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Background. The study of the sensitive portion of the medial plantar nerve is relevant not only in the examination of patients with tibial nerve mononeuropathy or its branches, but also in the diagnosis of polyneuropathies.Objective: to analyze the normative parameters of the sensory potential recorded during the study of the medial plantar nerve by the orthodromic method in healthy adults.Materials and methods. 126 sensitive fibers of the medial plantar nerves were studied on the Dantec Keypoint G4 device (Denmark) in 63 healthy individuals (31 men and 32 women; age from 20 to 80 years). 3 groups were identified taking into account age: group 1 included healthy people aged 20 to 39 years (n = 23); group 2 consisted of people aged 40 to 60 years (n = 20); and 3 – older than 60 years (n = 20). The parameters of the sensory potential of the medial plantar nerve are analyzed.Results. The sensory potential in the study of the sensitive portion of the medial plantar nerve was registered in all 126 healthy subjects. Comparative statistical analysis did not demonstrate significant differences between groups 1–3 in the values of such parameters of the sensory potential as the latency of the onset, the duration of the negative phase and the rate of propagation of excitation. At the same time, in groups 2 and 3, the magnitude of the amplitude from peak to peak of the sensory potential was significantly lower compared to group 1, and averaged 8.92 and 7.86 MV, respectively.Conclusion. Knowledge of the regulatory parameters will allow expanding the use of electroneuromyography of the sensitive portion of the medial plantar nerve in clinical and research practice.

Timely diagnosis and optimal management of patients with cognitive impairment (CI) without dementia can potentially reduce the risk of their progression to dementia. In our study, we assessed the features of mild CI (MCI) syndrome in patients with neurological disorders based on the specialized outpatient service data analysis.Objective: to analyze clinical, neuropsychological, and neuroimaging characteristics of MCI syndrome in the Russian population in real clinical practice.Patients and methods. We enrolled 515 patients (209 men and 306 women, mean age – 71.2±8.0 years) with memory and/or other cognitive complaints. Seventy healthy volunteers (25 men and 45 women, mean age – 69.5±5.71 years) without cognitive complaints and central nervous system or mental disorders were enrolled in the control group. DSM-V diagnostic criteria for mild neurocognitive disorder were used. Participants underwent comprehensive neuropsychological testing with a qualitative and quantitative assessment of the results. In some of them (29.13%), brain magnetic resonance imaging (MRI) was performed.Results and discussion. The following types of MCI were identified in study participants: monofunctional non-amnestic type (MFNAT) – 1.2%, monofunctional amnestic type (MFAT) – 12.6%, polyfunctional amnestic type (PFAT) – 22.9%, polyfunctional non-amnestic type (PFNAT) – 63.3%. We found a higher prevalence of executive dysfunction and attention deficit in PFNAT, and executive dysfunction, attention deficit, and memory decline in PFAT. Cardiovascular risk factors and signs of vascular leukoencephalopathy on MRI were more frequently observed in PFNAT and PFAT.Conclusion. The clinical and neuropsychological analysis allows us to assume the pathophysiology of CI before the development of dementia. In the Russian population, cerebrovascular insufficiency plays a significant role in the development of MCI syndrome.

Vascular brain diseases are one of the leading causes of death and disability in developed countries. Along with acute disorders of cerebral circulation, chronic cerebrovascular disorders are of great medical and social importance, one of the main clinical manifestations is vascular cognitive impairments. The article discusses the pathogenetic and clinical variants of vascular cognitive impairments, presents their modern classification and approaches to diagnosis. The importance of the earliest possible diagnosis of vascular cognitive impairments is due to the fact that they can be one of the first manifestations of cerebrovascular insufficiency, before the development of clinically obvious strokes or cardiovascular diseases in general. Early diagnosis of vascular cognitive impairments is necessary both for the prevention of vascular and neurodegenerative dementia and for the prevention of strokes and other acute vascular episodes. A clinical example of non-stroke formation of mild vascular cognitive impairment is presented. Signs of cognitive impairments typical of chronic cerebrovascular insufficiency, such as a slowdown in the rate of mental activity and disorders of frontal executive functions in combination with behavioral and emotional disorders, are described. The article discusses the issues of treatment of vascular cognitive impairments, which should be comprehensive and include the correction of the underlying vascular disease, non-drug (regular physical activity, smoking cessation, cognitive training) and drug treatment methods aimed at improving cognitive functions. Possibilities of modern neuroprotective and symptomatic therapy of cognitive disorders, the place of EGb 761® in the treatment of vascular cognitive impairments are shown.

