RU2149659C1 - Method for treating the consequences of craniocervical trauma - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves exposing scalp of a patient to contact laser radiation therapy. Wavelength is equal to 0.82-0.02 mcm, operation mode is pulsating one, frequency is 30-50 Hz, impulse power is 50 mW. The treatment course is 10 procedures long. EFFECT: enhanced effectiveness of treatment. 4 tbl

Description

 The invention relates to medicine, in particular to neuropathology.

 A known method of treatment with laser exposure to biologically active points in diseases of the nervous system (Fundamentals of laser physical and reflexotherapy. / Edited by prof. O. Skobelkina. - Samara-Kiev: Health, 1993. - S. 134 - 153). In this case, helium is exposed to a neon laser on acupuncture points for 30-60 seconds (according to the generally accepted reflexotherapy technique) with a wavelength of 0.63 microns at a power of 5 to 10 mW, and up to 10 to 15 procedures per treatment course. This method of treatment provides relief of autonomic dysfunctions, a sedative effect, but since the biologically active points used are usually located at a considerable distance from the lesion, the effectiveness of the treatment is reduced.

 The essence of the invention lies in the fact that they carry out the action of laser radiation on special biologically active zones located in a certain order in the scalp area. The radiation wavelength is 0.82 + 0.02 μm, the radiation mode is pulsed, the radiation frequency is 30 - 50 hertz, and the pulse power is 50 mW.

 When low-intensity laser radiation acts on biological tissues, it has a multifunctional effect, in particular, it enhances microcirculation, increases the level of redox reactions, and helps normalize vascular tone.

 The method is as follows: in the position of the patient sitting, the light guide is installed on the scalp of the patient in accordance with the location of biologically active zones on the skull and carry out uniform contact action over the entire projection of the zone for 20 to 30 seconds. After the specified time, the effect is transferred to the next zone. In one session, 5 zones are processed. The procedure is carried out daily. There are 10 procedures per treatment course.

Exposed Areas
To determine the localization of biologically active points on the scalp area, two installation lines must be distinguished:
1) medial line - connecting the in-tan point (in the middle of the distance between the inner edges of the eyebrows) and the point in the middle of the lower edge of the outer occipital protuberance. In the middle of this line is the central point.

 2) a horizontal line - which connects the upper edge of the eyebrows and the lower edge of the external occipital protuberance.

The treatment course used 5 exposure zones:
1) motor zone - it starts 0.5 cm posteriorly from the central point and ends at the intersection of the horizontal line with the center of the temporal bone;
2) the sensitive zone runs parallel to the motor zone posteriorly by 1.5 cm;
3) the dizziness zone - above the apex of the auricle at a distance of 1.5 mm (this is a horizontal line - its length is 1.5 cm);
4) the zone of vision - 1 cm above the external occipital protuberance - 3 cm long;
5) the psyche zone - from the external occipital tubercle to the second spinous process of the cervical vertebra.

 The method is illustrated by the following examples.

 Patient S., 53 years old, medical history N 51, was treated in the neurological department of the Pyatigorsk clinic from 02/04/95 to 02/27/95.

 Upon admission, she complained of periodic headaches in the frontal, parieto-occipital region, more to the left, of a pulsating nature, aggravated by changing weather, overwork, stressful situations; for irregular dizziness, noise, ringing in the ears, flickering of “flies” in front of the eyes, rapid fatigability, weakness, pain in the cervical spine, periodic heartbeat, stitching pains in the heart area. From the anamnesis it is known that in January 1992 she fell during ice, having hit the back of her head with over-extension in the cervical spine (SHOP). Short-term loss of consciousness was noted within a few seconds, then - headache, nausea, vomiting once. Within a month she was treated in a hospital, was discharged with improvement. She is registered with a neuropathologist and regularly receives outpatient drug therapy courses. Before the injury, the above complaints did not bother. Objectively in somatic status without pathology. At a neurological examination: the consciousness is clear, emotionally labile, tearful, intellectually preserved. The palpebral fissures are d = s, the eyeballs do not bring out slightly, the convergence act is weakened, the tongue is in the midline. Muscle strength is good, tendon and periosteal reflexes are evenly revitalized, without a convincing difference of sides. There are no pathological stop signs. Easy staggering in the Romberg position, tremor of the eyelids and fingers of outstretched hands, coordinating tests satisfactorily performed. Distal hyperhidrosis. Cervical lordosis is smoothed, with palpation soreness of points of vertebral arteries on both sides. On REG - a decrease in blood supply, arterial hypertension, difficulty in venous outflow. On the EEG, a disorganized alpha rhythm. On X-ray photographs of SHOP in two projections with functional tests - osteochondrosis of the cervical spine. ECG without pathology. Ophthalmic status is normal. Final diagnosis: long-term consequences of combined cranio-cervical injury (CCT), syndromes: asthenic, vegetovascular dystonia. Osteochondrosis of the cervical spine, vertebral artery syndrome. After a comprehensive balneological treatment using laser scalping (the affected areas are motor, sensitive, dizziness, vision, psyche), with a frequency of 50 Hz for 30 seconds, a wavelength of 0.82 μm, a power of 50 μm), the patient's condition improved significantly: headaches stopped pain, dizziness, pain in the shop, fatigue decreased. On repeated EEG - without pathology, the alpha rhythm dominates. On REG - improved blood supply, cerebral vascular tone within normal limits, improved venous outflow from the cranial cavity. Discharged in satisfactory condition, recommendations on the house.

