RU2464049C1 - Method of treating encephalopathy - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely - to physiotherapy, neurology. The method involves exposure to extremely high-frequency radiation. The exposure is performed at wave lengths 4.9 mm and 7.1 mm alternated every second day. The exposure is performed in a continuous mode of power 10 mWt/cm². The four fields are exposed. At first, the exposure is performed on side of the greatest cerebral involvement. The exposure on a projection of a vertebral artery is suboccipital. The exposure is directed forward under base of the skull. It is followed by the exposure on a projection of a neurovascular beam behind angle of the jaw under an auricle. The exposure is directed backwards under base of the skull. Then the exposure is applied to a contralateral side. The exposure takes 4 minutes for each field. The therapy is assisted by EEG-control. The procedures are daily. The therapeutic course is 10 procedures.

EFFECT: method provides higher clinical effectiveness ensured by optimising activation of cerebral adaptation-compensatory systems.

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Description

The invention relates to medicine, namely physiotherapy, neurorehabilitation, neurology, neurosurgery, and can be used to treat patients with encephalopathy of traumatic, vascular, inflammatory and other genesis.

A known method of treating perinatal encephalopathy by exposure to EHF radiation with a frequency of 61.5 GHz (wavelength 4.9 mm) on one or more acupuncture points for 5-15 minutes each. The course of treatment consists of 7-10 daily procedures, the number of which can be increased to 15-20 (Physical factors in the treatment of cerebral palsy. / Edited by N.A. Usakova and R.G. Krasilnikova. - M.: Soviet Sport , 2006. - P.93). The method does not allow purposefully and optimally activate the adaptive-compensatory reactions of the brain, since the impact on the acupuncture points causes a wide range of changes throughout the body; in the used range of EHF radiation, there is no 7.1 mm wavelength with the most pronounced effect of restoring the function of the brain and its bioelectric activity (Lebedeva N.N., Tarasova O.P. Use of spatio-temporal organization of human brain biopotentials with peripheral exposure to EHF- radiation // Millimeter waves in medicine. - M., 1991. - T.1. - P.187-197; Godlevsky L.S., Nizov V.N., Zaporozhan V.N., Rebrova TB The effect of low-intensity electromagnetic fields on excitation generators in the cerebral cortex. // Ibid. - P.257-264). In addition, the method is not used for the treatment of encephalopathy of a different genesis.

There is a method of treating traumatic encephalopathy with symptomatic epilepsy by exposure to 4.9 mm EHF radiation to a point of the collar zone under the seventh spinous cervical process for 20 minutes 2 times a week with a course of 15 procedures (Pashnin A.G., Lebedeva N.P. ., Avakyan GN The use of extremely high-frequency therapy in patients with pharmacoresistant epilepsy. // Vopr kursor. - 2007. - No. 2. - S.12-14). However, the known method does not allow to optimally activate the adaptive-compensatory reactions of the brain, since it does not use a wavelength of 7.1 mm with the most pronounced effect of restoring brain functions and its bioelectric activity. In addition, the method is not used for the treatment of encephalopathy of a different genesis.

A known method for the treatment of discirculatory encephalopathy by exposure to EHF-radiation with a wavelength of 4.9 mm in a pulsed mode on the shoulder joint heterolateral with respect to brain damage for 18 minutes with a course of 10 procedures. The method provides a decrease in fibrinogen B in blood plasma and a preferential improvement of cerebral blood flow in the carotid pool (Karlov V.A., Rodshtat I.V., Kalashnikov Yu.D., Kitaeva L.V., Khokhlov Yu.K. EHF-disseminated therapy intravascular coagulation in vascular diseases of the brain and spinal cord. // Millimeter waves in medicine. - M., 1991. - T.1. - P.82-91). The method does not allow to optimally activate the adaptive-compensatory reactions of the brain due to the deficit of a significant positive effect on the vertebrobasilar blood flow and the functioning of the subcortical-stem regulatory systems of the brain. In addition, the method is not used for the treatment of encephalopathy of a different genesis.

Closest to the claimed method is a method of treating encephalopathy (RF patent No. 2131277, publ. 06/10/1999, bull. No. 16), adopted as a prototype. EHF radiation affects the palmar surfaces of both hands and the plantar surfaces of both feet with wavelengths of 5.6 mm and 7.1 mm, alternating them every other day, with a power of 10 mW / cm ² , in continuous mode, in 4 fields of 2-7 min for each daily for 5-10 days under EEG control. According to the prototype, the adaptive-compensatory reactions of the brain are activated through the action of EHF radiation on the peripheral receptor fields, which is possible provided that feedback of the central nervous system and the peripheral nervous system is maintained.

