A literature review on the peculiarities of the diagnosis, course and treatment of myasthenia gravis in the elderly has been done. Despite the fact that myasthenia gravis is a disease of the young and middle-aged, in recent years, several authors observe an increased incidence among the elderly. A proper diagnosis in this age group tend to cause difficulties, and concomitant diseases complicate the choice of therapeutic approach which includes: acetylcholinesterase inhibitors, steroids, immunosuppressants, intravenous immunoglobulins and plasmapheresis. Thymectomy in older age groups, except for the presence of thymoma, due to side effects and the lack of a strong evidence base, is not widely held. The question of the effectiveness and optimal therapeutic approach of myasthenia gravis in elderly patients is still not fully resolved.

Background. Cognitive disorders may often lead to professional invalidisation and increasing dependence on the external assistance in every day life. Identification of patients with preserved intellectual status and social adaptation but with mild cognitive impairment (MCI) is considered to be an effective measure. MCI detection and timely initiation of treatment in most patients is essential to delay the onset of severe dementia.
Objective. Investigating influence of Cellex in patients with chronic cerebral ischemia and MCI.
Materials and methods. As a part of non-interventional observational comparative study we evaluated the results of Cellex administration in 90 patients with MCI. Patients were divided into 2 groups. Patients from both groups received 1 course of 10 subcutaneous injections of Cellex drug at the dose of 1 mL, and patients from group 2 received two identical courses with an interval of two months. The survey, which included psychometric testing by using special questionnaires (Mini-Mental State Examination, “Frontal Assessment Battery” and “Clock Drawing” tests, Schulte test) was performed before treatment, and at months 1 and 2 after its completion.

Results. Neuropsychological examination revealed improvement in the patients state, more pronounced after the 2nd course of therapy.
Discussion. Our results provide a basis for using Cellex in patients with chronic cerebral ischemia and MCI, allowing to proceede with further studies on the optimal dosage of that drug.

Background. Carpal tunnel syndrome (CTS) is one of the most common tunnel neuropathies. Early symptoms are often limited by periodic and slight discomfort in the area of innervation of a median nerve on the hand, so the patients are not willing to be treated invasively. Thus, a noninvasive therapy, such as kinesiotaping, could be perspective.
Objective. Assessment of the efficiency of a kinesiotaping monotheraphy of patients on initial stage of CTS.
Materials and methods. We included 120 patients with the initial stage of CTS: 51 men and 69 women aged from 24 till 54 years old. The main group included 70 people, and the control group – 50 patients. The main group was treated within 2 months by kinesiotaping only, control group was observed without any therapeutic intervention.
Results. 60 % of the patients from the main group reported beneficial effect of kinesiotaping on clinical symptoms of the CTS.

Conclusions. Kinesiotaping monotherapy at initial stages of CTS in our cohort relieves subjective symptoms in the majority of patients. To recommend kinesiotaping as an effective and safe method on initial stages of CTS to patients unwilling to undergo standard invasive treatment methods, a larger multicenter study is needed.

Chronic sclerosing sialadenitis, also known as Küttner’s tumor, is a benign tumour-like chronic inflammatory lesion of the salivary glands predominantly involving the submandibular gland. It was first described in 1896 by H. Küttner, a German physician. Histopathological examination reveales dilated ducts with a dense lymphoplasmacytic infiltration, periductal fibrosis and acinaratrophy. Clinical characteristics include painless swelling of the submandibular gland. Mostly the submandibular gland is affected unilaterally. For the moment Küttner's tumor is thought to be a lesion of immunoglobulin G4-related disease (IgG4-related disease). This is an inflammatory condition accompanied
by dense lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, fibrosis in various organs and elevated serum IgG4 levels. Küttner’s tumour creates an interesting diagnostic dilemma in clinical practice because it resembles closely the clinical characteristics
of malignancy. Herein, we report the case of a 69-year-old female with the hypoglossal nerve paresis caused by IgG4-associated chronic sclerosing sialadenitis. At first stroke was suspected.