Background. Headache and orofacial pain (OFP) are widespread at specialized pain centers. However, reliable data on their prevalence and co-occurrence are lacking, and prevalence of OFP in headache patients seems to be underestimated. The aim of this study was to evaluate the types of headache in patients with OFP and types of OFP in patients with headache.
Methods. We enrolled patients presenting with headache and/or OFP. Patients were examined by an experienced headache and pain specialist who questioned the patients about the presence of OFP. Depression was assessed with the Beck Depression Inventory (BDI-II), anxiety – with the Beck Anxiety Inventory (BAI). Bruxism was evaluated based on subject self-report.
Results. We recruited 310 patients: 177 (57%) patients with headache, 28 (9%) patients with OFP and 105 (34%) patients presenting with both types of pain. The prevalence of OFP in headache patients was 37.2%. Migraine was the most prevalent type of headache, while painful temporomandibular disorder (TMD) – the most prevalent form of OFP. Patients with PFP presented with a high prevalence of sleep and awake bruxism.
Conclusion. Migraine and pain-related TMD are the most prevalent diagnoses in a specialized pain center. OKI and OKI ACT are soluble forms of ketoprofen and reach peak concentration in 15 minutes. This enables faster onset of action compared to conventional NSAIDs and better tolerability. OKI and OKI ACT are recommended in the acute treatment of migraine with comorbid painful TMD.

This article discusses contemporary approaches to multimodal, NSAID-sparing management of primary musculoskeletal pain. Despite the scientific advances, musculoskeletal pain remains extremely challenging to manage clinically. While the number of potential treatment targets has grown substantially and a strong case has been made for a mechanism-based and individualized approach to pain therapy, arguably clinicians are not much more advanced now in their capacity to either diagnose or effectively treat patients with musculoskeletal pain. The International Association for the Study of Pain (IASP) pain taxonomy includes pain mechanisms as one of the 3 dimensions that need to be considered when making a diagnostic classification for the concurrent use of separate therapeutic interventions with various mechanisms of action aimed at different pain mechanisms. Combination of shock-wave therapy with topical NSAID tenoxicam is more effective in primary musculoskeletal pain treatment.

The article summarizes the results of their own research in the field of one of the original areas of reflexology – pharmacopuncture or, in other words, local stimulation. This term in our case refers to a method of irritating reflexology points with small doses of drugs considered as low-energy factors. Synonyms of the method, reflecting little significant differences, are aquapuncture, biopuncture, mesotherapy and some others. In the mechanisms of method, the significance of the prolongation of the reflex response due to changes in the volume of tissues in the region of points and the formation of multiple depots of the drug used are highlighted. However, the issues of more subtle links remain unclear, which determined the purpose of the study – to identify as such the targeted effect of drugs used through local stimulation. Dorsopathy at the lumbosacral level was chosen as a research model, which is to a certain extent associated with the formation of reflexology in the country, the methods of which were largely developed and refined using the model of neurological pain syndromes. Naturally, we took into account the medical, social and economic significance of the problem. In a series of completed dissertation studies of our employees, the therapeutic possibilities of local use of the drug Alflutop, indicated for the studied pathology, were analyzed. Evaluation of the effectiveness of this approach was based on taking into account the dynamics of clinical and additional characteristics and, in particular, the results of psychological and electrophysiological examination, including zonal thermography, vascular tests, etc. At the same time, the addition and even potentiation of the reflex and drug links of the method was noted, which determines a reliable superiority over the standard therapeutic effect or placebo control. Fundamentally significant in this regard was the positive structural and modifying effect in relation to the state of the intervertebral discs, confirmed by the data of ultrasonic video densitometry of these structures. Attention should also be paid to the fact of strengthening the effectiveness of pharmacopuncture through the parallel use of modern hardware technology – low-frequency electromagnetic stimulation. The presented materials are also reflected in monographs, a number of methodological manuals and protected patents for the invention.

COVID‑19 infection is associated with many neurological complications, one of which is acute autoimmune polyneuropathy or Guillain-Barré syndrome.
The aim of this study. To analyze clinical symptoms, electrophysiological parameters, and evaluate the efficacy of therapy for Guillain-Barré syndrome associated with SARS-CoV‑2 viral infection. The relationship between the severity of a previous COVID‑19 infection and the severity of damage to the peripheral nervous system was also studied. The article presents three clinical cases with different pathophysiological variants of the disease.
Methods of research. All patients underwent electroneuromyography, lumbar puncture, laboratory tests. In one case, the patient underwent confocal microscopy of the cornea to assess the condition of the corneal nerve fibers.
Conclusions. With timely diagnosis and treatment of Guillain-Barré syndrome associated with SARS-CoV‑2 virus, a good recovery of neurological disorders is observed, despite the severity of the viral infection itself

