A method of treatment of paralysis and paresis

 

(57) Abstract:

The invention relates to neurology and can be used in the treatment of paralysis and paresis. Enter solution neostigmine methylsulfate in the age dosage. The dose is distributed in equal parts over three acupuncture points on the affected neuromuscular unit. After 10-15 minutes, conduct electrical stimulation of the paretic muscles sinusoidal modulated current. Peripheral paralysis and paresis use II(I) the mode 2 type of work, with a frequency of 30 Hz, a modulation depth of 75-100%, with a ratio of current and pause 2:3. When the Central paralysis and paresis I use mode 3 the nature of work, with a frequency of 50 Hz, a modulation depth of 75%, with a ratio of current and pause 2:3.

The invention relates to medicine, namely to neurosurgery and neurology, may be used for the treatment of peripheral and Central paralysis and paresis, particularly in children.

There is a method of treatment of paralysis and paresis with pharmacochemical with a preliminary introduction to motor point adenosintriphosphate acid (ATP) (A. S. USSR N 562289 A 61 N 1/32, publ. 25.06.77,, bull. N 23). While imposing ATP number 1 ml each motor point and after 1 hour hold electrostimulations if necessary stimulation 5 paretic muscles spent 5 ml of ATP on the procedure. The duration of the procedure is stretched on 1.5-2 hours. Introduction ATP justified in scar tissue in peripheral paralysis and impractical at the Central, because in this case the muscles enough of my ATF. In addition, ATP, acting on the muscle, improves nerve conduction and does not affect the recovery of sensitivity. Contractility of the muscles increases after the procedure only for 1-2 hours.

The prototype of the proposed method is a method of treatment of paralysis and paresis (Markov Y. C. Acupuncture in modern medicine. Science, 1992, page 146) is injected into the acupuncture points neostigmine methylsulfate.

This method has the following disadvantages:

- in the absence of reducing or weak muscle contraction isolated introduction neostigmine methylsulfate does not lead to a full workout that does not give the full recovery.

- isolated introduction of neostigmine methylsulfate in acupuncture points can cause increased muscle tone antagonists that in spastic paresis prevents full recovery. In addition, this leads to spasm of blood vessels, affects the microcirculation by slowing nerve regeneration. It is known that neostigmine no significant effect on the receptors of the brain, that the treatment of paralysis and paresis, providing the most complete recovery of motor function. In some cases the application of the method allows you to avoid surgical intervention.

The invention consists in the following. Conduct introduction the solution of neostigmine methylsulfate in the age dosage in acupuncture points. After 10-15 minutes doing electrical stimulation CMT affected neuromuscular apparatus. The time interval of 10-15 minutes due to early and completeness of action of acupuncture points and neostigmine methylsulfate on the neuro-muscular system.

The claimed method differs from the prototype in that after administration of neostigmine methylsulfate in 10-15 min conducting electrical stimulation of the affected neuromuscular apparatus. The stimulation trains paretic muscles, reduces the area of functional sinopse in the spinal cord and brain. Prevents the increased tone of muscles-antagonists. Ganglioblokiruyuschee effect of this procedure prevents spasm of the blood vessels after injection of neostigmine methylsulfate.

The method is as follows. Enter neostigmine is administered subcutaneously in a dosage of age, distributing it in equal parts of 3 acupuncture points on the affected neuromuscular unit. Acupuncture points are changed daily. 10-15 mi work frequency of 30 Hz, a modulation depth of 75-100%, with a ratio of current and pause 2/3. When the Central paralysis and paresis of the first mode, 3 the nature of work, with a frequency of 50 Hz, a modulation depth of 75%, with a ratio of current and pause 2/3. The choice of current is determined by the presence of muscle contraction and stimulation of nerve - projection sensations. The duration of the procedure depends on the number of affected neuromuscular units, at 2-4 min exposure per unit. The duration of the entire procedure does not exceed 30-40 minutes treatment 10 sessions. Refresher course in 1-2 months.

The proposed method for the treatment of paralysis and paresis developed in the Polenov research neurosurgical Institute them. Professor A. L. Polenov and passed clinical trials in the treatment of 6 children with lesions of the brachial plexus and traumatic brain injury, have for a long time the traditional treatment was to no avail. Clinical trials have shown that using the proposed method allows to restore the paretic muscle. In 5 of 6 patients recovered muscle strength up to 3-4 points that allowed in the case of peripheral lesions to avoid surgical intervention to reduce disability.

Here is an example extract from the history.

Patient A. , 3, Diagnosis of consequences of hospitals, S.-Petersburg. The Institute was hospitalized for surgery brachial plexus.

At the first visit in may 1992, the right arm is shorter than the left by 5 see Strength was less than 2 points, hypohidrosis temperature on the right hand lower than on the left on the 2o. EMG revealed deformation of the M-response from the muscles of the right hand. The speed caused by the capacity of the ulnar and radial nerves of the patient hands of 20-25 m/s

According to the claimed method the girl underwent a course of treatment, including the introduction of a solution neostigmine methylsulfate 0.3 ml subcutaneously in each of 3 acupuncture points located over the affected muscles. Points were changed daily. After 10-15 min was performed electrical stimulation of the paretic muscles OMT with the use of a bipolar electrode. I used mode 2 type of operation, frequency 30 Hz, the ratio of current and pause 2/3, the modulation depth of 75%, duration - 2 min exposure to one of the neuromuscular unit. The session was facilitated by 5 units. Treatment of 12 sessions. Refresher course conducted over 2 months. After the second course the strength of the muscles of the right scapula was 3 points, the deltoid muscle is 3-4 points, biceps - 3 points, triceps shoulder - 3-4 points, flexor brush eplica - 2 points. The sensitivity of the hand improved to 3 points. EMG: M-the answer became clearer, less distorted. The speed caused by the capacity of the ulnar nerve was increased to 40 m/s, radiation - up to 36 m/s, the temperature Difference of the right and left hand amounted to 1o.

Thus, from the above example shows that the treatment led to a significant improvement of function of the hand, to improve the sensitivity, thus avoiding surgical intervention.

The proposed method has the following advantages: provides the most complete rehabilitation of the paretic muscles due to the combined effects of two potentiating each other factors, the introduction of neostigmine methylsulfate in acupuncture points, known for their high biological activity and stimulation of neuromuscular units, which provides direct training contractility of the paretic muscle. Electrostimulation with ganglioblokiruyuschimi effect, improves microcirculation in the neuromuscular unit. It reduces the increased tone of muscles-antagonists in patients with Central paralysis. Electrical stimulation reduces the area functional synapse is more short term.

A method of treatment of paralysis and paresis by introducing a neostigmine methylsulfate in acupuncture points, characterized in that the solution neostigmine methylsulfate is administered in a dosage of age, distributing it in equal parts by three acupuncture points on the affected neuromuscular unit, and 10-15 min conducting electrical stimulation of the paretic muscles sinusoidal modulated current, while in peripheral paralysis and paresis use II(I) the mode 2 type of work, with a frequency of 30 Hz, a modulation depth of 75% and 100% when the ratio of current and pause 2:3 and when the Central paralysis and paresis use the first mode, 3 the nature of work, with a frequency of 50 Hz, a modulation depth of 75%, with a ratio of current and pause 2:3, the treatment course is 10 sessions.

 

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