 Patient P., 36 years old, medical history N 96, was treated in the neurological department of the Pyatigorsk clinic from 4.06.95 to 06.27.95. Upon admission, she complained of headaches of a compressive nature in the occipital region, unsystematic dizziness, irritability, weakness, temper, tendency to lower blood pressure, pain in the cervical and thoracic spine, numbness of the left arm, aching pain in the heart. From the anamnesis it is known that in January 1993 she fell during ice, having hit her head. There was no loss of consciousness, was not treated. After 2 months, the above complaints appeared. Passed a course of outpatient treatment with a good effect. Objectively, in the somatic status of the pathology is not revealed. In neurological status: the patient is emotionally labile, focused on her feelings. Cranial nerves - without pathology. Tendon and periosteal reflexes are lively, more to the right. There are no pathological foot reflexes. In the Romberg position - stable, tremor of the eyelids, in a complicated position ~ uniform swaying. Smoothed cervical lordosis, scoliosis in the thoracic spine. Limited scope of movements in the SHOP in all directions. On REG - a moderate decrease in blood supply, a slight increase in vascular tone. On the EEG - beta rhythm in all areas, there are no zonal differences. The reaction of depression to light and sound is absent, pathological signs are not registered. On X-ray photographs of SHOP in two projections with functional tests - osteochondrosis of the cervical spine. ECG - without pathology. Final diagnosis: long-term consequences of combined CCT; syndromes: vegetovascular dystonia, neurosis-like. Osteochondrosis of the cervical, thoracic spine, cervicalgia syndrome, thoracalgia with muscular-tonic manifestations, projection cardialgia syndrome. After a comprehensive balneotherapy using laser scalping (the affected areas are motor, sensitive, dizziness, vision, psyche), with a frequency of 50 Hz for 30 seconds, a wavelength of 0.82 microns, a power of 50 mW), headaches, dizziness, pains significantly decreased in the spine, there were pains in the heart, irritability. On repeated REG - normalization of vascular tone. EEG - without pathology. Discharged in satisfactory condition with relevant recommendations. At the same time, patients received a course of massage, physiotherapy exercises, radon baths (temperature 37 degrees, exposure 15 minutes, 10 procedures per course), the treatment was easily tolerated.

 Patient M., 56 years old, medical history N 60, was treated in the neurological department of the Pyatigorsk clinic from 01.03.95 to 03.24.95. Upon admission, he complained of constant headaches of a bursting nature in the occipital, frontal region, periodically intensifying , for unsystematic dizziness, poor sleep, memory loss, fatigue, weakness, irritability, pain in the cervical spine, aggravated by turning the head. From the anamnesis it is known that in 1989 in a mine he received a blow to the head with a metal object. There was a loss of consciousness within a few minutes, then a headache, nausea, and vomiting. He was treated in a hospital with a diagnosis of concussion. Discharged with improvement. Consists of a "dispensary" account with a neurologist. He regularly receives inpatient and outpatient treatment courses 2–3 times a year. Before the injury, the above complaints did not bother. The last year marks a deterioration in overall well-being, headaches, pains in the cervical spine took on a permanent character. In neurological status: the patient is emotionally stable, oriented, answers the questions correctly. The palpebral fissures d = s, does not bring the eyeballs outward, nystagmoid movements when looking to the right, the convergence act is weakened, the pharyngeal reflex on the left is reduced. Tendon and periosteal reflexes are evenly revitalized, without a convincing difference of sides. Induced reflexes of oral automatism (proboscis, Marinescu-Radovici on both sides, Rossolimo-Venderovich). No sensory disturbances. In the Romberg position - staggering, in the complicated - unstable, slight intentional trembling when performing a finger-nasal test on the right. Cervical lordosis is smoothed, palpation tenderness of the spinous processes, points of the vertebral artery on the right, limited range of movements in the SHOP in all directions. On REG - blood supply is reduced, spasm of small arteries. A disorganized rhythm is recorded on the EEG, there are no zonal differences, the reaction of depression to light and sound of an excitable type, insignificant pathological activity in the middle structures of the brain in the form of single slow sharp waves. On the fundus - uneven caliber veins. ECG - sinus rhythm, moderate disturbances in the processes of repolarization in the posterior wall of the left ventricle. On X-ray photographs of SHOP in two projections with functional tests - osteochondrosis of the cervical spine. Final diagnosis: long-term consequences of combined cranio-cervical trauma, chronic cerebral arachnoiditis. Osteochondrosis of the cervical spine, vertebral artery syndrome, cervicalgia syndrome. After the balneological treatment in combination with laser therapy according to the generally accepted reflexology methodology for BAP (wavelength 0.63 μm, frequency 10 Hz, power 10 mW for 30 seconds per point of exposure), the patient's condition improved slightly, headaches decreased in intensity and frequency of occurrence but they weren’t completely stopped. Pain in the cervical spine, fatigue remained. No dynamics of neurological status followed. On repeated REG and EEG - the data are the same.

