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Background: The first pump for intrathecal administration of baclofen was implanted in 1984. Over thirty years, intrathecal prolonged infusion of muscle relaxants has occupied a worthy niche among all methods for correction of non-focal drug-resistant disabling muscle spasticity. However, this method has not become routine despite high awareness of specialists in Russia and abroad, as well as undeniable advantages for restoring the daily activity, improving the walking pattern and providing care and quality of life in people with limited mobility. This is due to scrupulous analysis of adverse events and accurate attitude towards its use., The purpose of this review was to systematize data on indications, selection criteria, pump implantation technique, subsequent patient management and treatment outcomes over a 30-year history., Method: A review of national and foreign literature was performed., Results and Conclusion: Prolonged intrathecal baclofen therapy is perspective for long-term treatment of severe spasticity interfering with quality of life and self-care if oral muscle relaxants are contraindicated or ineffective. This procedure is effective for impaired articulation, chewing and spastic pain syndrome. One can reduce the incidence of side effects via correct dosage of the drug, and tolerance to therapy can be reduced by timely elimination of problems with catheter.

Patients with severe muscular spasticity still represent the most complex and resistant to therapy group of neuro-rehabilitation patients. In a few years, in Russia, intrathecal baclofen therapy has appeared to be the most effective method for such spasticity. For the first time the authors developed and implemented in clinical practice "Prospective register to treat spastic states using intrathecal baclofen therapy in Russian Federation" aimed at therapy classification of spastic patients: to reveal management characteristics, assess treatment outcomes and frequency of occurrence of adverse events that will finally help specify the need for the method employment in real clinical practice. The article presents the findings of a one-year usage of Register, which enabled to make a preliminary evaluation of intrathecal baclofen therapy in Russia., Competing Interests: Study funding and conflicts of interest. The study was not supported by any funds; there are no conflicts of interest related to the present study.

Aim: To increase the efficiency and improvement of rehabilitation in patients with a neglect syndrome after stroke., Material and Methods: The results of treatment of 750 stroke patients, 396 women and 354 men, aged from 30 to 82 years, average age 63.4 years, were analyzed. An influence of cortexin on removal of the neglect syndrome, functional rehabilitation, increase in daily life activities and quality of life was studied. All patients were divided into two matched-controlled groups, receiving and not receiving cortexin. The functional rehabilitation was followed up using Barthel, Lindmark, Scandinavian and Merton and Sutton scales, MMSE and MoCA scales for assessment of cognitive functions, Sickness Impact Profile for quality of life. Moreover, the efficacy was evaluated by absence of signs of neglect syndrome., Results: The combined rehabilitation with the use of cortexin helps to remove the neglect syndrome and improve the functional rehabilitation of stroke patients., Conclusion: Use of cortexin during rehabilitation in stroke patients with a neglect syndrome is justified and expedient for the increase of its efficiency that permits to recommend this drug for wide use in clinical practice.

This article is devoted to the basic principles of organization and carrying out the rehabilitation of patients with severe neurological diseases. Theoretical and practical aspects and prerequisites of effective rehabilitation are considered. An analysis of neurological dysfunctions due to focal brain's damages is important for the general organization of rehabilitation and for carrying out different methods of rehabilitation. Characteristics of multidisciplinary management of patients with severe neurological diseases are considered. Advantages and risks of early rehabilitation, and characteristics of passive verticalization are discussed.

Possibilities of increasing the therapeutic efficacy in patients with perinatal central nervous system (CNS) lesions of hypoxic-ischemic and infectious etiology are considered. Some questions of pathophysiological features of hypoxic-ischemic CNS disorders in newborns and their connection with further cascade of pathological changes in organs and systems are highlighted. In this light, the authors substantiate the need for adequate and effective neuro- (cerebro-) protection by the timely antioxidant energy correction and antihypoxic therapy with cytoflavin. The use of cytoflavin is justified in terms of efficacy and safety and can be recommended for use in practical health care in neonatology and pediatrics.