However, the prototype is not effective enough for the treatment of encephalopathy in the formed stable pathological state of the brain with a gross violation of the feedbacks of the central nervous system and peripheral nervous system (Ankylosing spondylitis, healthy and sick human brain. - L .: Nauka, 1980. - 208 p.).

The invention is aimed at creating a method for the treatment of encephalopathy, which provides an increase in the effectiveness of treatment by optimizing the activation of adaptive-compensatory systems of the brain.

The specified technical result in the implementation of the invention is achieved by the fact that in the known method of treating encephalopathy by exposure to EHF radiation of two wavelengths alternating every other day, in a constant mode with a capacity of 10 mW / cm ² , in 4 fields with a course of 10 daily procedures under EEG control , the peculiarity lies in the fact that they act on the side of the greatest brain damage on the projection of the vertebral artery suboccipitally, the radiation is directed anteriorly under the base of the skull, then on the projection of the neurovascular bundle around an angle of the jaw under the auricle, the radiation is directed posteriorly under the base of the skull, after which it acts on the contralateral side, the effect is carried out at wavelengths of 4.9 mm and 7.1 mm for 4 minutes per field.

The impact of EHF radiation on the projection of the vertebral artery suboccipitally before entering the cranial cavity improves blood flow in the vertebrobasilar basin and activates compensatory reactions of the brain stem and structures of the posterior cranial fossa.

The influence of EHF radiation on the projection of the neurovascular bundle around the angle of the lower jaw under the auricle at the medial edge of the upper third of the sternocleidomastoid muscle improves blood flow in the carotid pool and activates the compensatory reactions of the cortical-subcortical (including the ancient cortex) and median stem structures brain - neuroaxonal pathways, nuclei, reticular formation, thalamus, centers of autonomic innervation. This is due to the fact that both vascular structures - the internal carotid artery and jugular vein, and nerve - the upper cervical sympathetic ganglion and the caudal group of cranial nerves (VII-XII) are exposed to radiation.

The impact on the side of the greatest brain damage prevents the "robbery" syndrome. The directivity of the radiation towards each other on each side creates the effect of cumulation of energy of millimeter radio waves in the region of all significant neurovascular structures that affect blood circulation and the functional state of the median stem structures and deep cortex in the basal parts of the brain. Bilateral effect provides a holistic therapeutic effect on significant median stem formations of the brain, activates cerebrospinal fluid circulation in the basal tanks of the brain. The small penetrating power of EHF radiation prevents the occurrence of adverse shifts in the functional activity of the brain.

Exposure to EHF-generation by a wavelength of 7.1 mm provides the optimal mode for activating adaptive-compensatory reactions of brain systems, and a wavelength of 4.9 mm - to improve blood flow and brain metabolism. Not only arterial, but also difficult to correct venous component of cerebral blood flow improves (Sokolov B.A., Bezruchenko S.V., Kunitsyna L.A. Comparative assessment of the influence of an electromagnetic field of extremely high frequency on cerebral hemodynamics in patients with hypertension when exposed to various reflexogenic zones. // Vopr kurortol. - 1998. - No. 1. - P.16-18). This is extremely important for cerebral blood flow with limited anatomical spaces, when even slight venous congestion and edema can cause a significant deterioration in brain function.

The method is as follows.

EHF-therapy is performed using apparatus that generates EHF radiation with a wavelength of 4.9 mm and 7.1 mm with a power of 10 mW. The continuous mode and duration of exposure to 1 field are set for 4 minutes. They act percutaneously, contact by a stable technique. The waveguide diameter is 2 cm.

In 1 procedure, they are exposed to EHF radiation with a wavelength of 4.9 mm. First, the waveguide is installed in the projection of the vertebral artery suboccipitally on the side of the greatest brain damage so that the radiation is directed anteriorly under the base of the skull.

Then the waveguide is installed around the angle of the lower jaw under the auricle at the medial edge of the upper third of the sternocleidomastoid muscle on the same side so that the radiation is directed posteriorly under the base of the skull.

After that, the waveguide is installed in the same sequence on the contralateral side.

