Justification. Autoimmune encephalitis (AE) is a group of immune-mediated diseases based on autoconfl ict to cells of the central nervous system caused by paraneoplastic, postinfectious, iatrogenic or idiopathic processes. Clinical manifestations are represented by general systemic, neurological, psychiatric symptom complexes. The diagnosis is based on clinical, laboratory and instrumental methods: regularity of clinical picture formation, laboratory tests (autoantibody determination), use of neuroimaging methods. Treatment approaches have common medication steps, which vary depending on the type of AE.

Purpose of the work. To study the data of scientifi c publications with subsequent structuring of information and to provide clinical and diagnostic characteristics of diff erential diagnosis of AE.

Methods. We have analyzed 35 scientifi c publications in MEDLINE, PubMed, Google Scholar, eLIBRARY database: clinical trials, randomized controlled trials, systematic reviews, clinical cases from 2001 to 2025.

Results. The results of the analysis provide information on AEs: age of debut; clinical manifestations of each type, which occur in pediatrics; features of laboratory (antibody detection) and instrumental (electroencephalogram, neuroimaging) diagnosis; association with cancer processes; therapy and prognosis.

Pediatric patients with suspected AE should undergo the diagnostic minimum (cerebrospinal puncture for autoantibody determination, magnetic resonance examination of the brain), target therapy (use of fi rst-line drugs) with further evaluation of the results (ex juvantibus therapy if necessary). Post-therapeutic follow-up with further exclusion of paraneoplastic syndrome for 5 years (if idiopathic AE is suspected) is also an important aspect.

Conclusion. In pediatric practice, the course of autoimmune encephalitis (AE) has several clinical and diagnostic features: in most cases, encephalitis is accompanied by a seizure syndrome; the neuroimaging pattern is variable; therapy in all cases begins with glucocorticosteroids and intravenous immunoglobulin with the addition of plasmapheresis; in the absence of positive dynamics, there is a transition to cytostatic and/or antitumor drugs; pediatric patients have a favorable prognosis and high survival rates in most types of AE.

According to research data, the dynamics of pre-mild cognitive decline (PMCD) in the form of subsequent deterioration of cognitive functions is not unambiguous, there is no Russian data on this issue.

The aim of the study: to evaluate the dynamics of the cognitive status of patients with PMCD.

Material and methods. 56 middle-aged and elderly patients (61.05 ± 9.88 years old) with PMCD were re-examined on average after 3.60 ± 2.50 years (from 2 to 11 years old). To assess the cognitive status, quantitative neuropsychological scales and tests were used: to assess memory — a 12-word recall test with assessment of immediate and delayed recall, Literal and Categorical Association Test, Benton Visual Memory Test, Trail making test (parts A, B), Munsterberg Test, Symbol Digit Modalities Test, Clock Drawing Test; Mini-Mental State Examination (MMSE), executive functions — the Frontal Assessment Battery (FAB).

Results. 41% of patients demonstrated cognitive decline, including the transition from subjective cognitive decline to subtle cognitive decline. This decline was measured by tests assessing information processing speed (Trail making test, part А), attention (Munsterberg test and Symbol Digit Modalities Test), memory (12-Word Memory Test), and executive functions (Trail making test, parts В, FAB). There were no statistically signifi cant diff erences in the Clock Drawing Test. The most signifi cant diff erences in the fi nal scores concerned the MMSE, Trail making test, parts А and В, Symbol Digit Modalities Test and the immediate recall scores in the memory test, indicating an increase in general cognitive defi cits, as well as impairments in executive functions, memory, and attention. Progression of cognitive defi cit to mild cognitive impairment was observed in 19 patients (34%) and was represented by a decrease in scores of the MMSE and FAB screening scales, attention, memory and executive functions. Progression of cognitive decline was associated with older age, lower education, and a longer follow-up period.

Conclusion. Our fi ndings indicate a dynamic increase in general cognitive defi cits, as well as impairments in executive functions, memory, and attention, in patients with PMCD. This provides grounds for potential prevention of further cognitive deterioration. This study confi rms the role of education as a protective factor of subsequent cognitive decline.

Objective. To assess the long-term outcomes of endovascular treatment in patients with aneurysmal subarachnoid hemorrhage (SAH) who underwent endovascular treatment within 72 hours from the onset of hemorrhage.

Material and Methods. The study included 120 patients who underwent endovascular embolization of a ruptured cerebral aneurysm during the acute phase of SAH. Patients were stratified into two groups: early (n = 60) and ultra-early (n = 60) embolization. Functional outcomes were evaluated using the modified Rankin Scale (mRS) with long-term follow-up of up to 10 years.

Results. Long-term data were available for 101 of the 120 patients (84.2%). A favorable outcome (mRS 0–2) was recorded in 72.3% of patients, moderate to severe neurological deficit (mRS 3–5) in 5.0%, and long-term mortality was 23.8%. Survival analysis revealed no significant differences between the early and ultra-early embolization groups (p = 0.924). Multivariate analysis confirmed a significant impact of age and the degree of occlusion according to the Raymond–Roy classification on prognosis.

Conclusion. Endovascular embolization demonstrates high efficacy in the treatment of ruptured aneurysms, providing favorable functional outcomes in the majority of patients. The timing of intervention (early vs. ultra-early) does not significantly affect long-term survival.

