Zh Nevrol Psikhiatr
-
Restless legs syndrome (RLS) is seen widely in clinical practice. RLS commonly occurs at night time and presents with unpleasant or uncomfortable sensations in the legs that causes an urge to move them. This article describes the epidemiology, risk factors and pathophysiology of RLS. There is a detailed description of clinical presentations, diagnostic criteria and also management of RLS.
-
Zh Nevrol Psikhiatr · Jan 2021
[Clinical features of temporal lobe epilepsy with involvement of the insular lobe].
To determine the clinical features of the course of the disease when the insular lobe is involved in the epileptic process. ⋯ Paroxysmal syndrome in temporal plus epilepsy with involvement of the insular lobe undergoes significant changes in the form of increased seizures and the appearance of specific seizures and characteristic polymorphism.
-
Zh Nevrol Psikhiatr · Jan 2021
Review[Siponimod: a new view at the therapy of secondary progressive multiple sclerosis].
Siponimod is a selective modulator of sphingosine-1-phosphate (S1P) receptors of types 1 and 5, registered in the Russian Federation for the treatment of patients with secondary progressive multiple sclerosis (SPMS), regardless of the presence or absence of exacerbations. The effectiveness of the drug in comparison with placebo was demonstrated in patients with SPMS in the international clinical trial EXPAND (phase III). This review devotes actual problems in the treatment of patients with SPMS, discusses the pathophysiology of multiple sclerosis progression, describes the peripheral and central mechanisms of siponimod action and its differences from fingolimod. According to analysis of scientific literature experimental, clinical and neuroimaging data are presented, which could explain the reasons for the successful use of siponimod in patients with SPMS, taking into account the pathophysiological mechanisms of the development of progression and the mechanisms of drug action.
-
Zh Nevrol Psikhiatr · Jan 2021
[Neurophysiological methods in the assessment of different forms of migraine].
The review considers the efficacy of neurophysiological methods for the study of migraine. According to many authors, such neurophysiological methods as analysis of visual and somatosensory evoked potentials, trigeminal evoked potentials are informative for assessing the functional state of trigeminocervical and sensory systems. Analysis of bioelectric activity of the brain is used for differential diagnosis of migraine and epilepsy, evaluation of various forms and types of migraine. Studies with recording and analysis of laser evoked potentials, as well as the effects of transcranial magnetic stimulation, both diagnostic and non-pharmacological rehabilitation effects on pain syndrome, which increases the efficiency and quality of life in migraine, are considered.
-
Zh Nevrol Psikhiatr · Jan 2020
[Actual issues of serum aquaporin-4 autoantibodies evaluation in the diagnostics of neuromyelitis optica spectrum disorders].
To analyze the usage and timeliness of aquaporin-4 antibodies (AQP4-IgG) serology test in the diagnostics of neuromyelitis optica spectrum disorders (NMOSD) in routine clinical practice. ⋯ A comparison of the time from HS attack to the AQP4-IgG test administration (T1, years), from HS attack to NMOSD diagnosis (T2, years) was undertaken as well as the number of attacks during these periods (N1, N2) were counted in three groups of patients. Group 1 - with the first HS attack before or in 2008 (n=6), group 2 - from 2009 to 2013 (n=12), group 3 - from 2014 to 2018 (n=9) accordingly. A statistically significant decrease in T1, T2, N1, N2 was found in successive time intervals of 5 years (p<0.05). In 8 of 27 (28.6%) patients the first attack of NMOSD was presented with non-specific symptoms (NS attack). In 7 patients (77.8%) of 9 misdiagnosed as multiple sclerosis (MS) an increase in attack frequency was found while on disease modifying therapies (DMTs) and increase in attack severity was found in 8 (88.9%). In all 9 cases the diagnosis was revised to NMOSD after AQP4-IgG test was performed with positive result. The time interval from disease course worsening while on DMTs until the test was 7 [4; 37] months, and the number of relapses - 2 [0; 3]. In 4 of 27 patients with suspected NMOSD, the repeated AQP4-IgG test only was positive for increased antibodies titer. The time interval between first test negative and retest administered was 20 [6.1; 47.8] months. In 3 of 4 patients (75%) one or more attacks occurred during this time period. In 4 patients the presence of AQP4-IgG in the first analysis was not followed by the diagnosis of NMOSD. In recent years, apropos AQP4-IgG test administration improved, but the problem remains with the timeliness for retest with first result negative. It is advisable to expand the indications for its use. The timeliness for serum AQP4-IgG retest in cases of unexplained deterioration in the course of proposed MS on DMTs and the lack of awareness of the test diagnostic value are still relevant.