The article analyzes the reasons for the deletion of the section “Organic mental disorders” from the psychiatric classifications (ICD-11, DSM-5) and its replacement by the sections “Neurocognitive disorders” and “Secondary mental and behavioral disorders associated with disorders and diseases classified in other chapters”. It is argued that at the present stage of development of psychiatry it has become clear that not only organic mental disorders are associated with impaired brain function, but also all others, e.g. the disorders of the schizophrenic spectrum. This leads to the conclusion that the term “organic” has become an anachronism and no longer reflects the essence of psychogenesis. As a result, changes in terminology in modern psychiatric classifications should be recognized as justified. However, the term “organic disorders” did not have a stigmatizing character, unlike, for example, “psychopathy”, “oligophrenia”, “hysteria” or “manic-depressive psychosis”. It undoubtedly had an indeterminate character, as it interpreted pathological changes in the brain broadly and was opposed to the concept of “functional disorders”. At the current stage of development of psychoneurology, organic causes are often found behind the functional. Exclusion of the term “organic” from the psychiatric lexicon, rejection of the Bonhoeffer approach, the Walter-Buell triad and the psychoorganic syndrome can be considered superfluous, since the introduction of the concept of “secondary mental disorders” in their place does not alter the process of understanding the nature of psychogenesis. It is concluded that the division of mental disorders into so-called primary and secondary disorders is no better than the opposition of functional and organic disorders, and that the “outdated” approach can be used in the training of young psychiatrists, emphasizing that the term “organic” can also be extended to mental disorders that used to be called endogenous.

Non-specific (musculoskeletal) back pain (NBP) and tension-type headache (THA) are among the most common conditions in neurological practice that significantly impair patients' ability to work. The typical practice of treating patients with NBP and THA has not been sufficiently investigated, which formed the basis for conducting this study.

Objective: to evaluate the quality of diagnosis and treatment of chronic NBP and THA in real-life neurological practice.

Material and methods. The study included 120 patients with chronic NBP and combined THA of different frequency (32 men and 88 women, mean age 38.4±9.6 years) who were treated in A.Ya. Kozhevnikov Clinic of Neurologic Diseases (CND) of Sechenov University with complaints of back pain and headache and who had previously been examined and treated by neurologists and therapists in other medical institutions on an outpatient and/or inpatient basis. All patients underwent a clinical interview to establish a diagnosis and analyze previous treatment, a neurological and neuro-orthopedic examination and a psychometric examination to assess anxiety and depression symptoms.

Results. Prior to contacting CND, only 10% of patients had a diagnosis of chronic NBS, only 7% had a diagnosis of THA and the remaining patients had other misdiagnoses. All patients had previously undergone additional examinations, mainly neuroimaging of the spine and brain, ultrasound examination of the neck vessels, even if there were no "red flags" – signs of danger in back pain and headache. None of the patients had previously had their emotional state assessed, while 75% of patients had symptoms of depression of varying severity and all patients suffered from anxiety of varying severity. Neuro-orthopaedic examination was performed in only 10% of patients. All patients received nonsteroidal antiinflammatory drugs for back pain, and most patients received vascular and nootropic medication for headaches. Of the non-pharmacological methods, massage and passive physiotherapy were most frequently prescribed. Only 9% of patients were recommended kinesiotherapy, and only 5% of patients performed it.

Conclusion. In real-life medical practice, chronic NBP and THA are inadequately diagnosed, excessive and unjustified additional examinations are prescribed, unsatisfactory level of treatment, and patients with chronic NBP and THA are rarely prescribed kinesiotherapy.

Motor imagery training under the control of a brain-computer interface (BCI) facilitates motor recovery after stroke. The efficacy of BCI based on electroencephalography (EEG-BCI) has been confirmed by several meta-analyses, but a more convenient and noise-resistant method of near-infrared spectroscopy in the BCI circuit (NIRS-BCI) has been practically unexamined; comparisons of the two types of BCI have not been performed.

Objective: to compare the control accuracy and clinical efficacy of NIRS-BCI and EEG-IMC in post-stroke rehabilitation.