In the case of diffuse brain damage, an effect on the left begins (projections of the neurovascular structures of the dominant hemisphere of the brain).

In procedure 2, they are exposed to EHF-radiation with a wavelength of 7.1 mm according to the above scheme. In the following procedures, wavelengths alternate. The course of treatment consists of 10 daily procedures and is carried out under EEG control.

EEG studies are performed immediately before and after treatment. In the presence of positive clinical and EEG indicators, it is advisable to repeat the course of treatment after 6 months - 1 year or according to indications after 1-3 months. In the absence of positive dynamics in the EEG or the manifestation of a pacemaker of a negative reaction, which indicates the depletion of the resource capabilities of the protective adaptive-compensatory brain reactions, EHF therapy using this technology is impractical.

The method has passed clinical trials in the clinic of the Institute of Physics and Mathematics of the Russian Academy of Sciences in the treatment of 65 patients aged 12 to 68 years. The average age was 44.2 ± 1.7 years. There were 20 men and 45 women. Dyscirculatory encephalopathy was detected in 25 patients, traumatic in 24, encephalopathy due to inflammatory diseases of the brain in 8, brain tumors in 4 and degenerative-dystrophic brain damage in 4 patients. 16 patients had cerebral spastic paralysis, of which 5 were post-coma syndrome and 7 were speech disorders. 11 patients had impaired cranial nerve function, of which 9 sensorineural hearing loss and vestibulopathy were detected. Chronic daily headache was experienced by 22 patients, diencephalic syndrome 5, asthenic disorder 6 and epileptic syndrome 5 people. The pain level on the YOUR scale was 8.2 ± 0.3 points.

In the EEG picture, its quantitative analysis showed a decrease in power and disorganization of alpha activity, widespread and local changes in the bioelectric activity of the brain.

All patients underwent a course of EHF-therapy according to the proposed method. Immediately after treatment, in most patients, there was a significant improvement or improvement, which consisted in reducing the severity of the stable pathological state of the brain due to the activation of compensatory-adaptive reactions of the brain. In the clinical picture, relief or a significant decrease in the symptoms of hyperactivity in the form of pain, insomnia, irritability, spasticity of paretic muscles was observed. A significant decrease in hypoactivity symptoms was noted in the form of exhaustion, weakness, paresis depth, speech impoverishment, articulation weakness, etc. An increase in the average spectral power of alpha activity, a decrease in common and local changes in the bioelectric activity of the brain were noted in the EEG picture during its quantitative analysis.

Significant improvement occurred in 49 (75.4%) patients and an improvement in 13 (20.0%) patients. The level of pain on the VAS scale after treatment was 2.3 ± 0.1 points (t = 18.4). Patients noted reduction and relief of headache after 3-5 procedures. After treatment, the headache was stopped in 16 (72.7%), its degree was significantly reduced in 6 (27.3%). There were no changes in the condition of 3 (4.6%) patients due to the depletion of adaptive-compensatory brain reactions.

The decrease in symptoms of hyperactivity in the brain systems persisted in the nearest follow-up up to 2 months (no pain) and long-term up to 1 year (decrease in the frequency and intensity of pain attacks). The restoration of symptoms of hypoactivity (speech, movements, skills, other brain functions) achieved as a result of treatment was maintained in the near and distant past history. This indicated a prolonged optimization of the activation of adaptive-compensatory reactions of the brain under the influence of EHF-therapy according to the proposed method.

We give examples - extracts from medical records.

Example 1. Patient P., 30 years old, medical history No. 50, was treated from 01/17/2011 to 02/25/2011 with a diagnosis of Discirculatory encephalopathy. Chronic daily headache. Upon receipt of a complaint of a constant headache of a pulling and pulsating nature, occipital localization, radiating to the neck on the back surface. The pain level on the YOUR scale was 8.1 points. During the examination, there was a sharp pain in the projections of the vertebral arteries, more pronounced on the right. An ophthalmic examination revealed retinal angiopathy. An X-ray examination revealed a Kimmerly anomaly - a sign of compression of the vertebral arteries at a suboccipital level. The data of ultrasound scan indicated pronounced venous dyshemia of the hypotonic type in the internal jugular veins. Dysmetabolic changes in the myocardium were detected in the ECG.

