Huntington’s disease (HD) is an orphan disease with an average incidence of 5.5 cases per 100 000 population. It is characterized by a high degree of penetrance, variable expressivity, manifestation in different age periods. This disorder, transmitted in an autosomal dominant way, does not have gender differences. The disease often progresses slowly but steadily over many years, eventually leading to severe disability. The clinical picture of this disease has a pathognomonic combination of neurological (extrapyramidal) and neuropsychiatric disorders. With the addition of mental disorders, especially dementia, the diagnosis of HD becomes more likely and obvious. However, if disorders in the mental sphere, including irritability, irascibility, apathy, abulia, delirium, hallucinations, impaired memory and attention, become the debut of the disease, then they largely mask clinical picture. In such cases, patients are hastily made other diagnoses: psychopathy, schizophrenia, bipolar disorder, Alzheimer’s disease, and others. You should be wary of the possible secondary nature of neuropsychiatric disorders in patients, especially young patients.

Alzheimer’s disease (AD) is the most common neurodegenerative disorder in elderly population leading to the development of dementia. The emergence of modern diagnostic approaches makes possible reveal AD at predementia stage and study new drugs with pathogenetic and neuroprotective properties before severe cognitive impairment (dementia) arises. We present a description of patient with amnestic type of mild cognitive impairment with subsequent follow-up for more than two years. AD presence in mentioned patient was confirmed by evaluation of specific clinical, laboratory and instrumental biomarkers. Therapy with akatinol memantine (one of the main antidementia drugs in AD) at dose 20 mg/day was accompanied by cognitive defect stabilization. After two years of therapy acute severe decompensation related to hypoactive delirium due to respiratory infection was observed, which was followed by marked cognitive status deterioration. Daily dose of akatinol memantine was increased to 30 mg with subsequent restoration of baseline cognitive status. Possible mechanisms of akatinol memantine action and its effects in management of geriatric patients with AD including role in delirium therapy are discussed.

A rare version of paraproteinemic hemablastosis, with the onset characterized by Peripheral Nerve Disease, is POEMS- syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin Changes). In the foreground of the clinical picture of this oncohematological disease is progressive sensorimotor polyneuropathy, which is the reason for the primary reference to a neurologist long before the provision of specialized hematological care. The article provides an overview of recent scientific publications devoted to this disease. Its pathogenetic mechanisms are discussed, as well as the basis of endothelial growth factor. The authors present their own clinical observation of a 62-year-old patient. The onset of the disease was characterized by polyneuropathy accompanied by changes in the M-protein index, organomegaly in the absence of bone-destructive changes, which made the diagnosis difficult. Additional clinical signs included fever, edema (ascites, exudative pleurisy), and hypoproteinemia, changes in peripheral blood (moderate leukocytosis with a decrease in the level of erythrocytes and platelets, which is atypical), kidney and cardiovascular damage. Despite the specific therapy, the patient’s condition was complicated by the development of infectious complications and was fatal. This clinical observation illustrates the need for a careful differential search for a possible cause of non-polyneuropathy of unknown genesis.

In development of the «serotonin» hypothesis of depression put forward by I.P. Lapin and G.F. Oxenkrug in 1969, the combination of the two factors is proposed which are responsible for depression formation: reduced “basal” 5-HT cerebral level and excessive duration of early morning REM sleep periods during which the release of cerebral serotonin ceases altogether. As a means of prevention and treatment, not the deprivation, but rather fragmentation of REM sleep is proposed, which is much easier for patients to tolerate.

Psychological treatment methods can be used to reduce the intensity of the pain syndrome, the influence of psychological, social factors, comorbide disorders, and to improve the quality of life in patients with chronic back pain (CPS, i.e. chronical pain syndrome). The methods of assessing the psychological state, the effectiveness of various psychological methods are discussed. It is noted that the effectiveness of cognitive-behavioral therapy, mindfulness (mindfulness therapy), relaxation method and biofeedback is confirmed by the results of randomized controlled studies for CPS. Psychological methods of treatment for pain should be widely used in the management of patients with CPS.

The article provides a brief outline on the history of the first clinic of the nervous system diseases in Russia that was organized in 1969 in Moscow New Catherine hospital, and also presents information about its leaders — A.Ya. Kozhevnikov, G.I. Rossolimo, A.A. Kornilov, L.O. Darkshevitch, I.Yu. Tarasevitch.

Multiple systemic atrophy.(MSA) is a progressive neurodegenerative disease with a poor prognosis and unknown etiology, which belongs to the “atypical parkinsonism” group of diseases. Currently, the diagnosis of MSA is difficult and at the present stage remains predominantly clinical. But, despite the fact that no effective treatment has been developed, timely diagnosis and symptomatic therapy can improve the patient’s quality of life. The article presents a clinical observation of a patient with MSA, a feature of which was the combination of MSA with vascular pathology, which greatly complicated and delayed the diagnosis of MSA.

The article presents the results of safety fi ndings during international multicenter randomized double-blind, active and placebo-controlled, comparative phase 3 trial. 158 patients with relapsing-remitting multiple sclerosis were randomly assigned into 3 groups: Timexon (glatiramer acetate, manufactured by JSC «BIOCAD», Russia), copaxone-Teva (Teva Pharmaceutical Enterprise Co., Ltd., Israel) and placebo, at a ratio of 2:2:1, respectively. At the second group 63 patients received Copaxone-Teva, after 48 weeks of therapy they received Timexon. Switching between therapy was not associated with adverse eff ect frequency. There was no clinically signifi cant diff erences in profi le and frequency of adverse eff ects between the groups of Copaxone-Teva and Timexon. Also, effi cacy analysis of therapy demonstrated no diff erences between timexone group and Copaxone-Teva group in both MRI parameters and frequency of relapses. The data obtained from the present study confi rm the equivalence in safety of Timexon (CJSC BIOCAD, Russia) and Copaxone-Teva, that is important for further implementation of glatiramer acetate generic in the clinical practice of multiple sclerosis therapy.