[Diagnostic capabilities of spinal MR angiography and spinal MR tractography in a patient with motor neuron disease]. / Diagnosticheskie vozmozhnosti spinal'noi MR-angiografii i spinal'noi MRT-traktografii u bol'nogo s bolezn'yu dvigatel'nogo neirona.

Motor neuron diseases (MND) include two main forms - amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA). A certain part of these diseases is hereditary, while etiology of sporadic cases remains unknown. Both entities are known to develop because of motoneurons damage. Difference between them lies in the state of the descending pyramidal pathways. The pyramidal pathways in SMA are intact, as brain pyramidal neurons are not affected, thus pathology of SMA is restricted to anterior horns of spinal cord. Meanwhile, most forms of ALS arise due to loss of both cerebral and spinal motoneurons, which, in addition to anterior horn lesion, leads to pyramidal descending pathways damage either in brain or in spinal cord. While pathological distinction between these two entities is clear and definite, the clinical difference remains obscure. We present the case of 41-year old patient with MND, in whom spinal MR tractography has revealed lateral columns to be intact that proves the utility of spinal MR tractography in differential diagnosis between ALS and SMA. Given that ischemic diseases of the spinal cord often occur with a clinical picture of MND, we also examined this patient using spinal MRI angiography, revealing a pronounced narrowing and tortuosity of the spinal arteries, complicated by occlusion of the right twelve intercostal artery.

[Utility of spinal MRI tractography and spinal MRI angiography in the diagnosis of spastic diplegia]. / Diagnosticheskie vozmozhnosti spinal'noi MRT-traktografii i spinal'noi MRT-angiografii u bol'nogo spasticheskoi diplegiei.

There are different views on the nature of cerebral palsy, but no one has been accepted commonly. Since, every new observation of this disorder based on thorough clinical examination could convert the obscurity into clear and simple conception. We report the case of 4-year-old boy with lower paraplegia and speech retardation. The tonus was increased bilaterally in gastrocnemius muscles and thigh adductors. The muscle tonus was decreased in iliopsous. Electrophysiological examination revealed signs of decreased excitability of motoneurons at the level L 2 - S 2. MRI has confirmed lesions of spinal cord at that level in addition to injury at thoracic level and brain lesions. MRI spinal angiography has detected tortuous anterior spinal artery. The boy benefited from the electrophoresis with theophylllinum, applied on lower thoracic and first lumbar vertebrae with improvement of his legs motor skills. Our presentation testifies to involvement of spinal cord and benefits from therapy applied on spine and, thus, confirms the initial description of cerebral palsy in 1853 made by English surgeon James Little.

[Comparative characteristic of clinical efficacy of the original drug Movalis and its generic Amelotex in the treatment of non-specific lumbar pain]. / Sravnitel'naya kharakteristika klinicheskoi effektivnosti original'nogo preparata Movalis i Ameloteksa v lechenii nespetsificheskoi poyasnichnoi boli.

OBJECTIVE: To perform a comparative analysis of the efficacy of the original drug meloxicam (movalis) and its generic (amelotex) in the treatment of patients with lower back pain. MATERIALS AND METHODS: The analysis of treatment results of 112 (61 men and 51 women) employees of JSC «Admiralteyskie Verfi¼, aged 18 to 60 years, was carried out. All these patients were treated in the period from 2015 to 2017 at the Medical Center of JSC «Admiralteyskie Verfi¼ due to dorsalgia of lumbosacral localization (ICD-10, item M54). The average age of the patients was 42,6±10,4 (from 22 to 59 years). Age range of patients was 20-35 years (n=34); 36-50 years (n=49); >50 years (n=29). RESULTS: Compared to amelotex, movalis was more effective for the duration of pain intensity reduction (5±1,4 days (min 3, max 9) in the movalis group and 7,37±1,68 days (min 3, max 10) in the amelotex group) as well as for the total duration of temporary disability (labor losses 6,43±1,4 days (min 4, max 10) and 8,61±1,59 days (min 5, max 12), respectively). In addition, patients receiving movalis showed a more significant improvement in the Clinical Global Impression (CGI) score in all age groups compared with patients in the amelotex group. CONCLUSION: The lack of therapeutic equivalence between movalis and amelotex determines the relevance of the drug choice for complex therapy of these patients, which will improve the prognosis of the disease and the quality of life of the patient.