Method for assessing adequate general anaesthesia in children aged from 4 to 14 years old by long-latency auditory evoked potentials
SUBSTANCE: invention refers to medicine, namely to anaesthesiology, and may be used in assessing an adequate general anaesthesia in the children aged from 4 to 14 years old. That is ensured by pre-anaesthetic and intra-anaesthetic intraoperative recording of long-latency auditory evoked potentials. That is followed by summing up initial latencies of first three pre-anaesthetic peaks (P1, N1, P2) to calculate sum A, subtracting the sum of the latencies of the first three intraoperative peaks (P1, N1, P2) to calculate sum B. The A to B relation is multiplied by 100. A percentage of the latencies of the intra-anaesthetic peaks P1, N1, P2 to the pre-anaesthetic values is considered as the adequate general anaesthesia. For the children of the first age group of 4-6 years old, the general anaesthesia is considered to be adequate, if the percentage is 140-253%; for the children of the second age group of 7-9 years old, the adequate general anaesthesia is shown by the percentage of 133-253%; for the children of the third age group of 10-12 years old, the adequate anaesthesia is shown by the percentage of 159-190%; and the percentage of 125-271% provides the adequate general anaesthesia for the children of the fourth age group of 13-14 years old.
EFFECT: method provides the adequate and easy assessment of the anaesthesia ensured by reducing a time of examination and simplicity of data interpretation in the form of one three-peak wave.
1 ex, 6 tbl
The invention relates to medicine, namely to anesthesiology. Known measure of the hypnotic component of anesthesia is electroencephalography (EEG). The method consists in the registration of spontaneous brain activity with at least 8 electrodes placed on the surface of the head of the patient in the form of waves of different frequency and amplitude, which in the stage of surgical anesthesia, the amplitude of the waves increases and the frequency decreases. The disadvantage of this method is the complexity of registration in the form of a superposition of a large number of electrodes and the complexity of interpreting the results in the form of reading native EEG doctor, not a neurophysiologist or neurologist. Methods of computer processing of native EEG require temporary registration of EEG for at least 20 minutes, the choice of the epochs of analysis manually or automatically, which also increases the time of receipt of important information (Epuni S.N. Electroencephalography in clinical anesthesiology. - M., 1961; the Greedy mathematical SCIENCES. Biophysical mechanisms of the EEG. M.: Nauka, 1984; Zenkov LR Clinical electroencephalography with elements of epilepsy. - Taganrog, 1996; Ivanov LB Applied computational electroencephalography. - M: medical Research firm NMG, 2004; Ivanov LB Recognition of artifacts and some problems of practical Ana who studied computer EEG. - M., 2007; Mori, K. et al.: Factors modifying anestheticinduced EEG activities. In Stoeckel H (ed), Quantitation, Modeling and Control in Anesthesia. Georg Thime Verglag, Stutgard, New York. - 1985). Evoked potentials are generated by the same neuronal structures that spontaneous rhythm (Halliday A.M. the Standards of clinical practice registration EAP recommendations of the International society of EEG and clinical neurophysiology. - Amsterdam: El - sevier. - 1983; Gazdecki CENTURIES Inverse problem of EEG and clinical electroencephalography - Taganrog, 2000). Currently, the more common opinion about the availability in different parts of the CNS complexes (ensembles), columns of neurons" individual microstructures, in which the circulation of excitation that causes regular EEG. Among ensembles of neurons distinguish synchronization system (inhibitory), localized in the nonspecific nuclei of the thalamus, the hypothalamus and the reticular formation of the lower sections of the brain stem. They carry out the integration of separate neuronal columns in smoothly working group on EEG occur low-frequency, high-amplitude oscillations, showing slower intracerebral processes. Activity synchronization systems appears brighter while you sleep, anesthesia, mental peace and children. Desynchronizers (trigger) system are located in the cortex, the reticular form the AI at the level of the mid-brain and peoplechecking nuclei of the forebrain. Excitation reticulocytopenia systems leads to increased level of functional activity of the brain, manifested in the EEG high-frequency, low-amplitude rhythms, demonstrating the process of processing the incoming of information into the brain. Common to these systems is the reticular organization with bilateral cortical connections that determine bilateral symmetry, homogeneity EEG