RU2101012C1 - Method to treat migraine - Google Patents

Abstract

FIELD: medicine, neurology. SUBSTANCE: method deals with preliminary revealing a sickliness at palpating the points of one or two branches of trigeminal ophthalmic, temporal-aural and occipital nerves that enter cerebral cavity, then bayonet-like prick of soft tissues is conducted till touching a nerve with a needle tip and appearance of painful lumbago at innervation area. Medicinal mixture containing 2.0% novocaine solution, vitamin B12 solution, 2.5% hydrocortisone water suspension, 2.0% papaverine and hydrochloride solution, physiological solution at components ratio of 10: 0.2: 1.0:1.0:1.0 is injected paraneurally into dominant focus at the quantity of 2.0-3.0 ml. EFFECT: higher therapeutic efficiency in treating migraine.

Description

 The invention relates to medicine, in particular to neurosurgery and neurology, and may find application for the treatment of insatiable pain in migraines.

 A known method of eliminating migraine attacks, including the use of ergot derivatives, giving a vasoconstrictor effect.

Intravenous administration of ergotamine in a dose of 3-6 mg / kg increases resistance in the external carotid artery by 90% and in the internal carotid by only 27%
A valuable property of ergot derivatives is also their ability to increase the tone of capacitive vessels, i.e. veins, improves venous return.

 The disadvantage of this method is the short duration of the result, the occurrence of relapses of migraine attacks and the need for rotary intravenous injections.

 A known method of treating migraine with antiserotonin drugs of dyseryl, femoxetine, as well as clonidine, acetylsalicylic acid and corticosteroids in therapeutic doses.

 The disadvantages of this method include the lack of complete cessation of painful migraine attack. It is necessary to increase the dosage of drugs with repeated use.

 The technical and therapeutic results obtained using the proposed method consist in the complete removal of insatiable pain in the dominant pain center after a single paraneural administration of an extemporaneous mixture of drugs, in a significant reduction in hydraulic compression of perineural and endoneural blood vessels, the absence of cosmetic defects in the injection zone and significant savings medications.

These results are achieved due to the fact that a mixture of a 2% solution of novocaine, a solution of 0.05% vitamin B ₁₂ , an aqueous suspension of hydrocartisone, a 2% solution of papaverine hydrochloride and physiological saline with a component ratio of 5: 1: 0.2: 1: 1, respectively 1-1.5 mixtures are injected paraneurally without damaging the inflamed sensory nerve. The latter immediately stops the pathological impulse, which the patient perceives as a severe attack of an insatiable headache.

 One of the main problems of medicine is to find the cause of an insatiable headache and a way to eliminate it.

 The accumulated research results and many years of practical experience allow us to conclude that pain is inflammation of the sensory nerve, and treatment is the elimination of inflammation. There is no pain without inflammation of the sensory nerve.

 The main clinical manifestation of migraine is a sudden attack of various durations, an attack, as a rule, of hemicrania, i.e. the pain is localized on one side of the head right or left. An attack may be preceded by an aura. The frequency of attacks is uncertain. Insatiable pain can be accompanied by nausea, vomiting, impaired consciousness. The duration of attacks is from several hours to a day. A pain attack can be accompanied by hypothalamic, hemialgic coloration and radicular cervico-occipital, chest, lumbosacral pains of the same side. Each attack has a specific pain dominant. Objectively, there are no sensory disturbances and neurological focal symptoms of organic lesions of the central and peripheral nervous system. As a rule, pain attacks develop on the side of chronic foci of infection, tonsillitis, paradantosis, sinusitis, otitis media. As a rule, the entire complex of these foci of infection is present against a background of partial immune deficiency. On the opposite healthy side, migraine attacks never happen. Outside of the attack, distinct subcompensated pain foci are revealed on the side of the foci of infection - pain, hyperesthesia at the entry points of the sensory nerves into the cranial cavity of the branches of the ternary nerve, ocular, temporo-ear, occipital, paravertebral points at the cervical, thoracic and lumbosacral levels.

 Almost all sensitive nerves and spinal sensitive roots of the same side of the location of the foci of infection are involved in the infectious-toxic process, as they have the lowest threshold for sensitivity to toxins. Such a clear and convincing pattern objectively confirms the infectious-toxic true cause of migraine attacks of an unquenchable unilateral headache. A migraine attack is another release of infectious toxins into the bloodstream. Their maximum concentration in the blood is always on the side of chronic foci of infection.

 Therefore, the treatment is aimed at ending the infectious and toxic effects on the sensory nerves, on the side of the location of chronic infectious foci, and their rehabilitation of the relief of dominant pain foci.

 Existing methods of treating migraine are pollicative, because they do not eliminate the true cause of the disease.

 The introduction of a 2% solution of papaverine hydrochloride into the extemporaneous mixture of drugs improves the trophism of the inflammatory sensitive nerve, i.e., its nutrition due to the vasodilator solution, ensures that the pH of the drug mixture is equalized to the pH of the tissue fluid in the innervation zone.

 The indicated ratios of drugs in their extemporal mixture provide the greatest anti-inflammatory, analgesic, neurotropic, decongestant and desensitizing effect. Injection of 1-1.5 ml of extemporaneous drug mixture allows avoiding a cosmetic defect at the injection site, hydraulic compression of perineural and endoneural blood vessels in the innervation zone. Injection, deposition of the mixture paraneurally, i.e. on three sides of the affected nerve, provides a guaranteed therapeutic effect due to the complete coverage of the affected sensitive nerve with a medicinal mixture.

