[Neurotrophic therapy in the treatment of a comorbid patient with cerebrovascular pathology and diabetes mellitus]. / Neirotroficheskaya terapiya komorbidnykh bol'nykh s tserebrovaskulyarnoi patologiei i sakharnym diabetom.

OBJECTIVE: To study the use of Cellex in a population of patients aged 45 to 75 years with ischemic stroke and TIA, with a history of type 2 diabetes mellitus (T2DM), with diabetic distal symmetric polyneuropathy. MATERIAL AND METHODS: The study involved 80 patients (men - 52.5%, women - 47.5%) in the rehabilitation period of stroke, including TIA, developed in T2DM. The patients were divided into 2 groups (40 people in each): in the 1st group, patients received Cellex 1.0 ml subcutaneously 1 time per day in addition to routine practice; the 2nd group received only routine practice. Cellex was prescribed in the form of two 10-day treatment courses with a break of 1 month. The range of patients examination during the whole study period (4 visits, 65 days) included an assessment of neurological symptoms (NIHSS, NISLL, DN-4, TSS scales), neurophysiological examination (EMNG), analysis of daily activity (SF-36 questionnaire, the Rivermead Mobility Index, the Modified Rankin Scale), the emotional state assessment on the scale and the effects of therapy on the Clinical Global Impression Scale. RESULTS AND CONCLUSION: The clinical efficacy of the drug was shown in the form of an improvement of clinical parameters and data on EMNG of the lower extremities on the 60th day of the study. Improvement was observed in 17.5% of patients in the 1st group, while in the 2nd group deterioration was observed in 15.0% of patients, as evidenced by the presence of statistically significant differences. The study drug was also shown to be well tolerated and safe. CONCLUSION: The use of the Cellex is effective and safe in patients with T2DM in the recovery period of stroke.

[Efficiency of the application of miorelaxants in lower cross myofascial syndrome]. / Effektivnost' primeneniya miorelaksantov pri nizhnem perekrestnom sindrome.

OBJECTIVE: To evaluate the efficacy of the drug Tolperisone (Calmirex) in patients with inferior cross syndrome against the background of standard therapy. MATERIAL AND METHODS: The study involved male and female patients aged 25-55 years with inferior cross syndrome. The main research method was clinical, which was supplemented by biomechanical examination and the use of scales and questionnaires (VAS, Oswestry, McGill). RESULTS AND CONCLUSION: The effectiveness of the use of muscle relaxants in the treatment of the lower cross syndrome has been studied and proved with the identification of the most reliable and effective methods for correcting this pathology. The effectiveness of the use of muscle relaxants in the treatment of lower cross syndrome was studied, with the identification of the most reliable and effective methods for correcting this pathology. The presented clinical study of biomechanical and statodynamic disorders of the musculoskeletal system in myofascial pain syndromes, taking into account the peculiarities of the lesion of the sanogenetic and pathogenetic region, will be useful in prescribing personalized treatment not only for neurologists, but also for primary care physicians, chiropractors, osteopaths, rheumatologists and rehabilitologists.

[New treatment options for piriformis syndrome]. / Novye vozmozhnosti terapii sindroma grushevidnoi myshtsy.

This paper discusses modern approaches to the diagnosis and management of patients with piriformis syndrome. Epidemiological data on the prevalence of this syndrome in neurological practice are presented. The anatomical features of this region, leading to the formation of piriformis syndrome, are described in detail. The authors provide diagnostic criteria based on neurological examination and manual muscle testing and discuss the differential diagnosis of piriformis syndrome. New possibilities of treating this syndrome using a fixed combination of diclofenac and orphenadrine registered in the Russian Federation as a drug for intravenous infusion neodolpasse are discussed in detail. The authors cite materials from their own work, a clinical case of managing a patient with piriformis syndrome using neodolpasse is analyzed.

[Possi bilities of kinesiotaping in neurological patients]. / Vozmozhnosti primeneniya kinezioteipirovaniya u patsientov nevrologicheskogo profilya.

The review provides scientific data on modern aspects of using the kinesiotaping method in neurological patients. Possible clinical taping methods for myofascial pain and post-traumatic disorders of the musculoskeletal system are considered. The important role in the correction of biomechanical disorders and the rehabilitation potential of the taping method in the treatment and prevention of musculoskeletal pathology has been demonstrated. Experimental and clinical studies of Russian and foreign scientists are presented, indicating the promise of therapeutic and preventive possibilities of kinesiotaping. Conclusions are made about the advisability of using kinesiotaping in an interdisciplinary approach in the treatment of patients with neurological disorders.