and involvement of all departments in the Central nervous system even in case of local intracerebral process (the Greedy mathematical SCIENCES. Biophysical mechanisms of the EEG. - M.: Nauka, 1984; cutin, VA Functional and ultrasonic methods in practical medicine edited by Novikov AU - Ivanov, 2009). A special contribution in the generation of evoked potentials contribute to the so-called gradually potentials ITSP and TPSP (excitatory and inhibitory postsynaptic potentials) dendritic fibres of bark or different nuclei of the brain. Summation of synaptic gradually potentials gives the basic response of the brain when registering on the scalp. A smaller contribution to the registration of evoked potentials make the actual action potentials (experience in the use of evoked potentials in clinical practice edited by Gnezdilova CENTURIES, Shamshinova A.M. - M.: JSC "Antidoron", 2001; Sebel P.S., Glass P. Do evokeds potentials measure depth of anesthesia // J. Clin. Monit. - 1988. - Vol.5; Sadowski R. Evocierte potenciale in kliik und praxis. Eine Einfiirung in VEP, SEP, AEP, MEASURES, P 300 AND PAP. - Springer-Verlag. - 1993; Jorg J., H. Hielscher Evozierte potentiale in klinik und praxis. Eine Einfiirung in VEP, SEP, AEP, MEASURES, P 300 AND PAP - Springer-Verlag. - 1993). According to existing theories of anaesthesia and mechanism of action of anesthetics under the action of the latter is the reflex inhibition of the processes at the level of the reticular substance of the brain, it eliminates its activating effect on the above-lying structures of the brain, leading to their deafferentation. Loss of consciousness and amnesia, usually associated with the direct influence of the anesthetic on the cerebral cortex of the brain (Zaitsev, A. and et estimation Method analgesia - nociceptive evoked potentials. The first clinical observations // Anesti reanim., 2008; Jessop J., Jones J.G. Evaluation of the actions of general anaesthetics in the human brain // Gen Pharmacol - 1992. - Vol.23. - N 6, 1992; Concurrent recording of AEP, SSEP and EEG parameters during anaesthesia: a factor analysis / H.Schwilden, E.Kochs, M.Daunderer et al. // The British Journal of Anaesthesia. - 2005. - Vol.95. - N 2; Quantifying cortical activity during general anesthesia using wavelet analysis / T.Zikov, S.Bibian, G.A.Dumont / IEEE Trans. Bio-med. Eng. - 2006. - Vol.53. - N 4). Conducting registration of evoked potential near-field, we receive information from generators located in the cortex, the location of the electrode in the immediate vicinity of the generator. In this case, auditory cortex and the electrode is located at the point where the recorded maximum amplitude of the response - Cz vertex international scheme (experience in the use of you who bathrooms potentials in clinical practice edited by Gnezdilova CENTURIES, Shamshinova A.M. - M.: JSC "Antidoron", 2001).
To assess the adequacy of anesthesia we used a method of registration of long-latency auditory evoked potentials (DSVP). The survey was carried out in the operating room until the anesthesia and during anaesthesia, surgical stage, the onset of which was determined only clinical signs - lack of reflexes of the eyeball, the fixation of the pupil clearly in a neutral position, pupil diameter is narrow, the absence of pharyngeal reflex in the formulation of the duct, reduced muscle tone and the absence of motor responses to external stimulus.
Identification and designation of components of the response
DSIT dates back to the late components of the auditory response and occurs after 40 MS from the moment of stimulation. The result of the inquiry was a negative-positive complex of peaks, each of which has its origin time, called latency, msec. The first peak, facing down - P1, the second peak, facing up - N1, the third peak, facing down - P2, the fourth peak, facing up - N2. Before anesthesia, the most well-registered so-called V - wave: complex with peak latencies of N1 - from 70 to 90 MS and P2 is from 150 to 200 MS. Under the action of anesthetics change the shape of the response is better identified complex - N1-P2 and uvelichenie the camping latency of each peak (experience in the use of evoked potentials in clinical practice edited by Gnezdilova CENTURIES, Shamshinova A.M. - M.: JSC "Antidoron", 2001).
The closest analogue of the invention is a method of assessing the adequacy of anesthesia in children from 4 to 14 years by registering during anaesthesia, in the phase of its surgical stage, long-latency auditory evoked potentials (Evdokimov RV and other New method of determining the depth of General anesthesia method long-latency auditory evoked potentials (DSWP), proceedings of the 91st annual scientific-practical conference of students and young scientists Yugma "Week of science - 2011", Ivanovo, 2011).
