WO2011019301A2 - Procédé pour traiter la paralysie cérébrale - Google Patents

Procédé pour traiter la paralysie cérébrale Download PDF

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WO2011019301A2
WO2011019301A2 PCT/RU2010/000434 RU2010000434W WO2011019301A2 WO 2011019301 A2 WO2011019301 A2 WO 2011019301A2 RU 2010000434 W RU2010000434 W RU 2010000434W WO 2011019301 A2 WO2011019301 A2 WO 2011019301A2
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treatment
action
points
muscles
stimulating
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PCT/RU2010/000434
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WO2011019301A3 (fr
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Tatiana Alekseevna Ukhanova
Aleksey Petrovich Gavrilov
Evgeny Yurievich Ukhanov
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Tatiana Alekseevna Ukhanova
Aleksey Petrovich Gavrilov
Evgeny Yurievich Ukhanov
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Publication of WO2011019301A2 publication Critical patent/WO2011019301A2/fr
Publication of WO2011019301A3 publication Critical patent/WO2011019301A3/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H39/00—Devices for locating or stimulating specific reflex points of the body for physical therapy, e.g. acupuncture
    • A61H39/002—Using electric currents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/20—Applying electric currents by contact electrodes continuous direct currents
    • A61N1/205—Applying electric currents by contact electrodes continuous direct currents for promoting a biological process

Definitions

  • the invention relates to a medicine, particularly to neurology and reflexotherapy, and can be used for treatment of cerebral palsy in a wide range of patients with various disorders of muscle tone.
  • ICP Infantile cerebral palsy
  • the current classification of cerebral palsy does not reflect the diversity of pathological settings and etiological factors of this disease, which in the first place include a chronic fetal hypoxia, an intrauterine infection and fetal blood incompatibility of a mother and a child by rhesus-factor, as well as hydrocephalus with the formation of corresponding elements of pathogenesis in the form of residual symptoms of cortex perinatal hypoxia, dysfunction of brain-stem midline structures and abnormalities of liquor circulation. This dictates the need for treatment based on identified individual pathological settings and objective definition of the pathogenesis elements for their further treatment.
  • Surgical treatment of cerebral palsy, including dissection, followed by lengthening the tendon of spastic muscle is traumatic and requires a prolonged postoperative immobilization in the form of plastering, which leads to the formation of contractures and muscles atrophy.
  • For children suffering from cerebral palsy reflex treatment modes are preferable including those using an electric current to restore functional activity of the cortex and the mid-stem structures of the brain, selective reducing the activity of motoneurons in the cervical and lumbar enlargement to reduce stretch reflex, liquor dynamics stabilization with a decrease of various brain structures compression, including the cerebellum adjacent to the liquor paths and involved in motion acts, as well as correction of muscular tonus by selective treatment action on spastic and paretic antagonist muscles involved in the formation of pathological settings, and via combination of reflex and direct action upon muscle fibers.
  • a method for treating cerebral palsy is known (see Author's Certificate Ne 1718933, USSR, Int. Cl. 5 A61H 39/08, 1992), which includes a preliminary examination of a patient with identification of limbs pathological settings in the form of spastic contractures, more exact definition of muscles involved in the formation of appropriate pathological settings, palpation definition of reflexogenic zones in the places of these muscles attachment to the periosteum and conduction of indirect reflex therapy on the muscles for 10-20 minutes through the insertion of needles until they reach the periosteum at the rate of 10-12 procedures per treatment course.
  • the disadvantage of this method is in its invasiveness, because the skin injury is not desirable for the children with cerebral palsy by reason of the lower immune system reactivity, extreme painfullness of manipulations on the periosteum in connection with its rich innervation, as well as possible traumatization of the child in case of needle break in a spastic muscle in the event of dystonia attack during the treatment procedure.
  • This method does not include the stimulatory action on paretic muscles and therefore provides an incomplete therapeutic action on the antagonist muscles, which had led to the formation of contractures. Also the method does not provide for indirect treatment action on the cortex zones via the zones of the scalp and the zones of brain cortex projections on the scalp.
  • a method for treating cerebral palsy taken as a prototype is also known (see Author's Certificate Ns 43555, Bulgaria, Int. Cl. 4 A61H 39/00, A61N 5/06, 1/32, 1988), which comprise a patient examination with detection of pathological settings and with a more exact definition of spastic and paretic antagonist muscles forming these settings, applying treatment action on the scalp zones by a beam of the 2 mW helium-neon laser with a 632 nm wavelength, operating at a 10-20 Hz frequency with an exposure time of 20-30 seconds for each zone, taking into account such clinical syndromes of affection as motor, coordination, ataxic, hyperkinetic, emotional, verbal and visual syndrome.
