Objective – to estimate the possible use of tumor necrosis factor alpha (TNF<α) as an informative biomarker of a severe status and prognosis at herpesvirus neuroinfection with temporal epilepsy syndrome.

Methods and subjects. The studied group (SG) consisted of 43 patients aged from 16 to 60 with a verified herpesvirus neuroinfection with epilepsy syndrome. The control group (CG) consisted of 20 patients of the similar age having epilepsy, not associated with herpesvirus neuroinfection. TNF<α concentration in blood serum was determined by the method of enzyme.

Results. The patients of SG marked high concentration of TNF<α in blood serum (Х ± m = 288 ± 44.7 pg/ml) being confidently higher than that of CG (р < 0.05; Z < Z0.05). The level of serum TNF<α concentration, higher than 100 pg/ml, correlates with a patient’s general severe condition, a pronounced epilepsy syndrome, a longer disease history and deep organic brain lesion as well as low.

Conclusions. Patients with herpesvirus neuroinfection in the form of epilepsy syndrome present the syndrome of a systemic inflammatory response that affects patient’s state and can be an object for therapeutic intervention. TNF-alpha may be used as an informatory biomarker to provide an objective evaluation of a patient’s severe state as well as to make a substantiated prognosis of a further disease flow in patients with virus-induced temporal epilepsy.

Keywords: tumor necrosis factor alpha, herpesviruses, temporal epilepsy, biomarker.

The article deals with one of the most dangerous human disease – neuroAIDS. The epidemiology, pathogenesis, clinical manifestations of primary and secondary nervous system lesions with AIDS are disclosed. Much prominence is given to primary lesion syndrome such as AIDS-dimension and nervous system impairments connected with infections against the background of immunodeficiency. The importance of early diagnostics of AIDS neurological complications is signified in the article.

Keywords: neuroAIDS, primary impairments, AIDS-dimension, secondary impairments.

The article deals with one of the most dangerous human disease – neuroAIDS. The epidemiology, pathogenesis, clinical manifestations of primary and secondary nervous system lesions with AIDS are disclosed. Much prominence is given to primary lesion syndrome such as AIDS-dimension and nervous system impairments connected with infections against the background of immunodeficiency. The importance of early diagnostics of AIDS neurological complications is signified in the article.

Keywords: neuroAIDS, primary impairments, AIDS-dimension, secondary impairments.

Objective – to reveal characteristic neurologic and clinical features of a current cerebral toxoplasmosis at sick of a HIV-infection and broaden the etiotropic treatment tactics and secondary prevention.

Methods and subjects. 36 cases toxoplasmosis encephalitis at a HIV – infected patients have been analyzed who underwent treatment on the basis of the Odessa Regional center on preventive maintenance and AIDS control.

Results. It is established that the given etiology of encephalitis is frequent primary AIDS display disease, it is well diagnosed on modern laboratory equipment and x-ray apparatus, as a whole has favorable vital prognosis.

Conclusions. Toxoplasmosis is the most widespread parasitogenic opportunistic infection of central nervous system at sick of AIDS. Knowledge of typical clinical presentation and risk factors is important for timely diagnostics and treatment of cerebral toxoplasmosis. In the article the clinical displays of disease a toxoplasmosis encephalitis are studied at HIV – infected patients. The high informing MRI.

Keywords: AIDS, cerebral toxoplasmosis, diagnostics, treatment.

Objective – to reveal characteristic neurologic and clinical features of a current cerebral toxoplasmosis at sick of a HIV-infection and broaden the etiotropic treatment tactics and secondary prevention.

Methods and subjects. 36 cases toxoplasmosis encephalitis at a HIV – infected patients have been analyzed who underwent treatment on the basis of the Odessa Regional center on preventive maintenance and AIDS control.

Results. It is established that the given etiology of encephalitis is frequent primary AIDS display disease, it is well diagnosed on modern laboratory equipment and x-ray apparatus, as a whole has favorable vital prognosis.

Conclusions. Toxoplasmosis is the most widespread parasitogenic opportunistic infection of central nervous system at sick of AIDS. Knowledge of typical clinical presentation and risk factors is important for timely diagnostics and treatment of cerebral toxoplasmosis. In the article the clinical displays of disease a toxoplasmosis encephalitis are studied at HIV – infected patients. The high informing MRI.

Keywords: AIDS, cerebral toxoplasmosis, diagnostics, treatment.

Оbjective – to study clinical and biochemical indicators and electrolytic data in blood serum of patients with pharmaco-resistant epilepsy under baseline conditions.

Methods and subjects. 46 patients with therapy-resistant epilepsy (ranged 24–42 years) and 10 healthy females (28–34 years) were examined. Serum levels of cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, total lipids, non-etherified fatty acids, electrolytes were measured with spectrophotometric method, tau-immunofluorescence methods with using primary and secondary monoclonal antibodies.

Results. Results of this investigation showed that patients with epilepsy with frequent seizures, pharmaco-resistant course and psychiatric complications under a baseline condition had increased serum levels of tau protein vs. controls that could reflect the severe of disease either because of high frequent seizures or long epilepsy duration. Changes in electrolytes were not observed in patients with epilepsy. Investigating of lipids exchange revealed in 9 patients demonstrated slightly high cholesterol and high-density lipoproteins levels.

Conclusions. In patients with epilepsy and pharmaco-resistant course tau protein levels are getting higher in blood serum under baseline conditions.

Keywords: neurobiochemistry, pharmaco-resistant epilepsy.

Оbjective – to study clinical and biochemical indicators and electrolytic data in blood serum of patients with pharmaco-resistant epilepsy under baseline conditions.

Methods and subjects. 46 patients with therapy-resistant epilepsy (ranged 24–42 years) and 10 healthy females (28–34 years) were examined. Serum levels of cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, total lipids, non-etherified fatty acids, electrolytes were measured with spectrophotometric method, tau-immunofluorescence methods with using primary and secondary monoclonal antibodies.

Results. Results of this investigation showed that patients with epilepsy with frequent seizures, pharmaco-resistant course and psychiatric complications under a baseline condition had increased serum levels of tau protein vs. controls that could reflect the severe of disease either because of high frequent seizures or long epilepsy duration. Changes in electrolytes were not observed in patients with epilepsy. Investigating of lipids exchange revealed in 9 patients demonstrated slightly high cholesterol and high-density lipoproteins levels.

Conclusions. In patients with epilepsy and pharmaco-resistant course tau protein levels are getting higher in blood serum under baseline conditions.

Keywords: neurobiochemistry, pharmaco-resistant epilepsy.

Objective – to estimate the importance of clinical neurological criteria and neuroimaging methods in the diagnosis of medullar infarcts.

Methods and subjects. A clinical neurological examination and neuroimaging investigation were carried out in 22 patients with acute medullar infarcts (12 men and 10 women) at the age from 50 to 85 years (mean age – 61.3 ± 10.4 year) that were treated during 2007–2010 year in the neurological center of the Alexander Hospital in Kiev. Comprehensive examination included a study of the anamnesis and rate of the development of stroke, assessment of neurological status with the use of scales NIHSS, Hoffenberth B. et al., modified Rankin scale, Barthel index. Localization and size of the ischemic lesion were verified with the method MRI.

Results. Infarcts of the medulla oblongata were manifested with severe and very severe neurological deficit. Depending on the localization of infarction lesion they were divided into lateral, medial, and also combination of lateral and medial medullar infarcts. In this case, they were manifested as combination of neurological symptoms, manifestation of signs. Lateral localization of the infarction lesion in 60 % was followed by alternating Wallenberg syndrome. Unilateral medial medullar infarcts manifested with pure motor hemiplegia, disturbance of proprioceptive sensitivity on the contralateral side; bilateral – with bulbar syndrome, flaccid tetraparesis, respiratory disorders. Clinical course of medullar infarct is more favorable in cases of lateral localization of the lesion, medial medullar and combined infarcts were characterized with more severe course and had unfavorable consequences.

Conclusions. Statistical analysis showed that lateral medullar infarcts correlated with vertigo, nausea and vomiting (p = 0.031, CI 0.54–0.94), nystagmus (p = 0.004, CI 0.54–0.94), ipsilateral – segmental disturbances of pain and temperature sensitivity on the face (p = 0.03, CI 0.36–0.8), Bernard–Horner syndrome (p = 0.008, CI 0.48–0.9), cerebellar ataxia (p = 0.004, CI 0.54–0.94), contralateral – conductive hypesthesia of pain and temperature sensitivity (p = 0.03, CI 0.36–0.8). Medial medullar infarction correlated with the contralateral tactile anesthesia and bathyanesthesia (p = 0.001, CI 0.36–0.98), tetraparesis (p = 0.009, CI 0.23–0.89). Quite often dysarthria, dysphonia (65 %), dysphagia (55 %), rarer hiccups, respiratory dysfunction (35 %) were determined. Knowledge of specific neurological signs of the proximal vascular territory lesion can improve the clinical diagnostics of medullar infarct. However, reliable determination of individual type of medullar infarction is possible only on condition of taking into account typical clinical signs and neuroimaging data.

Keywords: ischemic stroke, medullar infarct, clinical forms, radiological diagnostics.

Objective – to estimate the importance of clinical neurological criteria and neuroimaging methods in the diagnosis of medullar infarcts.

