Background. Pain is a common complication after stroke and is associated with the presence of depression, cognitive dysfunction, and impaired quality of life. It remains underdiagnosed and undertreated, despite evidence that effective treatment of pain may improve function and quality of life. The article highlights the issues of epidemiology, pathogenesis, methods of clinical assessment and risk factors for the development of post-stroke pain. A review of the literature on the most common post-stroke pain syndromes including central post-stroke pain, complex regional pain syndrome, musculoskeletal pain, shoulder pain, pain associated with spasticity and headache is presented. Modern management of the pain is analyzed.
Conclusion. In the best interests of optimizing the rehabilitation of a stroke patient, improving his quality of life and function after stroke, clinicians should be aware of pain as a common complication after stroke, identify those patients at highest risk, detail the presence and characteristics of pain, and also be aware of options for correcting post-stroke pain syndromes.

Chronic back pain is the complaint with which patients most often seek medical help from general practitioners, neurologists, surgeons, traumatologists and other subspecialists. Pain in the lower back can be either nonspecific, i. e., have no specific nosologic cause, or be specific, i. e., have a certain pathophysiologic mechanism of occurrence due to both spinal and extra-spinal causes. This fact determines the importance of complex and multidisciplinary assessment of the characteristics of chronic low back pain syndrome.
The aim of the present study was to investigate the possibility of realizing a multidisciplinary approach in the treatment of nonspecific low back pain syndrome.
Results. Low back pain is pain that is localized between the twelfth pair of ribs and the gluteal folds. It is not always possible to determine the source of pain when it is nonspecific; moreover, there is no convincing evidence that clarification of localization will favorably affect the course and outcome of the disease. There are three main causes of nonspecific low back pain: myofascial syndrome; pathology of joints and ligamentous apparatus of the spine; and lumbar osteochondrosis, which is a natural process of degeneration of spinal structures and is observed to varying degrees in all people, increasing significantly with age. It is believed that the pain syndrome of the back region has a multifaceted pathophysiology, which is influenced by somatic pathology, psychological and social factors. This explains the need for an integrated multidisciplinary approach to a particular patient and the compilation of an individual program of treatment, rehabilitation and prevention of subsequent exacerbations. Multidisciplinary approach means complex coordinated parallel work of specialists aimed at solving the problem of chronic pain.
Conclusion. Multidisciplinary approach to the treatment of patients with chronic nonspecific low back pain syndrome is more effective than monotherapy, because it takes into account individual features of clinical symptoms, allows to carry out treatment and rehabilitation according to an individual plan, including a set of interrelated measures aimed at improving the quality of life of the patient and his functional capabilities.

Cataplexy is rare disease, the main clinical features of which are loss of muscle tone without loss of consciousness, associated with specific factors such as laughter, and less often fear, anger or crying. The differential diagnosis of epileptic seizures and cataplexy is often difficult because of similar clinical features. Establishing the diagnosis of cataplexy is important because in most cases it is associated with narcolepsy; in addition, misinterpretation of cataplexy can lead to hyperdiagnosis of epilepsy or wrong efficiency mark of antiepileptic drugs. Clinical and instrumental examination is necessary to establish the right diagnosis. Literature review and own clinical case is described.

The objective of the study is to evaluate the effectiveness of rehabilitation treatment in patients with neurological pathology in inpatient department.
Materials and methods. The study included 101 patients undergoing hospital treatment due to an existing neurological disease. The mean age was 52.41 ± 13.49 years. The condition of each patient upon admission and after the course of inpatient treatment was assessed using special tools – scales, tests, indices and questionnaires, such as the Rehabilitation Routing Scale and the modified Rankin scale, and according to the clinical specifics and needs of rehabilitation treatment – the Ashworth scale, Caprini Scale, Muscle Strength Grading Scale, National Institutes of Health Stroke Scale, HAS-BLED Scale, Berg Scale, Functional Independence Measure, Waterlow Score, Numeric Pain Rating Scale, Frenchay Arm Test, Rivermead Mobility Index, Hauser Index, EQ-5D, Barthel Index. The dynamics of recovery were calculated by comparing scores obtained using special instruments upon admission to rehabilitation treatment and after it.
Results. By analyzing the results of the study, a positive dynamic of recovery was established, confirming the effectiveness of an inpatient course of neurorehabilitation, which is expressed in an improvement in the condition of patients when assessed using the designated tools for its objectification.
Conclusions. The study confirms the effectiveness of an inpatient course of medical rehabilitation in restoring neurological deficits, increasing the activity of daily living, reducing the degree of social maladjustment and improving the rehabilitation prognosis.