Material and methods. The NIRS-BCI group consisted of patients from an uncontrolled study (n=15; 9 men and 6 women; age – 59.0 [49.0; 70.0] years; stroke duration – 7.0 [2.0; 10.0] months; upper limb paresis – 47.0 [35.0; 54.0] points on the Fugl-Meyer Assessment for motor function evaluation of the upper limb – FM-UL). The EEG-IMC group was formed from the main group of the randomized controlled trial “iMove” (n=17; 13 men and 4 women; age – 53.0 [49.0; 70.0] years; stroke duration – 10.0 [6.0; 13.0] months; upper limb paresis – 33.0 [12.0; 53.0] points on the FM-UL). Patients participated in a comprehensive rehabilitation program supplemented by BCI-guided movement imagery training (average of 9 training sessions).

Results. Median of average BCI control rates achieved by the patients was 46.4 [44.2; 60.4]% in the NIRS group and 40.0 [35.7; 45.1]% in the EEG group (p=0.004). For the NIRS-BCI group, the median of the maximum BCI control accuracy achieved was 66.2 [56.4; 73.7]%, for EEGBCI – 50.6 [43.0; 62.3]% (p=0.006). The proportion of patients who achieved a clinically significant improvement according ARAT and the proportion of patients who achieved a clinically significant improvement according FM-UL were comparable in both groups. The NIRS-BCI group showed greater improvement in motor function compared to the EEG-BCI group according to Action Research Arm Test (ARAT; an increase of 5.0 [4.0; 8.0] points compared to an increase of 1.0 [0.0; 3.0] points; p=0.008), but not according to FM-UL scale (an increase of 5.0 [1.0; 10.0] and 4.0 [2.0; 5.0] points, respectively; p=0.455).

Conclusion. NIRS-BCI has an advantage in control accuracy and ease of use in clinical practice. Achieving higher control accuracy of BCI provides additional opportunities for the use of game feedback scenarios to increase patient motivation.

Major Depressive Disorder (MDD) is a psychiatric illness that imposes a high cost on the patient and the community. Over the past few decades, a variety of treatments have been used to treat depression. One of the most common treatments for depression is medication. Today, specific serotonin reuptake inhibitors are the first line of treatment for major depression. Another drug that has been considered in the treatment of depression is agomelatine.

Objective of this study was to evaluate the effect of adding agomelatine to Escitalopram in treatment of major depressive disorder.

Materials and methods. This study was a double-blind randomized clinical trial with before and after designs (b and a). In this study, 70 patients with MDD referred to psychiatric clinics affiliated with Yazd University of Medical Sciences were studied. Patients were randomly divided into two groups of 35 patients (agomelatine + Escitalopram and Escitalopram + placebo) and were treated for 12 weeks. Depression Scale was the Hamilton Depression Inventory and was assessed before treatment, 1, 2, and 3 months after treatment. Variables such as gender, age, marital status, level of education, occupation, and duration of illness were also collected. The data were entered into SPSS version 18 software and analyzed using statistical tests.

Results. Of the 70 patients studied, 31 (44.3%) were male and 39 (55.7%) were female. There was not significant difference between gender distribution (p=0.810), marital status(p=0.789), job (p=0.651) and educational level (p=0.794). Also, no significant difference was found between the mean variables: age (p=0.563) and duration of depression (p=0.958). There was a statistically significant difference between the mean score of depression 2 months after treatment (p=0.10) and 3 months after treatment (p=0.023) in the two groups. Also the mean depression score after treatment compared to before, was significantly lower in both groups (p=0.000). Also, no significant difference was found between the frequency of drug side effects in the two groups (p=0.970).

Conclusion. Adding agomelatine to Escitalopram is more effective than mood-boosting depression as a result of depression or depressive disorder alone.

Future researchers in the field of MDD treatment could consider investigating the long-term effects and comparative efficacy of combining agomelatine with other antidepressants beyond Escitalopram to further enhance treatment outcomes for patients with MDD.

Dizziness is often accompanied by affective disorders such as anxiety and depression, in the occurrence of which the role of the serotonergic system is discussed.

Objective: to investigate the serotonin content in blood serum and neuropsychological status in patients with vestibular and non-vestibular dizziness.

Material and methods. The study included 97 patients. Two observation groups were formed according to the type of dizziness complaints. The first group (n=47) comprised patients with vestibular (systemic) dizziness against a background of peripheral vestibulopathy, the second group (n=35) comprised patients with non-vestibular (non-systemic) dizziness with a diagnosis of probable persistent postural-perceptual dizziness (PPPD). The control group (n=15) consisted of patients without complaints of dizziness. Neurological and otoneurological status, psychoemotional parameters (level of anxiety and depression) and cognitive functions were analyzed, and the quantitative level of serotonin in blood serum was determined by enzyme immunoassay.

