Наведені результати клінічного й нейропсихологічного обстеження 25 пацієнтів із розсіяним склерозом та їх динаміка на фоні лікування препаратом альфа-ліпоєвої кислоти. Обговорюється вплив альфа-ліпоєвої кислоти на неврологічний дефіцит, когнітивні розлади, вираженість синдрому втоми та якість життя хворих на розсіяний склероз. Зроблено висновок про доцільність використання препаратів альфа-ліпоєвої кислоти в симптоматичному лікуванні хворих на розсіяний склероз.

Aim. To study the features of the clinical course, diagnosis and treatment of chronic relapsing inflammatory optic neuropathy based on clinical cases. Materials and Methods. Clinical cases of chronic relapsing inflammatory optic neuropathy in two men are presented. The patients underwent neurological and ophthalmological examination, laboratory blood tests, testing of cerebrospinal fluid, magnetic resonance imaging of the brain and spinal cord, perimetry, ophtalmoscopy, optical coherence tomography, ultrasound examination of internal organs and of the branches of the aortic arch, and chest radiography. Results and Discussion. Two cases of chronic relapsing inflammatory optic neuropathy were described in two men aged 44 and 22 years. Episodes of recurrent optic neuritis, both unilateral and bilateral, were observed in patients; their vision improved after corticosteroid therapy. No etiological factors or comorbidities capable of causing the condition were identified. The older patient had 8 attacks of recurrent optic neuritis, with complete recovery of vision after therapy in seven cases, and partial recovery after the last relapse . The 22-year-old patient endured 5 episodes without complete recovery of vision after treatment. Based on the diagnostic criteria of chronic recurrent inflammatory optic neuropathy, this diagnosis was suspected in the patients. Conclusions. Chronic relapsing inflammatory optic neuropathy is a rare pathology whose clinical manifestations must meet diagnostic criteria. Patients with recurrent optic neuritis are to be well examined, in order to make a correct diagnosis and prescribe adequate therapy. Clinical manifestations of chronic relapsing inflammatory optic neuropathy tend to regress and stabilize against a background of immunosuppressive therapy. Keywords: chronic relapsing inflammatory optic neuropathy, clinical cases

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system with different disorders of neurological and higher cortical functions. It is important to identify biomarkers that can control the dynamics of neuropsychological changes and predict the progression of this process. The aim of the study was to investigate the pathogenic and clinical significance of serum autoantibodies to the myelin basic protein (MBP) and histone h1 in the occurrence of neurological and neuropsychological disorders in patients with MS. Fifty-five patients diagnosed for MS were examined. A general clinical and neurological examination, determination of cognitive status, depression level and the content of autoantibodies to histone h1 and MBP in the blood serum were conducted. Blood serum samples of 20 healthy volunteers were used as control. The serum of patients with MS was shown to contain antibodies of IgG class to MBP and histone h1. The level of anti-histone h1 IgG-antibodies in blood serum of MS patients was found to be higher compared with the level of anti-MBP IgG-antibodies (P < 0.05). Increased levels of anti-MBP antibodies correlated with the severity of trunk ataxia, impaired conceptualization, and mood. High level of anti-histone H1 antibodies correlated with the severity of paresis, trunk ataxia, impaired conceptualization, semantic language, and mood. The level of anti-histone H1 antibodies in blood serum of MS patients might serve as a biomarker of inflammatory and, probably, of the neurodegenerative processes of this disease and determine the dynamics of clinical course of the MS. anti-MBP antibodies play an important role in the pathogenesis of the MS and are an additional marker of the severity of the clinical course of neurological and some neuropsychological disorders. K e y w o r d s: multiple sclerosis, IgG-autoantibodies, histone h1, myelin basic protein, cognitive impairments, depression.

Headache is one of the most common complications after lumbal punction or epidural anesthesia. The article presents a clinical case of post dural puncture headache in a 26-year-old woman, 25 days long. An intracranial hypotension was confirmed by the help of magnetic resonance imaging of the brain, a pituitary gland with a slightly convex upper contour and a rounded form of transverse venous sinus were found. Positive effect of rehidratation, analgesics, non-steroid anti-inflammatory and antiemetic drugs and drugs of caffeine in the treatment of post-dural puncture headache was noted.

Наведені результати клінічного й нейропсихологічного обстеження 7 пацієнтів із розсіяним склерозом та їх динаміка на фоні лікування фінголімодом. Обговорюється вплив фінголімоду на неврологічний дефіцит, когнітивні розлади, вираженість синдрому втоми та якість життя хворих на розсіяний склероз. Зроблено висновок про доцільність використання препарату патогенетичного спрямування фінголімод в лікуванні хворих на розсіяний склероз.