An EEG study on January 24, 2011 revealed slight diffuse changes in the bioelectrical activity of the brain against dysfunction of the median stem structures at a diencephalic level, moderately pronounced local changes in the bioelectrical activity of an irritative nature in the right fossa in the resting and functional loads. The spectral power of alpha activity averaged over 19 leads was 21.1 uV ² .

According to the proposed method, from 01/25/2011 to 02/09/2011 a course of EHF-therapy was carried out using the apparatus "EHF-ND" of 10 daily procedures. In 1 procedure, EHF radiation of a wavelength of 4.9 mm irradiated 4 fields of 4 minutes each, placing the waveguide in the projection of the vertebral artery suboccipitally and then around the angle of the lower jaw under the auricle, first to the right, and then to similar areas to the left. In the second procedure, they were exposed to EHF radiation with a wavelength of 7.1 mm similarly.

After the first 3 procedures, the pain syndrome was completely stopped (0 points on the YOUR scale). During the course of treatment, an ECG was performed on January 28, 2011, which showed a decrease in the severity of changes in the ventricular complex, the ST segment returned to the isoline, T from a weakly negative became isometric. At the end of the course of treatment, the patient felt fine, noted a significant increase in activity and performance.

A control EEG study showed an increase in alpha rhythm power and a decrease in the severity of local changes. The averaged over 19 leads spectral power of the EEG in the alpha range increased and amounted to 41 μV ² .

Example 2. Patient U., 50 years old, medical history No. 1369, was treated from 11/16/2010 to 12/29/2010 with a diagnosis of Encephalopathy of traumatic origin. Benign intracranial hypertension. Chronic daily headache. In youth, as a result of an accident, she suffered a severe intracranial injury with a long period of impaired consciousness, after which she suffers from a chronic headache of aching nature of the frontooccipital localization without clear lateralization, fatigue and weakness, and decreased working capacity. In neurological status without convincing pathological signs. The intensity of the pain syndrome is 6.8 points on the YOUR scale. An ophthalmological study did not reveal changes in the state of the vessels in the fundus. According to the ECG and echocardiography, pathology was also not detected. Doppler ultrasound revealed hypertensive venous dyshemia. MRI showed a low location of the cerebellar tonsils - in the cavity of the large occipital foramen, osteochondrosis C5-6-7 without conflict with the roots. On MRI and EchoEG signs of expansion of subarachnoid spaces were found.

An EEG study on November 18, 2010 revealed moderate diffuse changes in bioelectric activity - a decrease in ascending thalamocortical influences, hypoactivity of stem structures, and a decrease in the functional activity of neurons in the cerebral cortex. The spectral power of the EEG averaged over 19 leads in the alpha range was 1 μV ² .

According to the proposed method, from 07/12/2010 to 12/30/2010 a course of EHF-therapy was carried out using the apparatus "EHF-ND" of 10 daily procedures.

After the course of treatment, positive clinical dynamics were noted, which consisted in stopping the headache (0 points on the YOUR scale), increasing activity and working capacity.

During the control EEG study, an increase in the activity of stem structures and ascending thalamocortical influences was noted, the power of alpha activity became larger, and in the spectral analysis, the spectral power of the EEG averaged over 19 leads in the alpha range increased to 3.6 μV ² .

Example 3. Patient K., 68 years old, medical history No. 36, was treated from 01/13/2001 to 02/10/2011 with a diagnosis of Encephalopathy of degenerative-dystrophic origin. Benign intracranial hypertension syndrome. Intellectual-mnestic disorders. Upon receipt of a complaint of a diffuse headache of a aching character with irradiation on the back of the neck, a feeling of constant heaviness in the head, memory loss, distracted attention, dizziness, tinnitus, insecurity when walking, rare fainting conditions. The pain level on the YOUR scale was 2.8 points. A history of prolonged work with radioactive substances, under the influence of which a money-dystrophic process in the thyroid gland developed. For a long time suffers from a nodal form of autoimmune thyroiditis. During the examination, there was a sharp pain in the projections of the vertebral arteries, more pronounced on the right. An ophthalmological study revealed hypertensive retinal angiopathy. In the ECG there were signs of myocardial infarction on the front wall of the left ventricle, chronic coronary insufficiency. An MRI study revealed focal changes in the subcortical white matter of both frontal lobes, the expansion of subarachnoid spaces above the parietal lobes and ventricles of the brain, indicating a degenerative and dystrophic and atrophic process in the brain.

