[Modern ideas about the relationship between fibromyalgia and mental disorders]. / Sovremennye predstavleniya o sootnoshenii fibromialgii i psikhicheskikh rasstroistv.

Fibromyalgia (FM) is a pain syndrome with a high burden and an understudied etiology and pathogenesis. There is now considerable evidence that FM has a strong bidirectional relationship with psychiatric disorders and is associated with certain personality traits that contribute to the severity of key somatic symptoms and affect overall prognosis. In this article, the authors present data from recent epidemiological and neurobiological studies, discuss the multilevel relationship between FM and psychiatric disorders, and briefly review approaches to the treatment of co-morbid conditions.

[Ocular myasthenia gravis]. / Miasteniya, glaznaya forma.

The article describes an urgent medical and social problem - the diagnosis and treatment of the ocular myasthenia gravis. Despite recent advances in the study of synaptic pathology, the diagnosis of the ocular form of myasthenia gravis remains a challenging problem. This is due to the poor information content of laboratory and electromyographic methods in the diagnosis of ocular myasthenia gravis, and the generalized myasthenia gravis manifests in 90% of cases by external ophthalmoplegia and ptosis. The article highlights the features of the diagnosis and differential diagnosis of ocular myasthenia gravis. Data on the course and features of the clinical presentation of the disease are presented. The importance of analyzing anamnestic data and clinical manifestations of the disease is emphasized. The article discusses modern approaches to the treatment of the ocular myasthenia gravis. The authors present clinical observations of 2 patients with ocular myasthenia gravis.

[Transcranial magnetic stimulation in the treatment of depressive disorder in Parkinson's disease]. / Primenenie transkranial'noi magnitnoi stimulyatsii v lechenii depressivnogo rasstroistva pri bolezni Parkinsona.

The prevalence of affective disorders in patients with Parkinson's disease (PD) is significantly higher than in the general population of people of the same age. It is known that the effectiveness of antidepressants in PD with depressive disorder is lower than in patients with primary depression. For depression resistant to standard treatments, other therapeutic strategies are available. Transcranial magnetic stimulation (TMS) is one of the most popular and safe brain stimulation methods that has been successfully used to treat primary depression. The accumulation of experience in the use of TMS has made it possible to expand the application of the method to other diseases, including PD. The article provides literature data on the use of different TMS protocols for the treatment of depressive disorder in patients with PD.

[Neuralgic amyotrophy]. / Nevralgicheskaya amiotrofiya.

A review of the literature covering the issues of etiology, pathogenesis, variety of atypical forms, diagnosis and management of patients with neuralgic amyotrophy is presented.

[Seronegative nonparaneoplastic Lambert-Eaton myasthenic syndrome]. / Seronegativnyi neparaneoplasticheskii miastenicheskii sindrom Lamberta-Itona.

The authors studied two patients with Lambert-Eaton myasthenic syndrome (LEMS) in whom the repeated examination did not find specific of LEMS P/Q type voltage-gates calcium channel autoantibodies. The results of clinical testing and electrophysiological examination showed the typical character of movement disorders with the absence of tendon reflexes and signs of disautonomia as well as a decrease in M-response amplitude and phenomena of decrement with low frequency- and increment with high frequency stimulation. Both patients revealed no signs of paraneoplastic process. Autoimmune character of the damage was confirmed by the effectiveness of treatment with glucocorticoid hormones.

[Decrement pattern of M-response amplitude in the low-frequency repetitive nerve stimulation in the muscles of patients with myasthenia gravis and Lambert-Eaton myasthenic syndrome]. / Dekrement amplitudy M-otveta pri nizkochastotnoi stimulyatsii myshts bol'nykh miasteniei i miastenicheskim sindromom Lamberta­Itona.

AIM: To investigate the pattern of decrement in the muscles of patients with myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS). MATERIAL AND METHODS: Twenty-seven patients with MG and 39 patients with LEMS were studied using low frequency repetitive nerve stimulation (3/ sec). RESULTS AND CONCLUSION: The decrease of safety factor of neuromuscular transmission was equal in both groups. At the same time, a significant difference in the decrease of pattern of the amplitude compound of muscle action potential (CMAP) was found. In LEMS, by contrast with MG, another sequence of amplitude variability of CMAP from the second stimulus to the first and from the fifth stimulus to the fourth was noted. In LEMS patients, progressive decrement, manifesting by increasing ratios of late A9/A1 to early A4/A1 was found, whereas the MG patients showed retrogressive decrement expressed by the reduction in decrement ratio (from late to early). These differences reflect the mechanisms and status of acetylcholine mobilization and release from the axon terminal.

[The role of autonomic dysfunction in pathogenesis of irritable bowel syndrome].

This article presents the results of a comparative study of autonomic disorders in patients with differernt types of irritable bowel syndrome (IBS). We used several clinical and instrumental methods, including the Veyn questionnaire, Kerdo autonomic index, skin sympathetic response and heart rate variability analysis. The results show a prevalence of sympathetic tone in all groups of patients (more pronounced in IBS with constipation), as well as an elevated stress index and decreased arterial baroreflex sensitivity. In the IBS with diarrhea group there was a reliable increase of power spectral density alvery low frequency and a lowered respiratory sinus arrhythmia.