Background. Basilar artery occlusion (BAO) is a rare but life-threatening form of acute ischemic stroke (AIS) associated with high morbidity and mortality. While mechanical thrombectomy (MT) is established as the standard of care for large vessel occlusion (LVO) in the anterior circulation, its role in posterior circulation strokes is less clearly defined. This case report illustrates the effectiveness of direct MT in BAO management when intravenous thrombolysis is contraindicated.

Case presentation: A 38-year-old female presented with sudden-onset coma and quadriplegia. Neuroimaging revealed complete occlusion of the middle third of the basilar artery with absent contrast filling in its cranial segment. Due to contraindications to intravenous thrombolysis, the patient underwent urgent endovascular treatment. Direct MT was performed using an aspiration catheter and a stent retriever, resulting in full recanalization (TICI 3). The patient showed early neurological recovery, including restoration of spontaneous breathing and consciousness. She was discharged with only mild residual deficits, specifically a neocerebellar syndrome.

Conclusion. This case supports the growing evidence that direct mechanical thrombectomy is a safe and eff ective therapeutic option for posterior circulation strokes such as BAO, especially when systemic thrombolysis is contraindicated. Timely diagnosis, advanced neuroimaging, and rapid endovascular intervention remain crucial for achieving favorable outcomes in this high-risk population.

Multiple sclerosis (MS) is often accompanied by various neurological disorders, including headache, which is common among patients with MS, but its relationship with other comorbid conditions such as depression and insomnia remains poorly understood.

The aim. To assess the incidence of headache in patients with MS, and to examine the incidence and severity of emotional disorders (depression, anxiety) and insomnia in patients with MS.

Material and methods. The study included 60 patients who were divided into 3 groups of 20 people each. The fi rst group consisted of patients with MS complaining of headache, the second group (comparison group) consisted of patients with multiple sclerosis without headache. The control group consisted of 20 patients with primary headache (tension headache and migraine). A numerical pain rating scale was used to assess headache intensity. Emotional disorders were assessed using the Beck Depression Inventory and the Spielberger–Hanin Anxiety Scale, and the severity of sleep disorders was assessed using the Pittsburgh Sleep Quality Index Questionnaire. Descriptive statistics methods were used for statistical analysis. Quantitative indicators with a normal sample distribution were described using arithmetic means (M) and standard deviations (SD). Comparison of percentages in the analysis of multifield contingency tables was performed using the Pearson chi-square test. Differences were considered statistically significant at p < 0.05.

Results. The average severity of headache according to the digital pain rating scale was 5.42 ± 1.34 points (the fi rst group — 5.75 ± 1.33, the control group — 5.10 ± 1.29, p = 0.126), which corresponds to moderate severity of cephalalgia. It was found that the presence of headache is associated with an increased level of depression and anxiety, as well as with an increase in the number of cases of insomnia. Statistically significant differences in the severity of depression between the first and control groups were noted (p < 0.001), with a greater number of patients with MS and concomitant headache experiencing depression, and also more often demonstrating a high level of situational and personal anxiety. The intensity of headache correlates with the severity of situational and personal anxiety. Sleep problems are more common in patients with MS with headache, while sleep disorders increase with the growth of neurological deficit.

Conclusion. The obtained data indicate the need for a comprehensive approach to the treatment of patients with MS, including assessment and correction of not only the main neurological symptoms, but also concomitant emotional and insomnia disorders. Headache may be considered as an important indicator of the patient's general condition and the potential risk of developing the studied comorbid conditions.

Justification. The content of serotonin in blood platelets has not been studied in children with various paroxysmal disorders of consciousness.

The aim of the study was to study of serotonin metabolism in the structures of the brain in children with epilepsy.

Material and methods. The study involved 106 children up to 4.5 years with paroxysmal disorders of consciousness, 88 their mothers, 113 healthy children and 15 their mothers.

Were studied the data of the content of serotonin in blood platelets and cerebrospinal fluid, also data of anamnesis, clinical and instrumental examination. The indicators of serotonin contained in blood platelets and cerebrospinal fluid were determined based on a modified fluorometric method. The methods used in the mathematical and statistical processing included the parametric Student t-test, as well as the χ2-distribution and Fisher's F-distribution.

Results. In healthy newborns the levels of serotonin contained in blood platelets were significantly higher compared to it levels in children older than 1 months. In children with epilepsy the levels of serotonin are significantly higher than in children with non-epileptic paroxysms older than 1 month. The levels of serotonin contained in the cerebrospinal fluid of children with epilepsy correlate with high levels of serotonin contained in blood platelets.

Conclusion. The data of the content of serotonin in children with epilepsy, healthy children and their mothers indicate the advisability of their direct use for the differential diagnosis in young children with paroxysmal conditions. The content of serotonin in the cerebrospinal fluid of children with epilepsy is significantly higher than its content in the cerebrospinal fluid of healthy adults.

Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR-encephalitis) was first described as an immune-mediated disorder of behavior and cognitive functions in patients with ovarian teratoma. Subsequently, it was recognized as a separate type of autoimmune encephalitis with a characteristic clinical picture and the possibility of development in the absence of data on tumor formations. The course can have both monophase and recurrent variants with periods of improvement or stabilization of the condition and subsequent progression of the disease. The article presents a clinical observation of a patient with a relapse of the disease 2 years later. The diagnosis of anti-NMDAR-encephalitis was established based on the presence of antibodies to NMDA receptor epitopes in the patient's cerebrospinal fluid, both at the onset of the disease and during the relapse. According to foreign literature, the incidence of recurrent anti-NMDAR-encephalitis varies from 12% to 24%, depending on the study, which requires additional monitoring of patients with this diagnosis.