Methods and subjects. A clinical neurological examination and neuroimaging investigation were carried out in 22 patients with acute medullar infarcts (12 men and 10 women) at the age from 50 to 85 years (mean age – 61.3 ± 10.4 year) that were treated during 2007–2010 year in the neurological center of the Alexander Hospital in Kiev. Comprehensive examination included a study of the anamnesis and rate of the development of stroke, assessment of neurological status with the use of scales NIHSS, Hoffenberth B. et al., modified Rankin scale, Barthel index. Localization and size of the ischemic lesion were verified with the method MRI.

Results. Infarcts of the medulla oblongata were manifested with severe and very severe neurological deficit. Depending on the localization of infarction lesion they were divided into lateral, medial, and also combination of lateral and medial medullar infarcts. In this case, they were manifested as combination of neurological symptoms, manifestation of signs. Lateral localization of the infarction lesion in 60 % was followed by alternating Wallenberg syndrome. Unilateral medial medullar infarcts manifested with pure motor hemiplegia, disturbance of proprioceptive sensitivity on the contralateral side; bilateral – with bulbar syndrome, flaccid tetraparesis, respiratory disorders. Clinical course of medullar infarct is more favorable in cases of lateral localization of the lesion, medial medullar and combined infarcts were characterized with more severe course and had unfavorable consequences.

Conclusions. Statistical analysis showed that lateral medullar infarcts correlated with vertigo, nausea and vomiting (p = 0.031, CI 0.54–0.94), nystagmus (p = 0.004, CI 0.54–0.94), ipsilateral – segmental disturbances of pain and temperature sensitivity on the face (p = 0.03, CI 0.36–0.8), Bernard–Horner syndrome (p = 0.008, CI 0.48–0.9), cerebellar ataxia (p = 0.004, CI 0.54–0.94), contralateral – conductive hypesthesia of pain and temperature sensitivity (p = 0.03, CI 0.36–0.8). Medial medullar infarction correlated with the contralateral tactile anesthesia and bathyanesthesia (p = 0.001, CI 0.36–0.98), tetraparesis (p = 0.009, CI 0.23–0.89). Quite often dysarthria, dysphonia (65 %), dysphagia (55 %), rarer hiccups, respiratory dysfunction (35 %) were determined. Knowledge of specific neurological signs of the proximal vascular territory lesion can improve the clinical diagnostics of medullar infarct. However, reliable determination of individual type of medullar infarction is possible only on condition of taking into account typical clinical signs and neuroimaging data.

Keywords: ischemic stroke, medullar infarct, clinical forms, radiological diagnostics.

Objective – to estimate the importance of clinical neurological criteria and neuroimaging methods in the diagnosis of medullar infarcts.

Methods and subjects. A clinical neurological examination and neuroimaging investigation were carried out in 22 patients with acute medullar infarcts (12 men and 10 women) at the age from 50 to 85 years (mean age – 61.3 ± 10.4 year) that were treated during 2007–2010 year in the neurological center of the Alexander Hospital in Kiev. Comprehensive examination included a study of the anamnesis and rate of the development of stroke, assessment of neurological status with the use of scales NIHSS, Hoffenberth B. et al., modified Rankin scale, Barthel index. Localization and size of the ischemic lesion were verified with the method MRI.

Results. Infarcts of the medulla oblongata were manifested with severe and very severe neurological deficit. Depending on the localization of infarction lesion they were divided into lateral, medial, and also combination of lateral and medial medullar infarcts. In this case, they were manifested as combination of neurological symptoms, manifestation of signs. Lateral localization of the infarction lesion in 60 % was followed by alternating Wallenberg syndrome. Unilateral medial medullar infarcts manifested with pure motor hemiplegia, disturbance of proprioceptive sensitivity on the contralateral side; bilateral – with bulbar syndrome, flaccid tetraparesis, respiratory disorders. Clinical course of medullar infarct is more favorable in cases of lateral localization of the lesion, medial medullar and combined infarcts were characterized with more severe course and had unfavorable consequences.

Conclusions. Statistical analysis showed that lateral medullar infarcts correlated with vertigo, nausea and vomiting (p = 0.031, CI 0.54–0.94), nystagmus (p = 0.004, CI 0.54–0.94), ipsilateral – segmental disturbances of pain and temperature sensitivity on the face (p = 0.03, CI 0.36–0.8), Bernard–Horner syndrome (p = 0.008, CI 0.48–0.9), cerebellar ataxia (p = 0.004, CI 0.54–0.94), contralateral – conductive hypesthesia of pain and temperature sensitivity (p = 0.03, CI 0.36–0.8). Medial medullar infarction correlated with the contralateral tactile anesthesia and bathyanesthesia (p = 0.001, CI 0.36–0.98), tetraparesis (p = 0.009, CI 0.23–0.89). Quite often dysarthria, dysphonia (65 %), dysphagia (55 %), rarer hiccups, respiratory dysfunction (35 %) were determined. Knowledge of specific neurological signs of the proximal vascular territory lesion can improve the clinical diagnostics of medullar infarct. However, reliable determination of individual type of medullar infarction is possible only on condition of taking into account typical clinical signs and neuroimaging data.

Keywords: ischemic stroke, medullar infarct, clinical forms, radiological diagnostics.

Objective – an estimation of endothelial functions’ parameters at the patients with diabetic encephalopathy (DE) and correlation relations with parameters of cerebral hemodynamic.

Methods and subjects. 88 patients with diabetes mellitus were examined: 27 patients with a syndrome of a autonomic dystonia, 33 – with a DE of I stage, 28 – with DE II stage. Transcranial ultrasound dopplerography of the main brain arteries and level of endothelial functions’ parameters (arterial endothelial grow factor – AEGF, nitrites, nitrates, induced NO-synthase and endothelinum-1) were carried out for all patients.

Results. Statistical validity increase of the levels of endothelial functions’ parameters at the patients suffering from diabetes mellitus with cerebral impairments is established. Correlation relations between the level of AEGF and average speed of a blood flow in frontal brain artery (r = –0.4447, p = 0.0044), in posterior brain artery (r = –0.6694, p = 0.0023), in basilar artery (r = –0.4104, p = 0.0049), with an index of resistance in middle brain artery (r = 0.4924, p = 0.0037) and an index of resistance in posterior brain artery (r = 0.5109, p = 0.003) have been revealed. Correlation relations between the level of glycemia and the level of induced NO-synthase (r = 0.56, p = 0.0036), nitrite- and nitrate-anions (accordingly r = 0.48, p = 0.0024 and r = 0.42, p = 0.0028), the level of AEGF (r = 0.5806, p = 0.0023) have been revealed.

Conclusions. At the patients with a diabetic encephalopathy the impairments of endothelial functions’ parameters were revealed, which is correlated with increased manifestations cerebral dysfunctions and decreased parameters of cerebral hemodynamic. Correlation relations between the level of hyperglycemia and formation of endothelial dysfunction were established.

Keywords: diabetic encephalopathy, cerebral hemodynamic, endothelial dysfunction.

Objective – an estimation of endothelial functions’ parameters at the patients with diabetic encephalopathy (DE) and correlation relations with parameters of cerebral hemodynamic.

Methods and subjects. 88 patients with diabetes mellitus were examined: 27 patients with a syndrome of a autonomic dystonia, 33 – with a DE of I stage, 28 – with DE II stage. Transcranial ultrasound dopplerography of the main brain arteries and level of endothelial functions’ parameters (arterial endothelial grow factor – AEGF, nitrites, nitrates, induced NO-synthase and endothelinum-1) were carried out for all patients.

Results. Statistical validity increase of the levels of endothelial functions’ parameters at the patients suffering from diabetes mellitus with cerebral impairments is established. Correlation relations between the level of AEGF and average speed of a blood flow in frontal brain artery (r = –0.4447, p = 0.0044), in posterior brain artery (r = –0.6694, p = 0.0023), in basilar artery (r = –0.4104, p = 0.0049), with an index of resistance in middle brain artery (r = 0.4924, p = 0.0037) and an index of resistance in posterior brain artery (r = 0.5109, p = 0.003) have been revealed. Correlation relations between the level of glycemia and the level of induced NO-synthase (r = 0.56, p = 0.0036), nitrite- and nitrate-anions (accordingly r = 0.48, p = 0.0024 and r = 0.42, p = 0.0028), the level of AEGF (r = 0.5806, p = 0.0023) have been revealed.

Conclusions. At the patients with a diabetic encephalopathy the impairments of endothelial functions’ parameters were revealed, which is correlated with increased manifestations cerebral dysfunctions and decreased parameters of cerebral hemodynamic. Correlation relations between the level of hyperglycemia and formation of endothelial dysfunction were established.

Keywords: diabetic encephalopathy, cerebral hemodynamic, endothelial dysfunction.

Objective – to elucidate peculiarities of psychological dysfunction indices, namely trait and reactive anxiety in patients with chronic cerebral ischemia (CCI) against the background of arterial hypertension (AH).

Methods and subjects. 91 patients (25 male and 66 female) with AH were examined, they underwent the treatment at Cardiovascular Care and Neurology Units of Kyiv City Clinical Hospital N 12 where Neurology Department N 2 of National Medical Academy of Postgraduate Education named after P.L. Shupyk is located. Stroke in medical history, diabetes mellitus and other somatic diseases were referred to exclusion criteria. Patients’ examination included medical history data and presenting complaints analysis on specifically developed questionnaires, general clinical examination with arterial pressure profile monitoring, assessment of neurological status and a range of neuropsychological data as well as complex rheography.