  • a therapeutic action is applied with an exposure of 5-10 seconds on acupuncture points of the paravertebral region and with an exposure of 3-6 seconds to the acupuncture points located on the head and the neck such as: VB14, VB20, VG14, VG15, VG16, VG17, VG19, VG20, VG21, VG23, V7, V9, E9.
  • a reflex action is applied with an exposure of 5-10 seconds on the points located on the flexor (bending) surface of the hands and, adductor (drawing inward) surface of the feet such as: Cl, C3, C7, MS6, MS8, P5, P9, Rl, RP6, RPlO and over the insertion site of the adductor muscle to the pubic bone.
  • action is applied on the flexor surface of elbow and wrist joints and on the dorsal (from behind a back) surface of the hip, knee joint and lower leg with an impact to the following acupuncture points: C3, MC3, P5 , C7, MC7, P9 and V36, V37, V40, V58, V60.
  • a treatment is carried out on the control acupuncture points R3, R6, R7, V23, VG4 5 VC4, VC6, including those located on the front and the posterior-medial meridians, with an exposure of 3-6 seconds per point.
  • an electromassage treatment during 10-15 minutes using low-frequency current of 2-10 Hz at a threshold current intensity is effected on the acupuncture points GIl 1, TR9, TR5, VB31, VB34, VB39, E31, E34, E36, E41, what provide a reflexive and stimulatory action on paretic muscles of extensor (unbending) groups of the hand muscles and extensor and abductor (drawing away) groups of the leg muscles.
  • the known method drawback is in that it does not provide for the direct electric current treatment action on the acupuncture points located over the spastic muscles for their relaxation and is suitable only for treating children with a narrow range of pathological settings of the upper extremities caused by increased tone of flexor group and decreased tone of extensor group of antagonist muscles for bending arms at the elbow and wrist joints.
  • a further drawback of the known method is the limited number of lower extremities pathological settings caused by increased tone of adductor muscle groups and decreased tone of extensor and abductor groups of antagonist muscles of lower extremities resulting in crossing, thrusting on tiptoes and bending in the knee joints.
  • One more drawback of the known method is that it does not provide for electric current treatment action on the scalp zones.
  • Such treatment contrary to the laser impact not only improves microcirculation, but is physiologically adequate stimulus of the neural structures of the central nervous system (CNS) what is necessary for increasing the functional activity of neurons in respective divisions of a brain.
  • the known invention does not use the zones of brain cortex projections on the scalp, such as the initiative zone, the zone of active thinking, and the zone of movements sequence, treatment action on which is necessary for enhancing motor activity, reducing protest reactions, increasing motivation for physical exercises, and development of movement stereotypes.
  • the treatment action on the control acupuncture points in the known method is not substantiated as it is carried out without objective assessment of the meridians condition with the help of Nakatani diagnostics and personal peculiarities of the patient are not taken into account in the course of treatment.
  • the condition of the C, F 5 RP, V meridians is not accessed and there is no possibility using the known method to exert effective influence by means of control points on such pathogenesis elements, as the residual symptoms of perinatal hypoxia of brain cortex, the dysfunction of the brain-stem midline structures and different types of the liquor dynamics disorders.
  • the known method is restricted by patients with a narrow range of pathological settings and is not sufficiently effective in treating children with severe forms of hydrocephalus and organic brain damage.
  • An object of the present invention is to enhance the efficiency of cerebral palsy treatment due to more complete detection of pathological settings, combined correction of muscle tone via reflex and direct action upon muscle fibers of spastic and paretic muscles forming proper pathological setting, and due to differentiated impact on the paravertebral acupuncture points.
  • Another object of the present invention is to apply a treatment action to individual elements of the disease pathogenesis with regard to actual state of the meridians identified using the Nakatani diagnostics and to extend the therapeutic effect to the psychomotor development delay through the use of the zones of brain cortex projections on the scalp.
