The problem of pediatric stroke has become relevant in recent decades. The method of the register helps to assess the epidemiological situation, the effectiveness of treatment and prevention of stroke in children. The article provides an analysis of the existing registers of pediatric stroke in different countries and the experience of the regional Moscow register.

Background. The growing incidence of such central nervous system disorders as encephalitis (EP), acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) in pediatric population, similarity of their clinical manifestations at the onset, lack of universal diagnostic criteria and the risk of ADEM transformation into MS in the case of late diagnosis and inadequate treatment suggest the importance of this problem.

Objective: to evaluate diagnostic and prognostic value of multimodal evoked potentials and transcranial magnetic stimulation (TCMS) in children with EP, ADEM and MS.

Materials and methods. The study included 200 participants: 50 children with MS (mean age 14.0 ± 3.7 years), 50 children with ADEM (mean age 14.0 ± 3.5 years), 50 children with EP (mean age 12.0 ± 2.2 years) and 50 controls (mean age 14.0 ± 3.1 years). All patients underwent neurological examination, magnetic resonance imaging of the brain, diagnostic TCMS and assessment of visual evoked potentials, brainstem auditory evoked potentials, cognitive evoked potentials P300 to an auditory stimulus and somatosensory evoked potentials.

Results. We found that the P37–N45 amplitude 124 msec) is a risk factor for ADEM transformation into MS. The P100 latency >132 msec and lack of cortical evoked motor response from the m. abductor hallucis at MS onset indicate a high risk of disease progression and further development of disability

Conclusion. TCMS and assessment of multimodal evoked potentials (with estimating response amplitudes) allow determining the nature and severity of brain lesions, detecting subclinical dysfunction of the central nervous system, monitoring of the recovery processes and predicting outcomes in children with EP, ADEM and MS.

Objective: to assess the efficiency and tolerability of cerebrolysin in patients with epilepsy.

Materials and methods. Sixty six epileptic patients with low Montreal Cognitive Assessment results (less than 26 scores) were studied. The examination included neurologic examination, routine electroencephalography and/or video-electroencephalography monitoring, magnetic resonance imaging of the brain, assessment of clinical and biochemical blood tests. Criteria for exclusion were processual brain damage and noncompliance. All patients were assigned cerebrolysin 10 ml intravenous, an assessment of seizures frequency and cognitive functions was performed 1 and 3 months after the 1st visit. All the procedures of the study were performed by 38 patients out of 66.

Results. In a group of patients with Alzheimer’s dementia there was a statistically insignificant tendency to decrease the final score over time (obviously associated with the progression of the disease); in the group of patients with brain damage the results of testing were improved, presumably related to the processes of neuroplasticity induced by cerebrolysin.

Conclusion. Our results suggest that cerebrolysin is well tolerated and does not increase the frequency of epileptic seizures in patients with stable epilepsy (with no risk of developing status epilepticus) and cognitive disorders.

Epilepsy is a disease creating multiple obstacles for patients in terms of their social rights as well as for their associates. The level of physician’s legal literacy can both improve the life of a patient with epilepsy and significantly complicate it for many years. Despite the existing normative legal acts regulating the admission of patients with epilepsy and epileptic syndrome to various types of work, military service, weapon possession, and driving, there are still many questions, which is a significant defect in medical service. First of all, we should take into account that people with long-term remission (with or without pharmacotherapy) have the same legal restrictions as patients with incurable epilepsy. Therefore, accurate initial diagnostics in patients with symptoms similar to epilepsy is very important.

This article describes the main legislative rules regulating social rights of people with epilepsy and draws attention of the medical community to the problems of these patients.

Ophthalmoplegic cranial neuropathy (OCN) is a disease with unknown etiology, which manifests itself by episodes of intense headache, accompanied by completely or partially reversible dysfunction of the oculomotor nerve: ptosis, mydriasis and ophthalmoplegia. It is assumed that the pathology is demyelinating in nature, therefore in the International classification of headaches OCN excluded from rubric migraine and related to the painful cranial neuropathies. The question of the prevention and treatment of this disease is still controversial, the issue of the appointment of corticosteroids, calcium channel blockers and β-blockers, methods of surgical correction of strabismus and botulin therapy.

The article describes OCN in an 11-year-old boy. In the clinical picture headache attacks were observed. These attacks were with signs of selective lesions of the oculomotor nerve on one side. These functional changes are recurrent, and fully regress between attacks. Laboratory and instrumental examinations revealed no pathology that could cause this symptom, including myasthenia. The described case demonstrates the classical picture of OCN with a favorable course and the partial damage of the oculomotor nerve on one side.

Mutations of POLG gene can cause a variety of clinical manifestations, including autosomal recessive or autosomal dominant mitochondrial diseases. The article presents a clinical case demonstrating the difficulty of differential diagnosis of POLG-associated disease and juvenile myoclonic epilepsy. The case demonstrates the importance of molecular genetic diagnosis in idiopathic generalized epilepsy with atypical features for timely administration of appropriate therapy and minimize the development of adverse side reactions.

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