

The factors, influencing the development of cognitive defects in patients after chemotherapy are the following: personal individual intellectual and genetic characteristics, immune dysfunction and neurotoxicity. Cognitive domains, disturbed to a greater extent, are memory, attention, thinking rate and executive functions. Sixty one patients, diagnosed lymphoproliferative disease, (chronic lympholeukosis – 28 persons, multiple myeloma – 33) were examined; patients’ mean age was 63.87 ± 9.76 years. Reduced cognitive function was revealed in 73.77 % of patients, a mean score by MoCA scale was 22.87 ± 4.08. Cognitive defects negatively influence patients’ quality of life, significantly reduce their physical and mental working ability, everyday activity, make execution of professional duties difficult, besides they can complicate nursing.

The modern view on the application of botulinum toxin type A for the off-label use in neurology and foreign experience analysis are presented. The «off-label» category referred to any prescription of a medication in case of using it for unregistered indications, with product instruction violation or in the presence of contraindications including age restrictions. The sources of information about medicines were the leaflets of manufacturers of medicines and the State Register of Medicines. It is well known that Botulinum toxin type A is a good therapeutic option for treating children with cerebral palsy. Increased efficacy of regularly repeated cycles with Onabotulinumtoxin A in medication-overuse headache patients beyond the first year of treatment. Botulinum toxin type A is effective in the management of sialorrhea. Botulinum toxin type A is a safe and effective treatment for primary axillary hyperhidrosis and produces high levels of patient satisfaction. Facing depression with botulinum toxin: positive effects on mood have been observed in subjects who underwent treatment of glabellar frown lines with botulinum toxin and, in an open case series, depression remitted or improved after such a treatment. Botox injection significantly improved foot dystonia, pain and lower limb functional outcomes in patients with Parkinson’s disease with deep brain stimulation. The paper describes the problems associated with the lack of clinical data about the possibility of using botulinum toxin type A in different conditions, emphasizes the need to organize clinical trials and educational programs for neurologists as well as more active implementation of protocols for the treatment of patients.

The paper describes a clinical case of the rare status epilepticus syndrome FIRES (febrile infection responsive encephalopathy) + NORSE (new-onset refractory status epilepticus). The difficulty of diagnosing this condition is due to the fact that it occurs extremely rarely and the laboratory and instrumental findings are nonspecific. The disease is characterized by acute onset, fever, and subsequent development of status epilepticus, cognitive impairment, and pharmacotherapy-resistant epilepsy. The paper describes a 19-year-old male patient who was observed to have a favorable course of FIRES + NORSE syndrome without pharmacotherapy-resistant epilepsy, motor deficiency, and with the preservation of self-care skills.

The data on the etiology and pathogenesis of cerebellar cognitive affective syndrome (CCAS) as well as clinical observations are presented in the paper. Schmahmann J.D. and Sherman J.C. described the spectrum of behavioral and cognitive disorders, which are the results of cerebellum stroke and are called CCAS. This syndrome includes disturbances of executive functions and is characterized by perseverations, absent-mindedness or disatractibility, visual-spatial disorders, speech production difficulties and personality changes. The authors considered the historical description of this syndrome, its etiology, pathogenesis and presented their own clinical observation of CCAS in a 70-year-old woman.

Currently, there are a limited number of treatments for ischemic stroke. Intravenous thrombolytic therapy is the most effective method. However, its efficacy is very low in the case of stroke caused by occlusion of large intracranial arteries. Previous studies of endovascular recanalization techniques in the treatment of stroke, particularly randomized controlled trials (RCTs), such as IMS-3, SYNTHESIS Expansion, and MR RESCUE, have shown negative results. The results of other RCTs (MR CLEAN, ESCAPE, EXTENDIA, SWIFT PRIME, and REVASCAT) published in 2015 demonstrated that, in the case of careful selection of patients with verified occlusion of large intracranial arteries, endovascular recanalization significantly improves stroke outcomes.