Results. Statistically significant high levels of both trait (79 % of patients) and reactive (62 %) anxiety were recorded in patients with CCI in AH. With increase of disease duration the decreased number of cases with low level of reactive anxiety were observed but there was increased number of cases with average level. In duration of AH more than 10 years number of cases with high level of reactive anxiety was increased. High levels of both trait and reactive anxiety were statistically more frequent in women than in men.

Conclusions. In the course of the investigation the peculiarities of psychological dysfunction indices, namely trait and reactive anxiety in patients with CCI against the background of arterial hypertension AH were studied.

Keywords: chronic cerebral ischemia, arterial hypertension, trait anxiety, reactive anxiety.

Objective – to elucidate peculiarities of psychological dysfunction indices, namely trait and reactive anxiety in patients with chronic cerebral ischemia (CCI) against the background of arterial hypertension (AH).

Methods and subjects. 91 patients (25 male and 66 female) with AH were examined, they underwent the treatment at Cardiovascular Care and Neurology Units of Kyiv City Clinical Hospital N 12 where Neurology Department N 2 of National Medical Academy of Postgraduate Education named after P.L. Shupyk is located. Stroke in medical history, diabetes mellitus and other somatic diseases were referred to exclusion criteria. Patients’ examination included medical history data and presenting complaints analysis on specifically developed questionnaires, general clinical examination with arterial pressure profile monitoring, assessment of neurological status and a range of neuropsychological data as well as complex rheography.

Results. Statistically significant high levels of both trait (79 % of patients) and reactive (62 %) anxiety were recorded in patients with CCI in AH. With increase of disease duration the decreased number of cases with low level of reactive anxiety were observed but there was increased number of cases with average level. In duration of AH more than 10 years number of cases with high level of reactive anxiety was increased. High levels of both trait and reactive anxiety were statistically more frequent in women than in men.

Conclusions. In the course of the investigation the peculiarities of psychological dysfunction indices, namely trait and reactive anxiety in patients with CCI against the background of arterial hypertension AH were studied.

Keywords: chronic cerebral ischemia, arterial hypertension, trait anxiety, reactive anxiety.

Objective – to elucidate peculiarities of psychological dysfunction indices, namely trait and reactive anxiety in patients with chronic cerebral ischemia (CCI) against the background of arterial hypertension (AH).

Methods and subjects. 91 patients (25 male and 66 female) with AH were examined, they underwent the treatment at Cardiovascular Care and Neurology Units of Kyiv City Clinical Hospital N 12 where Neurology Department N 2 of National Medical Academy of Postgraduate Education named after P.L. Shupyk is located. Stroke in medical history, diabetes mellitus and other somatic diseases were referred to exclusion criteria. Patients’ examination included medical history data and presenting complaints analysis on specifically developed questionnaires, general clinical examination with arterial pressure profile monitoring, assessment of neurological status and a range of neuropsychological data as well as complex rheography.

Results. Statistically significant high levels of both trait (79 % of patients) and reactive (62 %) anxiety were recorded in patients with CCI in AH. With increase of disease duration the decreased number of cases with low level of reactive anxiety were observed but there was increased number of cases with average level. In duration of AH more than 10 years number of cases with high level of reactive anxiety was increased. High levels of both trait and reactive anxiety were statistically more frequent in women than in men.

Conclusions. In the course of the investigation the peculiarities of psychological dysfunction indices, namely trait and reactive anxiety in patients with CCI against the background of arterial hypertension AH were studied.

Keywords: chronic cerebral ischemia, arterial hypertension, trait anxiety, reactive anxiety.

Objective – to study the presence of a genetic predisposition to cognitive disorders based on the study of polymorphism of apolipoprotein E (ароЕ) in patients with repeated mild traumatic brain injury (TBI).

Methods and subjects.We examined 86 amateur boxers with high skill level aged from 18 to 32 years, playing a boxing classes ranging between 5 to 14 years. During a sports career boxers underwent TBI in the form knock down and knockouts in number from 1 to 10. The control group comprised 30 patients aged from 18 till 25 years without TBI, neurological complaints, nervous and cardiac system diseases. The neuropsychological research and genetic testing to determine the apoE genotype and apoE alleles were conducted.

Results. These neuropsychological tests shows a reduction of cognitive functions in boxers with repeated mild TBI. The lowest result was observed in patients with ε4 allele, and this difference is statistically reliable. In the control group rates of cognitive functions were slightly different from the norm.

Conclusions. Proved connection of apoE, including alleles ε4, with the development of cognitive disorders in boxers after deferred mild TBI. Genetic testing (determination apoEε4) allows to predict the possibility of developing complications from the side of the nervous system after TBI.

Keywords: genetic testing, apolipoprotein E, cognitive impairment, traumatic brain injury, boxer.

Objective – to study the presence of a genetic predisposition to cognitive disorders based on the study of polymorphism of apolipoprotein E (ароЕ) in patients with repeated mild traumatic brain injury (TBI).

Methods and subjects.We examined 86 amateur boxers with high skill level aged from 18 to 32 years, playing a boxing classes ranging between 5 to 14 years. During a sports career boxers underwent TBI in the form knock down and knockouts in number from 1 to 10. The control group comprised 30 patients aged from 18 till 25 years without TBI, neurological complaints, nervous and cardiac system diseases. The neuropsychological research and genetic testing to determine the apoE genotype and apoE alleles were conducted.

Results. These neuropsychological tests shows a reduction of cognitive functions in boxers with repeated mild TBI. The lowest result was observed in patients with ε4 allele, and this difference is statistically reliable. In the control group rates of cognitive functions were slightly different from the norm.

Conclusions. Proved connection of apoE, including alleles ε4, with the development of cognitive disorders in boxers after deferred mild TBI. Genetic testing (determination apoEε4) allows to predict the possibility of developing complications from the side of the nervous system after TBI.

Keywords: genetic testing, apolipoprotein E, cognitive impairment, traumatic brain injury, boxer.

Objective – to investigate prevalence and clinical course of migraine in Ukraine.

Methods and subjects. A total 2255 adult (1150 women/1105 men) at the age from 16 to 60 years in organized population of Sumy region of Ukraine were tested with anonym questionnaire (high-school students, workers, medical personal). Type of headache was classified according to the International Classification of Headache disorder 2nd edition.

Results. The population prevalence of migraine was 11.9 %, in women – 17.7 %, in men – 5.9 %. Migraine without aura was observed in 80.2 %, with aura – in 19.8 %. The episodic migraine with rare attack was in 38.8 %, with frequent attack in 53.4 %, chronic migraine – in 7.8 %. Many trigger factors of migraine attack were studied. Only 26.1 % patients consulted with doctors for headache treatment. Only 4.5 % used triptans for attack treatment.

Conclusions. The identification of migraine prevalence in organized group more accurately reflects the migraine population that should help to improve management of migraine in Ukraine.

Keywords: migraine, prevalence, clinical course.

Objective – to investigate prevalence and clinical course of migraine in Ukraine.

Methods and subjects. A total 2255 adult (1150 women/1105 men) at the age from 16 to 60 years in organized population of Sumy region of Ukraine were tested with anonym questionnaire (high-school students, workers, medical personal). Type of headache was classified according to the International Classification of Headache disorder 2nd edition.

Results. The population prevalence of migraine was 11.9 %, in women – 17.7 %, in men – 5.9 %. Migraine without aura was observed in 80.2 %, with aura – in 19.8 %. The episodic migraine with rare attack was in 38.8 %, with frequent attack in 53.4 %, chronic migraine – in 7.8 %. Many trigger factors of migraine attack were studied. Only 26.1 % patients consulted with doctors for headache treatment. Only 4.5 % used triptans for attack treatment.

Conclusions. The identification of migraine prevalence in organized group more accurately reflects the migraine population that should help to improve management of migraine in Ukraine.

Keywords: migraine, prevalence, clinical course.

Objective – to determine the effect of normobaric hypoxic therapy on the adaptive potential at children with the spastic variants of cerebral palsy.

Methods and subjects. The complex clinical instrumental examination was carried out in 128 children with cerebral palsy, aged from 1 to 7 years before and after the rehabilitation course. To assess the motor functional status of a child we used the scale and the gross motor function classification system. Among the instrumental methods the heart rate variability, electroencephalography and Doppler ultrasound of cerebral vessels were used.

Results. The application of normobaric hypoxic therapy in complex rehabilitation of children with cerebral palsy results in improvement of adaptive capacity, reduction of the manifestations of asthenovegetative syndrome, normalization of heart rate variability, improvement of EEG parameters and cerebral circulation at the end of the course of rehabilitation. In children who additionally received the course of normobaric hypoxic therapy, we observed the increase of the general motor activity and the formation of new motor skills compared with the children who received standard therapy.

Conclusions. The method of normobaric hypoxic therapy increases the adaptive capacities of children with cerebral palsy, conduces to improvement the efficiency of complex rehabilitation.

Keywords: child's cerebral palsy, normobaric hypoxic therapy, adaptation potential.

Objective – to determine the effect of normobaric hypoxic therapy on the adaptive potential at children with the spastic variants of cerebral palsy.

Methods and subjects. The complex clinical instrumental examination was carried out in 128 children with cerebral palsy, aged from 1 to 7 years before and after the rehabilitation course. To assess the motor functional status of a child we used the scale and the gross motor function classification system. Among the instrumental methods the heart rate variability, electroencephalography and Doppler ultrasound of cerebral vessels were used.

