Zh Nevrol Psikhiatr
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Treatment of neuropathic pain (NP) is a serious medical problem. Antiepileptic drugs and antidepressants, used to relief pain, act on the central pain mechanisms and cause several side-effects, thus substantially restricting possibilities of their clinical application. At the same time, NP often has a peripheral component. ⋯ Recently it has been shown that the local use of single high doses of capsaicin during 30-60 min causes a marked stable(> 12 weeks) effect. The decrease in NP (>50%) is seen in about half of patients. Current studies will allow to single out groups of patients with the maximal treatment effect of capsaicin.
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The article reviews the process of migration of nociogenic zones and principles of their integrative switching - off from the point of systematic approach and the informational-structural theory of pain. The phenomenon of migration of nociogenic zones underlies the development of clinical manifestations of pain.
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Zh Nevrol Psikhiatr · Jan 2014
Comparative Study[Clinical characteristics of internal carotid and vertebral arteries dissection].
To compare demographic, clinical, and imaging characteristics of patients with internal carotid artery dissection (ICAD) and vertebral artery dissection (VAD) in a Russian population. ⋯ There were significant differences between patients with ICAD and VAD in terms of gender distribution, precipitating events, clinical and imaging features. Different embryonic origin of ICA and VA, their anatomical differences, and intramural hematoma location in relation to intima and adventitia may underlay these differences.
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Delirium is a serious complication of disorders of nervous system and requires early detection for successful treatment. Confusion assessment method for intensive care unit (CAM-ICU) is a fast and reliable tool for detection of delirium. We performed screening for delirium among patients of neurological ward using CAM-ICU. Our experience showed that CAM-ICU could be used for the identification of delirium in neurological patients excluding those who suffer from severe aphasia.
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Moyamoya syndrome is a rare chronic progressive disease of brain vessels in which certain arteries in the brain are constricted. During the disease a collateral circulation develops around the blocked vessels to compensate for the blockage, and on angiography these collateral vessels have the appearance of a "puff of smoke". ⋯ The clinical features are an acute stroke in the right middle cerebral artery with dysarthria and paralysis of VII and XII cranial nerves. The diagnosis of moyamoya is suggested by MRI-angiogram results in accordance to the diagnostic criteria.