Objective. To study influence of Mexidol® and Mexidol® FORTE 250 on cognitive status of patients with post-COVID syndrome.
Material and methods. We examined 112 patients aged 24–60 years (55 men and 57 women) who were divided into tho groups. The main group consisted of 76 patients with confirmed SARS-CoV‑2 NEW coronavirus infection having symptoms that served as the basis for the diagnosis of post-COVID syndrome. The control group consisted of 36 people who were not ill with coronavirus infection. Patients underwent neurological and general somatic examination. To study cognitive functions, we used the Mini Mental State Examination (MMSE) and the Frontal Assessment Batter (FAB). Memory was evaluated according to results of ‘the Memory’ subtest of the MMSE, the 10-word test and tests of visual memory. The level of attention was studied using the Schulte tables and the word fluency test; visual-spatial functions were evaluated using the clock-drawing test. To correct the identified disorders, Mexidol® was used according to the scheme: 500 mg once daily intravenously for 14 days, followed by Mexidol® FORTE 250 750 mg per day orally (250 mg three times a day) for 2 months.
Results. Patients with post-COVID syndrome were characterized by cognitive heterogeneity: mild and moderate cognitive impairments prevailed in the structure of cognitive disorders. The course of treatment with Mexidol® led to decrease in the severity of cognitive symptoms of post-COVID syndrome. The high efficacy and safety of long-term sequential therapy with Mexidol® (injections followed by tablets of Mexidol® FORTE 250) have been shown.

Aim. To study the effect of insomnia on the severity of the condition and on the quality of life in patients with disabilities.
Materials and methods. A prospective cohort study was conducted from 2019 to 2022, in which 100 patients took part. Patients with acute cerebrovascular accident (ACV) were selected as a clinical model of persons with disabilities. Two groups were formed from the total number of patients included in the study. 50 patients with acute cerebrovascular accident and suffering from insomnia constituted the main group, which was divided into 2 subgroups by a simple choice according to the random sampling rule in the Statistica 12 program. MG1 – the main subgroup 1–26 people who received, as part of complex therapy, a course of short-term (five sessions) cognitive-behavioral therapy for insomnia in combination with doxylamine at a dose of 15 mg 15–30 minutes before bedtime for 10 days. The second subgroup of the main group of patients (MG2) – 24 people who received only standard treatment. The comparison group (GS) (50 people) and a part (48 %) of the patients of the main group (24 people) also received only standard treatment for the underlying disease. All patients were assessed using the SF-36 Quality of Life Questionnaire, the Perrudet-Badoux, Mendelsohn, Chiche Subjective Wellbeing Scale (PSS), sleep quality questionnaires (Pittsburgh Sleep Quality Questionnaire and the Insomnia Severity Scale).
Results and conclusions. Against the background of the treatment in the main group 1, there was a reduction in insomnia, as well as an improvement in the quality of life on all scales of the quality of life questionnaire and more pronounced than in the comparison group and the main group 2. Thus, the correction of insomnia in addition to the basic therapy of post-stroke patients with limited opportunities allows you to achieve a more significant result of treatment than the use of only basic therapy for patients.

The article describes vertigo diagnostic algorithm. Acute, paroxysmal, and chronic vestibular syndromes determination, attacks duration assessment, provoking factors and comorbid diseases are described. The otoneurologic examination main tests and their interpretation in assessing of spontaneous nystagmus, the results of stato-coordination tests, the head rotation test and positional tests are presented. Diagnostic criteria and basic approach to the most common disorders manifested by vertigo treatment are discussed, including benign paroxysmal positional vertigo, vestibular neuronitis, Meniere's disease, vestibular migraine, persistent postural-perceptual vertigo, bilateral vestibulopathy and others.

The purpose of the study. Analysis of the features of EEG spectral parameters in patients with polymorphic and monomorphic subtypes of prolonged and chronic endogenous manic-delusional states (PEMDS).
Materials and methods. A clinical-neurophysiological study was carried out in 76 female patients with monomorphic (group 1, 34 patients) and polymorphic (group 2, 42 patients) subtypes of PEMDS, identified based on clinical-dynamic analysis.
Results. In the group 1, compared with the group 2, there were significantly lower values of the spectral power of the pre-treatment EEG in most EEG leads and frequency sub-bands, which reflect a significant deficit in the brain inhibitory systems. In the group 2, the EEG slowdown (in the delta-frequency sub-band) after treatment course, was significantly more pronounced in the frontal-anterotemporal-central cortical zones of the left hemisphere, reflecting a greater increase of the neurophysiological processes of inhibition in these brain areas under the influence of treatment, which leads to an improvement in the clinical condition of patients.
Conclusions. The revealed differences in the brain functional activity organization may mediate the features of the clinical picture and therapeutic response in patients with polymorphic and monomorphic subtypes of PEMDS.

