Method for restoring cerebral hemodynamics in children with vertebrogenic disorders

FIELD: medicine, pediatrics, juvenile neuropathology.

SUBSTANCE: one should affect with neurosimilar impulse currents due to altering the disposition of electrodes daily: the first day - for the area of projection of atlanto-occipital symphysis and paravertebrally at the level of 5-6 thoracic vertebra (Th 5-6) from both sides, the second day - for the area of brachioscapular symphysis and paravertebrally at the level of 5-6 thoracic vertebra (C5-6) from both sides. The innovation provides the impact upon pathogenetic disease mechanisms.

EFFECT: higher efficiency.

3 dwg, 3 ex, 3 tbl

 

The invention relates to medicine, namely to Pediatrics, pediatric neuropathology, and can be used to restore cerebral hemodynamics in children with vertebral abnormalities.

One of the causes of cerebrovascular disorders in children are vertebrogenic disorders of the cervical spine.

To date, defined pathological phenomena, defining together craniovertebral pathology, namely: a violation of the anatomical structure of the cervical spine and skull, circulatory disorders of the brain and disorders of CSF dynamics associated with this function disorders structures of the brain and spinal cord. However, in the literature there is no systematic exposition of the methods etiopathogenetic treatment of this disease, especially in children.

There is a method of treatment of cerebral disorders in children, including the introduction of antispasmodics (1% solution of aminophylline and 1% solution of nicotinic acid) by electrophoresis transversely to the cervical spine, in which electrodes are placed as follows: one on the handle of the sternum, on the second cervical-occipital region (Ratner, A. Late complications of birth injuries of the nervous system. - Publishing house of Kazan University, 1990. - 285 S.).

The disadvantages on the frame of the method include the use of drugs, in some cases, individual intolerance to side effects, the possibility of formation of products of electrolysis at the subelectrode pads that cause local side effects such as irritation, etc.

Object of the invention is to provide a method for recovery of cerebral hemodynamics in children with vertebrogenic disorders that enhance the effectiveness of treatment due to the effect on pathogenic components of the process.

The problem is solved in that in the method of recovery of cerebral hemodynamics in children with vertebral disorders, including a course in physical effects on the cervical spine, according to the invention the influence exercised by the neural pulse currents, daily alternating arrangement of electrodes, the first day on the area of projection atlantization articulation and paravertebral level 5-6 thoracic vertebra (Th 5-6) on both sides, the second day - on the area of the upper arm and paravertebral level 5-6 cervical vertebrae (C5-6) on both sides.

The neural impulse currents have a maximum amplitude value of up to 100 mA, modulated in the form of bipolar pulses, characterized by short cathode discharge with continuous low-amplitude anodic phase is th. This pulse shape is as close to the action potential in the area of interception of Ranvier. The total component of the momentum of this form is equal to zero, which eliminates the possibility of formation of products of electrolysis to the subelectrode layers. The duration of the impulse comes to 1.3 MS with a frequency of from 20 to 120 Hz (Agiman, Sverakova, Evergrove, Senatorova, Abiscan. Low-frequency impulse electrotherapy diseases of the peripheral nervous system. St. Petersburg 2003 s-29). The above characteristics of the electrical pulses cause physiological sparing action of current and tolerability of treatments.

The authors found that the impact of the neural pulse currents on the cervical spine and shoulder girdle alternately on the first day - on the area of projection atlantization articulation and paravertebral level Th 5-6 on both sides, on the second day - on the area of the upper arm and paravertebral at the level of C5-6 on both sides reduces the tonus of smooth muscles of blood vessels, improves trophic tissues, reducing tonic contraction of the muscles, helps to eliminate the tonic tension of the neck muscles and spasm of the vertebral arteries, microcirculation of tissues of the neck, which eliminates muscular-tonic and muscular-degenerative disorders specified in the zone. Data pathogenetic mechanisms lead to compensate for irregularities in craniovertebral region, elimination of a spasm of the vertebral arteries; reduction of irritation periarterial nerve plexus and the elimination of their secondary manifestations, in particular to the recovery of cerebral hemodynamics in children.

1 shows a layout of electrodes on the first day, 2 on the second day.

The method is carried out, for example, as follows.

Apparatus of Bioritm-040" applying pulses to therapeutic outputs is carried out in the mode of "drift"in which there is a change of frequency in the range 20-120 Hz with a parallel change in the amplitude of the pulses. Change the frequency and amplitude of the pulses is in a trapezoidal shape of the envelope. This mode prevents adaptation to impact and fatigue of the muscles. Set the group mode with a period of the pulse 4-8 seconds.

