[Towards a question of formation mechanisms of hand muscular dystonia].

Review researches on a problem of muscular dystonia mechanisms formation on an example of a writer's cramp (WC) was presented. WC is a movement disorder, task-specific dystonia, characterised by involuntary excessive muscle contractions producing abnormal postures during selective motor activities that often involve highly skilled, repetitive movements. The precise pathophysiology remains unclear, increasing evidence suggests reduced inhibition at different levels of the sensorimotor system. There has also been a greater understanding of the causes ofdystonic movements, from the study of genetics, neurophysiology (TMS, EMP), and functional imaging (fMRI, PET). Last investigation of hand motor skill by a method of the three-dimensional kinematics analysis has shown that at WC there is an inconsistency of processes of planning of movement.

[Hand motor dysfunctions in computer users].

It were studied 239 female typists aged from 16 to 62 years (mean age 20,1±7,8 years) using author's questionnaire for computer typists to assess hand function and develop preventive measures of disturbances revealed. Indirect signs of tunnel hand neuropathy (27,2%), focal hand dystonia (21,4%) and muscular-tonic syndromes of different localization (18%) have been found. Typists are a risk group of fine hand motor dysfunctions. As preventive measures, authors recommend to use computer auxiliary devices, to change a motor stereotype during the day, to make hand "motor holidays", to organize working place.

[Paradoxical kinesis phenomenon in focal hand dystonia--writer's cramp].

Paradoxical kinesis (PK) phenomenon and its variants, exerting a beneficial influence on dystonia dynamics, are described using self clinical examination of 57 writer's cramp patients. PK was found in all the patients independently of writer's cramp variant, duration and severity. The most frequent writing maneuvers were as follows: hand printed (100%), proximal arm muscles writing (82.5%), individually selected writing instrument (67.5-80%), unusual means (67.5-75%), writing imitation with unlike-pen object (70%), marked papers (52.5%). The beneficial influence of PK phenomenon on dystonia expression may be considered as one of the directions of writer's cramp rehabilitation.

[Coaxil treatment of primary headaches comorbid with depression].

Twenty patients with headaches and concomitant mild depression (the Beck scale mean score 13,6), aged 20-62 years (mean 40,3), illness duration 0,5-40 years, (mean 17,7), attack frequency 3-30 days, (mean 13,4), have been studied. Coaxil was prescribed in dosage of 12,5 mg daily during 6 weeks. Neurological examination and clinical evaluation using a number of scales, along with patients self-rating, was conducted. Twenty one patients have completed the treatment course. Coaxil therapy resulted in significant decrease of frequency and severity of headache attacks and improvement of the patient's general state.

[Clinical and physiological analysis and treatment of writer's cramp]. / Kliniko-fiziologicheskii analiz i lechenie pischego spazma.

Clinical, psychological and electrophysiological features of 43 patients with writer's cramp (WC) were studied. "Complex clinical inventory for patients with a focal dystonia form--writer's cramp" has been elaborated. The stages in the disease development were found and focal and tremor forms were identified. According to electroneuromyography, a tremor form is characterized by higher awkwardness (defect in motor program) and peripheral disability compared to a spastic form. In a spastic form, a movement defect was more local. In WC treatment, complex action on central factors and peripheral mechanisms of pathogenesis is needed. Treatment duration, including clonazepam and motor defect correction, is not less than 12 months. Efficacy of clinical treatment was more pronounced in a spastic form.