Paraproteinemic polyneuropathies (PPN) occur generally infrequently and arise from diseases, associated with formation and accumulation of a pathological protein, commonly known as paraprotein, which is typically an immunoglobulin or its free light chain. Such diseases include the following: monoclonal gammopathy of undetermined significance, multiple myeloma, Waldenström’s macroglobulinemia, AL amyloidosis, POEMS syndrome, etc. Diagnosis of PPN is challenging due to nonspecific, indistinct or atypical clinical manifestation, and it is necessary to apply specialized laboratory methods, including immunochemical analysis of blood and urine. Moreover, medications can cause symptoms of polyneuropathy themselves. Thus, it is important to suspect the first symptoms of the disease in time, determine the mechanism of damage to nerve fibers, carry out differential diagnosis and initiate therapy targeting the suppression of pathological protein synthesis.

Headaches are one of the most common causes of disability worldwide, with migraines coming to the fore. A new and promising preventive strategy to combat migraine is drugs from the group of monoclonal antibodies to calcitonin-a gene-related peptide. High efficacy, good tolerability, and the ability to increase patient compliance increase the interest of specialists in these drugs. A potentially significant reduction in the economic burden on society and healthcare also plays an important role as a significant impact on improving the quality of life of patients. Despite the prospects of using these drugs for the prevention of migraine headaches, not all aspects related to this have been fully considered and resolved to date.

The purpose of the study is activity identification CXC family cytokines in patients with cognitive impairments in the acute period of ischemic stroke.

Material and methods. 78 patients with diagnosis “Ischemic stroke” were examined. Depending on cognitive impairment (Montreal Cognitive Assessment (MoCA)) patients were divided into two groups: the 1st group — 58 patients with cognitive decline (MoCA ≤ 25 points); the 2nd group — 20 patients without cognitive decline. Neuropsychologic testing was performed on the second day of hospitalisation and included episodic memory, executive function, speech, gnosis, praxis and IQCODE parameters examination. Laboratory diagnosis consisted of level assessing of CXC family chemokines (CXCL10, CXCL11, CXCL9, CXCL1, CXCL8) and TNF-α cytokine in patients’ plasma on the second day of hospitalisation. Statistical analysis was employed using the Python programing language and its libraries Pandas and SciPy.

Results. Statistical analysis revealed the highest level of IP-10/CXCL10 chemokines (p = 0.002) and Gro-a/CXCL1 (p = 0.044) in patients of the 1st group, statistically significant correlations of MoCA and IQCODE with IP-10/CXCL10 and Gro-a/CXCL1 concentrations, correlations of IP-10/CXCL10 concentrations with semantic information processing functions (r = –0.512), subject gnosis (r = –0.211), memory (r = 0.275), speech (r = –0.400), and Gro-a/ CXCL1 level with semantic information processing (r = –0.418).

Conclusion. The study of chemokines of the CXC cluster represents a relevant and promising direction in the diagnosis and assessment of progression of early post-stroke cognitive impairment of mixed genesis due to minimal invasiveness and high specificity. Further studies are needed to verify CXCL chemokines, particularly IP-10/CXCL10 and Gro-a/CXCL1 as potential molecular markers of neurological damage in neurodegenerative and inflammatory diseases of the central nervous system.

Introduction: Wernicke’s encephalopathy is a life-threatening disease caused by thiamine deficiency with the development of damage to brain. Objective: to analyze the etiological factors, clinical, laboratory and instrumental data, as well as clinical outcomes of Wernicke’s encephalopathy.

Material and мethods: the study included 36 patients with Wernicke’s encephalopathy. the average age of patients was 54.5 ± 15.9 years, women were 52.8%, men — 47.2%.

Results: the most common causes of Wernicke’s encephalopathy were long-term alcohol abuse and diseases of the gastrointestinal tract or liver. A decrease in the level of wakefulness was detected in 63.9% of patients at the onset of the disease and in 72.2% during the entire period of hospitalization. In all patients, MRI of the brain revealed symmetrical areas of increased signal in the T2 FLAIR and DWI modes in the medial parts of both thalami, and in some cases also in the area of the quadrigeminal plate and/or periaqueductal space of the midbrain.

Conclusion. Assessment of blood thiamine levels is not mandatory before starting therapy; thiamine administration should be started without laboratory confirmation of deficiency. Preventive administration of thiamine at a dose of 1000 mg per day is justified for any clinical suspicion of Wernicke’s encephalopathy.

This article presents the results of a study of 19 patients with pseudotumor cerebri syndrome. An analysis of symptoms, signs and clinical data was carried out, which made it possible to create a diagnostic algorithm, and to determine an effective non-surgical treatment of these patients. A review of the literature on this issue is presented.

Carotid artery dissection is a cerebrovascular disease, the cause of which is assumed to be connective tissue dysplasia. The provoking factors may be injury, infections, high-intensity sports. This disease can occur both asymptomatically and manifest itself with various neurological symptoms (headache, Gorner syndrome). In our clinical case, the young patient showed no signs of connective tissue dysplasia, nor provoking factors. Timely diagnosis contributed to the rapid determination of arterial dissection, and early treatment provided stabilization of the patient’s condition and regression of neurological deficit. The literature data on the diagnosis and treatment of the disease are presented.

Among functional neurological disorders functional dystonia (FD) is the most difficult to diagnose. We present an observation of a 44-year-old patient, who was observed for a long time with a diagnosis of cervical dystonia (CD) and received disability for this disease. The patient did not have typical manifestations of CD — repetitive stereotypical movements or postures of the head/neck, sensory trick, tonic tension of the neck muscles. For a long time, the patient experienced pain of various localizations and other manifestations of FNR. The psychiatrist regarded the condition as symptoms of a schizotypal disorder. An educational program, therapeutic exercises, and botulinum toxin management led to a decrease in the manifestations of FD. The issues of pathogenesis, diagnosis, differential diagnosis and treatment of FD are discussed.

Schwannomas are benign tumors that arise from Schwann cells and account for approximately 5% of all benign soft tissue tumors, are characterized by slow growth (1–2 mm per year) and are clinically asymptomatic for a long time.

Material and methods. A review of literary sources for 2000–2023 was carried out, sources from the Russian scientific electronic library eLIBRARY, RSCI databases, and PubMed were used. A clinical case of patient with geniculate ganglion schwannoma is presented.

Results. Schwannomas can occur at any age, no gender specific characteristics have been identified, the incidence most often occurs between the third and sixth decades, and there is an association with genetic disorders, in particular with neurofibromatosis. The dominant diagnostic methods remain MRI and MSCT of the brain.

Conclusion. The presented clinical case demonstrates a long-term, asymptomatic course of geniculate ganglion schwannoma with intracranial spread. The surgical treatment contributed to improving the patient’s quality of life.