[Trigeminal autonomic cephalgias].

Review of literature on the trigeminal autonomic cephalgias are presented. Trigeminal autonomic cephalgias are primary headaches with phenotype consisting of trigeminal pain with autonomic sign including lacrimation, rhinorrhea and miosis. Discussed are issues of classification, pathogenesis, clinical picture, diagnosis, differential diagnosis and treatment of this headache. Special attention is paid to cluster headache, paroxysmal hemicrania, SUNCT syndrome, hemicrania continua.

[Herpes zoster-induced neuralgia (neuropathy)].

Neuralgia (neuropathy) is the most common manifestation of herpes zoster (HZ). In spinal and cranial neuralgia, there are 3 types of pain: 1) spontaneous, persistent, burning pain; 2) intermittent sharp pain; 3) pain occurring with nonpainful stimulation. The skin exhibits areas of hypesthesia, anesthesia, and dysesthesia. Ophthalmic neuralgia (of the first branch of the trigeminal nerve) is encountered in 20% of HZ cases. HZ of the auricle and external auditory meatus concurrent with facial and vestibulocochlear neuropathy is diagnosed as Ramsay Hunt syndrome. Postherpetic neuralgia (neuropathy) is characterized by pain present for 3 months or more after the appearance of herpetic eruptions. Combined therapy involving the earlier use of antiviral agents, tricyclic antidepressants, analgesics, and neuromidine is the most effective option for HZ-induced neuralgia (neuropathy).

[Neyromidin in the treatment of stage I hypertensive dyscirculatory encephalopathy].

AIM: To evaluate the efficacy and safety of neyromidin in the treatment of Stage I hypertensive dyscirculatory encephalopathy (HDE) and to analyze long-term treatment results. SUBJECTS AND METHODS: Fifty-seven with Stage I dyscirculatory encephalopathy in the presence of grades 1-2 arterial hypertension were examined. Clinical, psychological, and electrophysiological studies were performed and the efficacy of neyromidin was evaluated using the SANDOS geriatric scale. Neyromidin as monotherapy was used as one tablet (20 mg) b.i.d. during a meal. The duration of course treatment was 3 months. RESULTS: Positive changes in the early manifestations of HDE were observed just on day 45 of therapy. The therapeutic effect of the drug manifested as a reduction in the degree of clinical symptoms. There were positive changes in attention, memory, kinetics, verbal associations, counting. The most noticeable improvement was seen in the values of memory and intellectual processes, suggesting higher working capacity, reduced fatigability, and eliminated sluggishness of intellectual processes. EEG displayed a higher amplitude level, a better response to rhythmic photostimulation, and a total power rise in a- and 8-ranges, which was indicative of the activated effect of neyromidin on the functional state of brain structures. CONCLUSION: Neyromidin (20 mg b.i.d. for 3 months) was shown to be effective and well tolerated. The drug reduced the magnitude of clinical manifestations and improved psychological functions and electrophysiological parameters.

[Neyromidin in ischemic stroke].

An aim of the study was to evaluate the therapeutic effect of neyromidin in patients with ischemic stroke. Forty patients with acute carotid artery stroke were enrolled into the study. The diagnosis was made on the basis of general clinical methods as well as the neurological examination, CT or MRI scans of the head, investigation of hemodynamic parameters, ECG, ultrasound dopplerography of major brain arteries. Neurological deficit was measured using the Scandinavian Scale. According to the TOAST classification, 14 (35%) of the patients suffered from large vessel disease, 16 (40%) patients were diagnosed with cardioembolic disease and 10 (25%) with the small vessel disease. Patients were randomized to the study and control groups (n=20 patients). All patients received standard treatment. Patients of the study group were treated with neyromidin. The study duration was 80 days. Clinical examinations were performed in the acute phase, on 21st and 80th days after stroke. Better recovery of neurological functions was identified in patients treated with neyromidin compared to control patients. No side-effects of neyromidin was found. Neyromidin is recommended for complex treatment of patients in the acute stage of ischemic stroke of carotid origin.

[The use of neuromidin in patients with minor ischemic stroke].

Efficacy of neuromidin was studied in 62 patients with a small ischemic stroke and cognitive disorders. Patients of the main group received neuromidin as an add-on to basic treatment and patients of the comparison group received only basic treatment (antiaggregant, antihypertensive, cardiac and antidiabetic drugs with the exclusion of nootropic and psychotropic medications). The decrease of subjective complaints, improvement of memory, attention, abstract and practical reasoning assessed by neuropsychological tests were seen in 32 patients of the main group after the end of treatment course. Neuromidin did not cause side-effects and was well tolerated. The long use of this led to the reduction of cognitive impairment, a predictor of vascular dementia.

[Hormonal disorders in women with prosopalgia in osteochondrosis of the cervical spine and the possible means for their correction]. / Gormonal'nye narusheniia u zhenshchin s prozopalgiiami pri osteokhondroze sheinogo otdela pozvonochnika i vozmozhnye puti ikh korrektsii.

Radioimmunoassay was employed to determine basal levels of LH, FSH, prolactin, total testosterone and 17 beta-estradiol in plasma from 52 pre- or postmenopausal women with prosopalgia consequent to cervical osteochondrosis. The measurements were made before and after laser treatment. Different from the control, basal levels of the hormones and the trends in their changes due to laser therapy depended on the patients' age and the disease stage.

[Clinical picture and treatment of bilateral facial pain in lesions of the trigeminal nerve system]. / Klinika i lechenie dvustoronnikh litsevykh bolei pri porazhenii sistemy troinichnogo nerva.

A total of 104 patients with bilateral facial pain were examined at a specialized neurostomatological department. The authors analyze the main mechanisms of the development of bilateral facial pain in patients with an impaired system of the trigeminal nerve (trigeminal neuralgias, dental plexalgia, syndrome of the nosociliary nerve), as well as the characteristics of their clinical manifestations. A classification of bilateral prosopalgias is proposed. The criteria of their diagnosis with the use of clinical and electrophysiological methods of examination (EEG, REG, EMG, electrothermometry, esthesiometry, electrical excitability of the exit sites of the trigeminal nerve branches and radioisotopic examination of the muscular blood flow in the face with the help of 133Xe) are also presented. The main principles of the treatment of bilateral prosopalgias are outlined.

[Facial muscle blood flow in patients with trigeminal nerve lesions]. / Myshechnyi krovotok litsa u bol'nykn s porazheniem sistemy troinichnogo nerva.

Examinations of the muscle blood flow in the face have shown that this method may be used as one of the criteria in the objective evaluation of pain and for the follow-up of its severity in patients with trigeminal injury.