[Tenoxicam (texamen) in the treatment of acute cervicalgia: results of an open comparative trial].

OBJECTIVE: Acute cervical pain is one of the most common reasons for a visit to a doctor and temporal disability. We studied efficacy and safety of the nonsteroid anti-inflammatory drug tenoxicam (texamen) in the treatment of acute cervical pain in myofascial syndrome. MATERIAL AND METHODS: A trial included 50 people (42 women and 8 men, mean age 42,2±6,8 years) with acute cephalgia. A main group (30 patients) received tenoxicam in dose 20 mg daily in the morning during 7 days with simultaneous therapeutic exercises with elements of postisometric relaxation of cervical muscles. A control group (20 patients) received myorelaxants and massage of a cervical-collar zone. RESULTS: The analgesic effect was more rapid in patients treated with texamen compared to controls. Statistically significant differences were seen in 1-3 days of treatment. In the main group, the analgesic effect long, only 16,6% of patients reported the aggravation of pain in the evening hours during the first day of treatment and 10% in the 2nd day; 23,3% patients of the main group used an additional dose of texamen, another nonsteroid anti-inflammatory drug (ibuprofen) or triptan to stop pain. CONCLUSION: The introduction of nonsteroid anti-inflammatory drugs, in particular texamen, in the complex treatment of acute cephalgia can significantly reduce pain syndrome.

[Topiramate in the treatment of chronic migraine].

Patients with frequent episodic and chronic migraine, which is often complicated with drug abuse, are resistant to treatment. An objective of the study was to evaluate the efficacy and safety of topalepsin (topiramate) in the preventive treatment of migraine. Thirty patients with frequent episodic and chronic migraine were treated with topalepsin (100 mg daily) during 6 months. After treatment, there was a significant reduction in the number of days with headache and migraine attacks as well as their duration, severity of concomitant symptoms and amount of analgesics used by patients.

[The multimodal strategy for the neuroprotection in stroke: results of the Russian multicenter clinical-epidemiological program SOKOL].

A search for approaches to treatment of cerebrovascular diseases is urgent due to high prevalence and severity of this pathology. The objectives of the program were to analyze epidemiological indicators, risk factors, treatment patterns of chronic brain ischemia developed in patients with arterial hypertension (AH), to specify the scheme of treatment of patients with ischemic stroke (IS) with cavinton and cavinton forte and to evaluate the advantages of this drug in the complex schemes of standard therapy. An open comparison randomized multicenter prospective study included 661 patients, aged from 30 to 70 years, from 29 cities and 12 regions of the Russian Federation. Inpatients of the main group (n=344 or 52%) with II in the acute stage (5-14 days) received standard treatment with the addition of cavinton in infusions and then in tablets (cavinton forte). Patients of the comparison group received standard treatment without cavinton. The significant improvement by all indicators of efficacy was identified in both groups though positive changes were greater in the main group of patients. It is concluded that infusions of cavinton in the acute stage of IS with the following long-term treatment with tablets improve the restoration of neurological functions in the remote period compared to standard therapy.

[Preventive treatment of migraine with vasobral: a multicenter trial].

The results of an open prospective trial on the treatment of migraine with vasobral which was conducted in 170 medical centers (27 cities) of the Russian Federation are summarized. The trial included 5475 patients treated with vasobral in dosage 2 ml (1 ml contains 1 mg of alpha-dihydroergocryptine and 10 mg of caffeine) twice a day during 2 months. Assessment criteria of treatment efficacy were frequency and duration of migraine seizures, pain syndrome severity, presence of concomitant syndromes, general state and working capacity of patients and side-effects. Vasobral was effective and safe medication for the prevention of migraine. Its preventive effect is due to the decrease of frequency and duration of migraine seizures, pain severity and to the overall improvement of patient's state. Vasobral can be recommended to many migraine patients, in particular to those in the young age and with short disease duration.

[Trimigren in stopping migraine attacks: an open prospective multicenter comparative study of rectal suppository and tablet forms of sumatriptan].

Efficacy and safety of sumatriptan in rectal suppository (50 mg) and tablet forms (50 mg) in stopping migraine attacks has been studied in 80 patients with migraine with or without aura. Dynamics of migraine pain intensity measured with the VAS 30 min, 1, 2, 6 and 24 h after the first dose of drug was a primary index of efficacy. Secondary indices were the VAS intensity of nausea, vomiting, photophobia, phonophobia, duration of each migraine attack, quality of life parameters of a patient during the migraine attack assessed with the 24-hour questionnaire, severity of migraine course on the MIDAS, percentage of patients with complete regression of migraine pain, at least in 2 out of 3 attacks. To assess drug safety, any adverse effects, data of instrumental methods (clinical and biochemical blood tests, clinical urine test), EKG were taken into account. Rectal suppository had the more rapid effect on headache reduction compared to tablets. Changes of intensity of concomitant symptoms (nausea, vomiting, photophobia, phonophobia) as well as other secondary indices of drug efficacy were similar in both groups. In the group treated with rectal suppository, 9 (22.5%) patients had 12 adverse effects. In the group treated with tablets, 22 adverse effects were noted in 15 (37.5%) patients. Adverse effects related to the cardio-vascular system were observed less often in the group treated with rectal suppository (6.6 and 32%, respectively, p=0,004).

[Efficacy of sumamigren at early and late stages of migraine attack].

Three migraine attacks have been studied in 30 patients aged 39.4+/-10.5 years. A significant decrease of headache and concomitant symptoms was found 1, 2 and 6 h after receiving of sumamigren (sumatriptan). The drug was effective in 2 out of 3 attacks in most of the patients (53.3%); in 3 attacks--in 26.7%; in 1 attack--in 6.7%. In 13.3% of the patients the drug did not exert a therapeutic effect. When administering at the early stage of the attack, the drug reduced the headache after 1 and 2 h more significantly comparing to patients receiving it at the later stage. In case of early prescription of sumamigren, the relapse of headache was observed in 7,8% and in later one--in 20.5% of patients. During the first 24 h of attack, patients switched to the drug at the early stage reported higher quality of life (mean score 45.1+/-14.6) than those with later prescription (71.4+/-18.3). It has been concluded that sumamigren is an effective medication for stopping the migraine attack, in particular at its the beginning.

[The case of prominent EEG sleeping activity in thalamic stroke patients]. / Sluchai vyrazhennoi asimmetrii élektroéhtsefalograficheskoi aktivnosti vo vremia sna pri insul'te talamicheskoi lokalizatsii.

Presented here is a clinical case of thalamic stroke which affected mainly non-specific thalamic regions. In acute disease stage, the patient exhibited a prominent psychopathological features, slight hemihypoaesthesia and sleep disturbances. Polysomnography confirmed the disturbances of sleep structure: the increase of sleep onset latency, number of awakenings, waking time and stage 1 duration, decrease of both deep sleep stages (3 and 4) and REM sleep. Visual analysis revealed EEG spindle asymmetry in stage 2 of the first sleep cycle, with sleep spindles predominating in the undamaged hemisphere. Spectral EEG analysis confirmed the presence of power asymmetry not only in the sigma-band but also in the other band ranges. This clinical case allows discussing the role of the thalamus in generation of quiet sleep EEG phenomena.