To study the compliance of neurologists and headache specialists to chronic headache and chronic migraine (CM) diagnosis and treatment guidelines.The survey included 634 neurologists from all regions of the Russian Federation. Mean age of respondents was 40.7±8.5 years, mean years of experience 14.2±7.8 years.Most doctors work in outpatient or hospital settings (49% and 24%, respectively), 7% were headache specialists. Tension-type headache (TTH) was diagnosed in 30% and CM in 17% of patients while 44% of patients were presumed to have a mixed headache disorder (TTH+CM). Only 10% of physicians do not use instrumental diagnostic methods in chronic headache. This study has shown sufficient attention to comorbid conditions and frequent prescription of headache preventative treatment. Botox prescription data is equivocal: 35% of physicians recommend such treatment, 27% do not, while other doctors prescribe it for off-label indications.To overcome clinical inertia, further education in chronic headaches and their optimal treatment is warranted.Цель исследования. Изучение приверженности практикующих врачей-неврологов и специалистов по головной боли (ГБ) протоколам диагностики и лечения хронической ГБ и хронической мигрени (ХМ). Материал и методы. Опрошены 634 невролога из всех регионов Российской Федерации. Средний возраст участников составил 40,7±8,5 года, средний опыт работы по специальности - 14,2±7,8 года. Результаты. Большинство врачей работали в поликлинике и стационаре (49 и 24% соответственно), в специализированных кабинетах и центрах ГБ - 7%. В 30% случаев диагностируется ГБ напряжения, в 17% - ХМ, в 44% предполагается комбинированная ГБ напряжения и ХМ. Только 10% специалистов не используют диагностические методы для уточнения причин хронической ГБ. Отмечены как достаточное внимание врачей к проблемам коморбидности, так и высокий уровень назначения рекомендованных для профилактического лечения частой ГБ лекарственных препаратов. Результаты анкетирования о рекомендации лечения Ботоксом были оценены как неоднозначные: 35% специалистов рекомендуют данное лечение, 27% - нет, остальные назначают препарат по незарегистрированным показаниям. Заключение. Для преодоления клинической инерции специалистов необходимо дальнейшее распространение знаний о хронических формах ГБ и адекватных методах их лечения.

Mobility recovery is one of the main purposes of physical rehabilitation after acute stroke and in a number of other neurological diseases.To quantify the efficiency of rehabilitation measures in patients after stroke and to compare the effectiveness of motor function restoration in patients in the acute phase of stroke and in the early recovery period.Examinations were made in 116 patients aged 27 to 88 years who had experienced a stroke (75% of ischemic stroke cases) and been admitted to the Department of Medical Rehabilitation. A control group consisted of 111 sex- and age-matched patients who had suffered a stroke (86% of ischemic stroke cases) and been admitted to the Department of Neurology for patients with acute cerebrovascular accident. The methods of working with patients included a clinical interview and an evaluation of complaints and history data, as well as a classic neurological examination using quantitative scales to assess symptoms, degree of disability and mobility.The cycle of rehabilitation measures provided the following quantitative recovery indicators: the strength scale showed recovery indicators (from 0 to 5 scores) by an average of 1 score in both groups; Ashworth's scale scores for spasticity improved by an average of 1 in the Department of Rehabilitation; the average Rankin scale demonstrated 1 score better in both groups; and the Rivermead mobility index improved by an average of 3 scores in the Department of Rehabilitation and by an average of 8 scores in the Department of Neurology for patients with acute cerebrovascular accident.The investigation demonstrated the quantitatively best indicators in patients with acute stroke, in those with more severe motor deficits, and in younger individuals.Обоснование. Восстановление мобильности является одной из основных целей физической реабилитации после перенесенного острого нарушения мозгового кровообращения и при ряде других неврологических заболеваний. Цель исследования - количественно оценить эффективность реабилитационных мероприятий у пациентов, перенесших инсульт, и сравнить результативность восстановления двигательных функций у больных в остром периоде инсульта и в раннем восстановительном периоде. Материал и методы. Обследованы 116 пациентов в возрасте от 27 до 88 лет, перенесших инсульт (ишемический - 75% случаев), госпитализированных в отделение медицинской реабилитации. Контрольную группу составили 111 пациентов, сопоставимых по полу и возрасту, перенесших инсульт (ишемический - 86% случаев), госпитализированных в отделение неврологии для больных с острыми нарушениями мозгового кровообращения. Методы работы с пациентами включали клиническое интервью с оценкой жалоб и анамнеза, а также классический неврологический осмотр с использованием количественных шкал для оценки симптоматики, степени инвалидизации и мобильности. Результаты. Курс реабилитационных мероприятий дал следующие количественные показатели восстановления: по шкале силы (от 0 до 5 баллов) - в среднем на 1 балл в обеих группах, по шкале спастичности Ашворта - в среднем на 1 балл в реабилитационном отделении, по шкале Рэнкина - на 1 балл в обеих группах и по индексу Ривермид - в среднем на 3 балла в реабилитационном отделении и на 8 баллов в отделении неврологии для больных с острыми нарушениями мозгового кровообращения. Заключение. Продемонстрированы количественно лучшие показатели для пациентов в остром периоде, больных с более выраженным моторным дефицитом и для более молодых лиц.