Frontotemporal degeneration (FTD) is a heterogeneous group of diseases causing neurodegeneration on the frontal and/or anterior temporal lobes. FTD is the second most common dementia in presenile age (up to 65 years) after Alzheimer’s disease. Usually, FTD is diagnosed at the age of 45-65 years, but an earlier and later onset is possible. Up to 40% of FTD cases have a positive family history. According to the current classification, the following clinical variants of FTD are distinguished: behavioral variant of FTD, agrammatic variant of primary progressive aphasia (PPA) and semantic variant of PPA. As they develop, these clinical syndromes overlap widely with each other and with atypical parkinsonism syndromes (progressive supranuclear paralysis, cortico-basal syndrome) and less often with motor neuron disease. Variations in the clinical features are determined by the localization of the degenerative-atrophic process. The behavioral variant of FTD accounts for more than half of the cases of FTD and is characterized by a combination of cognitive, behavioral, and emotional-affective disorders. In PPA, speech disorders appear for no apparent reason and progress continuously in the absence or with minimal severity of other cognitive and behavioral disorders for two or more years. The clinical features of PPA depend on the localization of the pathological process. The article reviews a clinical case of an agrammatic variant of PPA. Modern approaches to the diagnosis and management of this group of patients are shown. It seems appropriate to use memantin in patients with agrammatic variant of PPA.

Introduction. The heterogeneity of the forms and severity of Guillain-Barre syndrome explains the variability of recovery: from rapid and complete (in most cases) to slow with the development of persistent residual deficiency (rarely). It is unclear how effective the Erasmus Guillain–Barre syndrome Outcome Scores and its modified version are for different forms of the disease.The aim of the study – to demonstrate the features of recovery in acute motor axonal neuropathy with conduction blocks on the example of 2 clinical cases; to show the possibilities of Erasmus Guillain–Barre syndrome Outcome Scores and its modified version in predicting recovery in this form of the disease.Materials and methods. Data from 2 patients with acute motor axonal neuropathy with motor conduction blocks were retrospectively analyzed. Calculation of the score and assessment of the prognosis of walking recovery by 6 months from the onset of the disease were performed using the online calculator International Guillain-Barre syndrome Outcome Study Prognosis tool in the acute period.Results. In both patients, the forecast of recovery of walking by half a year from the onset of the disease on the Erasmus Guillain–Barre syndrome Outcome Scores and modified Erasmus Guillain–Barre syndrome Outcome Scores scales in the acute period was erroneous. In the first case, the total score on the Erasmus Guillain–Barre syndrome Outcome Scores and its modification in the acute period was 5 and 10 points respectively (poor prognosis), which foreshadowed a long rehabilitation process and incomplete recovery. However, the regression of disorders was dramatic and complete, and by the second month of the disease, only minimal motor disorders remained. In the second patient, on the contrary, the total Erasmus Guillain–Barre syndrome Outcome Scores and its modification during the period of increasing symptoms was 3 and 7 points respectively (good prognosis), while recovery was delayed – only by 5 months from the onset of the disease, the ability to move with support was restored.Conclusion. The Guillain–Barre syndrome is a disease with a favorable prognosis for recovery. However, the prediction of regression of motor disorders should be approached carefully, because in some cases, generally accepted criteria and prognostic scales may not work. Acute motor axonal neuropathy with conduction blocks is a unique form of the disease that has pathophysiological and clinical-neurophysiological features, which should be taken into account when managing this category of patients.

