Relevance. Stato-locomotor disorders are associated with poor quality of life and risk of premature death in afterstroke patients.

Aim. To evaluate the effect of functional electrical stimulation (FES) and biofeedback (BFB) stabilometric training on muscle strength and muscle tone in the chronic period of ischemic stroke (IS) patients.

Matherials and Methods. The 160 patients in the chronic period of IS were randomized into four equal groups (n=40) depending on the rehabilitation programm: 1 group of FES, 2 group using BFB-stabilometric training, 3 group of combined application of FES and BFB-stabilometric training, and 4 control group receiving the standard medical rehabilitation (MR). The follow-up period was 6 months. Muscle strength was assessed using the MRC scale, muscle tone – by the modified Ashworth scale, and patients' functional independence in daily life – by the Barthel index (BI).

Results. Complex MR with the FES and BFB-stability training significantly (p <0.05) improved muscle strength: in the group with FES, thigh muscles – from 3.48±0.17 to 4.22±0.15 points (hip); in the group of FES and BFB-stability training – from 3.33±0.22 to 4.3±0.12 (hip) and from 3.18±0.14 to 3.52±0.12 points (shin). The positive statistically significant dynamics were determined by week 5 and 6 months of follow-up in groups 1 and 3 of patients and was associated with an improvement in functional independence according to the BI (p <0.05).

Conclusions. The use of BFB-based methods in the MR process contributes to a recovery of motor functions and functional independence of the patient in the chronic stroke period.

Chronic imflammatory demyelinating polyneuropathy (CIPD) is a heterogenous group of disimmune polyneuropathies, characterised by progressive or relapsing-remitting disease course, with electrophysiologically and pathomorphologically detected peripheral nerve demyelination. Immunotherapy is considered reasonable in CIDP. CIDP associated with antibodies against nodo-paranodal proteins, namely, NF155, CNTN1, Contactin associated protein has been described amongst the rare atypical CIDP subtypes. The detection of antibodies against nodo-paranodal proteins might have a predictive value for a more severe disease course with resistance to corticosteroid and/or IVIG treatment. Herein we report a case of severe relapsing-remitting CIDP, characterized by respiratory muscle weakness requiring assisted ventilation, with a previous history of proteinuria, later also diagnosed with Minimal change disease (MCD).

Relevance. Primary headaches are currently one of the most common neurological diseases, and the role of sex hormones in their occurrence has been proven.

The purpose of the study is to analyze the levels of sex hormones (estradiol and testosterone) in the blood of patients with various clinical forms of migraine during an attack and outside of an attack.

Materials and methods. The study included 60 patients aged 18–45 years with migraine, who formed the main group. Each patient in the main group was diagnosed according to the International Classification of Headache Disorders, Third Revision (ICHD3). The control group consisted of 15 practically healthy individuals, comparable in age with the main group, who did not suffer from migraine. The study was conducted inpatient and outpatient in a multidisciplinary clinic of the Center for Advanced Professional Development of Medical Workers, the clinical base of the Department of Neurology and Medical Psychology of the Tashkent Medical Academy.

Results. The study examined the concentration of sex hormones – testosterone and estradiol – in the blood serum of female and male patients with migraine with and without aura during an attack and outside of an attack, and compared the obtained values with the results of studies in the control group. The level of estradiol is higher in women and men with migraine with aura, which affects the duration and intensity of attacks. In women with migraine without aura, the level of estradiol in the blood decreases in the 1st phase of the menstrual cycle, and its normal value in the 2nd phase is associated with the duration of the headache attack. No statistically significant change in testosterone levels was noted.

Conclusions. Our data can be used for considering the possibility of hormonal therapy as a preventive measure against headache attacks in patients with various clinical forms of migraine.

A comparative study on the treatment of anxiety-depressive syndrome with xenon, including 60 patients. To assess the effectiveness of xenon therapy, the patients were divided into 2 groups of 30 people: the main group and the control group. The first group received anti-anxiety drugs and antidepressants of the SSRI group and 5 xenotherapy procedures for 10 days, while the control group received only anti-anxiety drugs and antidepressants. The groups were comparable in age, gender, and severity of anxiety and depressive symptoms. In patients receiving xenon inhalation in addition to drug therapy, there was a better regression of both anxiety and depressive complaints after five sessions of xenon therapy.

Gait is a motor act which is necessary to do everyday tasks and social interaction. Moreover, it is an important psycho-emotional factor affecting the normal development of person. Nowadays we have a lot of research and hypotheses about when and how the most complex locomotor skill is formed. We made this review summarizing various Russian and foreign publications on this topic over the past 5–10 years to show modern scientific ideas in this field. The review represents the normal biomechanics of gait and the walking cycle in healthy people, factors which affect the development of gait in children, as well as its various pathological forms which may cause some deformities of the musculoskeletal system and diseases. Gait is the most complex cyclic process of interaction between biological mechanisms and social factors of human life. The hereditary and own biological aspects have an influence on gait formation, as well as the character, temperament, profession and upbringing of the child affect the gait biomechanics and the gait pathology in children.

This article presents a clinical case of a patient with a herniated disc of the lumbar spine with psoas abscess and spondylitis of the lumbar spine.