The technical result of the proposed method lies in the fact that children in four age groups conducting registration DSWP to anesthesia and during anaesthesia, in the phase of its surgical stage, evaluating the adequacy of anesthesia on the ratio of the sum of the latencies of the first three peaks (P1, N1, P2) in anaesthesia, to the data before anaesthesia, expressed in percent. The effect of the use of the method consists in a significant simplification of the registration parameters (overlay only 4 electrodes), the reduction of the time of the survey is on average 2-3 minutes, which is necessary for stimulation, ease of interpretation of the survey data in the form of a single wave, having three peaks. As the active electrode is used Cz - vertex international circuit, supplied the th to the first amplifier input (-). Reference electrode - earflap or mastoid connected to the second amplifier input (+) lead Cz-A2 (A1). The grounding electrode on the frontal pole (Gazdecki CENTURIES, 2001). Headphones beaurline signal-clicking the capacity of 126 decibels, which is on average 20% above the lower hearing threshold. The duration of the stimulus is not more than 50 MS, with a frequency no more than once per second. Highly sensitive amplifiers and digital devices allow you to register a response to an auditory stimulus by averaging, accumulation and filtering a large number of weak responses of the brain. The responses of the brain to stimuli and their variances are estimated by the change of basic parameters - the amplitude and latency of the recorded peaks.
The method is as follows. Calculates the sum And source indicators P1, N1, P2 to anesthesia. Calculates the sum of the latencies of the peaks P1, N1, P2 in anaesthesia. Then the ratio of the sum In the sum And multiply by 100, so the result will be the percentage of indicators the latencies of the peaks P1, N1, P2 in anaesthesia to the indicators before anaesthesia. When children first age group 4-6 years the percentage was 140-253%, for children the second age group 7-9 years 133-253%, for the third age group 10-12 years 159-190%, for children-fourth age group 13-14 years - 125-271%, the addict is C evaluate adequate.
To ensure the validity of a study, it was necessary that before anesthesia patients in groups according to the main indicators: sex, age, nosological forms, did not differ from each other, that is statistically fair for them was the null hypothesis. The proposed method, an evaluation of the adequacy of anesthesia in 51 children (39 boys and 12 girls) aged 4 to 14 years, operated in a planned manner about hernias of different locations and varicocele. At the time of the survey, all children were healthy.
As the sedation was used atropine and seduxen in the age dosages. The first group consisted of 20 children, in whom anesthesia was used inhalation anesthetic halothane and nitrous oxide. The second group consisted of 21 children, in whom anesthesia was used in the preparation and nitrous oxide. The third group consisted of 10 children for anesthesia was used intravenous anesthetic propofol and narcotic analgesic fentanyl.
In tables (see Appendix) used the following notation:
M - medium, m is the standard error, σ - standard deviation, p is the probability of the null hypothesis. As can be seen from tables 1 and 2, the performance of the latencies of the main peaks correspond to the normal increase in latency and amplitude of all components DSWP in surgical stage n is rcosa has a statistically significant and does not depend on the type of anesthetic. Statistically significant differences in the analysis of components DSIT during anaesthesia by age groups were not found (table 3-6). You can talk about the trend is quite stable and uniform increase in the latencies of the first three peaks in all age groups for surgery under anaesthesia. Latency component N2 is more variable and surgery under anaesthesia its increase is less pronounced in relation to the increase in the latencies of the first three peaks.
The patient P. Smirnova, 7 years registration DSIT before surgical intervention (see examination report). Indicators of the latencies of the first three peaks amounted to P1 - 79 MS, N1 - 111 MS, P2 - 144 MS. Premedication for 30 minutes before anesthesia was administered intramuscularly atropine and dormicum in dosages of 20 mg/kg and 0.3 mg/kg, respectively. Held mask anesthesia for semi-loop. As an inhalation anesthetic used a combination of preparation and nitrous oxide. The onset of surgery under anaesthesia defined clinical criteria - absence of reflexes of the eyeball, the fixation of the pupil clearly in a neutral position, pupil diameter is narrow, the absence of pharyngeal reflex in the formulation of the duct, reduced muscle tone and the absence of motor responses to external will raskazhite the ü. After 5 minutes after skin incision was registered DSWP. Indicators of the latencies of the first three peaks amounted to P1 - 175 MS, N1 - 194 MS, P2 : 246 MS. Perform the calculation of the percentage of latency is calculated by the ratio of the sum of the latencies in anaesthesia to the sum of the latencies to anesthesia and expressed in percent- ((175+194+246)/(79+111+144))*100=184%. We have calculated the index corresponds to surgery under anaesthesia in children in the age group 7-9 years (table 4).