Introduction. Atypical variants of chronic inflammatory demyelinating polyneuropathy are marked by its clinical heterogeneity and variable disease course.Aim of the study. To describe clinical, anamnestic and neurophysiological features of patients with atypical variants of chronic inflammatory demyelinating polyneuropathy, characterized by benign disease course, minimal motor involvement and not required pathogenic therapy.Materials and methods. 8 patients (7 men (87 %) and 1 woman (13 %) at the age of 52–77 years) with atypical variants of chronic inflammatory demyelinating polyneuropathy were analyzed: 5 patients (62.5 %) with asymmetric variant – multifocal acquired demyelinating sensorimotor neuropathy and 3 patients (37.5 %) with sensory variant. All patients were observed at the Research Center of Neurology for the period of 2016– 2019. In each patient the proper clinical and laboratory evaluation was performed along with nerve conduction study and nerve ultrasound.Results. The disease duration at the time of first visit was 1–8 years. By INCAT disability score 3 (37.5 %) patients had 0 points (normal), 3 (37.5 %) patients – 1 point and 1 patient had 2 (25 %) points. Nerve conduction study showed multifocal, asymmetric demyelinating changes in motor nerves. For the whole period of observation all patients were stable, so no one required pathogenic therapy.Conclusion. Chronic inflammatory demyelinating polyneuropathy is a clinically heterogeneous disorder, required clinical suspicion in all patients over 50 years with features of multiple nerve involvement; nerve conduction study helps to detect typical changes, including subclinical ones. The primary strategy of management typical and atypical disease variants in stable course and minimal symptoms is a case follow-up with precise assessment of advantages and disadvantages of pathogenic therapy.

Сhronic inflammatory demyelinating polyneuropathy (CIDP) is the most prevalent acquired dysimmune neuropathy with clinical picture of symmetric motor and sensory disturbances. Since the first description of CIDP, many atypical variants have been described, which may reach up to 50% of cases. Diagnosis of atypical CIDP may be challenging due to different clinical presentation and treatment response. Current researches improve our knowledge about dysimmune neuropathies and highlight the importance of its classification. Nowadays CIDP is considered as a spectrum of disorders rather than a separate disease entity. Up to date, more than 15 diagnostic criteria have been proposed reflecting the complexity of СIDP diagnosis. Many polyneuropathies may mimic CIDP, therefore CIDP is frequently a diagnosis of exclusion. The key diagnostic instrument is electroneuromyography; however, the issues related to results misinterpretation and some technical aspects are the most important in CIDP misdiagnosis. Supportive instrumental and laboratory methods have variable sensitivity and specificity, making challenging CIDP diagnosis, especially its atypical forms. The importance of an early and accurate diagnosis of CIDP is supported by an effective pathogenic treatment, which affects the patient's prognosis and level of disability.

Background. Carpal tunnel syndrome is the most common tunnel neuropathy in which the median nerve is compressed at the level of the wrist in the carpal canal. Treatment of carpal tunnel syndrome can be conservative and surgical. Surgical treatment is indicated in case of ineffective conservative treatment. However, the strategy of managing patients with carpal tunnel syndrome in the postoperative period has not yet been determined; there is no clear understanding of the effectiveness and necessity of rehabilitation in the early and long-term postoperative periods.Aim. Follow-up the patients after decompression of the median nerve in the late (up to 3 weeks after surgery) and long-term (3 weeks after surgery) postoperative periods to assess the effectiveness of different methods of rehabilitation.Materials and methods. A randomized controlled study included 108 cases of idiopathic carpal tunnel syndrome (unilateral and bilateral). After surgery, the patients were divided into three groups: the restorative treatment group using magnetic therapy, the kinesiotherapy group, and the control group. Clinical, neurophysiological and ultrasound monitoring was carried out for six months.Results. Patients of all the groups showed similar improvement in the most of the analyzed parameters, without any significant difference.Conclusion. Thus, according to the results of a comprehensive study, it is evident that early diagnosis of carpal tunnel syndrome and a high-quality surgical decompression of the median nerve with a complete dissection of the flexor retinaculum of the hand guarantee improvement within six months or later after surgical treatment without additional rehabilitation measures.

