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BackgroundIt was previously shown that the MTHFR gene polymorphism correlated with an increased risk of migraine, particularly migraine with aura. The substitution of cytosine for thymine at the position 677 of the MTHFR gene leads to formation of the thermolabile form of the protein and development of hyperhomocysteinemia, which increases the probability of migraine. The purpose of this study was to determine whether the replacement of C677T in the gene MTHFR influenced any particular symptoms of the disease.MethodsWe have analyzed clinical and electrophysiological characteristics of 83 patients with migraine (migraine with aura (MA), 19 patients, and migraine without aura (MO), 64 patients, according to the ICHD-II (2003)) taking into account their genotypes of C677T variant of MTHFR.ResultsWe have shown that MA was significantly more prevalent among the T-allele carriers (37.2%), as compared to the СС genotype patients (0%), р < 0.0001. Patients with TT genotype were not only more likely to have accompanying symptoms (significant differences were found only for photophobia), but also more sensitive to migraine attack triggers. In RP-VEP test results we observed a trend that the T-allele carriers were presented with the decreased N75/P100 amplitudes and a positive habituation index, as compared to the СС genotype patients.ConclusionsThus, according to our data, the MTHFR genotypes are associated with several clinical and electrophysiological characteristics of migraine.

Authors present a case-report of a 36-year-old patient with pain syndrome in the face region (craniomandibular dysfunction with occlusive disorders) involving pericranial muscles and shoulder girdle muscles. Thioctic acid was prescribed as a basic therapy, and relaxation tire, mimic gymnastics, post-isometric relaxation, vitamin and mineral complex were additionally used. Thioctic acid was prescribed according to the following scheme: stage I - intravenous injections of thioctic acid (600 mg/daily, 5 procedures, every other day); stage II - oral administration of the drug in the dose of 600 mg/daily for 3 months. A significant reduction of pain syndrome and the palpable tension of muscles were noted; the symmetric even muscle tone was revealed. This case-report demonstrates the high efficacy of thioctic acid in treatment of patients with craniomandibular disorders using the 2-stage scheme. There was a significant improvement of quality of life of the patients due to the additional use of vitamin and mineral complex and medical tools (relaxation tire) for treatment at all stages of pain formation.

Представлен клинический случай синдрома «пылающего рта». Мужчина 27 лет, обратился с жалобами на жгучие боли в языке и слизистой полости рта, нарушение вкуса, нарушения чувствительности. Все симптомы появились после перенесенного простудного заболевания и имели волнообразное течение на фоне самолечения (антибиотики). Болевой синдром продолжался в течение 8 мес. Ставились диагнозы: атипичная лицевая боль, глоссодиния, вторичная лицевая боль (краниомандибулярная дисфункция). Эффекта от лечения в стационаре не было. Был сделан посев на микрофлору, получено повышение титров патогенной микрофлоры. Поставлен диагноз: вторичная лицевая боль (синдром «пылающего рта») на фоне сочетанного поражения слизистой полости рта (стафилококк, кандида). Назначена комплексная терапия с выраженным положительным эффектом. Ключевые слова: вторичная лицевая боль, орофациальная боль, атипичная лицевая боль, синдром пылающего рта, глоссодиния, заболевания слизистой полости рта.

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