Results. The application of normobaric hypoxic therapy in complex rehabilitation of children with cerebral palsy results in improvement of adaptive capacity, reduction of the manifestations of asthenovegetative syndrome, normalization of heart rate variability, improvement of EEG parameters and cerebral circulation at the end of the course of rehabilitation. In children who additionally received the course of normobaric hypoxic therapy, we observed the increase of the general motor activity and the formation of new motor skills compared with the children who received standard therapy.

Conclusions. The method of normobaric hypoxic therapy increases the adaptive capacities of children with cerebral palsy, conduces to improvement the efficiency of complex rehabilitation.

Keywords: child's cerebral palsy, normobaric hypoxic therapy, adaptation potential.

Objective – to determine the effect of normobaric hypoxic therapy on the adaptive potential at children with the spastic variants of cerebral palsy.

Methods and subjects. The complex clinical instrumental examination was carried out in 128 children with cerebral palsy, aged from 1 to 7 years before and after the rehabilitation course. To assess the motor functional status of a child we used the scale and the gross motor function classification system. Among the instrumental methods the heart rate variability, electroencephalography and Doppler ultrasound of cerebral vessels were used.

Results. The application of normobaric hypoxic therapy in complex rehabilitation of children with cerebral palsy results in improvement of adaptive capacity, reduction of the manifestations of asthenovegetative syndrome, normalization of heart rate variability, improvement of EEG parameters and cerebral circulation at the end of the course of rehabilitation. In children who additionally received the course of normobaric hypoxic therapy, we observed the increase of the general motor activity and the formation of new motor skills compared with the children who received standard therapy.

Conclusions. The method of normobaric hypoxic therapy increases the adaptive capacities of children with cerebral palsy, conduces to improvement the efficiency of complex rehabilitation.

Keywords: child's cerebral palsy, normobaric hypoxic therapy, adaptation potential.

Objective – to improve the results of surgical treatment of spasticity and neuropathic pain syndrome in patients with consequences of cervical spine injury. Treatment of spasticity and neuropathic pain syndrome in patients with consequences of cervical spine injury is complex due to wide distribution of pain and spasticity and because of the majority of surgical techniques are aimed on resolving segmental dysfunctions.

Methods and subjects. Outcomes of surgical treatment of 26 patients suffering from neuropathic pain syndrome and spasticity due to cervical spine injury are presented. Of these 26 patients 7 suffered from pain, 12 – from spasticity and 7 patients had combination of spasticity and pain. Results of surgeries were graded depending on trauma severity and type of surgical intervention preformed.

Results. Epidural stimulation for neuropathic pain treatment was effective in 77.8 % of patients, cervical DREZ-tomy – in all patients; and as treatment modality for spasticity stimulation was effective in 33.3 %, cervical DREZ-tomy – 85.7 %, lumbar DREZ-tomy – in all patients.

Conclusions. Differential approach in choosing appropriate surgical technique for treatment of patients with consequences of cervical spine injury allows to achieve good recovery in a majority of patients.

Keywords: spinal cord injury, spasticity, pain syndrome.

Objective – to improve the results of surgical treatment of spasticity and neuropathic pain syndrome in patients with consequences of cervical spine injury. Treatment of spasticity and neuropathic pain syndrome in patients with consequences of cervical spine injury is complex due to wide distribution of pain and spasticity and because of the majority of surgical techniques are aimed on resolving segmental dysfunctions.

Methods and subjects. Outcomes of surgical treatment of 26 patients suffering from neuropathic pain syndrome and spasticity due to cervical spine injury are presented. Of these 26 patients 7 suffered from pain, 12 – from spasticity and 7 patients had combination of spasticity and pain. Results of surgeries were graded depending on trauma severity and type of surgical intervention preformed.

Results. Epidural stimulation for neuropathic pain treatment was effective in 77.8 % of patients, cervical DREZ-tomy – in all patients; and as treatment modality for spasticity stimulation was effective in 33.3 %, cervical DREZ-tomy – 85.7 %, lumbar DREZ-tomy – in all patients.

Conclusions. Differential approach in choosing appropriate surgical technique for treatment of patients with consequences of cervical spine injury allows to achieve good recovery in a majority of patients.

Keywords: spinal cord injury, spasticity, pain syndrome.

In the review of last years researches about the stem neural cells adult brain have been analyzed. New neurogenesis occurs only in discrete regions of the adult brain: the sub ventricular zone and the sub granular zone. In these areas, there are stem neural cells multipotent and self renewing, which are regulated by number of growth factors und cytokines of the immune system. The following cytokines are studied: chemokines CCL-2, CXCL-12, interleukin-4, -6, interferon γ and tumor necrosis factor α. These substances exert a considerable and survival, migration and differentiation.
Recently, chemokines and cytokines have been identified as important regulators stem neural cell of adult brain. Hence the immune system is emerging as a regulator of neurogenic niches.

Keywords: stem neural cells of adult brain, niches, chemokines, interleukins, interferons, migration, proliferation.

In the review of last years researches about the stem neural cells adult brain have been analyzed. New neurogenesis occurs only in discrete regions of the adult brain: the sub ventricular zone and the sub granular zone. In these areas, there are stem neural cells multipotent and self renewing, which are regulated by number of growth factors und cytokines of the immune system. The following cytokines are studied: chemokines CCL-2, CXCL-12, interleukin-4, -6, interferon γ and tumor necrosis factor α. These substances exert a considerable and survival, migration and differentiation.
Recently, chemokines and cytokines have been identified as important regulators stem neural cell of adult brain. Hence the immune system is emerging as a regulator of neurogenic niches.

Keywords: stem neural cells of adult brain, niches, chemokines, interleukins, interferons, migration, proliferation.

Because of the prevalence of the disease the questions of treatment of neurological manifestations of lumbar osteochondrosis remain extremely relevant, despite years of research in the field of vertebral neurology. Analyzing the general principles of modern treatment of this nosology authors concluded the necesity for primary use of methods of kinesiotherapy and especially its main component – manual therapy. Priority must be given to the «soft» methods – postisometric muscle relaxation and a point and segmental massage.

Keywords: lumbar osteochondrosis, manual therapy, spinal motion segment.

Because of the prevalence of the disease the questions of treatment of neurological manifestations of lumbar osteochondrosis remain extremely relevant, despite years of research in the field of vertebral neurology. Analyzing the general principles of modern treatment of this nosology authors concluded the necesity for primary use of methods of kinesiotherapy and especially its main component – manual therapy. Priority must be given to the «soft» methods – postisometric muscle relaxation and a point and segmental massage.

Keywords: lumbar osteochondrosis, manual therapy, spinal motion segment.

Objective – to study the effect of Actovegin application in complex rehabilitation treatment of patients with oculomotor disorders in early post operation period.

Methods and subjects. 120 patients with oculomotor disorders have been examined. Comprehensive clinical, neurological and neuroophthalmological examination, neurovisual methods (magnetic resonance, computer tomography of the brain) were carried out.

Results. Actovegin application in the early post operational period for patients with vascular pathology, brain injury, brain tumors with oculomotor disorders improves regeneration of III, IV, VI cranial nerves function. In 3 months after treatment 32 (53.3 %) patients presented complete regress in oculomotor disorders in main group, and in control group – 27 (45 %).

Conclusions. Actovegin application in the early post operational period in complex rehabilitation treatment of patients with oculomotor disorders contributes complete recovery of III, IV, VI nerves functions and quality of patients life.

Keywords: neurogenic ophthalmopathy, oculomotor disorders, rehabilitation treatment, Actovegin.

Objective – to study the effect of Actovegin application in complex rehabilitation treatment of patients with oculomotor disorders in early post operation period.

Methods and subjects. 120 patients with oculomotor disorders have been examined. Comprehensive clinical, neurological and neuroophthalmological examination, neurovisual methods (magnetic resonance, computer tomography of the brain) were carried out.

Results. Actovegin application in the early post operational period for patients with vascular pathology, brain injury, brain tumors with oculomotor disorders improves regeneration of III, IV, VI cranial nerves function. In 3 months after treatment 32 (53.3 %) patients presented complete regress in oculomotor disorders in main group, and in control group – 27 (45 %).

Conclusions. Actovegin application in the early post operational period in complex rehabilitation treatment of patients with oculomotor disorders contributes complete recovery of III, IV, VI nerves functions and quality of patients life.

Keywords: neurogenic ophthalmopathy, oculomotor disorders, rehabilitation treatment, Actovegin.

Objective – to study the influence of medications for anesthesiology on bioelectric brain activity, develop new approaches for the neuroprotective therapy while anesthesiology and early post surgery period.

Methods and subjects. 34 patients with children cerebral palsy were examined from 2007 till 2009 years. There were two groups of patients. The first group patients (n = 19) were given citicoline during anesthesiology and early post surgery period. The control group patients (n = 15) had anesthesiology without neuroprotection.

Results. Patients of the first group demonstrated all indexes of vital functions in norm and didn’t require additional medications. Patients from the control group presented with vomiting without relief, headaches (as liquor dynamic dysadaptation), hypertensive syndrome, that caused severe headaches and muscular spasticity intensification. These symptoms required application of dehydrative and sedative therapy. Also patients from the second group demonstrated worse results of electroencephalography: irritating phenomena intensification such as deltaand teta-rhythm increasing, their determination in all brain parts, absence of the reaction on eyes opening, pick-wave activity, nonspecific medial brain structures activity intensification, reduced regulation function.

Conclusions. Multi component neuroprotective therapy relieves early post surgery period, promotes with faster drug sleep recovery without side effects. Application of this therapy leads to positive bioelectrical brain activity that is evidenced by alpha-rhythm frequency improvements. Therapy also promotes with faster recovery and possibility to move independently.