Non-motor manifestations in focal muscular dystonia (FMD) have been little studied. Objective: to analyze the characteristics of cognitive impairment (CI) and mental disorders (MDs) in FMD. Patients and methods. Fifteen patients (7 men and 8 women) aged 25 to 80 years (mean age, 59.8±14.7 years) with FMD were examined. Cervical dystonia and blepharospasm were noted in 10 (66.7%) and 5 (33.3%) patients, respectively. A control group consisted of 15 healthy individuals (7 men and 8 women) (mean age, 58.2±14.9 years). Neurological and standardized psychiatric examinations and neuropsychological tests were performed; the Beck Depression Inventory and the Spielberger State-Trait Anxiety Inventory were used. Results and discussion. Patients with FMD were found to have moderate CI as impaired control functions. Depression was diagnosed in 9 (60%) patients; it corresponded to the pattern of protracted psychogenically provoked conditions in most cases (n = 8). Six (40%) patients with FMD had anxiety and somatic disorders. The pathophysiology of non-motor manifestations of FMD is likely to depend on many factors, including the relationship between different clinical factors and basal ganglia dysfunction. The data on the association between emotional disorders and CI in FMD are contradictory. MDs can seem to be as an additional factor that aggravates the manifestations of dystonia. Conclusion. In patients with FMD, moderate CI can be due to emotional disorders that aggravate the manifestations of the disease. The diagnosis and correction of emotional disorders are promising in the management of patients with FMD.

This literature review provides a range of neurological and other organic causes of brachialgia. Features of pain syndrome in different medical conditions are described.

The paper discusses the specific features of clinical presentations in patients with muscle dystonia, the presence of cognitive and mental disorders in dystonia. It presents a clinical case of severe segmental dystonia in a 72-year-old patient with cognitive and mental disorders. The manifestations of dystonia regressed during treatment with botulinum toxin; however, the patient did not report any improvement. An improvement could not be achieved after a psychiatrist's consultation and treatment for mental disorders.

The article discusses neuropsychological tests for diagnosing cognitive impairment. It presents data on the experience in using memantine (akatinol memantine) to treat dementia of various genesis. An analysis of efficacy of non-pharmacological approaches to the treatment of dementia including cognitive training is provided.

Intravenous high-dose immunotherapy is one of the highly effective proven treatments for a number of autoimmune diseases of the nervous system. Nowadays there is enough knowledge about the spectrum of side effects and approaches to their prevention and monitoring. Most of them are leveled by improving the technology of the production process, but anaphylactic reactions remain one of the uncontrolled, albeit rare, undesirable reactions. The development of allergic reactions is associated with the presence of antibodies to immunoglobulin class A (IgA) in the patient, which is manifested by a decrease in the level of IgA during routine immunological examination. The article provides a review of the literature on the prevalence of IgA deficiency, its causes. A modern view of the need for routine testing of IgA level before the course of intravenous immunotherapy, approaches to reduce the risk of developing serious adverse reactions in such cases is described. A clinical case of treatment of a patient with chronic inflammatory demyelinating polyneuropathy and a reduced level of IgA is presented.

Prevention of progression to moderate vascular cognitive disorders (MVCD) in dementia is based on medicinal and nonmedicinal correction of major cardiovascular risk factors, at the same time antidementia, vasoactive and nootropic drugs efficiency is not proven. The own experience of use in 30 patients (22 women and 8 men) with MVCD in age from 46 to 75 years (mean age 67,1 ± 6.6 years) of Naftidrofuryl (Duzofarm) at a dose of 100 mg three times a day for 30 days is provided. After a month of treatment a significant improvement of cognitive function by the Montreal scale assessment of mental functions, the alpha-numeric coding test, and emotional state test is established as measured by the hospital scale of anxiety and depression. Good tolerability, absence of significant side effects when using Naftidrofuryl for MVCD are observed. Longer placebo-controlled studies of the effectiveness of Naftidrofuryl in patients with MVCD are needed.

The effect of di-tert-butylhydroxylamine on polymerization of methyl methacrylate and styrene under conditions of radical initiation, similar to the commercial synthesis conditions, was studied. [ABSTRACT FROM AUTHOR]

Glucocorticoids (GCs) are often prescribed for neurologic patients. Autoimmune diseases of central and peripheral nervous system, neuromuscular disorders are associated with disability and life-threatening complications, and require long-term high-dosage administration of GCs. GC-therapy is a crucial decision to be made by a neurologist in collaboration with a patient, and requires strict observance of clear guidelines on the prevention, diagnosis and treatment of possible complications. One of the most frequent complications of GCs is osteoporosis. According to the Russian and international guidelines, all the patients must undergo preliminary and follow-up laboratory and instrumental examination, as well as administration of calcium and vitamin D during the whole period of GC-therapy. In case of a high fracture risk or if osteoporosis is diagnosed, antiresorptive therapy is indicated.