Results. The study revealed a significant decrease in the serum serotonin levels in vestibular and non-vestibular dizziness; a lower serotonin level was found in non-vestibular dizziness (p<0.05). The presence of affective disorders did not correlate with a decrease in serotonin levels in vestibular dizziness against a background of peripheral vestibulopathy. It is assumed that a decrease in serotonin content plays a role in pathogenesis of vestibular dizziness on the background of peripheral part of vestibular system involvement.

Conclusion. We demonstrated possibility of using the level of serotonin in peripheral blood as an objective laboratory marker of vestibular and non-vestibular dizziness in general clinical medical practice.

Patients with medication-overuse headache (MOH) and chronic migraine (CM) have varying degrees of addiction to painkillers (PK), which complicates treatment and leads to relapses. Development of addiction to PK is associated with various clinical and psychological characteristics and disorders in patients with MOH.

Objective: to investigate the relationship between PK addiction and individual clinical and psychological characteristics in patients with CM and MOH.

Material and methods. The study included 156 patients with CM and MOH (61 men and 95 women, mean age 34.1±8.9 years). Clinical and psychological characteristics were assessed in all patients using a clinical interview, tests and headache diaries. The relationship between PK addiction (according to the Leeds Dependence Questionnaire – LDQ) and clinical and psychological characteristics (duration of migraine and CM, frequency and intensity of headaches, duration of MOH, frequency of PK use, number of PK doses, personal and situational anxiety, depression, pain catastrophizing, beliefs about the body and health, coping strategies for stressful situations, daily activities during headache, insomnia) was investigated using regression analysis.

Results. All patients had misconceptions and wrong behavior regarding PK. The majority (59%) of patients had moderate degree of PK addiction according to the LDQ. Twenty six percent of patients had other forms of addictive behavior (smoking, excessive alcohol consumption, overeating, excessive use of sleeping pills), and 52.6% of patients had relatives with addictive behavior. There was a statistically significantly positive correlation (R≥0.45; p<0.05) between PK addiction and smoking, alcohol consumption, use of sleeping pills, body mass index (BMI), frequency of PK use, attitudes towards pain, body and health (pain catastrophizing, hopelessness about pain, intolerance of body sensations, overestimation of symptom severity, catastrophizing in the interpretation of body symptoms), depression, personal anxiety and avoidance (maladaptive coping behavior). Adequate treatment of CM and MOH was provided in only 7.7% of patients.

Conclusion: A positive association was found between PK addiction and smoking, alcohol consumption, use of sleeping pills, BMI, frequency of PK usage, attitudes towards pain, body and health, depression, personal anxiety and avoidance behavior.

Vascular cognitive impairment (VCI) can occur in cerebrovascular disease of varying degree of severity, which requires further investigation.

Objective: to identify specific features of attention deficit and executive function (EF) impairment in VCI and to determine the relationship between cognitive, neurological and radiological signs of the disease.

Material and methods. The study involved 80 patients (51 with VCI – the main group and 29 healthy volunteers – the control group). All participants underwent clinical and neuropsychological examination and MRI of the brain. VCI was diagnosed according to 2014 VASCOG criteria. The neuropsychological examination included an assessment of the general cognitive function (MoCA test, MMSE); general EF (FAB, EXIT-25); episodic memory (12-word memory test and Benton Visual Retention Test); semantic memory (categorical association method); initiation and productivity of cognitive activity (literal associations); attention [TMT-A, Symbol-Digit Modalities Test (SDMT)]; cognitive flexibility (TMT-B); cognitive control (Stroop test).

Results. As a result of the study, three subgroups of patients with VCI were identified: 1) predominantly attention deficit (AD); 2) AD and significant decrease in cognitive flexibility (CFD); 3) AD in combination with a significant cognitive control deficiency (CCD). The TMT-A and SDMT tests were significantly worse in all subgroups of VCI compared to the control group, with the worst SDMT score in subgroup 2. Subgroup 2 also had the longest time to complete the TMT-B test. Subgroup 3 was characterized by the worst Stroop test results, and uncontrolled arterial hypertension was more common in this group. Gait disturbances were significantly more frequent in subgroup 2, and increased reflexes of oral automatism and grasp reflex were observed in subgroup 3. White matter hyperintensity (WMH) was more pronounced in subgroup 2, and lacunar infarcts (LI) were more frequent in subgroup 3. Prevalence of LI and severity of WMH were lowest in subgroup 1.