Keywords: children cerebral palsy, surgery, anesthesiology, electroencephalography, neuroprotection.

Objective – to study the influence of medications for anesthesiology on bioelectric brain activity, develop new approaches for the neuroprotective therapy while anesthesiology and early post surgery period.

Methods and subjects. 34 patients with children cerebral palsy were examined from 2007 till 2009 years. There were two groups of patients. The first group patients (n = 19) were given citicoline during anesthesiology and early post surgery period. The control group patients (n = 15) had anesthesiology without neuroprotection.

Results. Patients of the first group demonstrated all indexes of vital functions in norm and didn’t require additional medications. Patients from the control group presented with vomiting without relief, headaches (as liquor dynamic dysadaptation), hypertensive syndrome, that caused severe headaches and muscular spasticity intensification. These symptoms required application of dehydrative and sedative therapy. Also patients from the second group demonstrated worse results of electroencephalography: irritating phenomena intensification such as deltaand teta-rhythm increasing, their determination in all brain parts, absence of the reaction on eyes opening, pick-wave activity, nonspecific medial brain structures activity intensification, reduced regulation function.

Conclusions. Multi component neuroprotective therapy relieves early post surgery period, promotes with faster drug sleep recovery without side effects. Application of this therapy leads to positive bioelectrical brain activity that is evidenced by alpha-rhythm frequency improvements. Therapy also promotes with faster recovery and possibility to move independently.

Keywords: children cerebral palsy, surgery, anesthesiology, electroencephalography, neuroprotection.

Objective – to estimate the possible use of tumor necrosis factor alpha (TNF<α) as an informative biomarker of a severe status and prognosis at herpesvirus neuroinfection with temporal epilepsy syndrome.

Methods and subjects. The studied group (SG) consisted of 43 patients aged from 16 to 60 with a verified herpesvirus neuroinfection with epilepsy syndrome. The control group (CG) consisted of 20 patients of the similar age having epilepsy, not associated with herpesvirus neuroinfection. TNF<α concentration in blood serum was determined by the method of enzyme.

Results. The patients of SG marked high concentration of TNF<α in blood serum (Х ± m = 288 ± 44.7 pg/ml) being confidently higher than that of CG (р < 0.05; Z < Z0.05). The level of serum TNF<α concentration, higher than 100 pg/ml, correlates with a patient’s general severe condition, a pronounced epilepsy syndrome, a longer disease history and deep organic brain lesion as well as low.

Conclusions. Patients with herpesvirus neuroinfection in the form of epilepsy syndrome present the syndrome of a systemic inflammatory response that affects patient’s state and can be an object for therapeutic intervention. TNF-alpha may be used as an informatory biomarker to provide an objective evaluation of a patient’s severe state as well as to make a substantiated prognosis of a further disease flow in patients with virus-induced temporal epilepsy.

Keywords: tumor necrosis factor alpha, herpesviruses, temporal epilepsy, biomarker.

Objective – to study the influence of medications for anesthesiology on bioelectric brain activity, develop new approaches for the neuroprotective therapy while anesthesiology and early post surgery period.

Methods and subjects. 34 patients with children cerebral palsy were examined from 2007 till 2009 years. There were two groups of patients. The first group patients (n = 19) were given citicoline during anesthesiology and early post surgery period. The control group patients (n = 15) had anesthesiology without neuroprotection.

Results. Patients of the first group demonstrated all indexes of vital functions in norm and didn’t require additional medications. Patients from the control group presented with vomiting without relief, headaches (as liquor dynamic dysadaptation), hypertensive syndrome, that caused severe headaches and muscular spasticity intensification. These symptoms required application of dehydrative and sedative therapy. Also patients from the second group demonstrated worse results of electroencephalography: irritating phenomena intensification such as deltaand teta-rhythm increasing, their determination in all brain parts, absence of the reaction on eyes opening, pick-wave activity, nonspecific medial brain structures activity intensification, reduced regulation function.

Conclusions. Multi component neuroprotective therapy relieves early post surgery period, promotes with faster drug sleep recovery without side effects. Application of this therapy leads to positive bioelectrical brain activity that is evidenced by alpha-rhythm frequency improvements. Therapy also promotes with faster recovery and possibility to move independently.

Keywords: children cerebral palsy, surgery, anesthesiology, electroencephalography, neuroprotection.

Цель — изучить влияние на биоэлектрическую активность мозга препаратов, применяемых при анестезиологическом обеспечении хирургического лечения больных детским церебральным параличом, разработать подходы к нейропротекции во время анестезиологического пособия и в ранний послеоперационный период.

Материалы и методы. Обследовано 34 больных детским церебральным параличом (спастическая диплегия) в период с 2007 по 2009 г. Все больные были распределены на две группы. У пациентов первой группы (n = 19) применяли цитиколин во время операции и в ранний послеоперационный период. Во второй группе (контрольная, n = 15) проводили наркоз без нейропротекции.

Результаты. У больных первой группы в послеоперационный период все показатели жизненно важных функций были в пределах нормы, не требовалась их дополнительная медикаментозная коррекция. Во второй группе у пациентов наблюдали многократные рвоты натощак, не приносящие облегчения, упорные, распирающие головные боли (что расценивалось как дезадаптация ликвородинамики), нарастание явлений гипертензионного синдрома, приводящее к усилению болевого синдрома и нарастанию мышечной спастичности. Данные симптомы требовали назначения дегидратирующей и седативной терапии. В первой группе подобные явления не отмечены. Также у пациентов второй группы наблюдали негативную динамику показателей электроэнцефалографии: нарастание ирритативных явлений в виде увеличения индексов дельта- и тета-ритмов, их представленности во всех отделах мозга, отсутствие реакции на открывание глаз, появление пик-волновой активности, что расценивалось нами как нарастание активности неспецифических срединных структур мозга, снижение регулирующей функции коры мозга вследствие гипоксии и нарушения микроциркуляции.

Выводы. Многокомпонентная нейропротекция значительно облегчает ранний послеоперационный период, способствует более быстрому выходу из состояния медикаментозного сна, без каких либо побочных эффектов. Применение усовершенствованной методики приводит к позитивным изменениям биоэлектрической активности в виде улучшения частотно-амплитудных характеристик альфа-ритма, а также способствует более быстрому восстановлению и обучению ребенка самостоятельно передвигаться.

Keywords: детский церебральный паралич, операция, анестезия, электроэнцефалография, нейропротекция.

Цель — оценить возможность использования фактора некроза опухоли альфа (ФНО<α) в качестве информативного биомаркера тяжести состояния и прогнозирования при герпесвирусной нейроинфекции с височным эпилептическим синдромом.

Материалы и методы. В исследуемую группу вошли 43 пациента в возрасте от 16 до 60 лет с верифицированной герпесвирусной нейроинфекцией и эпилептическим синдромом, в контрольную — 20 пациентов аналогичного возраста с эпилепсией, не связанной с герпесвирусной нейроинфекцией. Концентрацию ФНО<α в сыворотке крови определяли методом твердофазного иммуноферментного анализа (реактивы «Вектор-Бест», РФ; норма — 0—50 пг/мл).

Результаты. У пациентов исследуемой группы отмечена высокая концентрация ФНО<α в сыворотке крови — (288 ± 44,7) пг/мл, которая была достоверно выше, чем в контрольной группе (р < 0,05; Z < Z0,05). Уровень сывороточной концентрации ФНП<α более 100 пг/мл коррелирует с тяжёлым общим состоянием больного, более выраженным эпилептическим синдромом, длительным анамнезом болезни, глубоким органическим поражением головного мозга, низкой чувствительностью к противосудорожным и противовирусным препаратам и неблагоприятным прогнозом.

Выводы. У пациентов с герпесвирусной нейроинфекцией в виде эпилептического синдрома имеет место синдром системного воспалительного ответа, влияющий на тяжесть состояния больного, который может быть объектом терапевтических вмешательств. ФНО<α можно использовать как информативный биомаркер для объективной оценки тяжести состояния больного и обоснованного прогнозирования дальнейшего течения болезни у пациентов с вирус-индуцированной височной эпилепсией.

Keywords: фактор некрозу пухлини альфа, герпесвіруси, скронева епілепсія, біомаркер.

In the review of last years researches about the stem neural cells adult brain have been analyzed. New neurogenesis occurs only in discrete regions of the adult brain: the sub ventricular zone and the sub granular zone. In these areas, there are stem neural cells multipotent and self renewing, which are regulated by number of growth factors und cytokines of the immune system. The following cytokines are studied: chemokines CCL-2, CXCL-12, interleukin-4, -6, interferon γ and tumor necrosis factor α. These substances exert a considerable and survival, migration and differentiation.
Recently, chemokines and cytokines have been identified as important regulators stem neural cell of adult brain. Hence the immune system is emerging as a regulator of neurogenic niches.

Keywords: stem neural cells of adult brain, niches, chemokines, interleukins, interferons, migration, proliferation.

Objective – to investigate prevalence and clinical course of migraine in Ukraine.

Methods and subjects. A total 2255 adult (1150 women/1105 men) at the age from 16 to 60 years in organized population of Sumy region of Ukraine were tested with anonym questionnaire (high-school students, workers, medical personal). Type of headache was classified according to the International Classification of Headache disorder 2nd edition.