To assess the neurological and cognitive status, identify the frequency of anxiety and depression in patients with lymphoproliferative diseases, and analyze their impact on the quality of life of patients.Fifty-eight patients, including 35 (60.34%) men and 23 (39.66%) women aged from 42 to 86 years, with a diagnosis of chronic lymphocytic leukemia (CLL) or multiple myeloma (MM) were examined. Clinical and anamnestic methods, the Montreal scale of cognitive function assessment, the Hospital Anxiety and Depression Scale (HADS), the Functional Assessment of Cancer Therapy-General (FACT-G) were administered.Cognitive impairment was observed in 44 (75.86%) patients. Thirty-two (56.14%) patients had no symptoms of depression, clinically diagnosed depression was observed only in 8 (14.04%). In 37 (64.91%) patients, there were no symptoms of anxiety, clinically diagnosed anxiety was revealed in 6 (10.53%). The average score on the FACT-G scale for quality of life was 62.72±23.29 with a maximum score of 108.Cognitive impairment was observed in a large number of patients. Symptoms of depression were found in less than half of the patients, and manifestations of anxiety were found in one third. The presence of affective disorders, such as anxiety and depression, reduced quality of life evaluated in all its modules.Цель исследования. Оценка неврологического и когнитивного статуса, частоты тревоги и депрессии у пациентов с лимфопролиферативными заболеваниями, а также анализ их влияния на качество жизни пациентов. Материал и методы. Обследованы 58 пациентов, из них 35 (60,34%) мужчин и 23 (39,66%) женщины в возрасте от 42 до 86 лет с диагнозами 'хронический лимфолейкоз' и 'множественная миелома'. Использованы клинико-анамнестический метод, Монреальская шкала оценки когнитивных функций, госпитальная шкала тревоги и депрессии, опросник оценки функций онкологического больного FACT-G для оценки качества жизни. Результаты. Когнитивные нарушения отмечены у 44 (75,86%) пациентов. У 32 (56,14%) пациентов отсутствовали симптомы депрессии, клинически выраженную депрессию наблюдали лишь у 8 (14,04%) пациентов. У 37 (64,91%) больных отсутствовали симптомы тревоги, клинически выраженная тревога выявлена у 6 (10,53%) пациентов. Средний балл по шкале FACT-G для оценки качества жизни составил 62,72±23,29 при максимальных 108 баллах. Заключение. Когнитивные нарушения отмечены у значительной части пациентов. Симптомы депрессии обнаружены менее чем у половины пациентов, а проявления тревоги различной выраженности - у трети больных. Наличие у пациентов аффективных нарушений, таких как тревога и депрессия, снижало качество жизни при оценке всех ее модулей.

