The method of detecting the focus of epileptic activity
(57) Abstract:The invention relates to medicine, namely neurosurgery and neurology, may be used to identify the focus of epileptic activity in patients with epilepsy. On the EEG record electrophotographic change the background provoking effects of intravenous laser irradiation of blood (ILIB) 5 mW for 15 minutes Immediately before the irradiation of the patient record EEG. Control EEG carried out immediately after the session and after hours. The method improves the accuracy of diagnosis. 3 Il. The invention relates to medicine, namely neurosurgery and neurology, and can be used to identify the focus of epileptic activity in patients with epilepsy.There is a method of detecting focus of epileptic activity in the EEG by conducting rhythmic photostimulation (Chugunov S. A. Clinical electroencephalography. 2nd ed. M: Medgiz, 1956. 392 C.). However, this method is effective in a small percentage of cases. In addition, light load often causes not only electroencephalographic realignment, but clinical manifestations, i.e. provokes prirodovedenia 3-minute hyperventilation, thus there is a decrease RS2the blood, which leads to reflex spasm of the arterioles and decrease cerebral blood flow, which ultimately leads to cerebral hypoxia (Drake M. E. , Miles E. Paroxysmal hyperventilation responses in the adult Electroencephalogram. //Clin. Electroencephalogr. 1986, v. 17, 2, p. 61-65). Experimental data show that hypoxia leads to depolarization of the membrane of neurons, increasing their excitability and General depolarization shift in the cortex, which is associated provoke pathological activity in epilepsy (Okudzhava C. M. Basic neurophysiological mechanisms of epileptic activity. Tbilisi: Back To Text, 1969. S. 224). The main drawback, as with the first method is the possibility of provoking expanded clinical convulsive seizure, in addition, a sharp decline RS blood leads to apnea.There is a method of detecting focus of epileptic activity on the EEG due to the so-called dark adaptation (Stepanova T. C. Functional state of the Central nervous system in conditions of adaptation to darkness (experimental and clinical study). Abstract thesis.... Kida. the honey. Sciences. Leningrad, 1964, 21 C.). Due to the significant reduction in external (trigger) incentives PR the spine. The disadvantage of this method are stringent conditions (absolute peace and silence in the chamber) and the duration of the procedure (1 hour).There is a method of detecting focus of epileptic activity by deprivation of sleep for one night. (Zenkov L. R., Ronkin, M. A. Functional diagnosis of nervous diseases. M , Medicine 1991, 640 S.). The mechanism of action is associated with the fact that sleep deprivation leads to increased synchronization in the EEG, and this, as already mentioned, is a factor favouring the development of epileptic potentials in the brain. The main disadvantage of this method is the severity of its performance for the patient.There is a method of detecting focus of epileptic activity by applying sedative (Relanium) funds. The effect is due to the fact that by reducing the overall irritation of the cortex creates conditions for the manifestation of focal seizure activity. (Charles C. A. Epilepsy. M, Medicine. 1990, 345 S. ). The disadvantages of this method is its small effects, because of the difficulty to find the minimum dose, do not cause suppression of all, including and focal epileptic activity.The prototype announced the e corsola or bemegrida. Korazol injected in the form of a 5-10% solution at the rate of 1-2 mg of dry matter per 1 kg of body weight with an introduction. Such single dose is administered once every 30 seconds when the continuous recording of the EEG. Limit the total dose should not exceed 8,8 mg/kg for adults and 6.6 mg/kg in children. Bemegride administered intravenously every 15 seconds at a rate of 1 mg per 10 kg of body weight at each administration. The total dose should not exceed 150 mg (Christian W. Klinishe Electroencephalographie: Lehrbuch und Atlas. Stuttgurt, 1975. 