[The efficacy of intravenous lacosamide in psychiatric hospital].

OBJECTIVE: To evaluate the efficacy and tolerability of intravenous lacosamide (vimpat) in inpatients with frequent partial-onset seizures and affective and cognitive disorders. MATERIAL AND METHODS: Fifteen patients were enrolled including 14 patients diagnosed with «organic personality disorder associated with epilepsy¼ (cryptogenic or symptomatic epilepsy with frequent partial-onset and/or secondary-generalized seizures (serial seizures in some cases) and 1 patient with a preliminary diagnosis of «organic schizophrenia-like disorder¼, which was changed for «organic personality disorder associated with epilepsy¼ after examination. Patients were treated with 2--3 antiepileptic drugs (AEDs), but no one of them received earlier lacosamide. Lacosamide was used intravenously in drops in the dose of 200 or 400 mg daily during 5 days. RESULTS AND CONCLUSION: In 4 patients with marked personality disorders, the frequency of seizures decreased by 75%, no seizures were noted after 2--3 days of treatment in 11 patients. A positive effect of lacosamide on the affective sphere and quality-of-life was observed in 11 (73.4%) patients with epilepsy. Mild and moderate adverse effects were found only in 2 patients. It has been concluded that lacosamide demonstrates the high efficacy in patients with frequent drug-resistant seizures.

[Experience in treating cysticercosis of the brain with azinox]. / Opyt lecheniia tsistitserkoza golovnogo mozga azinoksom.

A case of a patient resident from Tuva who had cerebral cysticercosis is presented. The diagnosis was established on the basis of the available clinical symptoms, brain RCT and NMRI findings and a positive serological reaction (enzyme immunoassay) with C. cellulosus antigen. The patient received 2 courses of treatment with the Russian drug azinox (praziquantel) in a daily dose of 50 mg/kg body weight thrice before meal. Prednisolone was additionally given in a daily dose of 30 mg. The course of treatment was 14 days. The first treatment days were marked by worse headache. Thereafter treatment induced no complications. Better condition, less headache, lower serological reaction titers, regressed cerebral structural changes were observed after the treatment. RCT and NMRI revealed transformation of cysts to high-density foci and calcificates.

[The catamnesis of patients with stenosis of the internal carotid artery who have undergone carotid endarterectomy and of unoperated patients]. / Katemnez bol'nykh so stenozom vnutrennei sonnoi arterii, podvergavshikhsia karotidnoi éndarteréktomii, i neoperirovannykh bol'nykh.

Investigation of catamnesis of 100 patients with atherosclerotic carotid artery stenosis (50 were operated and 50--non-operated) revealed, that in some cases carotid endarterectomy prevented repeated cerebrovascular disorders and had prophylactic significance. The frequency of repeated stroke in the group of non-operated patients was 3 times higher than in the group of operated patients. In operated cases no more TIAS were observed, but they persisted in non-operated cases.

[Endarterectomy in arteriosclerotic stenosis of the internal carotid artery]. / Endarteréktomiia pri ateroskleroticheskom stenoze vnutrennei sonnoi arterii.

The efficacy of carotid endarterectomy (CE) was estimated in 50 patients with stenosis of the internal carotid artery due to atherosclerosis. In addition to neurological investigations, all the patients were subjected to USDG of the head vessels, cerebral angiography and CT of the brain. Patients with the signs of cerebral circulation disorders or those who suffered ischemic brain stroke with a reversible neurological deficit were the most prospective candidates for CE. According to the cerebral angiography data, the degree of stenosis ranged from 50 to 90%. Surgical intervention was performed within different times after derangement of brain circulation, most frequently from 3 months to 1 year. The overwhelming majority of the patients suffered operations without any complications. The lethality amounted to 4% (because of acute cardiovascular failure and myocardial infarction). The total mortality and morbidity due to brain stroke were 5.9%. Indications for carotid endarterectomy in stenosis of the ICA are under consideration.

[Role of mitral valve prolapse in the pathogenesis of cerebral infarction]. / O roli prolapsa mitral'nogo klapana v patogeneze infakta mozga.

Two young patients with mitral valve prolapse and an ischemic disorder of the cerebral circulation were examined. The authors discuss the role of mitral valve prolapse in the pathogenesis of ischemic cerebral stroke in young patients.