The method of assessing the adequacy of anesthesia in children from 4 to 14 years by registering during anaesthesia, in the phase of its surgical stage, long-latency auditory evoked potentials, characterized in that the registration DSIT conducted additionally to General anesthesia, with subsequent calculation of the sum of the baseline latencies of the first three peaks (P1, N1, P2) to anesthesia - the amount And calculation of the sum of the indices of the latencies of the first three peaks (P1, N1, P2) in the surgical stage of anaesthesia amount, then the ratio of the sum to be multiplied by 100, assessing the adequacy of anaesthesia for the percentage ratio of the latencies of the peaks P1, N1, P2 anesthesia to the indicators before anaesthesia, while the percentage for children in the first age group of 4-6 years - 140-253%, for children the second age group 7-9 years 133-253%, for the third age group 10-12 Le is - 159-190%, for children-fourth age group 13-14 years - 125-271%, anaesthesia assess adequate.
SUBSTANCE: invention relates to field of medicine, namely to neurophysiological methods of examination. Registration of EEG is carried out, total power of modal fluctuation in alpha-rhythm range in one of leads is determined and FRα1 index is calculated as ration of said power to total power of all alpha range fluctuations in the same lead. Value of the sum of power of fluctuations, located ±0.5 Hz on the right and on the left from maximal power value, including maximal value, is determined, and FRα2 index is calculated as ratio of the obtained sum of power to total power of all fluctuations of alpha-range in the same lead. Intensity of brain affection is determined by comparison of obtained FRα1 and FRα2 values with standard values.
EFFECT: method makes it possible to determined quantitative ratio of alpha-rhythm, characteristic of separate nosologic units in psychiatry.
2 tbl, 1 dwg
SUBSTANCE: invention relates to medicine, namely to pediatrics and can be used in neurology, medical psychology and psychiatry. Clinical examination of children is carried out by complaints, anamnestic information and data of physical examination. Assessed are: symptoms of vegetative manifestations at the moment of examination and peculiarities of sensomotor reactions: weight and length of body at birth, gestation age, response to stimulation in children of first year of life, sleep in children of first year of life, EEG in children of early age, parasomnia, enuresis, meteosensitivity, headaches, vessel lability, vestibulopathy, peculiarities of motor sphere, feeding behaviour, skin manifestations, course of infectious and somatic diseases, menstrual disorders in adolescent girls, brain ultrasound examination. Connection of said disorders with predominant dysfunction of right or left brain hemispheres is determined.
EFFECT: method makes it possible to increase reliability of diagnostics, which is achieved due to taking into account vegetative reactions and disorders in child of first year of life.
1 tbl, 2 ex
SUBSTANCE: invention relates to field of medicine, namely to oncologic neurosurgery, neurology, psychiatry and functional diagnostics. Electroencephalographic examination is carried out. Level of coherent connection between pole-frontal and anterior temporal regions of cerebral cortex on the right is calculated in beta-range. If said parameter is higher than 0.52, Korsakoff's syndrome is diagnosed.
EFFECT: method makes it possible to increase reliability of Korsakoff's syndrome diagnostics.
1 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely to drug-free methods for activation of the cerebral verbal functions. Cerebral signals are recorded. Their duration is measured. A related verbal stimulus is established for the derived wave duration and has an effect on the patient. That is followed by measuring the duration of the next current wave through a time interval not less than the maximum duration of the used verbal stimuli, and the patient is exposed to the verbal stimulus corresponding to the current wave. According to the other version of implementing the method, the duration of the current wave is measured, and the corresponding verbal and contextually harmonised visual stimuli are set for the above duration. The patient is exposed thereto. That is followed by measuring the duration of the regular current wave through a time interval not less than the maximum duration of the used verbal stimuli, and the patient is exposed to the verbal and contextually harmonised visual stimuli corresponding to the current wave.
EFFECT: invention enables acceleration the process of verbal development in children.
1 dwg, 3 ex
SUBSTANCE: invention relates to medicine, namely to neurology, psychiatry and pediatrics. Factors of perinatal pathology risk are determined: extragenital diseases of mother during pregnancy and labour, complications of pregnancy and labour, low gestational age, estimation by Apgar scale and compromised obstetric history. Also determined is presence of neurological malfunctions during 1-st year of life: syndromes of motor malfunctions, increased neuroreflex excitability, vegetative-visceral disorders, depression, retardation of physhomotor and speech development; and in older age - cerebrosthenic syndrome and syndrome of child dysphasia in structure of symptom complex of MBD, epileptiform activity by EEG. Results of questionnaire for MBD detection are evaluated in points. Prognostic coefficients F1 and F2 are calculated in discriminating equations. If F1 is higher than F2, favorable courseof MBD is predicted, if F1 is less than F2, unfavorable course of MBD is predicted.
