[The role of lactate acidosis in the development and treatment of various neurologic syndromes in children and adolescents].

The aim of the study was to detect the role of lactate acidosis, also to find the share of mitochondrial insufficiency in development of various neurologic syndromes in children and adolescents. The detection of cellular energetic metabolism and acid based imbalance is also important for finding the specific method of management. We have studied 200 patients with various degree of neurodevelopment delay with epilepsy and epileptic syndromes, headache, vertigo, early strokes, floppy infant syndrome, atrophy of ophthalmic nerve, cataracta, neurosensory deafness, systemic myopathy, cerebral palsy. In 27% of cases with various ages we have detected lactate acidosis and increase level of pyruvate. Mitochondrial insufficiency was seen in 8% of cases which gives us opportunity to find the specific method of treatment in this group of patients. Each patient with neurological symptoms requires correction of parameters of energetic and oxidative metabolism.

Management of burning mouth syndrome taking into consideration various etiologic factors.

The aim of the research was to detect the stomatologic, endocrine and psycho-neurologic status in patients with burning mouth syndrome, elaborate different diagnostic criteria and effective therapy for the patients with burning mouth syndrome. 92 patients with burning mouth syndrome were studied. Patients ranged in age from 28 to 72 years. The conducted studies gave the possibility to make conclusions, the most important of which are: burning mouth syndrome (BMS) is not only stomatologic problem; this psychosomatic syndrome belongs to gerontologic disease and tendency of its "rejuvenation" was revealed as well (in the current study --2 women (28 and 32 year old, and 38 year old man); degree of revelation of the symptoms of depression, anxiety, obsession and somatization is closely related with duration of the diseases. These symptoms are progressing together with aging and reach the peak at 60-70 years old. Individual scheme of therapy was developed on the background of clinico-paraclinical study.

[Role of various etiologic factors in the development of burning mouth syndrome].

Burning mouth syndrome (BMS) has been comparatively recently isolated as the separate nosologic diagnosis. This disease is characterized by the feeling of burning, dryness, numbness, pricking and seldom by pain in the tongue or mouth cavity area (palate, lips, alveoli) without any changes in mucous membrane. Absence of visible causes of the disease complicates its treatment and makes the patients to address the physicians of various profiles, often without any result. All the above stated made the authors to define the etiologic factors of various clinical versions of BMS and to carry out their differential diagnostics along with the development of pathogenetic therapy of BMS. 30 women of 40 to 70 year of age were examined. According to the anamnesis, BMS was developing gradually and in most cases it was associated with the aggravation of the existing disease (hypertension, diabetes mellitus, aggravation of climacteric state) or with deterioration of psycho-emotional sphere due to conflicting situation. The carried out studies enabled the authors to select and divide patients with BMS into groups according to clinical values and the etiologic factors. In most cases diverse clinical versions of the burning mouth syndrome are cause-and-effect expressions of various somatic diseases, the timely determination and adequate therapy of which give the best results in the struggle against BMS.

[Peculiarities of epileptic syndrome in children with metabolic disorders of nervous system].

Metabolic diseases of the nervous system vary considerably in their clinical and pathological aspects. In neurological presentations of these disorders dominate mental retardation and epileptic syndrome. We have studied 27 patients of age from 3 months to 3 years: PKU -- 15 cases; homocystinuria -- 4; hyper-prolinemia -- 1; methylmalonic acidemia -- 5 and combined disorders -- 2. Epileptic syndrome was revealed in 21 patients, mental retardation in 1, spasticity in 5 and ataxia in 1 patient. Epileptic syndrome was presented with generalized seizures (grand mal -- 6 cases, myoclonic absences -- 13 cases) and partial seizures (simple motor -- 2 cases). Investigations did not found reliable correlations between certain forms of enzymophaties and EEG patterns. Patients were treated by pathogenic (dietary management with protein-modified diet and vitamin therapy) and symptomatic (anticonvulsants) treatment. We have achieved the positive therapeutic effect by pathogenic and anticonvulsive treatment in 11 patients. All these patients were from the first group (1-3 year). The best outcome was observed in the cases of the early diagnosed PKU. The most severe mental retardation and resistant epilepsy were revealed in patients with combined disorders of metabolism and vitamin-non-responsive forms of MMA and HCS.