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Aim. To describe best practices in using human normal immunoglobulin in patients with immune-mediated neurological disorders according to the data of one clinical center.Materials and methods. From 2016 to 2021, 20 patients with various autoimmune disorders of the peripheral and central nervous system were treated with human normal immunoglobulin at the Neurology Unit No.1 of Pavlov First Saint Petersburg State Medical University. Treatment efficacy was assessed by changes in the neurological examination data according to specialized scales for specific diseases or clinical manifestations (INCAT, QMGS, MoCA, EDSS). Safety of the therapy was assessed considering the instructions to the drug.Results. In the vast majority of patients, treatment allowed to stabilize the course of the disease or was accompanied by pronounced regression.Conclusion. The considered clinical cases of the use of human normal immunoglobulin preparations demonstrate the possibility of their use in the treatment of a number of autoimmune neurological diseases for unregistered indications.

Анализируются 200 пациентов с положительными тестами на скрытое левшество и исследованием когнитивных функций с применением авторского скринингового теста. Возраст больных — от 30 до 65 лет (в среднем 41,0 ± 5,3 года), из них мужчин — 116 (58,0 %), женщин — 84 (42,0 %). При использовании стандартного исследования неврологического статуса у них были установлены следующие неврологические коморбидные диагнозы: ишемический мозговой инсульт — у 22 больных (11,0 %), дискогенно-венозная люмбосакральная радикуломиелоишемия — у 74 (37,0 %), рассеянный склероз — у 16 (8,0 %), вегетососудистая дистония с гипоталамическими пароксизмами — у 74 (37,0 %), паркинсонизм — у 14 (7,0 %). Исследование тестов на скрытое левшество и состояние когнитивных функций в дополнение к стандартному изучению неврологического статуса значительно расширяет круг диагностических возможностей. Терапевтические и нейрореабилитационные мероприятия должны проводиться с учетом клинических симптомов и признаков всех коморбидных патологий и соблюдением правил хорошей клинической практики.

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.

The article discusses the prospects of role-playing games in the educational process to increase students’ motivation and involvement, as well as the possibility of modern information technologies (primarily social networks) for constructing innovative forms of such games. The author’s format of the live-action role-playing game is presented. It was developed and tested at the Saratov State University. It involves the integration of numerous educational tasks into a single plot, within which each participant plays a role and communicates with other participants to complete tasks. The main interaction, plot development and group activities occur in dialogs, conversations and groups of social networks. This approach has shown its viability in teaching legal disciplines, and also has prospects for use in IT education.

Comparison of common buckwheat varieties with determinate vs. indeterminate growth habit reveals no differences in leaf photosynthesis rate at stage before flowering. However, at stage of seed filling the difference was significant. Maximal difference was 20 days after early flowering, i.e in period of most intensive seed formation. These results show that determinate varieties have higher sink strength providing by developing seeds. It is correlated with higher yield ability of such varieties. Probably, growth limitation resulting from det-mutation leads to some shifts in system of sink priorities of buckwheat plant and allows initiate the development of additional seeds. One more possible cause of alteration of the physiological parameters in determinate varieties is some optimization of plant structure: in terms of physiology the determinate buckwheat is a plant which is more similar to cereals than indeterminate buckwheat. However, underlying physiological changes accompanying the transition from indeterminate toward determinate growth in buckwheat remain almost unknown. Assumption about strong effect of det-mutation per se on photosynthesis rate was not supported in our work. Alternative assumption about accumulation of additional genes enhancing the sink ability suggests opportunities for additional progress in the selection work using tools evaluating photosynthesis intensity at stage of grain filling.

The results of a comprehensive cooperation between BKO JSC, EVRAZ ZSMK JSC and Paul Wurth in the field of design, development and supply of a range of refractory materials intended for use in air heaters under construction are presented. The main development trends aimed at improving the technology and optimizing the parameters of the physicochemical characteristics of refractory materials are indicated. The main aspects of interaction between companies related to the implementation of the project of reconstruction of air heaters in the conditions of EVRAZ ZSMK JSC, the production and supply of innovative refractories, improvement of technical and economic performance indicators of air heaters and an increase in the resource for their operation are considered. Ill. 6. Ref. 3. Tab. 6.