The impact of exercise on the cervical spine and shoulder girdle in four fields. On the first day of the electrode 1 is placed in the projection atlantization articulation, and the electrode 2 is at the level of segments TP5-6 paravertebral (longitudinally). Similarly feature the electrodes 3 and 4 on the opposite side. On the second day of the electrode 5 is placed in the area of upper arm, and the electrode 6 is paravertebral is Ino at the level of C5-6. Similarly feature the electrodes 7 and 8 on the opposite side. The duration of the treatment is from 10 to 25 minutes. The course of treatment consists of 10 treatments carried out daily with alternating zones of influence.

The method is illustrated by the following clinical examples.

1. Girl B., age 9, was treated with a diagnosis of Vertebrobasilar insufficiency in the background craniovertebral pathology (congenital shortening of the rear arc Atlanta with protective contracture atlantization articulation). Poor posture. On admission the girl complained of motion sickness, dizziness, irritability, tearfulness, emotional lability, restless sleep, attention span. During the inspection notice: posture sluggish, the asymmetry of the shoulders, the corners of the blades, the symptoms of peripheral cervical insufficiency, tenderness to palpation of the point of the vertebral artery on both sides (more on the right), tenderness to palpation of the spinous processes of C1-C2, limitation of flexion of the head and tilt head to the right.

The neurological examination:

On the neck spondylogenic with functional tests: Congenital shortening of the rear arc Atlanta with protective contracture atlantization articulation (hypoplasia of the posterior arc of C1, which creates a local stenosis of the spinal canal is at this level; limitation of flexion in atlanticfilm.com the joint).

EEG: the maturity Level of the cerebral biorhythmic corresponds to the age. Signs of diffuse light irritation of the cerebral cortex and structures limpiaparabrisas complex. Focal changes and paroxysmal forms of bioelectric activity of the cerebral cortex is not registered.

Transcranial Doppler: Doppler signs of circulation failure in trunk and cerebral arteries of the head, mainly in the vertebrobasilar basin.

Had a course of 10 treatments impact the neural pulse currents on the cervical spine and shoulder girdle carried out daily for 10 to 25 minutes with alternating zones. On the first day, one electrode was positioned in the projection atlantization junction, and the second - level segments Th5-6 (longitudinally). Similarly disposed electrodes on the opposite side. On the second day of electrodes disposed in the region of upper arm and paravertebral at the level of C5-6 on both sides. The applying pulses was carried out in the "drift"; mode group. The submission period of the pulses 4-8 seconds.

After the procedure, the girl noted a significant improvement in well-being: the lack of dizziness, loss of temper and Plaks the news, improving sleep. At objective inspection - disappeared tenderness to palpation at the point of the vertebral artery on both sides.

When repeated transcranial Doppler: Doppler signs of circulation failure in trunk and cerebral arteries of the head, mainly in the vertebrobasilar basin, with significant positive dynamics (table 1):

a) the acceleration of blood flow in vertebrate arteries;

b) reducing the asymmetry of blood flow in vertebrate arteries (level V2) 2 times: before treatment - KA=120%; after treatment - KA=66,5%;

C) the acceleration of blood flow in the posterior cerebral arteries;

g) reducing the asymmetry of blood flow in the posterior cerebral arteries in 2 times: before treatment - KA=37,8%; after treatment - KA=19,2%;

d) the acceleration of blood flow in the carotid pool (anterior cerebral artery, internal carotid artery);

e) the disappearance of the asymmetry of blood flow in the anterior cerebral arteries: before treatment - KA=18%; after treatment - KA=4.8 per cent).

2. Girl K., age 8, was treated with a diagnosis of Vertebrobasilar insufficiency in the background craniovertebral pathology (Natal trauma in the form of damage to Atlanta with the formation of bone Krivoshei). Neurosis-like state with violation of the sleep formula. The syndrome of vegetative-vascular dystonia. Poor posture. When receiving e is the young lady made the following complaints: headache, often in the 2nd half of the day; fatigue, weakness, lethargy; insomnia (often wakes up, difficulty falling asleep). During the inspection notice: posture sluggish, the asymmetry of the shoulders, the corners of the blades; expressed symptoms of peripheral cervical insufficiency; limited tilt the head to the right, tenderness to palpation of the spinous processes of C1-C2.

The neurological examination:

On the neck spondylogenic with functional tests: cervical spondylogenic with functional tests: Atlas deformed, his right lateral mass is displaced laterally, the cracks formed by joints narrowed, his head tilted to the right shoulder movement in atlanticfilm.com the articulation sharply restricted; in other vertebral motor segments - hypermobility; the bases of the spinous processes of C2-Th1 flattened. Conclusion: the Natal trauma in the form of damage to Atlanta with the formation of bone Krivoshei. Of spinal disorders of CSF dynamics.

EEG: moderate diffuse changes in the bioelectrical activity of the cerebral cortex with irritating stem structures at the diencephalic level.