Delirium is a common of stroke complication that aggravates the patient’s prognosis. The aim of this study was to identify the groups that are at risk of developing delirium among elderly patients with acute stroke and assess the diagnostic value of the 4-A test in identifying delirium in this category of patients. In total, 73 patients were included in the study; 33 of them (45%) had the symptoms of delirium, according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Delirious patients had more severe neurological deficit and more prominent chronic changes in the brain on CT images; they also had more frequently positive primitive reflexes and a higher erythrocyte sedimentation rate. All six patients with pneumonia were delirious. The Russian version of the 4-A test demonstrated good psychometric properties. Thus, the risk of developing delirium in elderly patients in the acute period of stroke is increased in cases of severe strokes, in the presence of chronic changes in the brain according to CT and clinical examination, and inflammatory complications. The targeted screening of patients with the indicated risk factors using tools such as 4-AT will allow delirium to be identified more efficiently and quickly in its early stages in elderly patients with acute stroke.

The authors present a case-report of a 22-year-old man with Kleine-Levin syndrome (KLS) and consider the historical description of the syndrome, its symptoms, diagnostic criteria, its place in modern classifications of sleep disorders and KLS pathogenesis. Own data on the frequency of different sleep disorders in inpatients of a neurological unit are presented.Представлено клиническое наблюдение синдрома Кляйне-Левина у больного 22 лет, изложение истории описания синдрома, его проявлений, критериев диагностики, места в современных классификациях расстройств сна и представлений о патогенезе расстройства. Приведены также собственные данные авторов о частоте разных нарушений сна у больных одного из стационаров неврологического профиля.

Polyneuropathy in patients with diabetes mellitus is manifested by a lesion of peripheral sensory, motor and autonomic nervous system. Different severity of damage of sensory, motor and autonomic fibers in typical and atypical forms of diabetic polyneuropathy, requires a differentiated approach to therapy, but not the rejection of its implementation. In an interdisciplinary consensus, consultations are held with physicians from different regions of the Russian Federation, and modern methods of diagnosing and assessing the severity of diabetic polyneuropathies, which determine the algorithm for treating patients, are discussed.Полинейропатии у больных сахарным диабетом проявляются поражением периферической сенсомоторной и вегетативной нервной системы. Различная степень тяжести поражения сенсомоторных и вегетативных волокон при типичных и атипичных формах диабетических полинейропатий (ДПН) требует дифференцированного подхода к терапии, но не отказа от ее проведения. В междисциплинарном консенсусе ведущих специалистов по ДПН из разных регионов РФ обсуждаются современные методы диагностики и оценки степени тяжести ДПН, определяющие алгоритм лечения больных.

Early mobilization is an important prerequisite for the successful recovery after stroke. However, it is unclear at present how early mobilization should be started after stroke. Three randomized controlled trials were devoted to the comparison of the effectiveness and safety of very early (within the first day after stroke) and early (within two days after stroke) mobilization. The meta-analysis of the results of these studies did not reveal any advantages of very early mobilization over early mobilization. One randomized control study was designed to compare the consequences of mobilization within 3 and 7 days after stroke. It has demonstrated that earlier mobilization is associated with fewer complications and does not exert negative effect on cerebral haemodynamics. A number of observational studies confirmed the positive effect of early mobilization on the outcome of stroke. It is concluded that it may be justified to start mobilization on the second day after stroke provided there are no contraindications to such modality. The practicability of very early mobilization remains to be elucidated.Early mobilization is an important prerequisite for the successful recovery after stroke. However, it is unclear at present how early mobilization should be started after stroke. Three randomized controlled trials were devoted to the comparison of the effectiveness and safety of very early (within the first day after stroke) and early (within two days after stroke) mobilization. The meta-analysis of the results of these studies did not reveal any advantages of very early mobilization over early mobilization. One randomized control study was designed to compare the consequences of mobilization within 3 and 7 days after stroke. It has demonstrated that earlier mobilization is associated with fewer complications and does not exert negative effect on cerebral haemodynamics. A number of observational studies confirmed the positive effect of early mobilization on the outcome of stroke. It is concluded that it may be justified to start mobilization on the second day after stroke provided there are no contraindications to such modality. The practicability of very early mobilization remains to be elucidated.