Conclusion. The main features of VCI are attention deficit and EF impairment, characteristics of EF disorders depend on the severity and type of vascular lesions of the brain. Progression of WMH is associated with more pronounced CFD and an increase in the number of LI is associated with CCD. There is a correlation between CFD and gait disturbances and between CCD and lack of primitive reflexes inhibition.

Cladribine has a well-defined activity against lymphocytes, leading to their selective depletion.

Objective: to determine the efficacy and safety of cladribine in the treatment of multiple sclerosis (MS) in real-world clinical practice.

Material and methods. The study involved 82 patients (57 women and 25 men, mean age 36.4±9.3 years) with a disease duration of 2.2±1.5 years. Seven (9%) patients had secondary progressive MS (SPMS), 6 (7%) had rapidly progressive MS (RPMS) and 69 (84%) had highly active MS (HAMS). According to the instructions for use, oral therapy with cladribine was administered in two short courses (up to 10 days per year) to achieve a long-term effect on the immune system. The dose of cladribine was calculated based on the body weight.

Results. The average frequency of exacerbations per year before starting therapy was 1.6, while it decreased to 0.2 during cladribine therapy. An exacerbation was observed in 18 patients (22%) at the end of the first course of cladribine treatment and in one patient (2.6%) after the second treatment course. Thus, the number of exacerbations decreased by 78% after the first year of treatment and by 97.4% after the second year of treatment. The mean EDSS score was 3.2±2.5 points before the start of treatment, 3.6±2.5 points after the first course of treatment and 3.4±2.5 points after the second course (p>0.05). MRI results showed a decrease in disease activity by 83% after the first course of cladribine therapy and by 97.4% after the second course. No serious adverse events occurred in any of the patients.

Conclusion. We demonstrated efficacy and safety of cladribine in real-life clinical practice in MS patients with frequent exacerbations and rapid disability progression (SPMS, RPMS, HAMS).

One of the key mediator systems involved in the pathogenesis of migraine is the serotonergic system, which led to the development and introduction of serotonin 5-HT1 receptor agonists (triptans) into clinical practice as the most important means of preventing migraine attacks. Serotonin 5-HT1 receptor agonists have a high selectivity for the 5-HT1B and 5-HT1D receptor subtypes, which ensures their effect on the pathogenesis of migraine attack development.

Objective: to evaluate the efficacy of a standard dose of Relonova in the relief of four moderate to severe migraine attacks in outpatients in reallife clinical practice, including assessment of the rate of attack relief, the effect of the drug on headache intensity, concomitant symptoms and the general condition of the patient.

Material and methods. The study involved 415 patients with migraine (319 women and 96 men; mean age 35.7±7.8 years). A total of 1660 migraine attacks were analyzed. The average number of migraine days per month was 6.72±3.99. Migraine attacks with aura were observed in 125 patients (30.1%). Patients stopped four migraine attacks and filled out self-monitoring diaries. Treatment efficacy was assessed according to the European Headache Federation (EHF) Consensus Algorithm for Determining Effective Treatment of a Migraine Attack.

Results. After taking Relonova, pain became mild or disappeared completely in 30 minutes in 52% of patients, in 76% in 1 hour, in 93% in 2 hours, in 99% in 4 hours and in 99% of patients in 24 hours. A recurrence of the headache occurred in 8.8% of the attacks. Additional analgesic treatment after 30 minutes was required in 14% of cases, after which period the frequency did not exceed 2%. Adverse events were observed in 4% of patients and were mild. The overwhelming majority (90%) of study participants were able to successfully terminate three attacks and were responders.

Conclusion. Relonova is an effective and safe agent to stop migraine attack and can be recommended for use in daily clinical practice.

Post-stroke cognitive impairment (PSCI) is found in most patients over 50 years of age. At a young age, PSCI has a negative impact on daily activities, quality of life and return to work, regardless of physical recovery. Often PSCI are combined with asthenia, but there is very little information on the prevalence of post-stroke asthenia (PSA). Currently, the treatment of PSCI and PSA in young patients with citicoline is still controversial.

Objective: to evaluate the prevalence of PSCI and PSA in young patients and the efficacy and safety of the domestic drug Noocil (citicoline) in the treatment of PSCI and PSA in stroke patients of young age.