Testing for IgG+IgM autoantibodies to gangliosides of peripheralnerves (asialo-GM1, GM1, GM2, GD1a, GD1a, GD1b, GQ1b)was performed in 95 patients with GuillainBarr syndrome (GBS)in Moscow. In 70 patients (74%) acute inflammatory demyelinatingpolyneuropathy (AIDP) was diagnosed, and in 25 patients (26%) either acute motor axonal neuropathy (AMAN) or acute motorsensoryneuropathy (AMSAN). The role of antibodies to gangliosidesfor prognosis of the disease course and response to pathogenictreatment was assessed. Antibodies to gangliosides were found in55 patients (57.9%) more often in patients with AMAN/AMSAN(p0.05). The whole range of antibodies was found both in patientswith AIDP and AMAN/AMSAN. Anti-GM1 were found in bothsubtypes of GBS. Anti-GD1b were associated withAMAN/AMSAN (p0.05). There was a correlation between anti-GM1 and diarrhea (p0.05), anti-asialo-GM1 and campylobacteriosis(p0.05). There wasnt found significant correlation betweenanti-GD1 and axonal subtypes, diarrhea in anamnesis, and campylobacteriosis.Association of severe GBS and elderly age, camplylobacteriosisand axonal subtypes was confirmed. AMAN/AMSANsubtypes, severity of the disease, necessity in mechanical ventilationwere characterized by insufficient efficacy of pathogenic therapy.The same factors and elderly age were associated with unfavorableprognosis in terms of absence of unassisted walking in 6 and12months. Anti-GD1a were associated with sever course of the disease,including necessity in mechanical ventilation. Immunologicfactors are not sufficient in prognosis of the treatment efficacy.Antibodies to GM1 were associated with unfavorable prognosis withabsence of unassisted walking in 6 months. Clinical and neurophysiologicaldata is crucial for making diagnosis and prognosisof the GBS course. Testing for autoantibodies to gangliosidescould be helpful in diagnostics of GBS. It is possible to use thattest for revealing axonal type of the disease (anti-GD1b), prognosticationof severe course of GBS (anti-GD1a) and unfavorablerehabilitation of unassisted walking.

We carried out an examination of 74 patients who have had,from 3 months to 36 years ago, GuillainBarre syndrome (GBS)with severe impairmenet of motor functions. The average follow-up period was 2.3 years. Fifty-eight subjects had acuteinflammatory demyelinating polyneuropathy (AIDP), and theremaining 16 patients had axonal forms. In the structure ofresidual neurologic deficits of AIDP patients at all stages of earlyrecovery period (follow-up period 1 year) and in late (1 year)period sensory disorders and pain syndrome prevailed. Themajority of AIDP patients (90%) began to walk with supportafter 1 month of onset, and occasionally (3%) six months later. Patients with axonal forms could stand only after 6 months(88%) and later (12% patients up to 12 months). After 1 yearof onset, all AIDP patients walked unassisted, and most of themreturn to their job. Over the equal follow-up period every thirdpatient with an axonal form remained dependent in their dailyliving activities. This confirms that GBS is a disease with a favorableprognosis: even in severe cases most patients resumed walkingafter half a year, regardless of the disease form. Axonal formsshow lower recovery rate and greater severity of residual symptomscompared to AIDP, which affects quality of life in respectivepatients.

Published data concerning the ways to control the kinetic parameters of vinyl chloride polymerization and molecular-weight characteristics of polyvinyl chloride through directed modification of the reactivity of the growing macroradical are considered. [ABSTRACT FROM AUTHOR]

The problem of using nitrous oxide (“laughing gas”) is now important because young people often prefer this kind of entertainment. Regular short-term inhalation of nitrous oxide increases the risk of developing vitamin B12 deficiency, which is an essential cofactor of important metabolic processes. This article describes 2 clinical cases of neurological disorders in young adults who had used nitrous oxide. We demonstrate difficulties in the diagnosis, therapeutic tactics and prognosis.