EFFECT: method makes it possible to increase reliability of MBD course prediction.
2 tbl, 2 ex
SUBSTANCE: invention relates to medicine. Electroencephalogram (EEG) is registered in background mode, spectrograms are calculated by means of wavelet conversion with Morlet mother function. Frequency ranges of leading EEG rhythms are determined by finding values of coordinate minimums by frequency of envelope projections of wavelet spectrograms on "amplitude-frequency" coordinate plane. In frequency ranges times Ti of spectrogram peak appearance are determined by values of positions of maximums on envelope projection of wavelet spectrograms. Frequencies Fi and amplitudes Ai of peaks of spectrograms, which correspond to values of times of their appearance in each frequency range, are determined. For each discretisation window with ΔT, ΔF parameters, obtained by fragmentation of duration T and frequency range F of EEG registration, values ΣAi of sums of amplitudes of spectrogram peaks are calculated. If frequency increases, range of frequencies of peaks expands, interhemispheric asymmetry of electric activity is detected, early stage of Parkinson disease is diagnosed.
EFFECT: method makes it possible to increase reliability of determination of early stage of PD.
4 cl, 9 dwg, 1 ex
SUBSTANCE: invention relates to field of medicine, namely to functional diagnostics. Electroencephalogram (EEG) is registered, indices of averaged powers of spectra in background EEG registration in frequency range 8-13 Hz MI before 1up to 16 minute long HF impact and M2 after EHF impact consisting of 6-10 procedures are determined. Dynamics of ratios of said indices of powers M2/M1 presence of compensatory reserves of brain is determined. In case if ratios M2/M1, equal more than 1.2 are present, conclusion about positive dynamics of general functional state of brain an possibility of carrying out standard EHF therapy is made.
EFFECT: method extends arsenal of means for control over state of patient with encephalopathy in EHF therapy.
6 tbl, 3 ex
SUBSTANCE: invention relates to medicine, in particular to field of medical and psychophysiological diagnostics. Assessment of character of motor asymmetries - determination of degree of right-handedness - left-handedness by dominance of hand and leg, as well as sensor asymmetries - determination of leading eye and ear, is performed. Also calculated is coefficient of amplitude and frequency of mu-rhythm in central parts of left and right hemisphere, as ratio of difference of maximal and minimal values to their sum. Difference between maximal and minimal values is calculated within 3-second long interval. Dominating hemisphere of motor cortex by mu-rhythm is registered at the moment of alternate clenching right and left hand fist with application of sensomotor test by scheme: "Close eyes - make right fist - open eyes - undo the fist", "Close eyes - make left fist - open eyes - then undo the fist', during standard registration of electroencephalogram.
EFFECT: method extends arsenal of means for assessment of functional interhemispheric asymmetry.
9 dwg, 4 tbl, 2 ex
SUBSTANCE: invention relates to field of medicine, namely to neuroinfections. Assessment of anamnesis data, virological indices, fever reaction and spotty-papular rash appearance is carried out. EEG is additionally registered in the first three days from the moment of admission, leukocyte index of intoxication, presence of mixed hypervirus infection are determined. If hypoxy-ischemic affection of central nervous system, spotty-papular rash on the body from the first day of disease with its "additional appearance" during 5-7 days, fever to 39-40°C during first 3-5 days are present in child's anamnesis, reduction of index of main physiological rhythm less than 30%, increased paroxysmal activity in form of diffuse sharp waves and flashes of slow activity with amplitude more than 100 mcV during 3 days or at least on one of these days are detected on EEG, value of leukocyte index is 0.2-3 conv.units, mixed hyperviruses together with varicella zoster virus, virus of type 6 herpes and/or type I herpes simplex virus are detected, risk of neurological complications is predicted.
EFFECT: method makes it possible to increase reliability of predicting risk of neurological complications in case of chicken pox in children.
