[Manual differential diagnosis of migraine and cervicogenic headache]. / Manual'naia differentsial'naia diagnostika migreni i tservikogennoi golovnoi boli.

AIM: To study the informative nature of manual therapy for differential diagnosis of migraine and cervicogenic headache (CH). MATERIAL AND METHODS: The authors analyze two clinical cases of patients with a previously established diagnosis of migraine, with the duration of the disease of over ten years and neuroimaging signs of degenerative-dystrophic changes in the upper cervical spine. In both cases, there was no hereditary history and low efficacy of the previous drug therapy was noted. The informative value of the tests performed by methods of manual medicine followed by manipulation procedures of neck structures for the differential diagnosis of migraine and CH was assessed. RESULTS: Despite the absence of complaints, both patients demonstrated the limitation of the volume of neck movements during the tests performed by methods of manual medicine. After a course of manipulation procedures, headaches in both patients were completely stopped for a period of six to ten months. The analysis of literature suggests that manipulative effects on neck structures in cases of migraine can reduce the intensity and the duration of pain, and the frequency of attacks by no more than 20%. The therapeutic effectiveness of manual therapy for CH is much higher; this method provides an opportunity to reduce the severity of these pain characteristics by 30-80%. These results are the basis for changing the previously established diagnosis to CH. CONCLUSION: The complex of diagnostic and therapeutic techniques of manual therapy is an important tool for the differential diagnosis of migraine and CH.

[Spasticity: from pathophysiology to treatment]. / Spastichnost': ot patofiziologii k lecheniiu.

The article presents modern views on the pathophysiology of spasticity, which is a frequent disabling consequence to the upper motor neuron (UMN) damage. Morphological and functional system of motion organization and the changes after the UMN damage is considered. The authors analyze existing definitions of spasticity. Stages of spasticity development are described in the context of neuroplasticity as well as in the framework of pathogenesis and sanogenesis. Existing ideas of its pathogenesis are compared with the typical clinical symptoms. The occurring pathological processes in muscles, tendons and joints that can aggravate the development of spasticity and complicate the diagnosis are considered. In addition, the main pathological spasticity patterns are described and the current development of diagnostic techniques is estimated. A review of main methods of spasticity treatment is presented. Special attention is paid to the botulinum neurotoxin type A (BoNT) preparations and central action muscle relaxants. The pathophysiological basement for complex treatment of spasticity as a part of the general rehabilitation process is given, so that the BoNT can be considered as the obligatory element of standard rehabilitation programs.

[Efim Anatolyevich Dyskin - the hero of the Defence of Moscow (To the 75th anniversary of the Battle of Moscow 1941-1942)].

Efim Anatolyevich Dyskin - the hero of the Defence of Moscow (To the 75th anniversary of the Battle of Moscow 1941-1942). Efim Dyskin - one of the first artilleryman, who awarded the title of Hero of the Soviet Union for a feat accomplished in the Battle of Moscow. After the war he finished the Military Medical Academy and later became a prominent domestic scientist - anatomist and morphologist, head of the general anatomy department, teacher of high school, Major General of the Medical Service. He created a scientific morphological school that developed guidelines for the features of the morphology of the different species of a gunshot wound and the impact of extreme factors of the military working on the body brow-century. Under the leadership of E.A.Dyskin conducted research on. the status of collateral circulation, functional anatomy of the digestive system, craniology, histoty of military medicine and the Military Medical Academy.

[The structural and functional neurovisualization in patients with epileptic seizures in cerebro-vascular diseases].

The results of the dynamic study of patients with epileptic seizures in chronic and acute cerebral vascular pathology are presented. Various methods of structural and functional neurovisualization--magnetic resonance tomography using perfusion- and diffusion-weighted imaging, proton magnetic resonance spectroscopy, positron emission tomography, single photon emission computed tomography were used. Based on the results obtained in the study, the authors discuss etiopathogenetic variants of the development of these seizures and new possible approaches to the complex treatment besides the administration of antiepileptic medications.

[Determination of serum valproic acid drugs by capillary electrophoresis].

Monitoring of valproates is caused by the nonlinear pharmacokinetics of the drugs and by the clinical effect-concentration dependence. Rapid and simple procedure has been developed to determine valproic acid in the serum and spinal fluid by capillary electrophoresis. Under the chosen conditions, the calibration curve is linear in the range of concentrations of 10 to 150 mg/l. The detection limit of valproate is 1.0 mg/ml. The accuracy of valproate determination was confirmed by the addition method. The findings were compared by the results of ion chromatographic determination that had been chosen as the reference technique. More than 80 serum samples from patients with epilepsy were analyzed.

[The diagnosis of epilepsy by using blood analysis for the content of autoantibodies to glutamate neuroreceptors]. / Diagnostika épilepsii s pomoshch'iu analiza krovi na soderzhanie autoantitel k neiroretseptoram glutamata.

The glutamate receptor autoantibody level was studied in blood of 170 epileptic patients as well as of 114 control donors (64 patients with nonepileptic cerebral pathology and 50 healthy individuals). The elevation of autoantibodies level (higher than 140%) was observed in 63.5% of patients with paroxysmal epileptic disturbances. This elevation was observed more frequently in the initial period of the disease as well as in generalized (convulsive or nonconvulsive) fits irrespective of disease etiology. Combined application of the test with EEG method permitted to confirm the epileptic nature of the disease in 83.5% of cases. The results of repeated analysis of glutamate receptor autoantibody level in blood proved to be a significant criterion of the effectiveness of anticonvulsive therapy. It also allowed to predict the development of posttraumatic epilepsy in individuals with craniocerebral trauma in the past.

[The clinico-pathogenetic variants in the late sequelae of closed brain trauma]. / Kliniko-patogeneticheskie varianty otdalennykh posledstvii zakrytoi travmy golovnofo mozga.

To study clinical manifestations and pathogenetic mechanisms of long-term consequences of closed brain injury, 244 patients with a history of cerebral injury of varying severity were examined. For instrumental and laboratory verification of injury use was made of straight craniography, pneumoencephalography, computer-aided tomography, electroencephalography, rheoencephalography, psychophysiological techniques, immunological examination of the blood and CSF biochemistry. Comparative information content of the different research methods was defined. Broad clinical polymorphism and definite specificity of the manifestations of the consequences of closed braid injury of varying severity in decompensation were revealed. The role of immunological disorders (lowering of suppressor influences of T lymphocytes, elevation of the degree of autoneurosensitization) detectable in 87% of cases was established as was the importance of changes in the correlation of the main neuromediators of the CSF in the formation of the pathogenetically multilevel process of the traumatic disease of the brain.

[The clinical and instrumental characteristics of the sequelae of closed brain trauma]. / Klinicheskaia i instrumental'naia kharakteristika posledstvii zakrytoi travmy golovnogo mozga.

The complex analysis of clinico-instrumental data obtained during the examination of 220 patients with nonpenetrating cerebral trauma made it possible to determine the main neurologic syndromes and variants of clinical course of trauma consequences. The article shows the role of additional methods for objective studying of neurologic disorders, and for closer definition of cerebral pathology and pathogenetic mechanisms of some neurologic syndromes. The authors give a comparative characteristic of clinical, instrumental and psychological methods of study. The research has shown that there were no straight dependency between the gravity of trauma in the acute period and its possible consequences.