We describe the characteristic features of the steel smelting process in the 160-metric-ton converters at EVRAZ Consolidated West Siberian Metallurgical Plant JSC for the case where 10–50% of the solid metal charge consists of ferrous converter-slag waste products. Information on the chemical composition of the slag materials and the metal and slag components of the slag/scrap mixture was combined with the scrap consumption rate to quantitatively estimate the change in fundamental process statistics. The parameters of the traditional oxygen-injection process for the 160-metric-ton converters were compared against those for the technology to be discussed in this paper. Both the decrease in the concentration of non-ferrous-metal impurities and the required impurity removal levels at the exit from the converter are specified. The oxidative metal refining production data for the 160-metric ton converters at EVRAZ Consolidated West Siberian Metallurgical Plant JSC and the cost reductions from slag/metal scrap usage indicate that the process is economically promising.

Introduction. Nowadays an acute cerebrovascular accident and its consequences have become an important public health issue. One of the most common and severe complications of the stroke is periarthropathy of the shoulder joint, known as «frozen shoulder». According to different sources of information, the frequency of occurrence of this pathology ranges from 40 to 80 %. By now, no single concept of treatment of post-stroke periarthropathy of the shoulder joint has been developed.Goal of research — to study the effectiveness and safety of osteopathic correction in complex therapy of pain syndrome in post-stroke periarthropathy.Materials and methods. Patients undergoing treatment in the hospitals were randomly divided into 3 groups. In the fi rst group, the osteopathic treatment was performed in addition to the basic treatment. А periarticular blockade was additionally used in the second group. In the third group, traditional basic treatment was performed. The severity of the pain syndrome was assessed with the help of the visual analogue scale (VAS). The ability of movement in the shoulder joint and daily activity was controlled by a simple shoulder test (SST). The complex state of the shoulder joint was assessed according to the Swanson scale, which included both the patient′s subjective assessment and the medical examination data.Results. The data obtained in the course of the study indicated that the additional use of medical diagnostic blockades provided a signifi cantly more important reduction in the intensity of pain syndrome, in comparison with the control group. This is of particular importance for patients with severe pain syndrome. At the same time, in the fi rst group, additional osteopathic treatment contributed to a more rapid and pronounced restoration of the functions of the affected limb with less regression of the pain syndrome.Conclusion. Thus, the additional use of therapeutic blockade and osteopathic techniques should be differentiated and determined by the clinical performance of post-stroke periarthropathy of the shoulder joint.

Objectives. To study the parameters of vestibular evoked myogenic potentials in patients with various types of vertigo. Materials and methods. A total 77 patients (35 men, 42 women) aged 43.7 ± 12.5 years with vestibular vertigo and postural instability were studied. Surface electrode myography was used to record the activity of the sternocleidomastoid muscle arising in response to sound stimulation of the ipsilateral ear. Results and discussion. As compared with controls, patients with signs of impairment to the central compartment of the vestibular analyzer showed a tendency to an increase in the latent period of the N2 wave and a significant reduction in the amplitude of the P1–N2 complex on both sides (p < 0.005), without any significant change in the coefficient of asymmetry. Patients with signs of damage to the peripheral compartment of the vestibular analyzer showed signifi cant increases in the latent period of P1 as compared with healthy subjects (p < 0.005). In addition, there was a statistically signifi cant (p = 0.0007) increase in the coefficient of asymmetry of latent period P1. Patients with postural instability showed no significant differences in P2 and N2 latencies as compared with controls. Conclusions. The study results showed that patients with vertigo of both peripheral and central genesis have impairments to the formation of the vestibulospinal reflex at different levels of the vestibular analyzer.

