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During the fourth TM attack, partial positive dynamics was achieved only against the background of the combined use of intravenous methylprednisolone (pulse therapy), high-volume plasma exchange, rituximab and cyclophosphamide. The NMOSD is a rare disease leading to severe disability. In patients with MG, when symptoms of damage to the central nervous system appear, an analysis should be performed for AQP4-IgG and possibly for antibodies to myelin glycoprotein of oligodendrocytes (MOG-Ab), as well as markers characteristic of systemic connective tissue diseases (SCTD). In patients with STDD, when symptoms of involvement nervous systemappear, testing for AQP4-IgG (and, if necessary, for MOG-Ab) should be performed to exclude NMOSD, as well as AChR-Ab (and, if necessary, antibodies against muscle specific kinase (MuSK-Ab)) to exclude MG.Levamisole (L) is an anthelmintic agent that is widely used in clinical practice. L can enter the human organism during the treatment of helminthiasis as well as during the using the contaminated cocaine. Multifocal inflammatory levamisole-induced leukoencephalopathy (MILL) is one of the most serious complications of L use. The article discusses the clinical and radiological features of MILL which have a number of similarities of multiple sclerosis (MS) appearance. The disease has a favorable prognosis if started early, but the diagnosis of this rare form of leukoencephalopathy can cause difficulties. The case of MILL in patient with mistaken diagnosis of MS is descrThe case of MILL in patient with mistaken diagnosis of MS is descraibed.ibed. Vascular changes, including destabilization of the blood-brain barrier, are common pathological signs in multiple sclerosis (MS). There are prerequisites, which indicate the direct effects of disease modifying therapy (DMT) on the state of the vascular wall and reduce the damage to the endothelium in MS. Was to identify and evaluate the relationship of endothelial dysfunction in patients with multiple sclerosis with used DMT. The study included 85 patients with a reliable diagnosis of MS according to the McDonald criteria of 2010 (56 women, 29 men) aged from 17 to 62 years (average age 36.3±1.2 years). All patients underwent a comprehensive clinical and neurological examination, laboratory tests (blood serum analysis for the content of adhesion molecules sICAM-1, sPECAM-1, sE-selectin, sP-selectin, for the content of homocysteine and matrix metalloproteinase 9 (MMR-9) by ELISA; blood plasma analysis for Von Willebrand factor antigen (vWf) by ELISA). The study included 85 patients with a reliable diagnosis of MS according to the McDonald criteria of 2010 (56 women, 29 men) aged from 17 to 62 years (average age 36.3±1.2 years). All patients underwent a comprehensive clinical and neurological examination, laboratory tests (blood serum analysis for the content of adhesion molecules sICAM-1, sPECAM-1, sE-selectin, sP-selectin, for the content of homocysteine and matrix metalloproteinase 9 (MMR-9) by ELISA; blood plasma analysis for Von Willebrand factor antigen (vWf) by ELISA).The results of the study indicate a decrease of endothelial damage in MS during interferon therapy. Its also allow the use of indicators such as von Willebrand factor antigen, sPECAM-1, sE-selectin levels as potential markers of the effectiveness of DMT. To develop an electronic registry of patients with MS in the Russian Federation and to analyze the collected epidemiological and clinical data. Patients aged 18 and older with definite multiple sclerosis were included in the study. We designed a specialized electronic individual registration form (registry) to gather information about study participants. This paper presents data collected in the project between September 25, 2017 and March 25, 2020. We collected information on 2728 patients. This paper presents the results of data analysis from the registry of MS patients, including demographic, clinical and epidemiological characteristics, the type and timing of treatment received. Based on the data obtained, certain issues with primary diagnosis of multiple sclerosis and delayed initiation of disease-modifying therapy can be highlighted, which contribute to the transition of the disease to a secondary progressive course and disability increase. We collected information on 2728 patients. This paper presents the results of data analysis from the registry of MS patients, including demographic, clinical and epidemiological characteristics, the type and timing of treatment received. Based on the data obtained, certain issues with primary diagnosis of multiple sclerosis and delayed initiation of disease-modifying therapy can be highlighted, which contribute to the transition of the disease to a secondary progressive course and disability increase.Alemtuzumab (Lemtrada) is a recombinant humanized IgG1 kappa monoclonal antibody against cell surface glycoprotein CD 52. selleckchem It is authorized in more than 65 countries worldwide including the Russian Federation. This is one of the most effective drugs for the treatment of the aggressive form of multiple sclerosis. Its safety profile includes different infusion reactions. Current publication demonstrates our experience of using music therapy during alemtuzumab infusion and its role in the adverse reactions management. Was to evaluate the effect of selective serotonin reuptake inhibitor fluoxetine on the production of cytokines interleukin-6 (IL-6) and interleukin-1β (IL-1β) by dendritic cells in multiple sclerosis (MS). 5 patients with relapsing-remitting MS and five healthy subjects were examined. Levels of IL-6 and IL-1β were measured by ELISA in culture supernatants obtained from lipopolysaccharide stimulated dendritic cells. To assess the effect of fluoxetine on cytokine production, dendritic cells were stimulated in the presence of fluoxetine and antagonists of 5-HT –, 5-HT –, 5-HT -receptors or agonist of 5-HT -receptors. Cytokine production by dendritic cells was comparable in both groups. Fluoxetine suppressed IL-6 and IL-1β production in both groups. Blockade of 5-HT -receptors with specific antagonist RS 127445 reduced the inhibitory effect of fluoxetine on IL-1β production in both groups and IL-6 production in healthy subjects. In contrast, activation of 5-HT -receptors by specific agonist BW 723C86 increased the inhibitory effect of fluoxetine on IL-6 production by dendritic cells in both groups, but did not affect on IL-1β production.