SUBSTANCE: group of inventions refers to medicine and medical equipment, particularly to methods and apparatuses for scalp electric potential measurement. The apparatus comprises a number of sensors obtaining the initial measurement of a scalp electric potential through a hair-covering and an air contact area; a number of preamplifiers connected to one of the appropriate mentioned sensors. The contact area produces a high and variable coupling impedance of the source and the scalp. Each preamplifier contains a broadband high-impedance input and an active bias circuit generating input impedance more than 10 petaOhm over the range from 0.01 Hz to 400 Hz; a high-gain low-noise operating amplifier with the input impedance of 10 teraOhm; and a shielded feedback and bias circuit. The preamplifier is configured to have the input impedance substantially higher than the impedance produced by the source-sensor contact area. One version of the implementation of the method for scalp electric potential measurement, the preamplifier obtains the initial measurement of the scalp electric potential and forms a pre-intensified measurement of the scalp electric potential. The measurement is taken through the hair-covering and air. In the other version of the implementation of the method, an input signal of the initial scalp electric potential is obtained from the number of sensors to generate an appropriate number of channels. It is followed by the signal pre-amplification by the preamplifier with the high input impedance to form the pre-intensified measurement of the scalp electric potential. Then, a measurement mode is configured in a group containing a channel mode relative to a reference channel, a channel mode relative to a middle channel and a differential interchannel mode. Then, the pre-intensified measurement of the scalp electric potential is biased with maintaining the mentioned high input impedance; a channel gain is adjusted to differential obtaining of the channel signal. An additional stage providing the processed channel signal is suppressing radiofrequency interferences of the channel signal with maintaining adjustment of the gain and the phase; a common-mode of the channel signal is suppressed, and the band-pass channel filtration is provided. The processed channel signal is digitised to present a digital signal of the measurement of the scalp electric potential, characterising the mentioned input signal measured according to the mentioned chosen measurement mode.
EFFECT: use of the group of inventions allows more effective measurements of the scalp electric potential due to the preamplifiers, and allows reducing the need of exfoliating of the necrotic epithelial cells or application of abrasive or conducting gels.
27 cl, 11 dwg
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.
5 dwg, 1 ex, 1 tbl
FIELD: medicine, neurology.
SUBSTANCE: one should establish neurological status, bioelectric cerebral activity, availability of perinatal and ORL pathology in patients, establish their gradations and numerical values followed by calculation of prognostic coefficients F1 and F2 by the following formulas: F1=-31,42+1,49·a1-2,44·a2+0,2·а3+1,63·a4+0,62·а5+3,75·a6+1,8·а7-3,23·a8-0,8·а9-1,32·а10+3,26·а11+8,92·a12-2,0·a13+3,88·а14+1,79·a15+0,83·a16-2,78·a17; F2=-27,58+1,43·a1+3,31·а2+0,08·а3+3,05·а4-0,27·а5+2,69·а6+3,11·а7-6,47·a8-6,55·a9+1,99·а10+5,25·а11+7,07·a12-0,47·a13+0,13·a14+4,04·a15-1,0·a16-1,14·а17, correspondingly, where a1 - patient's age, a2 - studying either at the hospital or polyclinic, a3 - duration of stationary treatment (in days), a4 - unconscious period, a5 - terms of hospitalization since the moment of light close craniocerebral trauma, a6 - smoking, a7 - alcohol misuse, a8 - arterial hypertension, a9 - amnesia, a10 - close craniocerebral trauma in anamnesis, a11 - psychoemotional tension, a12 - meteolability, a13 - cervical osteochondrosis, a14 - ORL pathology, a15 - availability of perinatal trauma in anamnesis with pronounced hypertension-hydrocephalic syndrome, a16 - availability of paroxysmal activity, a17 - availability and manifestation value of dysfunction of diencephalic structures. At F1 ≥ F2 on should predict the development of remote aftereffects in young people due to evaluating premorbid background of a patients at the moment of trauma.
EFFECT: higher reliability of prediction.
2 ex, 1 tbl
FIELD: medicine; medical engineering.
SUBSTANCE: method involves doing multi-channel recording of electroencephalogram and carrying out functional tests. Recording and storing rheoencephalograms is carried out additionally with multi-channel recording of electroencephalogram synchronously and in real time mode in carotid and vertebral arteries. Electroencephalograms and rheoencephalograms are visualized in single window with single time axis. Functional brain state is evaluated from synchronous changes of electroencephalograms, rheoencephalograms and electrocardiograms in response to functional test. The device has electrode unit 1 for recording bioelectric brain activity signals, electrode unit 2 for recording electric cardiac activity signals, current and potential electrode unit 3 for recording rheosignals, leads commutator 4, current rheosignal oscillator 5, synchronous rheosignal detector 6, multi-channel bioelectric brain activity signals amplifier 7, electrophysiological signal amplifier 8, demultiplexer 9, multi-channel rheosignal amplifier 10, multi-channel analog-to-digital converter 11, micro-computer 12 having galvanically isolated input/output port and personal computer 13 of standard configuration.
EFFECT: enhanced effectiveness of differential diagnosis-making.
11 cl, 6 dwg
FIELD: medicine; medical engineering.
