[Temporomandibular disorder and cervicalgia: pathophysiology underlying the comorbidity with chronic migraine]. / Disfunktsiia visochno-nizhnecheliustnogo sustava i tservikalgiia: patofiziologicheskie mekhanizmy i komorbidnaia sviaz' s khronicheskoi migren'iu.

AIM: To analyze the prevalence of various clinical forms of temporomandibular disorder (TMD) and cervicalgia in episodic (EM) and chronic migraine (CM). MATERIAL AND METHODS: Ninety patients with CM and 42 patients with EM as defined by the International Classification of Headache Disorders (ICHD)-3 beta were recruited. TMD and sleep bruxism were diagnosed according to the DC/TMD criteria and the International Classification of Sleep Disorders (ICSD-R), respectively. RESULTS: Myofascial pain was the most prevalent form of TMD in both EM and CM. The prevalence of TMD was higher in CM as compared to EM (60% vs. 21.4%, respectively, p=0.0001). The prevalence of bruxism was comparable across EM and CM (14.3% vs. 28.8%, respectively, p=0.08) and significantly lower than that of TMD in the CM population (28.8% vs. 60%, respectively, p=0.0001). Frequent cervicalgia (≥15 days per month) was reported by 65.5% and 21.4% of CM and EM patients, respectively (p=0.0001); 44.4% of CM patients reported neck pain immediately before or during migraine attacks only, 14.4% during the headache and interictal phases. CONCLUSION: The higher prevalence of pain-related TMD and cervicalgia in CM population compared to EM and the general population was shown. In CM, myofascial pain and tenderness in the masticatory and neck muscles may be caused by central sensitization (CS) with no link to temporomandibular joint or spinal pathology. Myofascial TMD and neck muscle dysfunction are an integral part of CM pathophysiology underlying headache chronification.

[Some problems in rehabilitating disabled people with multiple sclerosis in agencies for social protection].

The state social policy with regard to disable people in the Russian Federation is developed in accordance with international instruments which include the "Declaration on the Rights of People with Disabilities" adopted by the UN General Assembly, the ILO Convention (No159) "Vocational Rehabilitation and Employment of Disabled Persons", the "Standard Rules on the Equalization of Opportunities for Persons with Disabilities" adopted by the UN General Assembly, the World Program of Action Concerning Disabled Persons etc. All these instruments mainly focus on the issue of social rehabilitation of people with health disabilities in order to offer them "equal opportunities" in different areas of their life. The paper is devoted to research of some backbone arrangements of rehabilitation of people with multiple sclerosis (MS) and major lines of proficiency training and retraining of professionals on issues of social rehabilitation of people with health disabilities as well as methods of rehabilitation of MS patients.