Background: The coronavirus infection caused by SARS-Cov-2 is characterized by a damage to many organs and systems of the human body. To date, convincing information has been obtained about the involvement of various parts of the nervous system in the pathological process in patients with COVID-19. Among the most frequently described impairments, there are disorders of smell and taste, common disorders of the central nervous system, characterized by general cerebral symptoms, such as headache, asthenization, psychopathological disorders. One of the rare and severe forms of the peripheral nervous system damage in COVID-19 is Guillain-Barre syndrome (GBS), characterized by acute post-infectious inflammatory polyneuropathy with an autoimmune etiology. Clinical case description. We present a clinical case of GBS associated with COVID-19. The disease debuted as a peripheral tetraparesis with a progredient course of up to 21 days. Systemic administration of immunoglobulin stopped the disease progression. The association of GBS with COVID-19 was clarified a month after the disease onset, when bilateral polysegmental pneumonia was diagnosed, and a high level of IgG to the S-protein of SARS-CoV-2 was found, 3 times higher than the level of IgM, which indicated the duration of the disease was not less than three weeks. Conclusion: The GBS development upon infection with SARS-CoV-2 may precede the lung damage. The debut of GBS during the COVID-19 pandemic requires the exclusion of the SARS-CoV-2 etiological role in each case.

The results of a comprehensive clinical examination of 418 patients with various manifestations of cerebrovascular diseases (CVD) are analyzed. From the standpoint of functional disorders the analysis identified clinical manifestations CVD was performed and clarified their influence on the restriction of the fundamental types of activity. Multidisciplinary approach in restorative treatment and rehabilitation of patients with CVD is justified.

Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Институт повышения квалификации Федерального медико-биологического агентства», Москва, РоссияЦелью исследования явилось изучение представленности афферентного дефицита у больных с ишемическим инсультом и анализ эффективности проводимой реабилитации с учетом наруше-ния соматосенсорного обеспечения.Материалы и методы. Было обследовано 119 пациентов с гемипарезом после ишемического инсульта. Контрольную группу составили 35 здоровых испытуемых. Все пациенты проходили курс реабилитационного лечения, до и после которого применялись транскраниальная магнит-ная стимуляция (ТМС) и исследование соматосенсорных вызванных потенциалов (ССВП). Результаты. Реабилитация с применением персонифицированного, патогенетически обоснован-ного подхода способствовала лучшему восстановлению неврологического дефицита. Зарегистрированы достоверно меньшие значения параметров ТМС -времени центрального моторного проведения в покое и при пробе с фасилитацией при ТМС, но не при исследовании ССВП у больных, получавших персонализированную нейрореабилитацию. Заключение. Была продемонстрирована эффективность патогенетически обоснованной реабилитации пациентов после ишемического инсульта. Продемонстрирована большая эффективность восстановительно-го лечения в отношении двигательного дефицита; соматосенсорные функции восстанавливались хуже, что предполагает выявление и учёт афферентного дефицита, как и нейрофизиологический мониторинг восстановительного процесса с использованием ТМС и ССВП для повышения эффективности проводимой реабилитации у данной категории больных.Ключевые слова: ишемический инсульт, сенсомоторные нарушения, нейрореабилитация, транскраниальная магнитная стимуляция, соматосенсорные вызванные потенциалы. INNOVATIVE APPROACHES TO REHABILITATION OF PATIENTS AFTER ISCHEMIC HEMISPHERIC STROkEEkusheva E.V., Kiparisova E.S., Shirshova E.V.Our aim was to study efficacy of pathogenetically substantiated rehabilitation of sensorimotor disorders in patients after ischemic stroke. Methods. A total of 119 patients were studied all with hemiparesis following ishemic stroke. There were 35 controls. All patients underwent rehabilitation which included robotized mechanotherapy, stabilography, neuro-muscular stimulation, physical therapy, ergotherapy, massage etc. Before and after the rehabilitation therapy TMS and SSEP parameters were evaluated in all patients. Results. Rehabilitation with the use of a personified, pathogenetically grounded approach contributed to a better recovery of the neurological deficit. In those patients who received personalized therapy significant changes of TMS parameters (central motor conduction time at rest and in facilitation probe), but not SSEP ones were registered. Conclusions. The effectiveness of the pathogenetically substantiated rehabilitation of patients after ischemic stroke was demonstrated. Were demonstrated more effective in restorative treatment of motor deficits. Somatosensory functions were rest...

The aim of the study was to investigate the clinical and neurophysiological features of sensorimotor disturbances in patients at different time periods after ischemic stroke. Methods. The study involved 133 patients with ischemic stroke in the right and left cerebral hemispheres in the late recovery (58) and residual (75) periods. There were 35 controls. Were performed transcranial magnetic stimulation, evoked abdominal reflexes and somatosensory evoked potentials. Results. It was shown that functional recovery processes are continuing with varying degrees of severity in patients and in a year after stroke. Conclusions. Persistence and severity of sensorimotor disturbances, as well as compensatory opportunities, defined afferent component of poststroke deficit, which implies an additional impact in this area to expand the possibilities of neurorehabilitation in patients after stroke.