SUBSTANCE: method involves recording multichannel electroencephalogram, electrocardiogram record and carrying out functional test and computer analysis of electrophysiological signals synchronously with multichannel record of electroencephalogram and electrocardiogram in real time mode. Superslow brain activity is recorded, carotid and spinal artery pools rheoelectroencephalogram is recorded and photopletysmogram of fingers and/or toes is built and subelectrode resistance of electrodes for recording bioelectrical cerebral activity is measured. Physiological values of bioelectrical cerebral activity are calculated and visualized in integrated cardiac cycle time scale as absolute and relative values of alpha-activity, pathological slow wave activity in delta and theta wave bandwidth. Cerebral metabolism activity dynamics level values are calculated and visualized at constant potential level. Heart beat rate is determined from electrocardiogram, pulsating blood-filling of cerebral blood vessels are determined from rheological indices data. Peripheral blood vessel resistance level, peripheral blood vessel tonus are determined as peripheral photoplethysmogram pulsation amplitude, large blood vessel tonus is determined from pulse wave propagation time data beginning from Q-tooth signal of electrocardiogram to the beginning of systolic wave of peripheral photoplethysmogram. Postcapillary venular blood vessels tonus is determined from constant photoplethysmogram component. Functional brain state is determined from dynamic changes of physiological values before during and after the functional test. Device for evaluating functional brain state has in series connected multichannel analog-to-digital converter, microcomputer having galvanically isolated input/output ports and PC of standard configuration and electrode unit for reading bioelectric cerebral activity signals connected to multichannel bioelectric cerebral activity signals amplifier. Current and potential electrode unit for recording rheosignals, multichannel rheosignals amplifier, current rheosignals generator and synchronous rheosignals detector are available. The device additionally has two-frequency high precision current generator, master input of which is connected to microcomputer. The first output group is connected to working electrodes and the second one is connected to reference electrodes of electrode unit for reading bioelectrical cerebral activity signals. Lead switch is available with its first input group being connected to potential electrodes of current and potential electrodes unit for recording rheosignals. The second group of inputs is connected to outputs of current rheosignals oscillator. The first group of outputs is connected to current electrodes of current and potential electrodes unit for recording rheosignals. The second group of outputs is connected to inputs of synchronous detector of rheosignals. Demultiplexer input is connected to output of synchronous detector of rheosignals and its outputs are connected to multichannel rheosignals amplifier inputs. Outputs of multichannel bioelectrical cerebral activity signals amplifier, multichannel rheosignals amplifier and electrophysiological signal amplifier are connected to corresponding inputs of multichannel analog-to-digital converter. Microcomputer outputs are connected to control input of lead switch, control input of multichannel demultiplexer, control input of multichannel analog-to-digital converter and synchronization inputs of current rheosignals oscillator and synchronous detector of rheosignals. To measure subelectrode resistance, a signal from narrow bandwidth current generator of frequency f1 exceeding the upper frequency fup of signals under recording is supplied. A signal from narrow bandwidth current generator of frequency f2≠ f1>fup is supplied to reference electrode. Voltages are selected and measured at output of each amplifier with frequencies of f1, f2 - Uf1 and Uf2 using narrow bandwidth filtering. Subelectrode resistance of each working electrode is determined from formula Zj=Ujf1 :(Jf1xKj), where Zj is the subelectrode resistance of j-th electrode, Ujf1 is the voltage at output from j-th amplifier with frequency of f1, Kj is the amplification coefficient of the j-th amplifier. Subelectrode resistance of reference electrode is determined from formula ZA=Ujf2 :(Jf2xKj), where ZA is the subelectrode resistance of reference electrode, Ujf2 is the voltage at output from j-th amplifier with frequency of f2, Jf2 is the voltage of narrow bandwidth current oscillator with frequency of f2.
EFFECT: wide range of functional applications.
15 cl, 10 dwg
FIELD: medicine, psychiatry.
SUBSTANCE: one should conduct EEG-testing to detect total value of the indices of spectral power or percentage spectral power of delta- and teta-rhythms due to spectrometric technique in frontal, parietal, central and temporal areas both before and during emotional-negative loading when visual emotionally negative stimuli are presented followed by their imaginary reproduction. In case of higher indices to visual stimuli being above 15% against the background one should diagnose epilepsy. The method enables to increase the number of diagnostic means, increase accuracy and objectivity in predicting epilepsy with polymorphic paroxysms at dissociation of clinical and EEG-values.
EFFECT: higher efficiency of diagnostics.
1 ex, 1 tbl
FIELD: medicine, neurophysiology.