Material and methods. The work was conducted in two stages: the first stage was a longitudinal study of cognitive status using neurocognitive scales and assessment of signs of asthenia in patients aged 18 to 45 years; the second stage was an open prospective observational study of 47 patients aged 18 to 45 years with confirmed ischemic stroke (IS) who were randomly assigned to groups with Noocil administration (main group; n=26) or without treatment (control group; n=21). Cognitive function was assessed by Montreal Cognitive Assessment (MoCA) and asthenia by manifestations of general fatigue (Multidimensional Fatigue Inventory, MFI-20).

Results. High frequency of PSCI (51%) and the severity of asthenia according to MFI-20 scale were found in the hospital sample of young patients with IS. A direct correlation was found between the severity of PSA and the degree of cognitive decline. The positive effect of Noozil on cognitive functions, emotional state and severity of asthenia in the study group was noted. At the end of treatment, the mean MoCA score was 27.4±1.4 in the main group and 25.9±1.1 in the control group (p<0.01), and the mean MFI-20 score was 37.4±7.4 in the main group and 43.7±5.1 in the control group (p<0.01).

Conclusion. The high incidence of PSCI and PSA and the positive effect of Noocil on the non-motor consequences of stroke in young patients and the high safety profile of the drug were shown.

Polycystic kidney disease (PKD) is a genetic condition clinically manifested by the formation of multiple cysts in the kidneys, liver and pancreas, as well as cardiovascular pathology. One of the rare complications of PKD is the development of dissections of the aorta, coronary and cerebral arteries.

This article presents a clinical case of ischemic stroke due to dissection of the posterior cerebral artery in a young patient with PKD who had a history of recurrent bleeding in the deep parts of both cerebral hemispheres.

Back pain is one of the most common reasons for visits to the doctor and temporary disability. In non-specific chronic low back pain (CLBP) most effective approach is a complex (multidisciplinary) approach, aimed at relieving pain and improving the quality of life by using an educational program, kinesiotherapy, psychological methods and optimization of drug therapy. We present the observation of a 48-year-old patient with CLBP whose treatment was ineffective during one year. The patient was repeatedly prescribed medications, and the methods of magnetotherapy, massage, phonophoresis with hydrocortisone. Educational program, kinesiotherapy and psychological methods were not applied. The examination of the patient revealed emotional disorders, misconceptions about the disease and a pronounced functional impairment due to pain. The application of a complex therapy, which included an educational program, individual kinesiotherapy, psychological methods, Dexalgin as a non-steroidal anti-inflammatory drug, led to a significant reduction in pain after 7 days and a complete regression of symptoms after 2 months. The issues of efficacy and safety of the use of Dexalgin and the possibility of introducing the complex approach into the clinical practice of management of patients with chronic back pain are discussed.

A locomotor disability in the geriatric population is a physical condition that impairs mobility and movement in older persons. It is frequently caused by age-related causes such as degenerative diseases, osteoarthritis, or neurological abnormalities. This impairment can have a substantial influence on older people's quality of life by limiting their ability to conduct daily activities independently, such as walking, standing, or climbing stairs. Addressing locomotor impairments in older persons is critical for preserving their mobility, independence, and overall well-being, ultimately improving their quality of life as they age.

A comprehensive literature search was conducted, which were sourced from PubMed, google scholar, Japanese government websites, springer link, semantic scholar generated significant studies using the keywords like locomotor disability, older population, mobility, quality of life, aging. We included articles which were published from 2005–2024.

Locomotive Syndrome (LS) affects a significant portion of the elderly population, with prevalence ranging from 8.4% to 50.3%, increasing with age and higher in women. It shows the correlations with osteoporosis and sarcopenia, suggesting potential shared risk factors or pathways. By this the older people tend to have lower quality of life, particularly concerning spinal alignment and trunk deformity. Exercise interventions, including locomotive training, aerobic exercise, and muscle training, are suggested for LS prevention. Vitamin D supplementation may benefit bone health and fall prevention in older individuals.

Locomotor syndrome is a substantial concern, especially in ageing populations, with considerable implications for quality of life. Its prevalence, which is frequently associated with osteoporosis and sarcopenia, highlights the necessity of preventive measures including exercise and vitamin D supplementation. Recognising the impact of LS on mobility and well-being is critical for establishing focused interventions to prevent and manage its progression, thereby improving the overall health and independence of geriatric population.

