[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.

Changes in cognitive evoked potentials during non pharmacological treatment in children with attention deficit/hyperactivity disorder.

UNLABELLED: Attention deficit/hyperactivity disorder (ADHD) is one of the most widely spread condition of school aged children affecting 5% of children of this age. The unified consensus of the precise diagnosis of this condition is still absent. This fact encourages the researchers to seek the alternative neurometric tools which will help the clinicians in diagnosis making process of ADHD. The neurophysiologic approaches especially event-related potentials (ERPs) are mostly important from this point of view. The later response of ERPs (P3) reflects the most important parts of executive functioning frequently affected in ADHD children - the process of mental effortfullness to select the appropriate behavior and decision making. Besides the diagnosis the treatment of ADHD is also the point of concern of neurologists and neurophyschologists. In recent years EEG biofeedback ( Neurofeedback-NF) have become the alternative treatment as in some cases pharmacological drugs are non effective. The positive impact of NF was based on improvement detected by various questionnaires which are less valid but its effectiveness on ERPs parameters is still unknown. Thus we aimed to study the changes of ERPs after NF therapy. METHODS: We have studied 93 children with ADHD of combined subtype (ADHDcom) without any kind of pharmacological treatment. Age range 9-12 years. The children were divided into two subgroups: The first ADHDcom-1 (48 children) were children where NF treatment was carried out and the second subgroup of ADHDcom-2 (45 children) were non treated children. RESULTS: We have observed statistically significant improvement of parameters of later response like P3 in ADHD-1 compared with ADHD-2 whereas NF was non effective for earlier component like N1. CONCLUSIONS: NF can positively affect on the P3 parameters which is very important in ADHD children as P3 reflects the speed of information processing as well as selection of appropriate action and decision making which are frequently affected in ADHD children.

[Faun tail--isolated sacrolumbar hypertrichosis in pediatric endocrinology].

3 girls with Faun tail are presented. Local hairiness in the sacrolumbar area was associated with spinal dysraphism, tethered cord, intradural lipoma, meningomyelocele and dyastematomyelia, all confirmed by MRI. Moderate neurological findings were present in one case only. In all the cases the primary diagnosis of the principal spinal pathology was established by endocrinologist (two patients were referred by dermatologists, one by ortopaedist). This indicates that a physician of any specialty may have to establish the primary neurological diagnosis. Hence, the awareness of the possible connection between the neurological pathology and the cutaneous symptoms, including local hypertrichosis, is of major significance.

[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.

[Modern management of attention-deficit and hyperactivity syndrome (ADHD) in preschool children].

The aim of the study was to detect the ADHD syndrome in preschool children and elaboration of therapeutic recommendations. We have examined 84 patients with ADHD syndrome. Their age varies from 6 to 10 years. The first group of patients had the history of hypoxic-ischemic encephalopathy, while the second group had no perinatal pathology. Common level of intellectual development in the both groups of children was normal, which gave them ability to attend usual secondary school (IQ approximately equals 85-92). Physical data were normal as well. ADHD syndrome was revealed in the both groups of patients. Symptoms discovered in the II group of patients indicated to the preexistence of perinatal pathology, which was not noticed in the medical record. The incidence and expression of symptoms were more prominent in the I group of patients.

[Combined lesions of the major arteries of the head (clinico-doppleroangiographic correlations)]. / Sochetannye porazheniia magistral'nykh arterii golovy (kliniko-dopleroangiograficheskoe sopostavlenie).

Using Doppler ultrasonography (DUSG) under outpatient conditions multiple combined lesions of the main arteries of the head were found in 127 patients. Comparison of the above results with the findings of cerebral angiography showed a high efficiency of DUSG. In occlusion of the carotid and vertebral arteries the accuracy of the method was 99%, specificity 99%, sensitivity 100%; in stenoses of the internal carotid arteries the respective values were 88, 84, and 95%; in cases of all stenoses of the vertebral arteries they were 93, 92, and 94%. A comparative analysis of the clinical, Doppler and angiographic findings revealed that an increase in the frequency and degree of impairment of the main arteries of the head correlated with an elevated rate of cerebral circulation disorders in several vascular beds.