[The influence of nooclerin on the structure of sleep disturbances in children with tension headaches]. / Vliianie nooklerina na strukturu narushenii sna u detei s golovnymi boliami napriazheniia.

AIM: To study the effects of nooclerin (deanol aceglumate) on the structure of sleep disturbances in children with tension-type headache (TTH). MATERIAL AND METHODS: A blind randomized placebo-controlled study of the efficacy of nooclerin (deanol aceglumate), prescribed for 2 months to prevent TTH, was carried out. The study included 60 patients (30 boys and 30 girls), aged 9-16 years, with TTH. Patients were randomized into the nooclerin group (n=30) and the placebo group (n=30). Sleep disturbances were assessed before and after treatment with the Sleep Disturbance Scale for Children (SDSC). RESULTS: There was a significant positive dynamics (reduced total score on SDSC (p<0.001) and a significant decrease in the scores on scales 'Disorders of initiating and maintaining sleep', 'Disorders of excessive somnolence' (p<0.001), 'Sleep wake transition disorders' (p<0.01)) in the nooclerin group. No significant positive changes were detected in the placebo group. CONCLUSION: An anxiolytic action of nooclerin was confirmed. Further studies of the drug in child neurology and psychiatry using larger groups of patients are needed.

[Comorbidity of migraine and epilepsy in childhood]. / Migren' i épilepsiia: komorbidnost' v detskom vozraste.

Migraine and epilepsy represent prevalent chronic neurological disorders of childhood. Migraine and epilepsy comorbidity relies on the common pathophysiologic and genetic mechanisms of the paroxysmal disorders the similarity of their precipitating factors, clinical manifestations and therapeutic approaches. The problems of differential diagnosis of migraine and epilepsy are related to peculiarities of migraine manifestations in children. Some forms of epilepsy could be accompanied by cephalgic seizures. The diagnostic criteria of headaches in epileptic patients are presented. A number of genetic diseases accompanying by migraine and epilepsy could be a model for delineation of shared pathogenetic mechanisms of these paroxysmal disorders in which genetically determined channelopathies may play an important role. The efficacy of antiepileptic drugs has been proven as the prophylactic treatment of migraine in pediatric patients. The advantages of levetiracetam as the prophylactic treatment for migraine and epilepsy comorbidity in children are discussed.

[The course and development of epilepsy in patients with typical variant of Rett syndrome and mutations]. / Osobennosti épilepsii u detei s tipichnym variantom sindroma Retta, vyzvannym mutatsiei.

AIM: To study the anamnesis, clinical state, electro-encephalographic and brain MRI characteristics in patients with Rett syndrome (МЕСР2) and epilepsy. MATERIAL AND METHODS: Eleven female patients, aged from 3 to 23 years, with Rett syndrome and MeCP2 mutations were studied. The study continued for 10 years (2006-2015). Assessment of neurological and mental status, night sleep video-EEG monitoring, MRI were performed. RESULTS AND CONCLUSION: Epilepsy was diagnosed in six cases (54.5%). Mean age at onset of epileptic seizures was 3 years 9 month. The following types of seizures were described: generalized, myoclonic, myotonic, tonic, versive, focal motor, atypical absences. Status epilepticus developed in one patient. Generalized seizures were identified in 56.25%, focal seizures in 43.75%. EEG changes were found in 9 patients (81.8%): slowing of the activity, episodes of periodic regional slowing, regional epileptiform activity and diffuse epileptiform activity, benign focal epileptiform discharges (BFED) of childhood, multiregional epileptiform activity. Five patients were treated with antiepileptic drugs. All of them had improved during treatment: a reduction of frequency of seizures was up to 50% in 4 cases (80%). One patient with resistant epilepsy was treated with the combination of drugs (levetiracetam, topiramate, zonisamide, benzodiazepine) that led to stopping of seizures during night sleep and decrease in the frequency of daytime seizures by 50%. Further research of epilepsy and efficacy of antiepileptic drugs in Rett syndrome is required.

[The course and the development of epilepsy in patients with typical variant of Rett syndrome and mutations]. / Osobennosti techeniia i razvitiia épilepsii u detei s tipichnym variantom sindroma Retta, vyzvannogo mutatsiei.

AIM: Studying data of anamnesis, clinical state, electro-encephalographic, brain MRI in patients with Rett syndrome (МЕСР2). MATERIAL AND METHODS: We studied 11 patients (female) from three to 23 years old with Rett syndrome and MeCP2 mutations. Observation continued 10 years (2006-2015). We analyzed the results of the neurological status, night sleep video-EEG monitoring, MRI. RESULTS AND CONCLUSION: Epilepsy diagnosed in six cases (54, 5%). The overage age of debut of epileptic seizures was 3 years 9 months. There are some types of seizures: generalized, myoclonic, myotonic, tonic, versive, focal motor, atypical absences. Status epilepticus evolved in one patient. Generalized seizures were 56, 25%, focal seizures - 43, 75%. EEG changing marked in nine patients (81, 8%): slowdown back activity, episodes of periodic regional slowdown, regional epileptiform activity, and diffuse epileptiform activity like benign focal epileptiform discharges (BFED). five patients took antiepileptic drugs. All of them had improved during treatment. There were reducing of frequency of the seizures up 50% - 4 cases (80%). one patients with resistant epilepsy was taken combination of drugs (levetirecetam, topiromat, zonisamide, benzodiazepine) with stopping of seizures in the night sleep and decreasing of frequency of daytime seizures to 50%. We believe there is very important of study epilepsy in patients with Rett syndrome and improvement of its treatment.

[Treatment of speech disorders in preschool children]. / Terapiia rasstroistva razvitiia rechi u detei doshkol'nogo vozrasta.

AIM: To study the efficacy of neyroferon in developmental speech disorders (SDD). MATERIAL AND METHODS: Thirty preschool children were stratified into 3 groups: 4-5 years (n=8), 5-6 years (n=10) and 6-7 years (n=12). The children were treated with neyroferon in dose 1 tablet three times a day during 2 month. A multifaceted study of speech disorders using several methods was conducted. General mental state, emotional and behavioral characteristics of the children were assessed as well. RESULTS AND CONCLUSION: A therapeutic effect of neyroferon (the improvement of auditory-speech memory, expressive speech, phonemic perception, articulatory movements, vocabulary activity, connected speech etc) as well as the decrease in anxiety, hyperactivity and attention deficit was found in children with SDD. The safety of the drug was confirmed. The results should be treated as preliminary ones.

[Chronic tics and Tourette syndrome in children and adolescents: diagnostic and treatment characteristics].

Chronic tics (CT) are observed in 3-4% population, Tourette syndrome (TS) in 0.1-3.0%. In most cases, tic disorders start at age 2-15 years, but frequently they are diagnosed late. Clinical presentations of tics and comorbid disorders are various and depend on child's age. Difficulties in treatment of CT are associated with their persistence and those for TS with the fluctuating course of tics and probable onset of the disease in the form of behavioral disorders. Treatment of CT and TS is individual. Methods of behavioral and psychotherapy are recommended for a certain period of time if tics do not hamper everyday life. Increase in tick frequency and severity indicate the necessity of using pharmacological treatment. The European recommendations on pharmacotherapy of tic disorders and the drugs available in Russia are considered. Results of the studies on the efficacy of antiepileptic drugs and tenoten children in CT and TS are presented.