[Efficiency of erenumab in neurologist's real practice]. / Rezul'taty otsenki effektivnosti erenumaba v ambulatornoi praktike nevrologa.

OBJECTIVE: To assess the effectiveness and safety of erenumab in real-life study. MATERIAL AND METHODS: 33 patients with episodic and chronic migraine (30 females, mean age 39.2±9.2, 3 males, mean age - 49.3±7.6) received erenumab 70 mg for each 3 months. Patients achieved a 50% reduction in the number of days with headache, pain intensity, duration, the number of days of acute medication use, effect on daily activity (HIT-6), side effects, neuropsychological testing (Beck Depression scale, Spielberger-Khanin questionnaire, Hospital Depression and Anxiety Scale) were assessed. RESULTS: During the first month of therapy, a 50% decrease in headache days was observed in 48% of patients, during the second - in 53% of patients, during the third - in 51.5% of patients (p<0.001), a reduce in pain intensity, HIT-6 score, duration of migraine attack was observed (p<0.005). A decrease in situational anxiety was revealed (Spielberger-Khanin questionnaire, p=0.02), but not depression. There was a decrease in the consumption of triptans (p<0.0005) and other analgesics (p=0.0018). 1 patient noted transient constipation. CONCLUSION: The effectiveness and safety of erenumab in the outpatient practice is shown.

[Impact of antihypertensive therapy on clinical status and quality of life in patients with initial manifestations of hypertensive encephalopathy].

AIM: To study the clinical and instrumental characteristics of hypertensive encephalopathy (HE) in early stages, as well as the time course of their changes during long-term antihypertensive therapy (AHT). SUBJECTS AND METHODS: Prior to and after 9-month AHT, 57 patients aged 50-70 years who had uncomplicated grades 1-2 arterial hypertension (AH) with grades I-II HE underwent comprehensive examination comprising the studies of cognitive functions, quality of life (QL), hemorheology, and hemostasis, duplex scanning of great and intracerebral vessels, echocardiography, 24-hour blood pressure monitoring, magnetic resonance imaging. RESULTS: Early-stage HE was characterized by more cerebral complaints, higher rates of hypertensive crises, a greater degree of psychoautonomic syndrome, and worse QL. Focal brain lesions were detected in 74%; left ventricular hypertrophy (LVH) was diagnosed in 61% of cases. All the patients were observed to have cognitive dysfunctions. AHT (amlodipine, lisinopril) produced a good antihypertensive effect and substantial improvements of the patients' cognitive functions, health status, and QL. LVH regression was achieved. CONCLUSION: HE is a clinical manifestation of damage to the brain as the principal target organ in AH and should be therefore kept in mind in estimating the cardiovascular risk. The diagnosis of HE requires the use of tests to evaluate cognitive functions.

[Acute disorders of cerebral circulation: prognostic factors in essential hypertension].

AIM: To study subclinical signs of cerebrovascular pathology as prognostic factors of development of acute disorders of cerebral circulation (ADCC) in essential hypertension (EH). MATERIAL AND METHODS: A prospective (10-13 years) cohort trial of prognostic significance of subclinical forms of cerebral pathology in EH in relation to ADCC development covered 111 men aged 45-55 years who had undergone a unified neurological and cardiological examination in 1992-1993. RESULTS: Such factors as disordered circulation along major arteries of the head (a relative risk 3.1 [1.2; 10.3]), thick intima-media complex of the common carotid artery (a relative risk: 5.2 [2.1; 14.3]), the presence of asymptomatic lacunar brain infarctions (a relative risk: 6.6 [2.3; 13.5]) were revealed to be of unfavourable prognostic significance in respect to development of ADCC in EH. CONCLUSION: Some subclinical risk factors may have prognostic value in relation to development of ADCC in EH.

[Epidemiology, clinical features and betaserc therapy of vertigo in initial and reversible cerebrovascular pathology].

The study comprised two sections: epidemiologic and clinical. The aim of the epidemiologic investigation was to determine prevalence of vertigo, including its mild cases, in patients with initial and reversible forms of cerebrovascular pathology. While screening an open population, 726 men and women aged 35-60 years have been examined using uniform program. Vertigo was detected in 30%, frequent and long-lasting one in 14.6% cases (8.1% men and 21.9% women, p < 0.001). A clinical section included a profound examination of 40 patients. Along with duplex scanning of major brain arteries, neurologic and otoneurologic examination of the patients, aucoustic stem evoked potentials have been registered. Marked dysfunctions of autonomic nervous system and changes in functioning of different vestibular analyzer regions were revealed. High efficacy of betaserk used during 2 months in dosage 16 mg three times a day was demonstrated by improvement of the patient's state in 97% cases.