Transcranial Doppler: Doppler signs of circulation failure in trunk and cerebral arteries of the head, mainly in the vertebrobasilar basin.

Course was held from 10% the dur neural pulse currents on the cervical spine and shoulder girdle, conducted daily for 10 to 25 minutes with alternating zones. On the first day of the electrode was positioned in the projection atlantization junction, and the second - level segments Th5-6 (longitudinally). Similarly disposed electrodes on the opposite side. On the second day of electrodes disposed in the region of upper arm and paravertebral at the level of C5-6 on both sides. The applying pulses was carried out in the "drift"; mode group. The submission period of the pulses 4-8 seconds.

After the procedure, the girl noted a significant improvement: no headaches, decrease fatigue, increase efficiency. At objective inspection - disappeared tenderness to palpation of the spinous processes.

When repeated transcranial Doppler: Doppler signs of circulation failure in trunk and cerebral arteries of the head with positive dynamics (table 2):

a) reduction of the asymmetry of the flow in 2 times in the internal carotid arteries;

b) alignment of the blood flow with a decrease in the asymmetry of blood flow in vertebrate extracranial arteries on level 5 times and intracranial almost in 2 times, the disappearance of the asymmetry of the flow in sadnesshow arteries.

3. Girl, 10 years of age, was treated with a diagnosis of Faiths is bromosilane failure on the background of craniovertebral pathology (abnormal development of transitional zones: C1 and C7). The syndrome of vegetative-vascular dystonia. Poor posture. On admission the girl was charged with the following complaints: headache, often in the 2nd half of the day; motion sickness; fatigue, weakness, lethargy; attention span. During the inspection notice: posture sluggish, the asymmetry of the shoulders, the corners of the blades; expressed symptoms of peripheral cervical insufficiency; pterygoid shoulders; the head is rejected to the left shoulder; limited motion in the cervical spine, tenderness to palpation of the point of the vertebral artery on both sides (more on the right).

The neurological examination:

On the neck spondylogenic with functional tests: unilateral anomaly of Kimmerle; posterior spina bifida C7 with uneven positioning of the plates of the arc; left cervical scoliosis. Conclusion: abnormal development of transitional zones (C1 and C7).

EEG: moderate diffuse changes in the bioelectrical activity of the cerebral cortex with close to significant irritative stem structures at the diencephalic level, the tendency to paroxizmalnoe.

Transcranial Doppler: Doppler signs of circulation failure in trunk and cerebral arteries of the head, mainly in the vertebrobasilar basin.

Had a course of 10 treatments neural pulse currents on the neck of the Affairs of the spine and shoulder girdle, conducted daily for 10 to 25 minutes with alternating zones. On the first day of the electrode was positioned in the projection atlantization junction, and the second - level segments Th5-6 (longitudinally). Similarly disposed electrodes on the opposite side. On the second day of electrodes disposed in the region of upper arm and paravertebral at the level of C5-6 on both sides. The applying pulses was carried out in the "drift"; mode group. The submission period of the pulses 4-8 seconds.

After the procedure, the girl noted a significant improvement: no headaches, decrease fatigue, increase efficiency. At objective inspection - disappeared tenderness to palpation at the point of the vertebral artery on both sides.

When repeated transcranial Doppler: Doppler signs of circulation failure in trunk and cerebral arteries of the head, mainly in the vertebrobasilar basin with significant positive dynamics (table 3):

(a) alignment of the flow with the disappearance of moderate asymmetry in the middle cerebral arteries;

b) alignment of the flow with the disappearance of the asymmetry in vertebrate arteries.

The proposed method was treated 30 children with vertebrogenic disorders. Tolerance f is zipreader using neural impulse currents was good. Positive dynamics of clinical symptoms, improvement of cerebral hemodynamics in carotid and vertebrobasilar basin was observed in 100% of cases. The positive dynamics of the functional state of the cervical spine (estimated mobility in the cervical spine, pain certain points craniovertebral zone, the voltage of the cervical-occipital muscles) was observed in 75% of cases. In the control group receiving medical therapy using vascular drugs, nootropics, vitamins, side dynamics craniovertebral region was observed significantly less frequently (21%).

Using the inventive method allows to achieve high efficiency recovery of cerebral hemodynamics in children with vertebrogenic disorders due to the impact on the pathogenetic mechanisms of the disease without the use of drug therapy. The method is physiological and safe.

Method of recovery of cerebral hemodynamics in children with vertebral disorders, including a course in physical effects on the cervical spine, characterized in that the impact of the exercise of the neural pulse currents, daily alternating arrangement of electrodes, the first day on the projection area of Atlanto-occipital what about the articulation and paravertebral level 5-6 thoracic vertebrae on both sides and the second day - on the area of the upper arm and paravertebral level 5-6 cervical vertebrae on both sides.



 

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