A method of treating migraine, according to the invention, is as follows. After diagnosing and identifying the dominant pain focus, a bayonet-shaped puncture of soft tissues (at an angle of 90 ^° to their surface) is performed until the tip of the nerve touches the surface of the nerve, i.e. until a painful "lumbago" appears, then, pulling up the needle, slowly inject 1 ml of the mixture over the nerve. At an angle of 80 ^o immerse it in 1-2 mm and slowly inject 1-1.5 ml of a mixture of drugs from the nerve. Then the needle is again pulled up and immersed on the other side of the nerve to a depth of 1-2 mm and 1-1.5 ml of the mixture is again injected, i.e., the injection is carried out paraneurally. A mixture of drugs contains a 2% solution of novocaine, 0.05% solution of vitamin B ₁₂ , an aqueous suspension of hydrocortisone, 2% solution of papaverine hydrochloride and physiological saline with a component ratio of 10: 0.2, respectively. The development of anesthesia in the innervation zone confirms the correct injection. The feeling of numbness regresses after 10-15 minutes. Insatiable pain in the innervation zone disappears for many years. Re-injection of the drug mixture in the same place is excluded, because That is unnecessary.

 Example. Patient N-va complained of insurmountable paroxysmal pains in the left half of the head with nausea, vomiting, general weakness, palpitations, pains in the heart area, a sense of fear of death, suffocation, dizziness, changes in blood pressure, chills, desuric phenomena, and short-term loss of consciousness. The duration of the attacks is uncertain - from 30 minutes to several hours. Attacks often develop spontaneously. Provoke an attack of emotional stress, overwork, hypothermia, acute respiratory infections, influenza, menstruation. The disease is about ten years old. The frequency of seizures is not countable.

 The day before the attack, general weakness, drowsiness, and decreased performance may develop. Against this background, a progressive decrease in vision develops in the left eye, in its outer half, until the vision disappears completely. After that, luminous dots of various sizes and brightness appear in the blinded outer half of the field of view. They may disappear. Instead, a luminous strip appears with a changing width and brightness. The duration of this condition varies from 1 to 20 minutes. Sometimes a migraine attack occurs without a visual aura.

 For the first time, pain appeared after severe flu in the form of tolerant backache in the left temporal region with spread to the forehead. Short-term attacks became more frequent, lengthened, their intensity increased, spread to the entire left half of the head. They became insatiable.

 Traditional outpatient and inpatient treatment provided temporary relief, and over the past years, drug therapy did not alleviate suffering. Drug allergy, gastroduodenitis, calculous cholecystitis. A comprehensive study revealed a distinct migraine syndrome with left-sided hemicranialgia, combined with hypothalamic paroxysms.

 Percussion of the head is painless. Severe painful palpation of entry points into the cranial cavity of 1-2 branches of the trigeminal nerve on the left, ocular, temporo-ear, occipital nerves. Hypesthesia is also determined here.

 Focal and cerebral symptoms of brain damage were not detected. The fundus without pathology. An otoneurological examination revealed left-sided sinusitis, otitis media, and chronic tonsillitis.

 On the review craniograms, there is no focal pathology. Computed tomography without focal pathology. EEG diffuse changes in bioelectric activity. Echo-EG without displacement of secondary structures.

 Based on a comprehensive examination, the diagnosis of migraine was established.

Drug therapy is discontinued. The patient was once given paraneural injection into the dominant focus of the extemporaneous mixture of drugs novocaine 2% solution, 0.05% solution of vitamin B ₁₂ , an aqueous suspension of hydrocortisone and physiological solution, with a ratio of components 10: 0.2: 1: 1: 1 by means of a bayonet-shaped puncture soft tissues with a needle 2 cm long, 0.1 mm in diameter in the zone of the dominant pain focus of the projection of the 1st branch of the trigeminal nerve, ophthalmic, temporomandibular, occipital, until it touches the surface until the pain "cross" in the innervation zone. Pulling the needle, 1 ml of the mixture is slowly injected over the nerve. At an angle of 80 ^o she immersed in 2 mm and slowly introduced 1.5 ml of the mixture from the side of the nerve. Then the needle is again pulled up and immersed 2 mm on the other side of the nerve and 1.5 ml of the mixture are again introduced. A mixture of drugs was injected on three sides of the nerve. The development of anesthesia in the autonomous innervation zone confirmed the paraneural administration of the mixture.

 A feeling of numbness regressed after 10-15 minutes. Insatiable pain attacks in the zone of the 1st branch of the trigeminal, ophthalmic, temporal-ear and occipital nerves regressed. Nausea, vomiting, palpitations, chills, fear of death stopped, sleep was normalized, blood pressure stabilized 120/70 mm Hg. dysuric phenomena, impaired consciousness disappeared.

 The annual follow-up examination of the patient does not reveal signs of migraine for four years.

Claims (1)

A method of treating migraine by administering drugs, characterized in that pain is detected on palpation of the entry points into the cranial cavity of the first and second branches of the trigeminal ocular, temporo-ear and occipital nerves, a bayonet-shaped soft tissue puncture is performed until the tip of the nerve touches the needle and pain appears " lumbago "in the innervation zone and a mixture of drugs containing 2.0% ethyl novocaine solution, a solution of vitamin B _{February 1,} 2.5% aqueous suspension of hydrocortisone, 2.0% solution of papaverine, Physiological matic solution at a component ratio 10.0 0.2 1.0 1.0 1.0 is introduced in paraneural dominant center in the amount of 2 3 ml.