The relevance of differential diagnosis and treatment of primary and secondary headaches remains an important problem for physicians of various specialties. Migraine is a maladaptive disease, which necessitates further study of new pathogenetic mechanisms, symptomatic treatment improvement of migraine, as well as the development of more effective non-drug and drug methods for preventing migraine attacks. It is also important to determine the predictors of the chronic migraine development, which will prevent the episodic migraine transformation into a chronic form. The team of authors conducted a study to assess the degree of cerebral circulatory disorders in patients suffering from chronic migraine. The obtained results of the study made it possible to improve the diagnosis of both chronic and episodic migraine, to clarify the pathogenetic mechanisms of the formation of migraine attacks and the transformation possibility into chronic migraine. Practical recommendations have been developed to improve the effectiveness of ongoing symptomatic and preventive treatment, which improves patient’s quality of life. This article will be useful for doctors – neurologists, algologists, cephalgologists, GPs, doctors of functional and radiation diagnostics and doctors of other specialties, both for beginners and with experience

Aim of the study. To reveal the pathogenetic and prognostic significance of disturbances in the content of interleukin‑1-alpha (IL‑1α) in the blood serum and cerebrospinal fluid (CSF) of patients in the acute period of hemorrhagic stroke (HI).
Materials and methods. In 100 patients with HI (50 men and 50 women aged 58.25 ± 12.43 years), the level of IL‑1α in blood serum and CSF was monitored on the 1st, 3rd and 10th days of the disease by enzyme immunoassay with a set of reagents from Cytokin (St. Petersburg, Russia).
Results. From the first day of stroke the content of IL‑1α in blood serum and CSF is 25–30 times higher than the level of healthy individuals, reaches peak values on the third day and slightly decreases by the tenth day of illness.
Conclusions. The pathogenetic significance of an increase in the content of IL‑1α in the acute period of hemorrhagic stroke is determined by its participation in the reactions of local and systemic inflammation that accompanies brain damage. The level of IL‑1α can serve as an early marker of the risk of death in patients with GI.

This article provides a review of the scientific literature over the past 30 years on the assessment of the anatomical or ‘true’ difference in leg length (structural Limb Length Discrepancy, sLLD), as well as a summary of our own clinical experience on this issue.
Purpose. Carrying out a systematic analysis of publications on methods for assessing the anatomical difference in leg length and the diagnostic significance of its detection in order to provide highly effective care to patients with diseases of the musculoskeletal system.
Materials and methods. The study presents a description of modern hardware and manual methods for assessing sLLD, the shortcomings of their isolated use, and substantiates the need for a comprehensive examination of patients with sLLD with a combination of manual and hardware diagnostic methods.
Results and discussion. The results of observations patients with various diseases of the musculoskeletal system and comorbid neurological symptoms are presented. Examples of postural radiographs of patients with anatomical difference in leg length after arthroplasty are given; with persistent functional shortening of the limb of traumatic origin. The possibilities of differentiated correction of pain syndromes of musculoskeletal origin under the influence of an anatomically short leg on pelvic skew, scoliosis in the form of lift therapy, and the possibility of manual correction in upslip functional dysfunction are considered.
Conclusions. An unrecognized and not timely compensated structural difference in the length of the legs is one of the main causes of asymmetries in posture, increased fatigue and chronic pain of the musculoskeletal system, as well as a consequence of subjectivity, insufficient reliability and accuracy of many direct methods proposed in the literature for quantifying the difference in leg size. The low threshold of clinical significance of sLLD, along with the wide prevalence of this phenomenon in the population, dictates the need for increased diagnostic alertness of specialists in order to provide effective assistance to this group of patients through the combined use of pharmacotherapy, manual techniques and adequate orthopedic correction

Introduction. Oxcarbazepine is the first-line therapy for newly diagnosed focal epilepsy in children, but data on its use in adult patients in the Russian population are limited.
Aim. Improvement of the efficacy of initial therapy with oxcarbazepine and controlled-release carbamazepine for newly diagnosed focal epilepsy in adults.
Patients and methods. The study included 74 adult patients, 39 of them were included in the oxcarbazepine group and 35 in the controlledrelease carbamazepine group. During the 6-month follow-up period, patients completed 5 visits, during which adverse events and effectiveness were assessed, as well as video-EEG monitoring with an assessment of the epileptiform activity index. Results. The proportion of patients with a reduction in seizure frequency of more than 50 % was comparable in both groups, constituting 82.4 % (n = 28) and 85.2 % (n = 23) in the oxcarbazepine and carbamazepine group, respectively. Adverse events developed in 20 % (n = 7) of patients taking carbamazepine, and in the oxcarbazepine group in 12.8 % (n = 5) of patients. The 6-month initial monotherapy retention rate was higher in oxcarbazepine group (71.8 %) compared to carbamazepine group (65.7 %). In both groups, a 2.0–3.5-fold decrease in the average and total epileptiform activity index and epileptiform activity index during sleep was registered.
Conclusions. The obtained results indicate similar effectiveness of oxcarbazepine and controlled-release carbamazepine in the treatment of newly diagnosed focal epilepsy in adults and better tolerability of oxcarbazepine in terms of both adverse events rate and lower frequency of drug discontinuation due to adverse events. A decrease in the epileptiform activity index by 2.0–3.5 times is evidence of possible use of the epileptiform activity index as an objective marker of the disease dynamics