[Palliative care in Parkinson's disease and neurodegenerative diseases]. / Palliativnaya pomoshch' pri bolezni Parkinsona i neirodegenerativnykh zabolevaniyakh.

Palliative care is traditionally associated with cancer and pain relief: however, the range of diseases requiring palliative care is much wider and includes many neurodegenerative diseases (Alzheimer's disease and Parkinson's disease (PD)). Provision of palliative care to patients with PD and other neurodegenerative diseases, such as multisystem atrophy, progressive supranuclear palsy, dementia with Lewy bodies, etc. is «terra incognita¼ for many neurologists who are not acknowledged with palliative medicine as well as for specialists in palliative medicine, who are mainly trained in providing care to patients with oncological profile and do not know the intricacies of managing patients in the late stages of PD and other neurodegenerative diseases. The aim of the article is to systematize modern knowledge in the field of palliative medicine and neurodegenerative diseases.

[The Capgras syndrome].

The Capgras syndrome is one of delusional-like misidentification syndrome in which a person holds a delusion that one or several his/her friends or relatives have been replaced by an identical-looking impostor. As any other delusional disorder, the Capgras syndrome is characterized by stability despite the indisputable arguments against fault views. Initially, this syndrome was considered as a presentation of schizophrenia but later it has been described in brain organic disorders, primarily in elderly patients with dementia.

[Dementia with Lewy bodies].

Current concepts on the clinical presentations, diagnosis and treatment of dementia with Lewy bodies (DLB), that makes up 10% percent of dementia cases, are considered. The nosological status of DLB and the correlation between DLB and Parkinson's disease are reviewed in the historical context. The authors suggest approaches to the formulation of diagnosis and coding of DLB in according to ICD-10. A role of cholinesterase inhibitors, antipsychotic drugs, levodopa, razagiline and other drugs in the treatment of DLB is analyzed.

[Hashimoto's encephalopathy].

Hashimoto's encephalopathy is an autoimmune inflammatory disease of the brain associated with the production of antithyoid antibodies. The case described in this article illustrates the diversity of clinical presentations of the disease that mimic symptoms of some neurological and mental disorders, difficulties of diagnosis and, at the same time, the importance of the timely diagnosis of this severe but curable disease. Diagnostic criteria of encephalopathy allowing the avoidance of both hypo- and hyper diagnosis of this disease are considered. The authors present the current tactics of its treatment based on the use of corticosteroids and other immunotropic drugs.

[Efficacy and tolerability of choline alphoscerate (cereton) in patients with Parkinson's disease with cognitive disorders].

An open 10-day study of treatment effect of cereton in comparison to piracetam has been conducted. Cereton was used in 40 patients (main group) in dosage 1000 mg, piracetam - in 20 patients (control group) in dosage 2000 mg. Both drugs were used intravenous in drops in 200 ml of physiologic saline along with antiparkinsonian medications. Patient's state was assessed with a battery of psychometric scales and neuropsychological tests as well as with instruments for measuring intensity of parkinsonian symptoms, side-effects and quality of life. Marked and moderate improvement of cognitive functions was found in patients of the main group compared to the control one (40% and 25%, respectively, p<0,05). Deterioration of cognitive functions was seen less often in the main group than in the control group (5% and 15%, respectively, p<0,05). Cereton was well-tolerated by patients. Side effects (brief and short-term) were found only in 6 (15%) patients.