В отечественной литературе недостаточно внимания уделено анатомическим вариантам иннервации конечностей. Тем не менее практикующему неврологу и нейрофизиологу регулярно приходится сталкиваться с нетипичной клинико-нейрофизиологической картиной, выявляемой как случайно, так и при патологии. В настоящей статье представлена информация о наиболее часто встречающихся вариантах межневральных анастомозов длинных нервов рук и ног. Особое внимание уделено нейрофизиологической картине данных межневральных коммуникаций. Настороженность в отношении возможной атипичной невральной иннервации поможет сократить ошибки в интерпретации данных, получаемых в ходе электронейромиографического исследования, улучшит понимание клинической картины при повреждении периферических нервов, участвующих в образовании анастомоза.

Current publication summarizes main indications and benefits of intravenous high-dose immunotherapy (IHI) in the treatment of various autoimmune diseases of the peripheral nervous system. Available products of intravenous immunoglobulin (IVIG) on the Russian market are reviewed. Tactics for choosing optimal medication for IHI based on its effectiveness and safety are analyzed. Dosage calculation and way of administration of IVIG are described, beeing of a high practical value in neurologist’s daily work.

The Russian literature gives inadequate attention to the problem of one of the most common form of autosomal recessive progressive limb-girdle muscular dystrophies type 2A (LGMD2A) (calpainopathy). This paper highlights current views on the physiological role of calpain 3 protein, possible pathogenetic mechanisms for the development of myodystrophy, diagnostic criteria, and therapeutic approaches. Clinical neurologists» awareness of LGMD2A will be able to reduce the time to a correct diagnosis, to take measures to slow down the rate of disease progression, to make medical and genetic counselling, a follow-up, and monitoring, as well as to use measures for the physical and social adaptation of a patient. Key words: progressive limb-girdle muscular dystrophy, calpainopathy, calpain 3, inherited myopathy, creatinine phosphokinase, electromyography, muscle magnetic resonance imaging, genetic analysis, muscle biopsy, differential diagnosis.

Presents clinical case the hereditary progressive muscular dystrophy type 2A (calpainopathy). Shows diagnostic difficulties and feature of presents clinical observations. This case is significance, as in the domestic scientific literature presents few articles on clinical examples of this muscle pathology.

The medical records of 186 patients diagnosed with Guillain-Barré syndrome (GBS) who had been followed up at the Research Center of Neurology, Russian Academy of Medical Sciences, in 2000 to 2011 were retrospectively analyzed. Most (65 %) of the patients had severe GBS; 19 % of the patients were on mechanical ventilation (MV) for an average of 21 (13; 48) days. The forms of GBS, such as acute inflammatory demyelinating polyneuropathy (AIDP) (n = 141; 78 %), and axonal variants, such as acute motor axonal neuropathy (AMAN), acute sensorimotor axonal neuropathy (AMSAN), i. e. AMAN / AMSAN (n = 39; 22 %), were studied separately. There was a significant difference in the seasonal revalence (p < 0.05). AIDP was encountered evenly throughout the year; AMAN / AMSAN occurred in 46 % of cases in summer. AIDP was followed by acute respiratory viral infection in 35 % of cases; diarrhea wasby the axonal forms in 36 % (p < 0.05). The axonal forms ran a severer course than AIDP: MV was performed twice more frequently (33 and 15 %, respectively); its duration was 6‑fold longer: 90 (46; 102) and 15 (10; 21) days (p < 0.05). AMAN / AMSAN was characterized by a severer neurological status and disability in the acute period, as shown by the NIS, MRCss, INCAT, R-ODS, and Barthel scales; these patients showed a poorer response to pathogenetic therapy (p < 0.05): 59 % with an insufficient effect; 15 % of those with AIDP. After six years, the majority (84 %) of the patients with AIDP walked alone and only 16 % were assisted. In the same period, less than half of the patients (40 %) with AMAN / AMSAN walked alone and a third (29 %) could move with assistance and almost the same percentage (31 %) could not walk.Thus, a number of specific features of GBS were found in a Russian population (equal age and sex distribution; a larger percentage of the axonal forms than in European countries and the United States); however, the most characteristics did not differ from the global data.

