Vol XXXIII, No 1-2 (2001)

Changes typical for elderly persons which may be detected clinically and with the use of paraclinical investigation techniques are discussed. The significance of correct assessment of anamnesis and patient’s symptoms is emphasized. Changes in neurologic state are studied in detail. Among paraclinical methods of investigation particular attention has been given to the results of computered tomography and magnetic-resonance tomography of brain. Causes of leukoareosis are considered.

The results of examination of 72 patients with clinical picture of syringomyelia using MRT are revealed. Images of spinal cord in sagittal and axial planes have been obtained. Deformity of cavity found in axial sections of 26 patients was considered as its spontaneous collapse.

When interpreting MRT picture drain communication between the cavity and subarachnoid space of spinal cord in 10 patients was supposed. Relation between the cavity diameter and duration of illness was determined. A decrease of cavity diameter during the long course of illness may be related to the cavity collapse, which is one of the possible compensatory mechanisms of syringomyelia course.

The prospective observation, clinical and biochemical examination of 252 mature infants with perinatal hypoxic encephalopathy from neonatal period till 1 years old and 55 infants with intracranial hemorrhages were carried out. The role of perinatal risk factors in the pathological forming as well as the dependence of clinical manifestations from hypoxia character (acute, chronic, combined) and the disease period was determined. The interrelation of disturbances of enzyme transmembrane transport of electrolytes activity and the level of intracellular calcium in thrombocytes with the character, degree of the severity, clinical syndromes and course of pathological process was revealed. The decrease of Ca²⁺-ATPase activity and increase of the level of intracellular calcium in patients with the chronic and combined character of hypoxia was noted. Clinical and biochemical efficiency of calcium antagonists (nimodipine) in children with perinatal hypoxic and hemorrhagic CNS disturbances was determined.

New approaches for increasing the effectiveness of treating drug abusers are described. Unique in complexity and daring conception of treatment integrating the most promissing approaches applied in various fields of medicine, such as in psychiatry, neuropathology, psychotherapy, anesthesiology, is developed and presented. All the principles of therapy, that is clinical and pathogenetic reasons, complexity, correlation with the state of the patient and individuality of treatment, are respected. All the components of this method are allowed to use for therapeutic purposes. Algorithm of their use according to therapeutic purposes is given.

The goal of the state social policy in relation to the situation of children in the Russian Federation is to overcome the negative trends caused by the influence of economic and political factors, to stabilize the situation in protecting the health of the younger generation and to create real conditions for consolidating positive dynamics in the life support of children. The reaction of society and the state mainly to negative consequences in the children's environment is suboptimal and ineffective. The need arose to define new conceptual approaches to protecting the health and development of children.

Among the pain syndromes of the face, trigeminal neuralgia ranks first in frequency. However, despite the fact that the disease has been known for more than 2000 years [14] and was isolated as a separate nosological form more than 200 years ago [7], the issues of etiology and pathogenesis, and, consequently, treatment, cannot be considered resolved. At the same time, knowledge of the mechanism of trigeminal neuralgia is of great importance for the treatment of patients.

The fruitful collaboration between German and Russian neurologists has its roots in the last century. In the formation of neurological science in both countries, such outstanding Russian scientists as V.M. Bekhterev, L.O. Darkshevich, Korsakov, Minor, Krol, as well as German neurologists Grisinger, Strumpel, Oppenheim. As a result of well-known historical events, this creative connection, mutually beneficial for both scientists and patients, was interrupted for 60 years. Only after the fall of the “Iron Curtain”, both on the one and on the other side, there was a desire to end the “Ice Age” and begin the path to rapprochement. The first meetings between scientists from both countries and the exchange of views on issues of interest to them served as the impetus for the first scientific conference dedicated to a wide range of neurological diseases, the diagnosis and treatment of which leave much to be desired.

The presence of familial cases of syringomyelia, basilar impression (intussusception) and Chiari malformation (MC) indicates the role of heredity in the occurrence of these diseases. Studies by a number of authors [32, 44] show that the primary pathology in this case is bone anomalies of the craniovertebral region (CVR), which contribute to the formation of the posterior cranial fossa (PCF) of reduced volume. As a result of this, the caudal parts of the cerebellum and the medulla oblongata descend through the foramen magnum (foramen magnum), i.e. formation of type I MC. In the presence of bone anomalies of KVO and MV type I, in some cases, a violation of CSF dynamics can occur at the level of the BVO, which will lead to the development and progression of syringomyelia. CVD abnormalities are, in turn, the result of defective development of the cartilaginous tissue of the bones of the skull and adjacent parts of the spine during the first weeks of embryonic development [34, 43]. Such dysembryogenesis may be due to dysfunction of genes that control the formation of the fifth occipital somite in the human body [49]. Literature data on familial cases of syringomyelia, basilar impression and MC confirm their common heredity basis.

The oldest Russian centers of progressive thought greatly influenced the scientific and social life of Russia and European countries. For a long time, the leading centers of Russian neuropathology were created for the first time in the world, the departments of nervous diseases of the medical faculties of Moscow and Kazan universities, which nurtured a galaxy of world-renowned neurologists. Within the walls of such famous educational institutions, domestic clinical medicine reached the highest development, original directions and schools appeared, the foundation of modern clinical neurology was laid.

The history of the development of the Moscow neurological school in the late 19th - early 20th centuries. is, in essence, the history of the clinic of nervous diseases named after A.Ya. Kozhevnikov Moscow Medical Academy named after I.M. Sechenov. The teaching of nervous and mental diseases began at the departments of pathology and therapy of Moscow University, headed by the most prominent clinicians M.Ya. Mudrov, I.E. Dyadkovsky, I.V. Varvinsky, I.T. Glebov and A.I. Polunin long before the creation of a neurological clinic. The new university charter of 1863, among others, provided for the organization of a clinic for nervous and mental diseases, and therefore in the same year the medical faculty recommended A.Ya. Kozhevnikov as a worthy candidate for heading a new department or course of nervous and mental diseases. According to the traditions of A.Ya. Kozhevnikov in 1866 was sent abroad for 3 years. He worked in clinics and laboratories headed by the largest specialists in neuropsychiatry and physiologists (J.-M. Charcot, V. Grisinger, E. Dubois-Raymond, etc.). During this period A.Ya. Kozhevnikov performed several independent histological studies. In 1869, the university council elected A.Ya. Kozhevnikov for the position of Associate Professor of Nervous Diseases and Psychiatry. In the summer of 1869, after returning from an overseas business trip, he headed the independent department of nervous and mental diseases created for the first time in the world and already in December submitted to the dean A.I. Polunin, a curriculum for teaching nervous diseases and psychiatry, began to give a course of lectures on nervous and mental diseases and to conduct practical classes on nervous diseases.

2001 marks the 120th anniversary of the birth and 30th anniversary of the death of the outstanding Russian neurologist Leonid Ivanovich Omorokov.

It has been suggested that there are two main approaches to the use of gene therapy in the treatment of chronic disease, which has been confirmed by recent studies in animals.

Acute flaccid paraparesis or ascending tetraparesis in children (including infants) is a serious neurological problem in emergency pediatrics.

Myasthenia gravis is an autoimmune disease characterized by the production of autoantibodies against acetylcholine receptors at the end plate of the neuromuscular synapse.

The main clinical features of dominantly inherited myotonic dystrophies are myotonia, muscle weakness, and cataracts.

The use of music as a therapeutic effect has been used in practical medicine for a long time, but only recently have serious clinical studies been carried out on the real therapeutic efficacy of music therapy.