Objective. To assess the frequency of main symptoms of posttraumatic stress disorder (PTSD) in post stroke patients. Material and methods. Forty-eight patients took part in the study. We used the Impact of Events Scale (IES) and other scales to assess the severity of posttraumatic stress. Results and conclusion. Thirty three percent of patients experienced posttraumatic stress, 12.5% suffered from PTSD. We found an association between the severity of posttraumatic stress after stroke and the level of anxiety, sleep disturbances and decrease of quality of life. Symptoms of posttraumatic stress are often observed after stroke, this needs to be taken into account during planning of rehabilitation programs.Цель исследования - изучение частоты основных симптомов посттравматического стрессового расстройства (ПТСР) у больных с церебральным инсультом. Материал и методы. Обследовали 48 больных. Для определения выраженности ПТСР использовалась шкала оценки влияния травматического события (ШОВТС) и ряд других шкал. Результаты и обсуждение. Симптомы ПТСР были отмечены у 33% больных, из них у 12,5% было диагностировано ПТСР. Выявлена связь между выраженностью стресса после инсульта и уровнем тревоги, нарушениями сна и снижением качества жизни. Состояние стресса после церебрального инсульта необходимо принимать во внимание при планировании реабилитационных мероприятий.

Migraine is the third most common disease in the world. The overall prevalence of migraine in the Russian Federation is estimated at 20% with an estimated global prevalence of 14.7%. Migraine affects mostly people of working age and has a significant negative impact on the quality of life, the level of adaptation, ability to work, social functioning. Migraine represents a significant social and economic burden for patients and society as a whole. A team of national experts on migraine offers a program to prioritize quality of management of patients with headache.Мигрень является третьим по распространенности заболеванием в мире. Общая распространенность мигрени в Российской Федерации составляет 20%, а глобальная распространенность - 14,7%. Заболевание поражает в основном лиц трудоспособного возраста, оказывает существенное негативное влияние на качество жизни, уровень адаптации, трудоспособность, социальное функционирование больных и является значительным социальным и экономическим бременем для пациентов и общества в целом. В статье представлена программа российских экспертов по вопросам мигрени по приоритизации качества ведения пациентов с головной болью.

Psychiatric disorders often develop after subarachnoid hemorrhage (SAH); the most frequent of them are depression and depression-related disorders (anxiety, apathy, pathological fatigue, posttraumatic stress disorder, etc.). Both biological and psychological mechanisms may underlie the development of these disorders. Depression and depression-related disorders decrease patients' quality of life and prevent the full recovery after SAH. Identification and correction of these disorders should take a prominent place in the rehabilitation of post-SAH patients. More research is needed in this area.Психические расстройства нередко развиваются у пациентов, перенесших субарахноидальное кровоизлияние (САК). Наиболее распространенные из них - депрессия и парадепрессивные расстройства (тревожное расстройство, апатия, патологическая усталость, посттравматическое стрессовое расстройство и др.), в основе которых задействованы как психологические, так и биологические механизмы. Депрессия и парадепрессивные расстройства снижают качество жизни пациентов и препятствуют полноценному восстановлению после САК. Выявление и коррекция депрессии и парадепрессивных расстройств должны занимать важное место в реабилитации пациентов после САК. Необходимы дальнейшие исследования в этой области.

We studied free radical oxidation in the brain and blood serum from experimental animals exposed to chronic stress and receiving psychotropic drugs (phenazepam, Atarax, Fluanxol, and valerian). Chronic stress was accompanied by activation of free radical oxidation, which could be modulated by psychotropic drugs.

In the Republic of Bashkortostan computer data bank on myotonia dystrophica (MD) was created where information on all diagnosed patients and members of their families was entered. For the first time in the republic qualitative molecular genetic RNA-diagnosis of MD started, with the help of which one phenotypically healthy mutation carrier is revealed. Clinical genetic characteristic of MD in Bashkortostan and main subpopulation of the republic is presented. Besides neuromuscular symptoms cerebral and extraneural symptoms are analyzed.