Administration of the disease modifying therapy in patients with multiple sclerosis is associated with alterations in immune system reactivity. Interferon’s IFN-β-1a and IFN-β-1b are included in the first-line treatment for multiple sclerosis cure. However, as protein substances, they are potentially immunogenic, hence neutralizing antibodies (Nab) can appear after 3–6 months in the serum of a multiple sclerosis patient, reducing IFN-molecules activity. Detection of the NAb to the administrated IFN-medication enables to change the patient management strategy. The level of inflammatory and apoptotic caspases in serum and cerebrospinal fluid may also be considered as a prognostic biomarker for the IFN-therapy efficiency. In addition, the level of microRNA, neurofilaments in serum and secreted glycoproteins (chitinases) in cerebrospinal fluid have certain prognostic value. Increasing of medical substances action specificity, searching for new pathogenesis links as targets for the therapeutic action and identification of the effective prognostic biomarkers are the main strategies of multiple sclerosis treatment nowadays.

The aim of the study was to analyze stroke case fatality in the regional stroke center (RSC) during the COVID-19 pandemic, in order to plan the prevention measures for reduction in mortality. A retrospective comparative analysis of the medical records of stroke patients who died in October-November 2019 and 2020, i.e. before and during the 2019 Coronavirus Disease Pandemic (COVID-19) was conducted. The age of patients, the NIHSS score and the Glasgow coma score at the admission did not differ on average in 2019 and 2020. Also, there were no differences in the incidence of ischemic and hemorrhagic stroke, the rate of early and late hospitalization, the average length of stay in the RSC prior to a lethal issue, but patients in 2020 were significantly more often diagnosed with pneumonia than in 2019. A “probable” case of COVID-19 was detected in October-November 2020 in 11 of 85 (12.9%) patients with fatal stroke before the lethal issue. In 8 of these 11 patients, laboratory confirmation of COVID-19 was obtained after the death. There was a statistically significant association between the presence of a “probable” or “confirmed” case of COVID-19 and pneumonia (Chi square 12.8, p = 0.000). According to the pathomorphological study the main cause of death in fatal stroke cases in October-November 2020 was stroke and its complications in 98% and pulmonary embolism with acute respiratory failure in 2% of cases, respectively.

Parkinson disease (PD) is one of the most common neurodegenerative diseases. Its main clinical manifestation is movement disorders. The study of innovative objective methods for the diagnosis and rehabilitation of movement disorders in PD is relevant and in demand taking into account the slowly progressive course of the disease and the complex set of symptoms that subsequently forms a characteristic movement pattern. This article provides an example of a personalized rehabilitation assessment of biomechanical manifestations of the gait function of a patient with exacted diagnosis, stage 3.5 PD according to Hoehn and Yahr, by means of the method of three-dimensional motion video analysis using the Vicon Motion Capture Systems soft-hardware complex. The patient has postural and gait disorders. This method was applied after a rehabilitation course based on the activation of lifting the foot from the support surface (“back push”). Changes in the tempo and rhythm parameters of gait in a patient with PD in comparison to a healthy person were revealed: acceleration of walking pace with shortening of the length of single and double step, a decrease in the time of limb advancement, acceleration of the moment of heel rise and a decrease in walking pace. Analysis of the locomotion also revealed a decrease in the amplitude of flexion-extension in the coxofemoral joint, knee joint and tibio-tarsic on the side with more pronounced Parkinsonism. Insufficient knee flexion and hip extension, excessive dorsal flexion of the foot with insufficient plantar flexion were noted. Revealing the last features of locomotion in a particular case allows one to make a plan for a targeted personalized rehabilitation program for a given patient. Thus, the method of three-dimensional video analysis is a valuable diagnostic tool that makes it possible to objectively assess the existing violations of locomotion and identify the targets of rehabilitation.

Huntington’s disease (HD) is an orphan disease with an average incidence of 5.5 cases per 100 000 population. It is characterized by a high degree of penetrance, variable expressivity, manifestation in different age periods. This disorder, transmitted in an autosomal dominant way, does not have gender differences. The disease often progresses slowly but steadily over many years, eventually leading to severe disability. The clinical picture of this disease has a pathognomonic combination of neurological (extrapyramidal) and neuropsychiatric disorders. With the addition of mental disorders, especially dementia, the diagnosis of HD becomes more likely and obvious. However, if disorders in the mental sphere, including irritability, irascibility, apathy, abulia, delirium, hallucinations, impaired memory and attention, become the debut of the disease, then they largely mask clinical picture. In such cases, patients are hastily made other diagnoses: psychopathy, schizophrenia, bipolar disorder, Alzheimer’s disease, and others. You should be wary of the possible secondary nature of neuropsychiatric disorders in patients, especially young patients.

This article represents the discussion of a clinical case of superior sagittal sinus thrombosis as a focal point of fatal pulmonary embolism. Pulmonary embolism is a life-threatening condition, with a mortality rate of up to 40%. The direct source of pulmonary embolism is deep vein thrombosis of the lower extremities and pelvis in 80–90% of all cases. The veins of the upper extremities and venous heart cause it less often. Pulmonary embolism in patients with cerebral venous thrombosis is observed in 1.4% of patients.
Cerebral venous thrombosis is a cerebrovascular disease manifested by venous outflow disorders due to acute occlusion of the sinuses and veins of the brain. It requires immediate treatment in order to prevent the development of intracranial hemorrhage, venous infarction, disability and death. Cerebral venous thrombosis accounts for approximately 0.5% of all cases of cerebrovascular disease worldwide. In contrast to ischemic stroke, cerebral venous thrombosis is more common in younger patients. Currently, the diagnosis of cerebral venous thrombosis is based on neuroimaging data, and timely treatment leads to a decrease in disability and mortality.

Neuralgic amyotrophy is an acute painful inflammatory neuropathy involving, as a rule, the trunks of the brachial plexus in one side. A clinical case of a bilateral form of neuralgic amyotrophy is presented with successively involvement of the brachial plexus on both sides in a 62-year-old man and relief of neuropathic pain in response to high doses of glucorticosteroids.