Results. The population prevalence of migraine was 11.9 %, in women – 17.7 %, in men – 5.9 %. Migraine without aura was observed in 80.2 %, with aura – in 19.8 %. The episodic migraine with rare attack was in 38.8 %, with frequent attack in 53.4 %, chronic migraine – in 7.8 %. Many trigger factors of migraine attack were studied. Only 26.1 % patients consulted with doctors for headache treatment. Only 4.5 % used triptans for attack treatment.

Conclusions. The identification of migraine prevalence in organized group more accurately reflects the migraine population that should help to improve management of migraine in Ukraine.

Keywords: migraine, prevalence, clinical course.

Objective – to study the presence of a genetic predisposition to cognitive disorders based on the study of polymorphism of apolipoprotein E (ароЕ) in patients with repeated mild traumatic brain injury (TBI).

Methods and subjects.We examined 86 amateur boxers with high skill level aged from 18 to 32 years, playing a boxing classes ranging between 5 to 14 years. During a sports career boxers underwent TBI in the form knock down and knockouts in number from 1 to 10. The control group comprised 30 patients aged from 18 till 25 years without TBI, neurological complaints, nervous and cardiac system diseases. The neuropsychological research and genetic testing to determine the apoE genotype and apoE alleles were conducted.

Results. These neuropsychological tests shows a reduction of cognitive functions in boxers with repeated mild TBI. The lowest result was observed in patients with ε4 allele, and this difference is statistically reliable. In the control group rates of cognitive functions were slightly different from the norm.

Conclusions. Proved connection of apoE, including alleles ε4, with the development of cognitive disorders in boxers after deferred mild TBI. Genetic testing (determination apoEε4) allows to predict the possibility of developing complications from the side of the nervous system after TBI.

Keywords: genetic testing, apolipoprotein E, cognitive impairment, traumatic brain injury, boxer.

Оbjective – to study clinical and biochemical indicators and electrolytic data in blood serum of patients with pharmaco-resistant epilepsy under baseline conditions.

Methods and subjects. 46 patients with therapy-resistant epilepsy (ranged 24–42 years) and 10 healthy females (28–34 years) were examined. Serum levels of cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, total lipids, non-etherified fatty acids, electrolytes were measured with spectrophotometric method, tau-immunofluorescence methods with using primary and secondary monoclonal antibodies.

Results. Results of this investigation showed that patients with epilepsy with frequent seizures, pharmaco-resistant course and psychiatric complications under a baseline condition had increased serum levels of tau protein vs. controls that could reflect the severe of disease either because of high frequent seizures or long epilepsy duration. Changes in electrolytes were not observed in patients with epilepsy. Investigating of lipids exchange revealed in 9 patients demonstrated slightly high cholesterol and high-density lipoproteins levels.

Conclusions. In patients with epilepsy and pharmaco-resistant course tau protein levels are getting higher in blood serum under baseline conditions.

Keywords: neurobiochemistry, pharmaco-resistant epilepsy.

В обзоре литературы проанализированы исследования последних лет, посвященные стволовым нервным клеткам взрослого головного мозга. Неонейрогенез во взрослом мозге происходит в определенных зонах: субвентрикулярной области и субгранулярной зоне зубчатой извилины гиппокампа. В этих зонах содержатся мультипотентные и самоподдерживающиеся стволовые клетки, которые регулируются факторами роста и цитокинами иммунной системы. Наиболее изучены хемокины ССL-2, СХСL-12, интерлейкин-4 и -6, γ-интерферон и фактор некроза опухоли α. Эти вещества определяют пролиферацию и выживаемость, а также миграцию и дифференцировку стволовых нервных клеток. Сегодня цитокины и хемокины рассматривают как новый класс нейромодуляторов, регулирующих функции стволовых клеток во взрослом мозге. Таким образом, цитокины иммунной системы организма являются важным регулятором пролиферации и миграции стволовых нервных клеток, а иммунная система — регулятором нейрогенеза в нишах взрослого мозга.

Keywords: стволовые нервные клетки взрослого головного мозга, биологические ниши, хемокины, интерлейкины, интерфероны, миграция, пролиферация.

Objective – to improve the results of surgical treatment of spasticity and neuropathic pain syndrome in patients with consequences of cervical spine injury. Treatment of spasticity and neuropathic pain syndrome in patients with consequences of cervical spine injury is complex due to wide distribution of pain and spasticity and because of the majority of surgical techniques are aimed on resolving segmental dysfunctions.

Methods and subjects. Outcomes of surgical treatment of 26 patients suffering from neuropathic pain syndrome and spasticity due to cervical spine injury are presented. Of these 26 patients 7 suffered from pain, 12 – from spasticity and 7 patients had combination of spasticity and pain. Results of surgeries were graded depending on trauma severity and type of surgical intervention preformed.

Results. Epidural stimulation for neuropathic pain treatment was effective in 77.8 % of patients, cervical DREZ-tomy – in all patients; and as treatment modality for spasticity stimulation was effective in 33.3 %, cervical DREZ-tomy – 85.7 %, lumbar DREZ-tomy – in all patients.

Conclusions. Differential approach in choosing appropriate surgical technique for treatment of patients with consequences of cervical spine injury allows to achieve good recovery in a majority of patients.

Keywords: spinal cord injury, spasticity, pain syndrome.

Лекция посвящена одному из самых опасных заболеваний человека — нейроСПИДу. Рассмотрены эпидемиология, патогенез, основные клинические формы первичных и вторичных поражений нервной системы при заболевании СПИДом. Основное внимание уделено синдрому первичного поражения — СПИД-деменции, а также поражениям нервной системы, связанным с инфекциями на фоне иммунодефицита. Подчеркнута необходимость ранней диагностики неврологических осложнений СПИДа.

Keywords: нейроСПИД, первичные поражения, СПИД-деменция, вторичные поражения.

Objective – to reveal characteristic neurologic and clinical features of a current cerebral toxoplasmosis at sick of a HIV-infection and broaden the etiotropic treatment tactics and secondary prevention.

Methods and subjects. 36 cases toxoplasmosis encephalitis at a HIV – infected patients have been analyzed who underwent treatment on the basis of the Odessa Regional center on preventive maintenance and AIDS control.

Results. It is established that the given etiology of encephalitis is frequent primary AIDS display disease, it is well diagnosed on modern laboratory equipment and x-ray apparatus, as a whole has favorable vital prognosis.

Conclusions. Toxoplasmosis is the most widespread parasitogenic opportunistic infection of central nervous system at sick of AIDS. Knowledge of typical clinical presentation and risk factors is important for timely diagnostics and treatment of cerebral toxoplasmosis. In the article the clinical displays of disease a toxoplasmosis encephalitis are studied at HIV – infected patients. The high informing MRI.

Keywords: AIDS, cerebral toxoplasmosis, diagnostics, treatment.

Objective – an estimation of endothelial functions’ parameters at the patients with diabetic encephalopathy (DE) and correlation relations with parameters of cerebral hemodynamic.

Methods and subjects. 88 patients with diabetes mellitus were examined: 27 patients with a syndrome of a autonomic dystonia, 33 – with a DE of I stage, 28 – with DE II stage. Transcranial ultrasound dopplerography of the main brain arteries and level of endothelial functions’ parameters (arterial endothelial grow factor – AEGF, nitrites, nitrates, induced NO-synthase and endothelinum-1) were carried out for all patients.

Results. Statistical validity increase of the levels of endothelial functions’ parameters at the patients suffering from diabetes mellitus with cerebral impairments is established. Correlation relations between the level of AEGF and average speed of a blood flow in frontal brain artery (r = –0.4447, p = 0.0044), in posterior brain artery (r = –0.6694, p = 0.0023), in basilar artery (r = –0.4104, p = 0.0049), with an index of resistance in middle brain artery (r = 0.4924, p = 0.0037) and an index of resistance in posterior brain artery (r = 0.5109, p = 0.003) have been revealed. Correlation relations between the level of glycemia and the level of induced NO-synthase (r = 0.56, p = 0.0036), nitrite- and nitrate-anions (accordingly r = 0.48, p = 0.0024 and r = 0.42, p = 0.0028), the level of AEGF (r = 0.5806, p = 0.0023) have been revealed.

Conclusions. At the patients with a diabetic encephalopathy the impairments of endothelial functions’ parameters were revealed, which is correlated with increased manifestations cerebral dysfunctions and decreased parameters of cerebral hemodynamic. Correlation relations between the level of hyperglycemia and formation of endothelial dysfunction were established.

Keywords: diabetic encephalopathy, cerebral hemodynamic, endothelial dysfunction.

Because of the prevalence of the disease the questions of treatment of neurological manifestations of lumbar osteochondrosis remain extremely relevant, despite years of research in the field of vertebral neurology. Analyzing the general principles of modern treatment of this nosology authors concluded the necesity for primary use of methods of kinesiotherapy and especially its main component – manual therapy. Priority must be given to the «soft» methods – postisometric muscle relaxation and a point and segmental massage.

Keywords: lumbar osteochondrosis, manual therapy, spinal motion segment.

Цель — выявить клинические особенности церебрального токсоплазмоза у больных ВИЧ-инфекцией и разработать предложения по расширению тактики этиотропного лечения и вторичной профилактики.

Материалы и методы. Проанализированы 36 случаев токсоплазмозного энцефалита у ВИЧ-инфицированных больных, проходивших стационарное лечение на базе Одесского областного центра по профилактике и борьбе со СПИДом.

Результаты. Установлено, что данная этиология энцефалита часто является первичным СПИД-индикаторным заболеванием, хорошо диагностируется на современном лабораторном и рентгеноборудовании, в целом имеет благоприятный витальный прогноз.