SUBSTANCE: one should carry out EEG survey to detect spectrometrically the index of full range if alpha-rhythm both before and after therapy. Moreover, power index of full range of alpha-rhythm and the index of 9-10 Hz-strip's spectral power should be detected in occipital cerebral areas. One should calculate the value of the ratio of the index of 9-10 Hz-strip's spectral power to the index of full range of alpha-rhythm and at the increase of this value by 20% against the background it is possible to evaluate positive result of therapy. The method increases the number of diagnostic means applied in evaluating therapeutic efficiency in the field of neurophysiology.
EFFECT: higher efficiency of evaluation.
FIELD: medicine, neurology.
SUBSTANCE: method involves carrying out the standard vascular and nootropic therapy. Diazepam is administrated under EEG control with the infusion rate that is calculated by the following formula: y = 0.0015x - 0.025 wherein y is the rate of diazepam administration, mg/h; x is an average EEG amplitude, mcV. Method provides enhancing the effectiveness of treatment of patients. Invention can be used for treatment of patients in critical severe period of ischemic insult.
EFFECT: enhanced effectiveness of treatment.
2 tbl, 1 dwg, 1 ex
SUBSTANCE: method involves selecting signals showing patient consciousness level and following evoked auditory potentials as responses to repeating acoustic stimuli, applying autoregression model with exogenous input signal and calculating AAI index showing anesthesia depth next to it.
EFFECT: quick tracing of unconscious to conscious state and vice versa; high accuracy of measurements.
9 cl, 3 dwg
FIELD: medicine; experimental and medicinal physiology.
SUBSTANCE: device can be used for controlling changes in functional condition of central nervous system. Device has receiving electrodes, unit for reading electroencephalograms out, analog-to-digital converter and inductor. Low noise amplifier, narrow band filter linear array which can be program-tuned, sample and store unit, online memory, microcontroller provided with controlled permanent storage, liquid-crystal indicator provided with external control unit are introduced into device additionally. Receiving electrodes are fastened to top part of patient's head. Outputs of electrodes are connected with narrow band filters linear array through electroencephalograph. Output of linear array is connected with input of input unit which has output connected with input of analog-to-digital converter. First bus of analog-to-digital converter is connected with online storage. Recording/reading bus of microcontroller is connected with control input of input unit and its starting bus is connected with address input of online storage. Third control bus is connected with narrow band filters linear array. Second control bus is connected with liquid-crystal indicator. Output bus is connected with inductor. External control (keyboard) of first control bus is connected with microcontroller. Output of online storage is connected with data input of microcontroller through 12-digit second data bus. Efficiency of influence is improved due to getting specific directed influence being based onto general technological transparency of processing of human brain's signals and strictly specific influence based on the condition of better stimulation.
EFFECT: increased efficiency.
3 cl, 1 dwg, 1 tbl
FIELD: medicine, neurology, professional pathology.
SUBSTANCE: one should carry out either biochemical blood testing and electroencephalography or SMIL test, or ultrasound dopplerography of the main cranial arteries, rheoencephalography (REG) to detect the volume of cerebral circulation and hypercapnic loading and their digital values. Then it is necessary to calculate diagnostic coefficients F by the following formulas: Fb/e=6.3-0.16·a1+0.12·a2-1·a3+0.2·a4, or FSMIL=9.6+0.16·a5-0.11·a6-0.14·a7+0.07·a8, or Fhem=48.6-0.04·a9+0.15·a10+13.7·a11-0.02·a12+24.7·a13, where Fb/e -diagnostic coefficient for biochemical blood testings and EEG; FSMIL - diagnostic coefficient for SMIL test; Fhem - diagnostic coefficient for hemodynamic testing; 6.3; 9.6 and 48.6 - constants; a1 - the level of vitamin C in blood; a2 - δ-index by EEG; a3 - atherogenicity index; a4 - the level of α-proteides in blood; a5 - scale 3 value by SMIL; a6 - scale K value by SMIL; a7 - scale 5 value by SMIL; a8 - scale 7 value by SMIL; a9 - the level of volumetric cerebral circulation; a10 - the value of linear circulatory rate along total carotid artery, a11 - the value of resistive index along total carotid artery; a12 - the value for the tonicity of cerebral vessels at carrying out hypercapnic sampling by REG; a13 - the value for the intensity of cerebral circulation in frontal-mastoid deviation by REG. At F value being above the constant one should diagnose toxic encephalopathy, at F value being below the constant - discirculatory encephalopathy due to applying informative values.
EFFECT: higher accuracy of diagnostics.
6 ex, 1 tbl