Резюме. В умовах реформування системи охорони здоров'я України курація хворих на розсіяний склероз є важливим напрямком надання медичної допомоги цьому контингенту хворих. У статті наведені принципи ведення хворих на розсіяний склероз в умовах як амбулаторно-поліклінічного рівня, так і стаціонарних. Викладені сучасні критерії діагностики розсіяного склерозу (McDonald, 2010), основні напрямки медикаментозної терапії залежно від типу перебігу, стадії загострення, принципи реабілітації.

58 patients with ischemic stroke were examined (29 young people — the main group and 29 middle-aged people — control group). Among the examined young patients, cardio embolic subtype of stroke prevailed (66 %), and among middle-aged patients was observed in 10 %. The athe rothrombotic subtype of stroke prevailed in middle-aged people (69 %), and among young people — 24 %. The lacunar subtype of stroke in young people was 3 %, and in middle-aged people — 21 %. Patients of young had such subtypes of strokes as hemodyna mic and hemorheological, which respectively equaled 3 %. In middle age these subtypes of strokes were not observed among the examined patients. In young people the proportion of vascular pools with ische mic stroke was: vertebrobasilar — 41 %, carotid prevailed to some extend — 59 %. In middle-aged people the proportion of strokes prevailed in the carotid pool — 64 %, in the vertebrobasilar it was 29 %. Middle-aged people also had a “combined stroke” (stroke that occurred in several pools at once), it amounted to 7 %. As a result, Doppler study of cerebral vessels proved that in young people linear velocity in the right middle cerebral artery was authentically higher compared with middle-aged patients. At the same time, the linear velocity in middle-aged patients was statistically greater in the left vertebral artery. Keywords: ischemic stroke subtypes, young age, hemodynamic parameters

Friedreich's ataxia (FA), an autosomal recessive neurodegenerative disease, is the greatest common of the inherited ataxias. The recent discovery of the gene that is mutated in this condition has led to rapid advances in Friedreich`s ataxia understanding of the pathogenesis. Nearly 98% of the mutant alleles have an expansion of the GAA trinucleotide repeat in the intron of 1 of the gene. It leads to the reduced levels of the protein, and called frataxin. Friedreich ataxia is the result of the accumulation of iron in the mitochondria leading and to excess of the creation of free radicals, which formerly leads to the cellular damage and death. This chapter outlines genetics, the most conjoint clinical features of this disease: gait and limb ataxia, poor balance and coordination, sensory loss, leg weakness, impaired walking, areflexia, dysarthria, eye movement abnormalities, dysphagia, scoliosis, foot deformities, cardiomyopathy and diabetes. At present day there is no known treatment that changes the natural progression of this disease.

В роботі наведені дані клініко-неврологічного та електронейроміографічного обстеження 30 хворих на розсіяний склероз та оцінка терапевтичної ефективності препарату Нуклео Ц.М.Ф. Форте в комплексному лікуванні хворих на розсіяний склероз.

Despite numerous investigations, fatigue remains one of the least studied manifestations of MS. However, significant prevalence of this symptom proves importance of its study. The aim of the study was to define a prognostic assessment of fatigue development accompanying lesions of certain functional systems and degree of disability. Material and methods. 96 patients, aged 15 to 58 years with a diagnosis of MS have been examined. MS patients were examined with the same protocol, using formalized scales. To detect fatigue and determine the degree of its severity was used Fatigue Severity Scale (FSS). The degree of disability in patients was assessed by Kurtzke EDSS (Expanded Disability Status Scale). Statistical methods for the data analysis were also used, including methods of descriptive statistics, probability assessment and prognostic significance of obtained data using odds ratio (OR). Results. Fatigue was detected in 49.1% of patients with a degree of disability lower than 4 EDSS scores and in 90.4% of patients with disability higher than 4 EDSS scores (p=0.0027). The assessment of functional systems at the time of observation has statistically significant prognostic values according to the following parameters: pyramidal system lesion (OR=7.43 (2.43–22.76)), coordination disorders (OR=4.60 (1.05–20.25)), cranial nerve lesion (OR=4.33 (1.40–13.39)), (p<0.05). Lesion of the pyramidal and coordination systems at the onset of the disease may increase risk for detection of fatigue higher than 4 scores in the follow-up observation (lesion of pyramidal system – OR=1.62 (0.5–5.25), coordination disorders OR=1.41 (0.58–5.16)). Conclusion. The results of our investigation showed that symptom of fatigue is observed in almost 90 % of MS patients. The study showed that fatigue in MS patients depends on the degree of disability and lesions of certain functional systems.