The article presents a description of a clinical case of a rare hereditary Hallervorden – Spatz disease with an atypical late form with onset in the fourth decade of life with a rapidly progressive course and unfavorable prognosis. The most characteristic signs of the disease in this patient were parkinsonism syndrome, pyramidal signs, various types of hyperkinesis, decreased cognitive functions, depression. The diagnosis was confirmed by a clinical and a typical MRI signs in the form of the “eye of the tiger” symptom. Due to the lack of effective treatment methods at present, the patient received symptomatic treatment.

Despite the centuries-old history of vitamin D analysis, this substance has unique properties, and recently has been showing its biological functions in a new way. It not only forms and supports the regeneration of the bone system, but also performs a number of other important effects in the human body, in particular, promoting the adequate functioning of the neurohumoral system of the body. This suggests that vitamin D deficiency entails consequences that in some cases can become irreversible.

Aim: to evaluate the effectiveness and tolerability of the domestic drug Diacerein-SZ in patients with osteoarthritis of the knee and hip joints.

Patients and Methods. A single-center clinical prospective study was conducted, which included patients with osteoatritis and metabolic syndrome. 65 patient with OA of the knee and/or hip joints of stage II–III according to Kellgren–Lawrence with pain intensity >30 mm on a visual analog scale, aged 40 to 71 years, was examined. The duration of therapy was 6 months: 1 month – taking the drug Diacerein-SZ at a dose of 50 mg/day, then 5 months at 50 mg 2 times a day. During each visit, pain syndrome (VAS, mm), BMI, and biochemical blood tests were assessed. Data on the use of additional drugs with anti-inflammatory effects, as well as adverse events, were analyzed.

Results. The average age of patients was 55.5 [49.5; 58] years. A pronounced anti-inflammatory effect was noted in the form of a decrease in the level of VAS and CRP (p <0.0001), which led to the complete abolition of NSAIDs by the end of the study in 67.7% of the subjects. A statistically significant decrease in uric acid and glycated hemoglobin was observed already by week 12 of the study (p = 0.011), (p = 0.0001), respectively. There were no significant differences in lipid profile and glucose levels (p >0.05). Adverse events were recorded in 12.9% of patients.

Conclusion. The use of the domestic drug Diacerein-SZ in patients with osteoarthritis led to a decrease in the need for NSAIDs, had a favorable effect profile on the level of uric acid and glycated hemoglobin, and was well tolerated.

Chronic Migraine and Cervicalgia Significantly Impact Patients’ Quality of Life. Botulinum Therapy is an Effective Treatment, but Its Limited Efficacy as Monotherapy Necessitates the Development of Combined Approaches.

Objective. To compare the effectiveness of botulinum therapy and its combination with electrotherapy in patients with chronic migraine and cervicalgia.

Materials and Methods. The study included 58 patients divided into two groups: the first group (n = 30) received botulinum therapy, while the second group (n = 28) underwent electrotherapy combined with botulinum therapy. Pain severity was assessed before treatment, and at 1 and 3 months after therapy initiation.

Results. After a month of treatment, in group II there was a significant decrease in the frequency of headache attacks, cervicalgia and the number of analgesics taken compared to group I. After 3 months, scores continued to improve, with no significant difference between groups.

Conclusions. The combined use of electrotherapy and botulinum therapy effectively reduces pain at all stages of observation.

Objective: to summarize the clinical experience of the antipsychotic brexpiprazole in the treatment of schizophrenia spectrum disorders in a psychiatric hospital.

Materials and Methods. A group of 26 patients (16 women; 61.5%) aged 19 to 64 years (mean age 35.73±9.33) with leading delusional, hallucinatorydelusional, manic-delusional, depressive-delusional or depressive-paranoid symptomatology constituted the study material. Patients were followed up for 6 weeks after brexpiprazole administration. The severity of psychotic symptomatology was assessed by selected items of the Positive and Negative Syndrome Rating Scale (PANSS). The General Clinical Impression Scale (CGI) was used for objective assessment of the patients' condition: the severity of condition subscale (CGI-S) and the mental status dynamics subscale (CGI–I). Patients' satisfaction with therapy was assessed in the dynamics of treatment and after the end of the follow-up period.

Results. Brexpiprazole was administered both on admission to hospital (65.4%) and after prior antipsychotic therapy (34.6%). The range of maximum doses was 2 to 4 mg per day. Side reactions were registered in 3 cases (11.5%), and only in one case it required withdrawal of the drug. Statistically significant improvement of mental state by the 7th day of therapy was registered for the majority of PANSS items (Delirium, Suspiciousness, Agitation, Anxiety, Tension, Aggressiveness). A statistically significant decrease in the severity of mental state according to CGI was observed from the second week of therapy. A distinct dynamics of change of attitude to therapy towards positive attitude to therapy was established (p=0,029).

Conclusions: clinical experience of brexpiprazole use in psychiatric inpatient settings demonstrated good results both in terms of therapy efficacy and safety, which allows us to evaluate the drug as promising for use in the treatment of psychotic exacerbations and maintenance therapy of patients with schizophrenia and schizophrenia spectrum disorders.