Перспективным в изучении биомаркеров мигрени может быть многолокусный анализ, в частности, анализ частот сочетанных генотипов. Цель исследования - поиск составных генетических биомаркеров индивидуальной предрасположенности к мигрени, полученных на основе полиморфизмов генов, уже показавших статистическую значимость при однолокусном ассоциативном анализе. Методика. Обследовано 155 пациентов с мигренью (104 пациента с эпизодической мигренью, 51 - с хронической мигренью), наблюдавшихся в Университетской клинике головной боли (Москва). Все пациенты - представители белой расы, жители Московского региона. Возраст пациентов - 30-50 лет. Контроль составили 365 необследованных лиц (популяционный контроль). Выявление исследуемых 22 генов (всего 31 SNP) осуществляли методом ПЦР, ПЦР-ПДРФ, аллель-специфичной ПЦР и ПЦР в реальном времени. Выявление ассоциированных с мигренью сочетанных генотипов проводили с использованием программы анализа полигенных данных APSampler v3.6. Результаты. Выявлено 8 сочетанных генотипов с высокой статистически значимой ассоциацией с мигренью (ОШ>20,0). В состав сочетанных генотипов вошли гены: CCKAR, CCKBR, COMT, MTHFR, MTR, MTRR. Так же выявлено 4 защитных сочетанных генотипа (ОШMultilocus analysis, specifically, analysis of combined genotype frequencies may be promising in studying migraine biomarkers. The aim of the study was to search for composite genetic biomarkers, which would predict individual predisposition to migraine, obtained on the basis of gene polymorphisms that have already shown a statistical significance in a single-locus associative analysis. Methods. 155 patients with migraine aging 41.7 ± 12.5 who had been followed up at the University Clinic of Headache, Moscow, were evaluated (104 patients with episodic migraine and 51 with chronic migraine). All patients were white and residents of the Moscow region. The control group included 365 unexamined individuals (population control). Identification of The 22 genes under study (total, 31 SNPs) were identified by PCR, PCR-RFLP, allele-specific PCR, and real-time PCR. Combined genotypes associated with migraine were identified using the APSampler v3.6 software for polygenic data analysis. Results. Eight combined genotypes were identified with a highly significant association with migraine (OR> 20.0). The combined genotypes included the CCKAR, CCKBR, COMT, MTHFR, MTR, and MTRR genes. Four protective combined genotypes were also identified (OS

In this paper, we consider a problem-solving technique of the texture changing of an object in a photograph. The task in hand is relevant in the field of intelligent image processing and has a number of practical applications. The solutions to this problem have been proposed in a number of works devoted to the neural network style transfer approach, but they have a number of limitations. Examples of the limitations are as follows: the texture transfer selectivity absence (the image is changed entirely), the target texture distortion with the heterogeneity of the original one, the initial illumination distortion of the object, and the absence of the photographic realism of the resulting image. To solve the problems mentioned above, in this paper we propose a sequential image processing with the use of several neural networks types: segmental, stylizing and generative-adversarial (GAN) ones. The reliable transfer problem of an object illumination is proposed to be solved by the joint work of GAN and methods that do not use the neural network approach. In the context of this paper we developed an algorithm that allows solving the texture transferring task with completely or partially elimination of the listed problems of classical methods. Its high quality of work is shown with the maintaining productivity acceptable for common use. Demonstration of the algorithm is performed on the task of a virtual furniture dust covers fitting (sofas, armchairs). In addition to the algorithm itself, this work includes an enumeration of some heuristics and limitations stated during its implementation and application.

We review the role of dopamine in the mechanisms of development of primary headaches, including migraine. Some data are given about the involvement of various types of dopamine receptors in the regulation of cranial blood flow and control of nociceptive transmission in the trigeminal nerve system. We discuss the role of the basal ganglia in the neurobiology of cephalgias. One part of the review is focused on dopaminergic drugs that may be used in the therapy of migraine.

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.

A literature review presented, with a clinical observation of non-Val30Mettransthyretin amyloid cardiomyopathy. Modern diagnostic and management algorithms discussed.

Headache is one of the widespread pain syndromes with polyneurochemical mechanisms. Here, we review the involvement of the cholinergic neurotransmitter system in the pathophysiology of various forms of headaches. Data on the sources of cholinergic and parasympathetic innervations of intracranial structures and distribution of N- and M-cholinoreceptors of various subtypes within the trigeminovascular system and their roles in the acetylcholine (ACh) effects on brain circulation and processing of nociception in headache are reviewed. We present data on the algogenic and anti-nociceptive effects of ACh in the peripheral and central parts of the trigeminal nerve system and its presumably analgesic effects at the supraspinal level of the CNS. We discuss the ACh-dependent mechanisms of the anticephalalgia action of pharmacological and nonpharmacological approaches that are used for the headache treatment and the future perspectives of the use of cholinergic drugs.