The protocols for electromyography (EMG) examination from the acute period of the disease (within the first 2 weeks after its onset) were retrospectively analyzed and residual neurological symptoms were evaluated in 50 patients who had sustained the Guillain-Barré syndrome 3 months to 15 years before. The EMG results of n. n. medianus, ulnaris, peroneus, and tibialis examinations were compared with the factors of a poor acute period and recovery. The distal latencies of M-responses (dM-responses) and motor conduction velocities were found to be of no prognostic value. ROC analysis revealed the dM-response amplitude decrement thresholds that were significantly associated with the development of severe form of the disease, an increase in the periods of plateau > 2 weeks and recovery capability to walk with the support of more than for > 1 month, an insuffient effect to pathogenetic therapy, and preserved noticeable residual motor deficit in the late disease period requiring help from other people in some instances. EMG was shown to be an informative study that can predict the course of the acute period and outcome in patients with the Guillain-Barré syndrome.

Objective: to conduct a comparative analysis of the previously valid “Card” with a new form of “Card” filled in for patients receiving medical care in a hospital setting with the focus of the attention of practitioners on the new paragraphs of this document.Materials and methods: a comparative analysis of the medical record of an inpatient patient approved by the order of the Ministry of Health of the USSR dated October 4, 1980 was carried out. No. 1030 “On Approval of Forms of primary Medical Documentation of healthcare institutions” and the Medical record of a patient receiving medical care in inpatient conditions, in a Day hospital, approved by the Order of the Ministry of Health of the Russian Federation dated August 5, 2022 No. 530n “On Approval of Unified Forms of medical documentation used in medical organizations providing medical care in inpatient conditions, in the conditions of the day hospital and the procedures for their management”.Results: based on the results of the study of two forms of “Cards”, the advantages of the new form have been established, which improve the quality of medical documentation and, as a result, taking into account the fact that the ECMP is carried out according to medical documentation, lead to a reduction in the risks of imposing financial sanctions on medical organizations during the relevant examinations. In particular, a number of shortcomings of the new form of the “Map” are indicated, requiring additional study and discussion with possible additions in the future.Conclusions: the relevance of the examination of the quality of medical care, which, as a rule, is carried out according to the medical documentation of completed cases, is reflected. It is noted that the correct filling in of all the provided graphs and lines will minimize the number of defects in the registration of medical documentation, which in turn will reduce the financial sanctions imposed on medical organizations during the ECMP.

Background. Acute cerebrovascular disorders are one of the main causes of severe disability in modern society. Russian and foreign researchers register the emerging trend towards rejuvenation of the patients with stroke, which, in turn, significantly increases the relevance of the treatment and rehabilitation of these patients at various stages.The aim. To study the social and hygienic characteristics of the stroke patients and to determine their need for medical rehabilitation in the early recovery period.Materials and methods. We studied the social and hygienic characteristics of 109 patients who had stroke in 2020 and 2021 and underwent rehabilitation in the specialized rehabilitation department of the Southern District Medical Center of the Federal Medical and Biological Agency, and determined their need for medical rehabilitation using the analytical method, the method of expert assessments and questionnaires.Results. The average portrait of a patient with a stroke in the early recovery period is as follows: this is a man aged 61 to 70 years with a higher or secondary specialized education, unemployed, living in the city. Up to 30 % of stroke survivors were recognized as disabled; among which, the persons with more severe disability (groups I and II) predominate – up to 90 %. Implementation of rehabilitation measures in the acute period in the hospital and in the early recovery period in the outpatient clinic is carried out at a fairly low level. The percentage of patients being examined by a multidisciplinary rehabilitation team ranges from 17.4 to 10.1 %.Conclusion. The availability of medical rehabilitation measures in a specialized rehabilitation center is quite limited; more than half of the surveyed contingent (52.3 %) experienced problems in obtaining a referral to treatment, about half of the respondents (46.8 %) waited up to 6 months for a referral, which indicates the need to expand the network of such institutions at the regional level.