An EEG study on January 17, 2011 indicated diffuse changes in the bioelectric activity of the brain according to the paroxysmal type with changes in the irritative nature in the projection of both temporal regions without interhemispheric asymmetry. In this case, paroxysmal activity can be regarded as a manifestation of the protective reactions of the brain in connection with a progressive dystrophic process in the brain. The average power of the EEG spectra in the alpha range was 14 μV ² .

According to the proposed method, from 01/21/2011 to 01/31/2011 a course of EHF-therapy was carried out using the apparatus "EHF-ND" of 10 daily procedures.

After each procedure, the patient felt "light in the head." After treatment, the pain syndrome was stopped (0 points on the YOUR scale). At the end of the course of treatment, the patient noted an improvement in health and general condition, increased activity, easier remembering and concentration.

A control EEG study on 02/03/2011 indicated a decrease in the disorganization of basic rhythms and a decrease in the amplitude of paroxysmal patterns, which indirectly indicated a decrease in the degree of progression of the degenerative-dystrophic process in the brain. The average power of the EEG spectra in the alpha range increased and amounted to 22 μV ² .

Example 4. Patient T., 57 years old, medical history No. 1253, was treated from 11/01/2010 to 12/29/2010 with a diagnosis of Encephalopathy of mixed origin (traumatic, discirculatory). Benign intracranial hypertension. Chronic daily headache. At 11 years old, as a result of an accident, she suffered a severe intracranial injury with a long period of impaired consciousness, after which she suffers from a chronic headache of a bursting nature of the frontooccipital localization, mainly right-sided, fatigue, weakness. In neurological status, pyramidal insufficiency on the right, intentional tremor. The intensity of the pain syndrome is 8.7 points on the YOUR scale. Migraine status within 4 days upon admission. An ophthalmic examination revealed retinal angiopathy. Tremoid EMG. A duplex study showed signs of atherosclerotic changes in extracranial carotid arteries. MRI revealed areas of pathological intensity of the MR signal in the white matter of the semi-oval center, subcortical, and in the temporal region on the left, mixed hydrocephalus.

An EEG study on November 3, 2010 revealed diffuse changes in bioelectric activity, local in the projection of the temporal lobes of an irritative nature with an emphasis on the right, increasing with functional loads. HS recorded 2 episodes of reduced epileptiform components in the right temporal region against the background of an increase in dysfunction of the middle regulatory structures at the diencephalic level. In the spectral analysis of the EEG, the power of the EEG spectra in the alpha range was 23.9 μV ² .

According to the proposed method, from 11/11/2010 to 11/24/2010, an EHF-therapy course was conducted using the EHF-ND apparatus from 10 daily procedures.

After the course of treatment, positive clinical dynamics were noted, which consisted in stopping the headache (0 points on the YOUR scale), improving well-being and mood, increasing activity and working capacity, and reducing tremor.

A control EEG study on November 25, 2010 found a significant decrease in the severity of local irritative changes in bioelectrical activity in the temporal regions and the degree of dysfunction of the median regulatory structures at the diencephalic level at rest and against the background of functional loads. In the spectral analysis of the EEG, the power of the EEG spectra in the alpha range increased to 28.9 μV ² .

Using the proposed method provides an increase in the effectiveness of the treatment of encephalopathy of various genesis by optimizing the activation of adaptive-compensatory reactions of the brain when the adapted parameters of the EHF radiation act on functionally significant neurovascular structures at the base of the brain. The effectiveness of the method is provided by the improvement of not only arterial, but also venous blood flow of the brain and activation of the protective mechanisms of the brain at all its levels. A positive effect on the functioning of the cortical-subcortical-stem regulatory systems of the brain, the activating systems of the reticular formation ensures the restoration of the basic rhythm of the brain, which confirms the increase in EEG power in the alpha range.

Claims (1)

A method for the treatment of encephalopathy by exposure to EHF radiation of two wavelengths alternating every other day, in a constant mode, with a capacity of 10 mW / cm ² , in 4 fields, a course of 10 daily procedures under EEG control, characterized in that they act on the side of the greatest lesion of the brain to the projection of the vertebral artery is suboccipital, the radiation is directed anteriorly under the base of the skull, then - to the projection of the neurovascular bundle around the angle of the lower jaw under the auricle, the radiation is sent posteriorly under the base of the skull, after which on the contralateral side, the effect is carried out with wavelengths of 4.9 mm and 7.1 mm, 4 min per field.