This paper presents a study of the impact of the fabrication process parameters on the high-voltage symmetric planar n-MOSFET and p-MOSFET electrical characteristics. The simulation was carried out using Sentaurus TCAD. Based on the simulation and experimental results, the desired fabrication process parameters, which allow achieving the enhanced breakdown voltage, were obtained. Also, the simulation results show the possibility of the future optimization of the MOSFETs structures, but this requires additional experiments and test blocks.

According to rough estimates, at least one third of the population in developed countries suffers, to varying degrees, from certain forms of primary headache, the modern pharmacotherapy of which is not always effective and has a number of limitations. The non-pharmacological treatment of headache can be an alternative to the prescription of pharmacological agents and the only possible assistance option for patients developing drug-resistant cephalalgias. This review describes various methods of electrical neuromodulation that are used for the management of primary headaches. The authors provide information on current stages in implementation of implantable and non-invasive equipment into clinical practice, which makes possible electrical stimulations of peripheral nerves and of the sphenopalatine ganglion, as well as allows transcranial magnetic stimulation. Also the appearance and usage of portable electrical devices available on the world market are described, and mechanisms that can underlie anticephalgic action of neuromodulation therapy are discussed. Special attention is paid to the methods that are applied for electrostimulation of the vagus nerve and occipital nerves.По приблизительным оценкам не менее трети населения развитых стран в разной степени страдает от тех или иных форм первичных головных болей (ГБ), фармакотерапия которых не всегда эффективна и имеет ряд ограничений. Немедикаментозное лечение ГБ может быть альтернативой назначению фармакологических средств и единственно возможным вариантом оказания помощи пациенту при развитии у него лекарственно-резистентной цефалгии. В обзоре рассмотрены различные методы электрической нейромодуляции, использующиеся в терапии первичных ГБ. Приведена информация об этапах внедрения в клиническую практику имплантируемых и неинвазивных устройств, позволяющих осуществлять электростимуляцию периферических нервов и крылонебного узла, а также выполнять транскраниальное магнитное воздействие. Описаны способы применения доступных на мировом рынке портативных электротехнических устройств и обсуждены механизмы антицефалгического действия нейромодулирующей терапии. Особое внимание уделено методам электростимуляции блуждающего и затылочных нервов.

The article presents a comparison of the values of the soil deformability characteristics obtained at different densities of the sand base based on the results of laboratory tests3 and the results of computer modeling, using the software systems "ANSYS" and "Plaxis 3D".It was found that for loose sandy soils, at densities of 1.48 – 1.53 g/cm 3, close to experimental values of the deformation modulus were obtained using a three-dimensional finite-element model of polylinear isotropic hardening "PLAS (Miso)," in the program "ANSYS." For average density bases at ρ = 1.55 – 1.66 g/cm3 minimum differences between experimental and numerical values were obtained using the «Plaxis 3D» complex.

In the increasing climate aridization context, water effective use by plants is important, which is strongly influenced by photosynthesis and plant transpiration. In these processes’ study, buckwheat plants have pronounced variances, manifested in ontogenesis and during the day at the leaves different tiers level, which accordingly affects the water use effectiveness by plants. The water effective use greatest’ values by plants are observed in the pre-dinner hours (from 9:00 a.m. to 11:00 a.m.) during active vegetative growth and mass seed pouring (20 days flowering phase), when photosynthesis processes are active and transpiration is at an average level. As a breeding result, this buckwheat plants property is enhanced, which has a positive effect on seed productivity growth. Modern crop varieties outperform local populations by an average of 19.5% in water use terms during the flowering + 20 days phase, 19.8% in photosynthesis intensity terms, 3.4% in transpiration intensity terms, and 37% in seed productivity terms. At the same time, their resistance to air and soil drought tends to decrease, which negatively affects the stability and photosynthesis, and transpiration, and yield. On this basis, it is not considered appropriate to use the water effective use indicator by plants to assess the breeding material for drought resistance but to recommend it for the only highly productive genotypes’ identification. The promising forms’ selection can be carried out in the field already in the selection’ early stages - the 1st and 2nd years nurseries selection.