Выводы. Токсоплазмоз является наиболее распространенной паразитарной оппортунистической инфекцией центральной нервной системы у больных СПИДом. Знания клинической картины и факторов риска являются важными для своевременной диагностики и лечения церебрального токсоплазмоза у этой категории больных. МРТ-исследование головного мозга как наиболее ранний метод нейровизуализации патологического процесса является высокоинформативным.

Keywords: СПИД, церебральный токсоплазмоз, диагностика, лечение.

Мета — вивчення клініко-біохімічних показників та показників електролітного обміну в сироватці крові хворих з фармакорезистентним перебігом епілепсії у період між нападами.

Матеріали і методи. Обстежено 46 жінок, хворих на епілепсію, віком 24—42 роки та 10 здорових жінок віком 28—34 роки. Рівень загального холестерину, тригліцеридів, ліпопротеїнів високої та низької щільності, загальних ліпідів, неетерифікованих жирних кислот, електролітів визначали спектрофотометричним методом, тау-протеїну — імунофлюоресцентним методом з використанням первинних та вторинних антитіл у сироватці крові.

Результати. У хворих на епілепсію з частими нападами, фармакорезистентним перебігом та психічними порушеннями у період між нападами має місце підвищення рівня тау-протеїну порівняно з контрольною групою, що може відображати тяжкість перебігу захворювання як за показником частоти епілептичних нападів, так і за тривалістю захворювання. Змін в електролітному спектрі у хворих на епілепсію не спостерігали. При дослідженні показників ліпідного спектра у 9 хворих виявлено незначне підвищення рівня загального холестерину та ліпопротеїнів високої щільності.

Висновки. У хворих на епілепсію з фармакорезистентним перебігом у період між нападами підвищується рівень тау-протеїну в сироватці крові.

Keywords: нейробіохімія, фармакорезистентна епілепсія.

Цель — оценить значение клинических неврологических критериев и методов нейровизуализации в диагностике инфарктов продолговатого мозга.

Материалы и методы. Проведено клинико-неврологическое и нейровизуализационное обследование 22 пациентов (12 мужчин и 10 женщин) с острым инфарктом продолговатого мозга в возрасте от 50 до 85 лет (средний возраст — (61,3 ± 10,4) года), которые лечились в 2007—2010 гг. в неврологическом центре Александровской клинической больницы г. Киева. Комплексное обследование включало изучение анамнеза и темпа развития инсульта, оценку неврологического статуса по шкале NIHSS, B. Hoffenberth и соавт., модифицированной шкале Ренкина, индексу Бартел. Локализацию и размер ишемического очага верифицировали с помощью магнитно-резонансного томографического обследования головного мозга.

Результаты. Инфаркты продолговатого мозга проявлялись тяжёлым и очень тяжёлым неврологическим дефицитом. В зависимости от локализации инфарктного очага различали латеральные, медиальные инфаркты, а также комбинации латеральных и медиальных медуллярных инфарктов. В последнем случае они характеризовались комбинацией неврологических симптомов, полиморфизмом проявлений. Латеральная локализация инфарктного очага в 60 % случаев сопровождалась альтернирующим синдромом Валленберга. Односторонние медиальные медуллярные инфаркты манифестировали синдромом чисто моторной гемиплегии, нарушением проприоцептивной чувствительности контралатерально; двусторонние — бульбарным синдромом, вялым тетрапарезом, нарушениями дыхания. Течение медуллярного инфаркта более благоприятно в случае латеральной локализации очага. Медиальные медуллярные, а также комбинированные инфаркты имели тяжёлое течение и неблагоприятные последствия.

Выводы. Статистический анализ показал, что латеральные медуллярные инфаркты коррелировали с системным головокружением, тошнотой и рвотой (р = 0,031; ДИ 0,54—0,94), нистагмом (р = 0,004; ДИ 0,54—0,94), ипсилатерально — с сегментарным нарушением болевой и температурной чувствительности на лице (р = 0,03; ДИ 0,36—0,8), синдромом Бернара—Горнера (р = 0,008; ДИ 0,48—0,9), мозжечковой атаксией (р = 0,004; ДИ 0,54—0,94), контралатерально — гипестезией болевой и температурной чувствительности по проводниковому типу (р = 0,03; ДИ 0,36—0,8). Медиальные медуллярные инфаркты коррелировали с контралатеральной тактильной анестезией и батианестезией (р = 0,001; ДИ 0,36—0,98), тетрапарезом (р = 0,009; ДИ 0,23—0,89). Часто определялись дизартрия, дисфония (у 65 % пациентов), дисфагия (у 55 %), реже — икота, дыхательная дисфункция (у 35 %). Знание специфических неврологических признаков поражения проксимальной сосудистой территории может улучшить клиническую диагностику инфаркта продолговатого мозга. Однако достоверное определение отдельных вариантов медуллярных инфарктов возможно лишь при условии учёта типичных клинических проявлений и данных нейровизуализации.

Keywords: ишемический инсульт, медуллярный инфаркт, клинические формы, лучевая диагностика.

Objective – an estimation of endothelial functions’ parameters at the patients with diabetic encephalopathy (DE) and correlation relations with parameters of cerebral hemodynamic.

Methods and subjects. 88 patients with diabetes mellitus were examined: 27 patients with a syndrome of a autonomic dystonia, 33 – with a DE of I stage, 28 – with DE II stage. Transcranial ultrasound dopplerography of the main brain arteries and level of endothelial functions’ parameters (arterial endothelial grow factor – AEGF, nitrites, nitrates, induced NO-synthase and endothelinum-1) were carried out for all patients.

Results. Statistical validity increase of the levels of endothelial functions’ parameters at the patients suffering from diabetes mellitus with cerebral impairments is established. Correlation relations between the level of AEGF and average speed of a blood flow in frontal brain artery (r = –0.4447, p = 0.0044), in posterior brain artery (r = –0.6694, p = 0.0023), in basilar artery (r = –0.4104, p = 0.0049), with an index of resistance in middle brain artery (r = 0.4924, p = 0.0037) and an index of resistance in posterior brain artery (r = 0.5109, p = 0.003) have been revealed. Correlation relations between the level of glycemia and the level of induced NO-synthase (r = 0.56, p = 0.0036), nitrite- and nitrate-anions (accordingly r = 0.48, p = 0.0024 and r = 0.42, p = 0.0028), the level of AEGF (r = 0.5806, p = 0.0023) have been revealed.

Conclusions. At the patients with a diabetic encephalopathy the impairments of endothelial functions’ parameters were revealed, which is correlated with increased manifestations cerebral dysfunctions and decreased parameters of cerebral hemodynamic. Correlation relations between the level of hyperglycemia and formation of endothelial dysfunction were established.

Keywords: diabetic encephalopathy, cerebral hemodynamic, endothelial dysfunction.

Цель — оценить показатели функционального состояния эндотелия у больных сахарным диабетом (СД) с диабетической энцефалопатией (ДЭ) и их корреляционные взаимосвязи с показателями церебральной гемодинамики.

Материалы и методы. Обследовано 88 больных СД: 27 — с синдромом вегетативной дистонии, 33 — с ДЭ I стадии, 28 — с ДЭ II стадии. Всем больным проведены транскраниальная допплерография магистральных сосудов головного мозга и определение показателей функционального состояния эндотелия — сосудисто-эндотелиального фактора роста (СЭФР), нитритов и нитратов, индуцибельной NO-синтазы и эндотелина-1.

Результаты. Установлено достоверное повышение уровня показателей функционального состояния эндотелия у больных СД с церебральными нарушениями. Выявлена достоверная корреляционная связь уровня СЭФР со средней скоростью кровотока в передней мозговой артерии (r = –0,4447, p = 0,0044), в задней мозговой артерии (r = –0,6694, p = 0,0023), в базилярной артерии (r = –0,4104, p = 0,0049), с индексом резистентности в средней мозговой артерии (r = 0,4924, p = 0,0037) и в задней мозговой артерии (r = 0,5109, p = 0,003), а также достоверная корреляционная связь уровня гликемии с активностью индуцибельной NO-синтазы (r = 0,56, p = 0,0036), уровнями нитрит- и нитрат-аниона (соответственно r = 0,48, p = 0,0024 и r = 0,42, p = 0,0028), СЭФР (r = 0,5806, p = 0,0023).

Выводы. У больных СД с ДЭ установлено нарушение функционального состояния эндотелия, которое связано с усилением проявлений церебральных дисфункций и ухудшением показателей церебральной гемодинамики. Выявлена связь гипергликемии с формированием эндотелиальной дисфункции.

Keywords: диабетическая энцефалопатия, церебральная гемодинамика, эндотелиальная дисфункция.

Цель — исследовать показатели психологической дисфункции — личностной (ЛТ) и реактивной (РТ) тревожности — у пациентов с хронической ишемией мозга (ХИМ) на фоне артериальной гипертензии (АГ).

Материалы и методы. Под нашим наблюдением находился 91 пациент среднего возраста (мужчин — 25, женщин — 66) с АГ. Все больные проходили обследование и лечение в отделениях кардиологии и неврологии Киевской городской клинической больницы № 12. Критерии исключения из исследования: инсульт в анамнезе, сахарный диабет и другие соматические заболевания. Обследование пациентов включало: анализ анамнестических данных и жалоб по специально разработанным опросникам, общеклиническое обследование с регистрацией динамики артериального давления, исследование неврологического статуса и ряда нейропсихологических характеристик, комплексное реографическое исследование.