 Treatment according to the proposed method was carried out in the conditions of the Pyatigorsk clinic in 120 patients with long-term consequences of cranio-cervical trauma (60 patients in the main and control groups). In the main group, treatment was carried out according to the method of the invention, in the control group according to the method of the prototype (laser exposure was performed on BAP in accordance with the generally accepted reflexology technique). Laser puncture is carried out daily, 10 procedures per course. Both groups of patients according to the main clinical characteristics were approximately the same (table. 1).

 Analysis of the treatment results by the proposed and known method revealed a positive dynamics of clinical and electroencephalographic parameters in patients of both groups, but it turned out to be more significant in patients treated with the proposed method (table. 2).

 According to the table. 2 positive dynamics of clinical symptoms (disappearance and reduction of symptoms during treatment) significant (P <0.05 - 0.001) prevailed in the main group. Thus, the percentage of disappearance of asthenia syndrome was 70% in the main group, 20% in the control group (P <0.001), 53.3% and 3.3% in the vestibular group (P <0.05), and auditory nerve neuropathies 33% and 5 % (P <0.05).

 The dynamics of electroencephalographic indicators are given in table. 3 and 4.

 Thus, as can be seen from the table. 3 and 4, patients showed a positive dynamics of the state of bioelectric activity of the brain, which reflects functional changes in the central nervous system. So in patients of the main group, the number of patients with the main alpha rhythm on the EEG increased from 8 to 41 (by 55%), in the control from 3 to 20 (by 28.3%), the number of patients with paroxysms of slow-wave activity in the main group decreased from 21 to 2 (by 31.7%), and in the control group from 8 to 7 (by 1.7%). In the main group, the functional activity of the cortex improved from 15 to 35 patients (by 33.3%), and in the control group from 14 to 17 people (by 5%).

 Based on the foregoing, determines the advantage of the proposed method of treatment in comparison with the prototype. We attribute the more pronounced effect of laser scalping to the presence of a closer anatomical and functional connection of biologically active zones on the skull with the meninges, the cerebral cortex, as well as non-glycemic regulatory structures of the reticulo-limbic system.

Claims (1)

 A method of treating patients with the consequences of cranio-cervical trauma (laser therapy) by exposure to low-intensity laser radiation, characterized in that at first two installation lines on the skull are determined: the medial line connecting the implant point in the middle of the distance between the inner edges of the eyebrows and the point in the middle of the lower edge external occipital protuberance, in the middle of this line there is a central point, horizontal, connecting the upper edge of the eyebrows and the lower edge of the external occipital protuberance; then biologically active zones of influence are determined: motor - starts at 0.5 cm posterior to the central point and ends at the intersection of the horizontal line with the center of the temporal bone; sensitive - runs parallel to the motor zone posteriorly by 1.5 cm, the dizziness zone - above the apex of the auricle at a distance of 1.5 mm - along a horizontal line 1.5 cm long; the visual zone is 1 cm higher than the external occipital protuberance - 3 cm long, the psyche zone is from the external occipital protuberance to the second spinous process of the cervical vertebra, after which laser therapy is performed with a radiation wavelength of 0.82 - 0.02 μm, the radiation mode is pulsed, the radiation frequency is 30 - 50 Hz, the pulse power is 50 mW, contact, evenly on these zones, using 5 zones per session, for 10 days.

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