The goal of this paper is to review the pharmacological profile of betahistine and evidence for using it in the treatment of common vestibular disorders. Betahistine is a weak agonist for histamine H1 receptors and strong antagonist for histamine H3 receptors. It demonstrates the maximum benefit in different types of peripheral vertigo, especially in Meniere's disease. The best results in decreasing intensity of vertigo, frequency of attacks and stimulation of vestibular compensation were obtained in daily dose 48 mg during 3 months. In benign paroxysmal positional vertigo betahistine is used to treat residual dizziness after successful treatment of otolithiasis and to reduce the severity of vertigo during repositioning maneuvers. In vestibular neuritis betahistine stimulates central compensation during vestibular rehabilitation. A new once-daily drug formulation of modified-release betahistine is non-inferior to traditional and has a comparable safety profile, and could improve patient adherence. The implication of betahistine in the treatment of central vestibular disorders is under-researched. The efficacy of betahistine in increasing of vestibular compensation in post-stroke central vestibular disorders, persistent postural-perceptual dizziness and its role in vestibular migraine need further investigation.Данной работы — обзор современных представлений о фармакологических свойствах бетагистина, его месте в лечении наиболее распространенных вестибулярных заболеваний. Бетагистин является частичным агонистом гистаминовых H1-рецепторов и сильным антагонистом гистаминовых H3-рецепторов. Наибольшая эффективность этого препарата продемонстрирована при лечении периферических вестибулярных расстройств, особенно болезни Меньера. Наилучшие результаты лечения в виде уменьшения интенсивности головокружения, снижения частоты приступов, стимуляции вестибулярной компенсации получены при приеме суточной дозы 48 мг в течение 3 мес. При доброкачественном пароксизмальном позиционном головокружении бетагистин используется для лечения резидуального головокружения после купирования отолитиаза и уменьшения выраженности головокружения при выполнении репозиционных упражнений. При вестибулярном нейроните бетагистин назначается для стимуляции центральной компенсации в процессе вестибулярной реабилитации. Повышению приверженности пациентов лечению может способствовать применение новой лекарственной формы бетагистина модифицированного высвобождения, назначаемого 1 раз в сутки, обладающего не меньшей эффективностью по сравнению с традиционной формой и сходным профилем безопасности. Роль бетагистина в лечении центральных вестибулярных расстройств недостаточно изучена. Способность бетагистина ускорять вестибулярную компенсацию при постинсультных центральных вестибулярных расстройствах, персистирующем постуральном перцептивном головокружении, а также его роль при вестибулярной мигрени должны быть изучены в дальнейших исследованиях.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants (MR) are successfully used to relieve pain, both in monotherapy and in combinations. The use of fixed drug combinations not only greatly facilitates daily clinical practice and increases patient adherence, but due to the potentiation of pharmacological effects, it allows to achieve better treatment results. This paper presents 3 clinical cases of successful inpatient use of a fixed combination of diclofenac 75 mg and orphenadrine 30 mg in the form of an infusion solution (NEODOLPASSE) for relief of acute back musculoskeletal pain syndrome.Нестероидные противовоспалительные препараты и мышечные релаксанты успешно используются при купировании болевого синдрома как в монотерапии, так и в комбинациях. Применение фиксированных комбинаций препаратов не только существенно облегчает повседневную клиническую практику и повышает приверженность пациентов лечению, но за счет потенцирования фармакологических эффектов позволяет добиться лучших результатов лечения. В данной работе представлены 3 клинических случая успешного применения в условиях стационара фиксированной комбинации диклофенака 75 мг и орфенадрина 30 мг в форме раствора для инфузии (Неодолпассе) для купирования скелетно-мышечного острого болевого синдрома в спине.

The work is devoted to the topic of researching the operation of a cooling tower in winter as a result of contact with cold air, when problems of freezing of its head wall arise. A methodic for calculating a cooling tower and an innovative way to improve its efficiency are proposed.

The characteristic features of slag formation and oxidative metal refining in 160-tonne converters of EVRAZ ZSMK JSC using metal slag scrap in the solid metal charge are considered. Technological advantages of the process are established for the reduction of iron oxides from the slag component of the iron-containing product in the processing of waste slags.