Результаты. У пациентов с ХИМ на фоне АГ достоверно чаще регистрировали высокий уровень как ЛТ (в 79 % случаев), так и РТ (в 62 % случаев). С увеличением длительности болезни уменьшалась частота случаев низкого уровня РТ и увеличивалась частота случаев среднего уровня РТ. Частота случаев высокого уровня РТ уменьшалась при длительности АГ более 10 лет. У женщин достоверно чаще, чем у мужчин, регистрировали высокие уровни как ЛТ, так и РТ.

Выводы. У пациентов с ХИМ при АГ достоверно чаще регистрировали высокий уровень как ЛТ (у 79 % обследованных), так и РТ (у 62 %). С увеличением длительности болезни уменьшалась частота случаев с низким уровнем РТ и увеличивалась — со средним уровнем. Частота случаев с высоким уровнем РТ уменьшалась при длительности АГ более 10 лет. У женщин достоверно чаще, чем у мужчин, регистрировали высокий уровень как ЛТ, так и РТ.

Keywords: хроническая ишемия мозга, артериальная гипертензия, личностная тревожность, реактивная тревожность.

Цель — исследовать наличие генетической предрасположенности к когнитивным нарушениям на основе изучения полиморфизма гена аполипопротеина Е (апоЕ) у пациентов с повторными легкими черепно-мозговыми травмами (ЧМТ).

Материалы и методы. Обследованы 86 боксеров-любителей высокого уровня квалификации в возрасте от 18 до 32 лет, продолжительность занятий боксом — от 5 до 14 лет. Количество перенесенных ЧМТ в виде нокдаунов и нокаутов в зависимости от продолжительности спортивной карьеры составляло от 1 до 10. Контрольную группу составили 30 лиц в возрасте от 18 до 25 лет без наличия в анамнезе перенесенных ЧМТ, жалоб неврологического характера, сопутствующих заболеваний нервной и сердечно-сосудистой систем. Всем пациентам проводили нейропсихологическое исследование и генетическое тестирование на предмет определения генотипа апоE и аллелей апоE.

Результаты. Данные нейропсихологических тестов указывали на снижение когнитивных функций у боксеров с повторными легкими ЧМТ. Самый низкий результат наблюдали у пациентов с аллелем ε4, различие статистически достоверно. В контрольной группе показатели когнитивных функций незначительно отличались от нормы.

Выводы. Доказана связь генотипа апоЕ, в частности аллеля ε4, с развитием когнитивных нарушений у боксеров после перенесенных легких ЧМТ. Проведение генетического тестирования (определение генотипа апоЕε4) позволяет прогнозировать возможность развития нейропсихологических осложнений после перенесенных ЧМТ.

Keywords: генетическое тестирование, аполипопротеин Е, когнитивные нарушения, черепно-мозговая травма, боксер.

Цель — изучить распространенность и особенности клинического течения мигрени в организованной популяции населения Сумской области.

Материалы и методы. Проведено безвыборочное анкетирование 2255 человек (1155 женщин и 1105 мужчин) в возрасте от 16 до 60 лет в организованной популяции населения Сумской области Украины (студенты, рабочие, служащие, медицинские работники). Тип головной боли определяли согласно Международной классификации головной боли 2-го пересмотра.

Результаты. Распространенность мигрени составила 11,9 %: среди женщин — 17,7 %, среди мужчин — 5,9 %. Мигрень без ауры выявлена у 80,2 % лиц, с аурой — у 19,8 %, эпизодическая мигрень с редкими приступами — у 38,8 %, с частыми приступами — у 53,4 %, хроническая мигрень — у 7,8 %. Проанализированы основные триггерные факторы мигренозных приступов. К врачу обращались только 26,1 % лиц, триптаны для купирования приступа принимали 4,5 % лиц.

Выводы. Определение распространённости мигрени в организованной популяции населения более точно отражает структуру заболевания, что позволяет улучшить оказание помощи больным мигренью в Украине.

Keywords: мигрень, распространённость, клиническое течение.

Objective – to determine the effect of normobaric hypoxic therapy on the adaptive potential at children with the spastic variants of cerebral palsy.

Methods and subjects. The complex clinical instrumental examination was carried out in 128 children with cerebral palsy, aged from 1 to 7 years before and after the rehabilitation course. To assess the motor functional status of a child we used the scale and the gross motor function classification system. Among the instrumental methods the heart rate variability, electroencephalography and Doppler ultrasound of cerebral vessels were used.

Results. The application of normobaric hypoxic therapy in complex rehabilitation of children with cerebral palsy results in improvement of adaptive capacity, reduction of the manifestations of asthenovegetative syndrome, normalization of heart rate variability, improvement of EEG parameters and cerebral circulation at the end of the course of rehabilitation. In children who additionally received the course of normobaric hypoxic therapy, we observed the increase of the general motor activity and the formation of new motor skills compared with the children who received standard therapy.

Conclusions. The method of normobaric hypoxic therapy increases the adaptive capacities of children with cerebral palsy, conduces to improvement the efficiency of complex rehabilitation.

Keywords: child's cerebral palsy, normobaric hypoxic therapy, adaptation potential.

Цель — изучить влияние нормобарической гипокситерапии на адаптационный потенциал детей со спастическими вариантами церебрального паралича во время прохождения курса комплексной реабилитации.

Материалы и методы. Проведено комплексное клинико-инструментальное исследование 128 детей с церебральным параличом в возрасте от 1 года до 7 лет до и после курса реабилитации. Для оценки функционального двигательного состояния ребенка применяли систему классификации и шкалу больших моторных функций. В динамике оценивали показатели кардиоинтервалографии, электроэнцефалографии и транскраниальной допплерографии сосудов головного мозга.

Результаты. Использование нормобарической гипокситерапии в комплексной реабилитации детей с церебральным параличом способствовало уменьшению проявлений вегетативной дисфункции и астенического синдрома, нормализации показателей кардиоинтервалографии, улучшению показателей мозговой гемодинамики. У детей, которые дополнительно получали курс нормобарической гипокситерапии, наблюдали увеличение темпов нарастания общей двигательной активности и формирования новых двигательных навыков по сравнению с детьми, которые получали только базисную терапию.

Выводы. Методика нормобарической гипокситерапии позволяет улучшить адаптационные возможности детей с церебральным параличом, что способствует повышению эффективности комплексной реабилитации.

Keywords: детский церебральный паралич, нормобарическая гипокситерапия, адаптационный потенциал.

Цель — улучшить результаты лечения невропатического болевого синдрома и спастичности у больных с последствиями травматического повреждения шейных сегментов спинного мозга.

Материалы и методы. Проанализированы результаты лечения 26 больных с невропатическим болевым синдромом и спастичностью на фоне последствий травматического повреждения шейных сегментов спинного мозга. Больных с высокой спастичностью было 12, с невропатическим болевым синдромом — 7, с сочетанием невропатического болевого синдрома и спастичности — 7. Оценку результатов лечения проводили в зависимости от тяжести травмы и вида проведенного лечения.

Результаты. В лечении болевого синдрома эпидуральная электростимуляция была эффективной у 77,8 % больных, DREZ-томия шейного утолщения — у всех больных. В лечении спастичности электростимуляция была эффективной у 33,3 % больных, DREZ-томия шейного утолщения — у 85,7 %, DREZ-томия поясничного утолщения — у всех больных.

Выводы. Дифференцированный подход к выбору метода лечения спастичности и невропатического болевого синдрома у больных с последствиями травматического повреждения шейных сегментов спинного мозга позволяет добиться хорошего результата у большинства пациентов.

Keywords: травма спинного мозга, спастичность, болевой синдром.

Несмотря на многолетние исследования в области вертеброневрологии, вопросы лечения неврологических проявлений при поясничном остеохондрозе остаются чрезвычайно актуальными, прежде всего из-за распространенности этого заболевания. Анализируя общие принципы современного лечения данной нозологии, авторы пришли к выводу о необходимости преимущественного использования кинезиотерапевтических методов лечения и прежде всего мануальной терапии. Предпочтение следует отдавать «мягким» методикам — точечному и сегментарному массажу, постизометрической и постреципрокной релаксации мышц.

Keywords: остеохондроз позвоночника, мануальная терапия, позвоночный двигательный сегмент.

Цель — изучить эффективность применения препарата Актовегин в комплексном лечении больных с глазодвигательными нарушениями в ранний послеоперационный период.

Материалы и методы. Обследовано 120 больных с глазодвигательными нарушениями. Проведено комплексное клинико-неврологическое и нейроофтальмологическое обследование, применены нейровизуализирующие методы (магнитно-резонансная, компьютерная томография головного мозга).

Результаты. Использование в ранний послеоперационный период препарата Актовегин в комплексной терапии глазодвигательных нарушений у больных с сосудистой патологией, черепно-мозговыми травмами, опухолями головного мозга способствует восстановлению функции III, IV, VI черепных нервов. Через 3 мес от начала лечения в основной группе у 32 (53,3 %) больных наблюдали полный регресс глазодвигательных нарушений, в контрольной — у 27 (45 %).

Выводы. Применение в ранний послеоперационный период препарата Актовегин в комплексной терапии больных с глазодвигательными нарушениями повышает эффективность лечения, способствует восстановлению функции III, IV, VI черепных нервов, повышает качество жизни пациентов.

Keywords: неврогенные офтальмопатии, глазодвигательные нарушения, восстановительное лечение, Актовегин.