Gidazepam is a benzodiazepine tranquilizer with several characteristic pharmacodynamic properties: lower affinity to GABAА-receptors than classical benzodiazepines, partial agonism and modulation of GABAА-receptors by stimulation of neurosteroid synthesis through binding to the TranSlocator PrOtein (TSPO), influence on the activity of the serotonergic, dopaminergic and noradrenergic systems. Clinically, Gidazepam is characterized by rapid and sustained anxiolytic, antiasthenic, vegetotropic and procognitive effects. In the lower range of therapeutic doses (20–50 mg/day), the drug has antiasthenic and procognitive properties without subsequent exhaustion; the effects of the upper dose range (from 100–150 mg/day) are closer to the effects of classic benzodiazepine tranquilizers. The drug is well tolerated, it is not characterized by sedation and muscle relaxation, and the risk of addiction or dependence is extremely low.

Treatment of patients with chest pain (thoracalgia) is a current medical issue. The most common cause of thoracalgia is a benign musculoskeletal pain such as intercostal myofascial pain, facet syndrome and osteoarthritis of the sternocostal joints. However, chest pain can also be caused by life-threatening conditions that require emergent medical care. The article presents the clinical symptoms and treatment approaches for various chest pain syndromes and the principles of differential diagnosis of cardiac pain. The basis of effective treatment is a comprehensive approach that includes patient education about the benign nature of the condition, kinesiotherapy and cognitive behavioral therapy for chronic pain. Among the drug methods, the prescription of non-steroidal anti-inflammatory drugs (NSAIDs) is the most important. Nimesulide is an NSAID with an optimal profile of efficacy and safety. The example of a clinical case shows the heterogeneity of pain syndromes in patients with chest pain, whose timely diagnosis and complex treatment can prevent pain chronification and improve patients' quality of life.

Treatment of patients with back pain is a global public health problem. The diagnosis of acute non-specific (musculoskeletal) back pain (ANBP) is made based on anamnestic data, results of somatic, neurological and neuroorthopaedic examinations, and exclusion of specific causes of back pain and discogenic radiculopathy. For ANBP, pharmacological treatment includes non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxers (MR). Most modern clinical guidelines recommend non-benzodiazepine MR as the treatment of choice for ANBP. The results of randomized clinical trials have shown the efficacy and good tolerability of tolperisone (Mydocalm) as monotherapy and in combination with NSAIDs for ANBP. Tolperisone (Mydocalm) has analgesic properties and its main advantage over other MR is that it has no sedative effect.

Alzheimer's disease (AD) is the most common neurodegenerative disease and the most common cause of dementia. In daily practice, AD is often diagnosed late, while the early stages of the disease are overlooked or mistaken for cerebrovascular pathology. However, the efficacy of existing and newly developed (disease-modifying) AD therapies is the greatest in the early stages of the disease. An accurate diagnosis of AD is possible when biological markers of the main pathological process (cerebral amyloidosis, tauopathy) are detected using positron emission tomography or neurochemical examination of cerebrospinal fluid, which are gradually being introduced into practice in Russia. The experts discussed the clinical aspects of the use of biological markers, obtained in the leading specialized centers of our country for the diagnosis and treatment of cognitive impairment (CI). First and foremost, biomarker testing is indicated in patients with mild CI and mild dementia possibly associated with AD, so that disease-modifying (pathogenetic) therapy can be initiated as early as possible upon on its availability (currently, drugs for anti-amyloid disease-modifying therapy are not registered in the Russian Federation). Patients with a non-classical (non-amnestic) or atypical AD phenotype are another group of patients in whom it is also advisable to analyze biomarkers for differential diagnostic purposes.

The treatment of patients with benign paroxysmal positional vertigo (BPPV) is an urgent issue in modern medicine.

Expert Council on the diagnosis and treatment of BPPV was held in Moscow on June 1, 2024. Timely diagnosis and effective treatment play a key role in the management of patients with BPPV, reduce the risk of falls and related injuries, prevent the development of emotional disorders and impairment of daily activities. Accurate patient routing and selection of appropriate treatment can significantly reduce the duration of disability and the burden on the healthcare system. Relatively simple positional tests aimed at detecting involvement of various semicircular canals have been found to be of paramount importance in the diagnosis of BPPV. Repositioning maneuvers are of paramount importance in the treatment of patients with BPPV. They vary depending on the canal affected and aim to move the otoliths out of the semicircular canals to the vestibule of the labyrinth. If repositioning maneuvers can not be performed, effective methods of vestibular gymnastics can be used. When discussing drug therapy, it was found that the use of betahistine in addition to repositioning maneuvers or vestibular gymnastics increases the efficacy of therapy, accelerates the recovery process and prevents the development of residual non-positional vertigo.