RU2473305C1 - Method of diagnosing conductivity of peeripheral nerves - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to reflexodiagnostics. Method includes measurement of electrodermal resistance (EDR). EDR is measured in proximal and distal zones of concerned and contralateral nerves. Maximal values of current intensity are registered. Current intensity above 10 mcA testifies to preservation of function of nerve conductivity along vegetative fibres.

EFFECT: method extends possibility of diagnosing state of peripheral nerves.

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Description

The present invention relates to medicine, namely to reflexology and rehabilitation, and can be used to diagnose the function of nerve conduction.

Known methods for assessing the conductivity of peripheral nerves, including the analysis of sweating using iodine-starch test Minor, the determination of ohmic resistance of the skin, thermal imaging using functional tests (Matev I., Bankov S. "Rehabilitation for injuries to the hand", Sofia, 1981, C. 81-118; Kodin A.V. "Clinical diagnosis in the rehabilitation treatment of patients with combined injuries of the flexor tendons", Ivanovo, 1996, pp. 71-77; Kolesov S.N., Volovik M.G., Priluchny M.A. . "Medical heat and radiation", N.N In city, 2008 S.89-101).

However, the known methods are uninformative, time-consuming, require the use of expensive equipment.

There is also a method for the diagnosis of peripheral nerve nerve conduction, which includes assessing the quality of electrical responses of muscles to indirect electrical stimulation of the peripheral nerve that innervates this muscle (needle electroneuromyography) (S. G. Nikolayev "Clinical Electromyography Workshop": Ivanovo, 2003. - P.27 )

However, the method is invasive and painful, and in the presence of edema and lymphostasis in the study area, its implementation is difficult. In addition, the method allows to assess the state of the autonomic portion of the nerve only in the distal extremities.

As a prototype, a method for diagnosing peripheral nerve conduction was selected, including measuring the electric skin resistance at symmetric representative acupuncture points corresponding to the projection of peripheral nerves for three seconds (RF patent No. 2178984, 2002).

However, this method determines the function of nerve conduction only in a narrowly localized area corresponding to a representative acupuncture point, therefore it is not suitable in case of nerve damage distal to the location of the representative point.

The task of the invention is to improve the method.

The technical result is an assessment of the state of autonomic nerve fibers that provide trophic tissue throughout the damaged nerve.

The technical result is achieved by the fact that in the method, including the measurement of electric skin resistance, the electric skin resistance is measured in the proximal and distal zones of the interested and contralateral nerves and the maximum current strengths are recorded, and if during the test the current strength above 10 μA is recorded, a conclusion is made about the safety of the function nerve conduction along vegetative fibers.

The method is as follows. The instrument is calibrated (current strength with closed electrodes 200 μA, voltage 12 V, active electrode area 1 cm ² ). The patient takes the passive electrode in one hand and holds it throughout the entire testing session. Then, under the active electrode, stimulation of the nerve receptors of the skin is carried out with an electric stimulus and maximum currents are recorded in the proximal and distal zones of the interested and contralateral nerves. Then, the obtained results are analyzed: if during testing the maximum current strengths above 10 μA are recorded, then the conduction function of the vegetative nerve fibers is considered preserved. In the case when the dynamics of the current strength is absent, and the maximum values of the current strength in the proximal and distal zones of the interested and contralateral nerves are 10 μA, it is concluded that the vegetative nerve fibers are damaged.

Clinical example No. 1. Patient L., 73, the number of medical history 249023.

Received at the NIIITO with a diagnosis of "Compression-ischemic neuropathy of the right calf nerve."

According to the results of clinical and instrumental examination, data were obtained that testified to severe damage to the right calf nerve.

The patient was exposed to the skin with an electric stimulus (current strength 200 μA, voltage - 12 V) in the innervation zone of the gastrocnemius nerves and the maximum current values were recorded on the skin projection of the nerve: in the proximal sections - 45 μA on the right and 52 μA on the left; in the distal regions, 27 μA on the right and 36 μA on the left.

The obtained indicators of the current strength on the skin projection of the right gastrocnemius nerve allowed us to conclude that the vegetative fibers are intact, which indicates the ability to restore conduction function against the background of ongoing rehabilitation treatment.

Clinical example No. 2: Patient K., 50 years old, No. of medical history 256179.

She was admitted to the NIIITO with the diagnosis: “Condition after neurolysis of the left radial nerve after osteosynthesis of the humerus.”

According to the results of clinical and instrumental examination, data were obtained that testify to severe damage to the left radial nerve.

The patient was exposed to an electric stimulus (current strength 200 μA, voltage - 12 V) on the skin in the area of radial nerve innervation and maximum current values were recorded: in the proximal sections - 63 μA on the right and 8 μA on the left; in the distal sections, 41 μA on the right and 7 μA on the left.

On the skin projection of the left radial nerve, a sharply reduced current value (8 μA) was recorded, which indicated damage to the vegetative nerve fibers and a violation of the conduction function of the left radial nerve.

A method for diagnosing peripheral nerve conduction makes it possible to screen the condition of autonomic nerve fibers that provide trophic tissue throughout the damaged nerve and can serve as a marker of the compensatory capabilities of the interested nerve and the effectiveness of further rehabilitation treatment, optimizing the volume and timing of rehabilitation of patients with traumatic damage to the peripheral nerves .

Claims (1)

A method for diagnosing peripheral nerve conduction, which consists in measuring electrodermal resistance, characterized in that they measure electrodermal resistance in the proximal and distal zones of the interested and contralateral nerves and record the maximum current strength and, if during the test, a current strength above 10 μA is recorded, we conclude preservation of the function of nerve conduction in vegetative fibers.