Chronic inflammatory demyelinating polyneuropathy is a rare immune-mediated polyneuropathy pathology of the peripheral nervous system. The presence of etiological factors in the patient, such as type 1 and 2 diabetes mellitus, alcohol intoxication in the anamnesis or other causes of polyneuropathy, which are often found in practice, can disguise chronic inflammatory demyelinating polyneuropathy and lead to delayed diagnosis of potentially curable polyneuropathy, which further increases the likelihood of disability of the patient and a significant decrease in the quality of his life. The clinical case under consideration is a demonstration of such diagnostic difficulties, which led to a delayed diagnosis of chronic inflammatory demyelinating polyneuropathy against the background of alcohol abuse in the debut of neurological disorders.

The purpose of the work is to study: analyze modern data on the problem of suicidal behavior in the structure of diseases of the endocrine system, eating disorders and metabolic disorders.
Materials and methods. The analysis of 52 sources. The search was carried out in special medical resources, namely: RusMed, Medline, PubMed, and Web of Science. In addition, electronic libraries such as eLibrary were involved.RU, CyberLeninka and the Library of dissertations and abstracts of Russia dslib.net.
Results. An attempt has been made to study the phenomenon of suicidal behavior in the structure of diseases of the endocrine system, eating disorders and metabolic disorders. In addition to studying the prevalence of suicidal behaviors in the above diseases, the features and clinic of suicidal behavior depending on the duration and stage of somatic diseases were also described. The risk of suicidal behavior is higher than in the general population at all stages of the development of somatic disease and treatment, including remission, is underestimated by statistics.
Conclusions. Diseases of the endocrine system, eating disorders and metabolic disorders should be considered by specialists as potentially dangerous conditions. Suicidal activity in the structure of these diseases remains very high and varies widely: from 0.10 to 65 %. The greatest suicidal activity is manifested in patients with the following diseases: diabetes mellitus, Hashimoto's thyroiditis, hypothyroidism, hyperthyroidism, obesity; Preventive strategies are proposed, which show the importance of screening suicidal behavior in the general medical network in view of the high incidence of suicides to specialists.

Objective. To study the pattern of cognitive changes and the content of cerebral neurotrophic factor (BDNF) in the blood serum of patients with chronic cerebral ischemia (CICI).
Materials and methods. We examined 128 people who were divided into two groups: the main group – 82 patients (38 men and 44 women) aged 60–74 years with CICI, the control group – 46 people comparable to the patients of the main group by gender and age, but without clinical manifestations of CICM. Cognitive functions were assessed using the Mini-Mental Status Scale (MSMS) and the Battery of Tests for the Assessment of Frontal Dysfunction (FMS). Attention (Schulte test), speech fluency (speech fluency subtest BTLD, verbal association test), memory (memory subtest KSHOPS; 5 words test) and visuospatial functions (clock drawing test) were studied. The content of BDNF in the blood serum of patients was determined by the enzyme immunoassay method.
Results. The pattern of cognitive impairment in CIGM was characterized by changes in the domains of executive brain functions and complex attention. The content of BDNF in the blood serum of patients with CICI was significantly lower than that of the control group; in men is lower compared to female patients. Significant correlations were revealed between the severity of cognitive disorders and the level of BDNF in the blood serum.