[Effects of COVID-19 on the central nervous system]. / Porazhenie tsentral'noi nervnoi sistemy pri COVID-19.

This review examines the current data on central nervous system damage in cases of the new coronavirus infection caused by the COVID-19 virus. The pathogenetic mechanisms leading to damage to the brain and spinal cord are considered. The analysis of available research articles and meta-analyzes published up to fall 2020 is carried out. The authors provide the results of their own clinical observations of various forms of damage to the central nervous system in cases of COVID-19 virus disease. Particular attention is paid to certain common forms of damage to the central nervous system, such as encephalitis, cerebrovascular pathology, and headaches. A form of acute hemorrhagic necrotizing encephalopathy is distinguished, which is a rather rare but fatal pathology, comorbid with the COVID-19 virus. The data of our own clinical case of acute necrotizing encephalopathy are presented. The importance of further studying the effect of coronavirus on the central nervous system and possible mechanisms of therapy and rehabilitation for this category of patients is emphasized.

Central Nervous System Lesions in COVID-19.

This review discusses current data on CNS lesions in infections with the new coronavirus that causes COVID-19. The pathogenetic mechanisms leading to infection of the brain and spinal cord are presented. Published studies and meta-analyses published by autumn 2020 are assessed. The authors present results from their own clinical observations of various types of CNS infection in COVID-19 virus disease. Particular attention is paid to certain common forms of CNS lesion such as encephalitis, cerebrovascular pathology, and headache. A form of acute hemorrhagic necrotic encephalopathy is identified, which is a quite rare but fatal pathology comorbid with COVID-19. A description of our own clinical observation of acute necrotic encephalopathy is presented. The importance of further studies of the effects of the coronavirus on the CNS and possible approaches to treatment and rehabilitation of this category of patients is emphasized.

[The use of myorelaxants in the treatment of chronic non-specific pelvic pain]. / Primenenie miorelaksantov v lechenii khronicheskoi nespetsificheskoi tazovoi boli.

Chronic nonspecific pelvic pain is one of the most pressing problems of modern neurology, due to complex interdisciplinary diagnostic and therapeutic studies. The etiology and pathophysiology of pain syndromes are studied from the point of view of each individual medical specialty, but do not consider the relationship and interaction of pathogenetic factors. In many areas, clinical guidelines for the treatment of chronic pelvic pain have been developed, but without taking into account the multidisciplinary approach to this polyetiological disease. OBJECTIVE: To evaluate the efficacy of tolperisone (calmirex) in patients with chronic nonspecific pelvic pain receiving standard therapy. MATERIAL AND METHODS: In the course of clinical work, 61 patients with chronic nonspecific pelvic pain were observed. To identify the dynamics of the study, all patients were assessed for the severity of pain using a visually analogue scale (VAS), the area of pain, muscle-tonic reactions estimated by the index of muscle tension according to Khabirov. Deviations of the biomechanical parameters of the pelvic region and restoration of the musculoskeletal system statics were evaluated. According to the study protocol, the efficacy of tolperisone (calmirex) was studied in patients receiving standard therapy. RESULTS AND CONCLUSION: Myofascial and muscle-tonic reactions play a significant role in the development and maintenance of chronic nonspecific pelvic pain. At the same time, tolperisone (calmirex) together with standard therapy of chronic nonspecific pelvic pain contributes to an effective regression of pain of myofascial and muscular-tonic origin, and creates a favorable restorative background for non-drug treatment.

[Lo-back pain and compression-ischemic neuropathies: strategies for diagnosis, therapy and rehabilitation]. / Bol' v spine i kompressionno-ishemicheskie neiropatii: strategii diagnostiki, terapii i reabilitatsii.

The article discusses such a common pathology as pain syndrome in the lower back and limbs. A variety of etiological causes, anatomical features leading to the formation of this persistent algic disorder lead to therapeutic failures in clinical practice. The authors consider in detail the most common types of compression-ischemic neuropathy accompanying back pain, suggest diagnostic algorithms and practical recommendations. Results of foreign, Russian and own research are presented.

[Correction of psychoemotional and autonomic dysfunction in patients with ischemic stroke].

Investigation of 106 patients in the early recovery period of ischemic stroke is conducted. Autonomic nervous system dysfunction and the psychoemotional disturbances are revealed. Efficacy of mexiprim in the correction of the revealed psychoautonomic problems in patients with ischemic stroke is shown.

[Gender characteristics of the pharmacological treatment in patients with back pain].

The authors present results of own studies and a review of current Russian and foreign publications devoted to gender characteristics of back pain. It is concluded that gender differences should be taken into account when planning treatment for patients with dorsalgia.