Background The non-invasive biomarkers of migraine can help to develop the personalized medication of this disorder. In testing of the antimigraine drugs the capsaicin-induced skin redness with activated TRPV1 receptors in sensory neurons associated with the release of the migraine mediator CGRP has already been widely used. Methods Fourteen migraine patients (mean age 34.6 ± 10.2 years) and 14 healthy volunteers (mean age 29.9 ± 9.7 years) participated in the experiment. A new arrangement of imaging photoplethysmography recently developed by us was used here to discover novel sensitive parameters of dermal blood flow during capsaicin applications in migraine patients. Results Blood pulsation amplitude (BPA) observed as optical-intensity waveform varying synchronously with heartbeat was used for detailed exploration of microcirculatory perfusion induced by capsicum patch application. The BPA signals, once having appeared after certain latent period, were progressively rising until being saturated. Capsaicin-induced high BPA areas were distributed unevenly under the patch, forming “hot spots.” Interestingly the hot spots were much more variable in migraine patients than in the control group. In contrast to BPA, a slow component of waveforms related to the skin redness changed significantly less than BPA highlighting the latter parameter as the potential sensitive biomarker of capsaicin-induced activation of the blood flow. Thus, in migraine patients, there is a non-uniform (both in space and in time) reaction to capsaicin, resulting in highly variable openings of skin capillaries. Conclusion BPA dynamics measured by imaging photoplethysmography could serve as a novel sensitive non-invasive biomarker of migraine-associated changes in microcirculation.

To study the parameters of vestibular evoked myogenic potentials (VEMPs) in different types of vertigo.Seventy-seven patients, 35 men and 42 women, aged 43.7±12.5 years, with vestibular vertigo and unsteadiness were examined. The activity of the stemocleidomastoid muscle in response to auditory stimulation of the ipsilateral ear was recorded using surface electromyography.There were a trend towards the increase in the N2 latency, the significant reduction of the P1-N2 amplitude (p0,005) on both sides and significant changes in the coefficient of asymmetry. Compared to healthy people, the P1 latency and asymmetry in P1 latency were significantly increased in patients with peripheral type of vertigo (p0,005 and р=0,0007, respectively). There were no differences in the P1 latency and N2 in patients with unsteadiness.In patients with peripheral vertigo, central vertigo and unsteadiness, vestibular-spinal reflex was disturbed at different levels of vestibular analyzer.Цель исследования. Изучение параметров вестибулярных миогенных вызванных потенциалов у пациентов с различными типами головокружения. Материал и методы. Обследовали 77 пациентов, 35 мужчин и 42 женщины, в возрасте 43,7±12,5 года с вестибулярным головокружением и постуральной неустойчивостью. С помощью метода поверхностной электромиографии регистрировали активность грудиноключично-сосцевидной мышцы, возникавшую в ответ на звуковую стимуляцию ипсилатерального уха. Результаты и обсуждение. У пациентов с признаками поражения центрального отдела вестибулярного анализатора выявлялась тенденция к увеличению по сравнению с контролем латентного периода N2, а также достоверное снижение амплитуды комплекса P1-N2 с двух сторон (p0,005) без значимых изменений коэффициента асимметрии. У больных с признаками поражения периферического отдела вестибулярного анализатора было выявлено значимое увеличение латентного периода Р1 по сравнению со здоровыми (p0,005). Кроме того, обнаружено статистически значимое (р=0,0007) увеличение коэффициента асимметрии латентного периода Р1. У пациентов с постуральной неустойчивостью достоверных различий латентности P1 и N2 по сравнению с контролем выявлено не было. Заключение. Результаты исследования показали, что у пациентов с головокружением как периферического, так и центрального генеза нарушено формирование вестибулоспинального рефлекса на разных уровнях вестибулярного анализатора.

These recommendations on the diagnosis and treatment of migraine were elaborated by Russian headache experts in accordance with the evidence-based practice. Together with the latest classification, diagnostic principles and criteria of different clinical sub-forms the consensus contains basic data on migraine epidemiology, pathophysiological mechanisms, differential diagnosis and most effective and evidence based approaches to pharmacological and non-pharmacological management of migraine patients.Представленные рекомендации по диагностике и лечению мигрени составлены на основании принципов доказательной медицины. Приведена Международная классификация мигрени последнего пересмотра. Методы диагностики и диагностические критерии ориентированы на различные формы мигрени. Рекомендации даны на основе сведений об эпидемиологии и патофизиологических механизмах мигрени. Охарактеризованы наиболее эффективные лекарственные и немедикаментозные подходы к ведению пациентов с мигренью.