300 s.). The disadvantage of this method is the high possibility of provoking deployed uncontrolled convulsive seizure. In addition, from the point of view of local diagnostics inconvenience of applying corsola is that it often gives primary generalized epileptic discharges on EEG in focal epilepsy.The invention is directed to a method of detecting focus of epileptic activity, providing increased accuracy of the method and the safety of the patient.The invention consists in that on the EEG record electrophotographic change the background provoking effects of intravenous laser irradiation of blood (ILIB) 5 mW for 15 minutes. The right near St who I am and an hour later.Impact vlok on the circulation and metabolism of the brain, including the activating influence of the laser beam directly on the membrane exchange mechanisms of brain cells, increasing the rate of depolarization of the cell membrane, leads to local activation of most of the affected cells. This effect vlok is particularly evident on the background of General therapy, sedative action of low-intensity laser radiation (NEELY), leading to lower overall irritation of the cortex.The inventive method differs from the prototype in that the effect of intravenous laser beam power of 5 mW for 15 minutes under dynamic EEG control.The method is as follows.Before the beginning of exposure recorded in the usual way EEG. During irradiation, the patient should be in a comfortable position: the patient lies on the couch on his back. Make puncture the vein and through the injection needle spend a flexible light guide through the irradiation of blood NEELY 5 mW for 15 minutes. Immediately after the session and after an hour of exercise a controlling recording of EEG, which shows characteristic epileptiform potentials. Usually the greatest treason is a clinical trial in 41 patients with epilepsy and arachnoid of the brain of the epileptic syndrome. All patients received vlok in accordance with the above method. Positive diagnostic effect was observed in 71% of cases, focal epileptic changes were detected in 64% of patients, strengthened their expression in 7%. Thus, the proposed method was effective in improving the accuracy of diagnosis.Here is an example extract from the history 256-98. Patient K., aged 44, was on the examination and treatment in the Polenov research neurosurgical Institute them. Professor A. L. Polenov with 17.02.98 on 13.03.98 with a diagnosis of post-Traumatic arachnoiditis brain. Epileptic syndrome. Upon receipt complained of periodic intense headaches without clear localization, the presence of seizures with a frequency of approximately 1 in every 2-3 months. Seizures began with unpleasant sensations in the epigastrium, palpitations, then the patient has lost consciousness, it was observed seizures tonic-clinical nature. Constantly took benzonal dose of 1 so at night daily.According to the claimed method the patient is in the prone position was performed EEG study, which revealed moderately expressed diffuse changes in the bioelectrical activity of brain and irritative nature (Fig. 1). As it is for 15 minutes. Immediately after the session vlok recorded EEG (Fig.2), which found the prevalence of sharp potentials, individual sharp waves in the left temporal leads. After an hour re-recorded EEG (Fig. 3) where in the left temporal leads registered a typical epileptic peak-wave complexes. Thus was revealed the focus of epileptic activity in the left temporal region.The proposed method has the following advantages: increases the accuracy of detection in EEG characteristic of electric potentials, expressed occurrence or strengthening of focal epileptiform activity. Furthermore, the method provides security for the health of the patient. The method of detecting the focus of epileptic activity by recording of brain potentials against the background of provoking impact and detection of epileptic electrophotographic elements, characterized in that the effect of intravenous laser beam power of 5 mW for 15 min under dynamic EEG control.
FIELD: medicine, neurology, psychopathology, neurosurgery, neurophysiology, experimental neurobiology.
SUBSTANCE: one should simultaneously register electroencephalogram (EEG) to detect the level of constant potential (LCP). At LCP negativization and increased EEG power one should detect depolarizational activation of neurons and enhanced metabolism. At LCP negativization and decreased EEG power - depolarized inhibition of neurons and metabolism suppression. At LCP positivation and increased EEG power - either repolarized or hyperpolarized activation of neurons and enhanced metabolism. At LCP positivation and decreased EEG power - hyperpolarized suppression of neurons and decreased metabolism of nervous tissue. The method enables to correctly detect therapeutic tactics due to simultaneous LCP and EEG registration that enables to differentiate transition from one functional and metabolic state into another.
EFFECT: higher accuracy of diagnostics.
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