The work is devoted to the analysis of the mechanisms and evaluation of the effectiveness of various methods of topical use of essential oils in dorsopathies.
Materials and methods. 90 patients (38 women and 52 men aged 40 to 75 years with exacerbation of dorsopathy at the lumbosacral level) were under observation. Along with neurological, psychological (using questionnaire methods) and electrophysiological analysis was performed, including thermography, rheovasography and ultrasound Doppler sonography of the vessels of the legs and feet. Three groups of 30 patients each were formed, in which standard treatment was performed. In addition to this, a mixture of essential oils was used in the first two groups. In the 1st group, with the use of this composition, massage of the lumbosacral zone was performed, in the 2nd group, the method of biopuncture was used, i. e., applying minimal doses of the mixture to the projection of reflexology points. In the 3rd control group, sesame oil was applied to the point area as a placebo.
Results. In the course of the work, the effectiveness of both types of true use of essential oils was confirmed, significantly exceeding the control indicators in this regard. However, stable analgesia was achieved in the 2nd group significantly earlier than in the 1st: in a proportion close to this, the final intensity of pain sensations also decreased. On the other hand, in both groups of oil use, there was a comparable improvement in zonal vascular provision, confirmed electrophysiologically.
Conclusions. During the follow-up evaluation, recurrences of dorsopathy in the control group were noted in a third of patients, whereas in the case of the use of essential oils, there were comparably fewer doses. Nevertheless, in these groups there are differences in the severity of recurring algias: in the 2nd group they increased slightly, while in others they increased to a greater extent. In addition, the data of rheovasograms testified in favor of greater stability of the results in the 2nd group. These differences can be explained by the cumulative effect inherent in the methods of reflexology and, in particular, biopuncture with essential oils.

Comparison of the development of chemically induced seizures in the experiment with the change in convulsive thresholds during electroconvulsive therapy (ECT) has demonstrated that repeated ‘chemical’ seizures can initiate the development of the kindling phenomenon, but regular ECT from the first to the 14th session most likely cause an increase in convulsive thresholds. However, the repeated ECT over 15 sessions is associated with a rapid decrease in the threshold current dose and probable dysregulation of endogenous anticonvulsant mechanisms, with the risk of the development of uncontrolled paroxysmal conditions and the risk of organic CNS lesions. The mechanisms of the convulsive action of ECT and pentylenetetrazolinduced kindling are fundamentally different. Differences in the pathogenesis of systemic convulsive reactions determine the divergent change in seizure thresholds during ECT and pentylenetetrazol stimulations.

COVID-19 infection is associated with many different complications. The consequences of COVID-19 infection affect the quality of life and cause emotional distress. Rehabilitation activities for various groups of patients who have undergone COVID-19 are of great importance from several aspects. Each patient must be fully evaluated by the rehabilitation team. Together with the patient, the team should develop rehabilitation goals, taking into account the wishes of the patient. The direct impact of COVID-19, its consequences and comorbidities determine the medical rehabilitation plan. It is necessary to assess the state of physical, cognitive, emotional disorders.
The purpose of the study. To determine the dynamics of anxiety-depressive and cognitive disorders in patients who have undergone COVID-19, using individual rehabilitation programs.
Research methods. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety-depressive disorders, and the Mini-Mental State Examination (MMSE) was used to identify cognitive impairment. A special rehabilitation scale for patient routing was used to assess the patient's condition, determine management and routing tactics.
Conclusions. Individually tailored post-acute multidisciplinary rehabilitation is associated with clinical and functional improvements in patients who have experienced varying degrees of severity of COVID-19.

Purpose of the study. Identification of cerebrorenal relationships in patients with chronic cerebral ischemia (CCI) of elderly and senile age.
Material and methods. We studied 522 elderly and senile patients with stage I and II CCI living in the Republic of Sakha (Yakutia). Doppler ultrasound was the main method for studying cerebral hemodynamics in this work. Glomerular filtration rate (GFR), which is the most reliable integral measure of the functional state of the kidneys, was calculated using the CKD-EPI formula, which takes into account race, gender, age, and serum creatinine levels.
Results. Between the value of the glomerular filtration rate and almost all ultrasonic indicators included in the analysis (except for the diameter of the right and left vertebral arteries and the linear velocity of blood flow in the vertebral artery on the right), weak and moderate negative correlations were found. A univariate analysis confirmed the existence of relationships between GFR, age, duration of CCI, and blood lipid parameters.
Conclusions. The study revealed a statistical relationship between GFR and age, duration of CCI, lipid spectrum parameters, as well as with all 12 ultrasound parameters characterizing cerebral hemodynamics.

Moya-moya syndrome is a chronic cerebrovascular disease associated with narrowing of the arteries of the brain, manifested by headache, epileptic seizures, transient ischemic attack, leading to the development of ischemic or hemorrhagic stroke. To date, the main pathogenetic mechanisms of moya-moya syndrome have not yet been fully identified, but some studies have shown that an important component of the development of moya-moya is a genetic factor. However, if the issue of diagnosis of this syndrome can be considered solved – it is the use of neuroimaging methods (MRI, CT) with contrast of cerebral vessels, then the issue of treatment remains relevant. The article presents a clinical case of a patient with moya-moya syndrome with the transformation of an ischemic stroke into a hemorrhagic type.