The aim: To pay attention of clinicians to sterile encephalitis in adults, which in fact may be caused by EVs. Results: A young woman was admitted to our clinic because of 3-month-history of mild fever, left-sided soft facial paralysis, and generalized weakness. MR brain imaging in T2W, FLAIR, and T1W mode showed focal hyper intensive abnormalities in various parts of the left hemisphere. EV RNA was detected in the patient’s CSF on admission. IgM class antibodies to B.burgdorferi were present in the blood. Antibiotics and ribavirin have been administrated with a good effect. Conclusion: This case shows that EV infection may cause brainstem encephalitis accompanied by severe neurological manifestations in adults.

Introduction: Routine immunization contributes immensely to decline the incidence of vaccine preventable diseases among children. Statistical data shown the sharply decrease the vaccination coverage rates in Sumy region of Ukraine. The aim: Assess routine immunization uptake and its effect on the incidence of vaccine preventable diseases among children in Sumy region of Ukraine. Review: During some years, only 50-60 % of Sumy region children had received all recommended vaccines, which is far below World Health Organization target of 80 %. This has led to an increase of morbidity associated with some infectious diseases. Outbreaks of measles were registered in 2006 and 2012, when were ill 9346 and 7931 children respectively. Massive measles outbreak ongoing nowadays. Total number infected have already exceeded 35,000 cases. Conclusions: RI uptake in Ukraine is still below World Health Organization target. The main reason for the ongoing measles outbreak was low vaccination coverage for routine immunization antigens as a result of which collective immunity decreased to a critical level. Strict monitoring of the implementation of the immunization schedule by medical institutions at all levels are recommended to improve vaccination status of Ukrainian children.

Introduction: Viral encephalitis accounts for 40-70% of all cases worldwide, central nervous system infections pose a diagnostic challenge because clinical manifestations are not typically pathognomonic for specific pathogens, and a wide range of agents can be causative. The aim: To assess the diagnostic value of intrathecal synthesis of specific antibodies in patients with inflammatory lesions of the central nervous system. Materials and methods: Within the framework of the study, two groups of 90 people in each were formed from the patients with neuroinfections admitted to our Center. Intrathecal synthesis (ITS) of total (unspecific) IgG in members of one of group (group of compare) was determined. Brain synthesis of specific antibodies (Ab) to some neurotropic pathogens (herpes simplex virus 1/2, cytomegalovirus, Epstein-Barr virus, varicella zoster virus, rubella virus, Borrelies) was studied in the second group of patients (group of interest). There were no statistically significant differences between groups by gender and age. Encephalitis and encephalomyelitis prevailed among patients of both groups Results: ITS of total IgG was established in 30 (33.3 ± 6.1 %) patients of the first group with IgG index more than 0.6 indicating on inflammatory process in CNS and no marked changes of CSF. ITS of specific Ab was determined in 23 of 90 (25.6 ± 4.6 %) patients included into group of interest. In more than half of cases Ab to several infectious agents were detected simultaneously. ITS of various specificity, in particular, to measles and rubella viruses, and VZV, known as MRZ-reaction, is characteristic of some autoimmune lesions of CNS, multiple sclerosis first of all. In fact, further research of 5 patients with MRZ-reaction confirmed their autoimmune failure of CNS. Detection of ITS in the CSF samples didn’t depend on concentration of specific Ab in serum and CSF and wasn’t followed by HEB dysfunctions which were observed with the same frequency in patients with or without ITS (13.0 % and 13.6 % respectively). Conclusion: Specific Ab synthesis to several neurotropic pathogens in the CSF of significant part of examined patients was established. Thus, diagnostic value of ITS of specific immunoglobulins seems to be limited to cases in which autoimmune damage of the CNS is suspected.

Ramsay Hunt syndrome (RHS) occurs due to reactivation of latent Varicella Zoster Virus (VZV) infection in the geniculate ganglion of the facial nerve. Major clinical symptoms include ipsilateral facial paralysis, otic pain, and herpetic vesicles (rashes) along the nerve with accompanying ear pain. Rarely clinical findings include retrograde transaxonal spread of the virus from the ganglion into the brain parenchyma with developing the encephalitis or multiple cranial nerve involvement. We describe here a patient with both RHS along with complicating brains

A very rare inflammatory disease of CNS, CLIPPERS syndrome, was recently described and only a few sporadic cases are reported in the medical literature. Its etiology and pathogenesis are unknown, that together with the polymorphic and sometimes confounding neurological manifestations, and radiological findings represent a real diagnostic and therapeutic challenge for clinicians. Aim: To highlight the importance of clear and specific diagnostic assessment. Here we present the case of a 40-year-old male with a subacute lymphocytic midbrain inflammation accompanied by vasculitis. We discuss the symptoms, imaging and treatment of this lesion.