  • the objects of the invention are attained by providing a method for treating cerebral palsy, comprising a patient examination with detection of pathological settings and with a more exact definition of spastic and paretic antagonist muscles forming these settings, applying treatment action to the central link of pathogenesis via action on the scalp zones and on the biologically active points of classical meridians along with a treatment action to the peripheral neuromuscular apparatus via electric current action on paravertebral points and the points disposed over the antagonist muscles, characterized in that, the electrical conductivity measurements are additionally carried out of the biologically active points on the C, F, RP 5 V meridians according to the Nakatani method, the hyperfunction of C meridian testifying the residual effects of perinatal hypoxia of brain cortex, the hyperfunction of F meridian testifying the dysfunction of the brain-stem midline structures, the hypo- or hyperfunction of RP meridian testifying the liquor dynamics disorders, and hypo- or hyperfunction of the V meridian testifying the decrease in liquor adsorption, the treatment action to the central
  • the pathological settings detected during the patient examination include the settings of upper and lower extremities, a trunk, a head, and a neck.
  • the scalp zones include the motor, the balance, the chorea and tremor, and the vision zone, said zones being subjected to a sedative treatment in accordance with the existing patient's manifestations of cerebral palsy.
  • the treatment action on the initiative zone is effected for increasing motion activity, on the zone of active thinking - for reducing protest reactions and enhancing motivation for physical exercises, and on the zone of movements sequence in case of motor stereotypes development slowdown, said zones being subjected to a stimulating treatment vie the biologically active points located in the centre of corresponding zones of brain cortex projections on the scalp in accordance with the existing patient's manifestations of cerebral palsy.
  • the treatment action on the spastic and paretic muscles is effected through the off-meridian points located in the centre of corresponding muscles projections on the surface of the body, the sedative treatment on spastic muscles being effected during the entire course of treatment, while the stimulating treatment on paretic muscles being effected within 4-10 sessions till the restoration of their motion functions.
  • the short-circuit direct current intensity is 40-110 mcA
  • the length of positive and negative polarity pulses during stimulating treatment is equal to 2-8 seconds
  • duration of treatment action on every biologically active point is 40-120 seconds during sedative treatment and 40-80 seconds during stimulating treatment.
  • the treatment course includes 12-20 procedures, the duration of one session being 40-60 minutes.
  • Carrying out the electrical conductivity measurements of acupuncture points of the C, F, RP, V meridians according to the Nakatani method allows to reveal such elements of pathogenesis as residual symptoms of perinatal hypoxia of brain cortex, dysfunction of the brain-stem midline structures, and different types of the liquor dynamics disorders for subsequent reflex therapy impact aimed at restoring the affected divisions of the brain and stabilization of liquor production and absorption.
  • Determining a pathogenesis element in the form of dysfunction of the brainstem midline structures according to hyperfunction of the F meridian allows to identify such disturbing factor as an intrauterine infection and/or toxic action of bilirubin on the neural tissue with subsequent curative action to the aggrieved mid- stem brain structures in order to stabilize their functional activity. That will reduce the frequency and severity of hyperkinetic disorders and distonic attacks.
  • Determining a pathogenesis element according to violations type of liquor dynamics disorders depending on hypo-or hyperfunction of the RP meridian, what testifies to the liquor overproduction, allows to specify such factor of cerebral palsy development as an internal hydrocephalus with subsequent medical treatment of excessive liquor production in order to reduce squeezing of the conductive ways of periventricular brain regions involved in implementation of motor acts.
  • Determining an element of the pathogenesis according to the violations type of liquor circulation helps to clarify such a factor of cerebral palsy as external hydrocephalus for further medical treatment of liquor absorption to reduce its pressure on various cortex zones and cerebellum in order to ease their functioning and further improve cognitive and motor functions.
  • the treatment action to the central link of the pathogenesis via action on such biologically active points of classical meridians according to working reflexotherapy regulations as Luo points, accomplice points, stimulating points, and connection points, provides a comprehensive therapeutic action to the individual combination of pathogenesis elements of the patient's cerebral palsy.
  • Reflex therapy treatment via biologically active points both to the central link of pathogenesis and to the peripheral neuromuscular apparatus by direct electric current action of negative polarity in the mode of sedative treatment and/or using pulses of direct electric current with alternating polarity in the mode of stimulating treatment allows to simulate a sedative and stimulating acupuncture effect, but without pain and damaging the skin, what permits to treat patients with reduced immunity and apparent neurotization.
  • Carrying out treatment action to the peripheral neuromuscular apparatus according to detected pathological settings by sedative action on spastic muscles and stimulating action on paretic muscles allows for to realize a complex treatment of antagonist muscles up to arresting proper pathological setting.
  • Sedative action on the paravertebral acupuncture points with regard to segmental innervation of spastic muscles reduces the severity of stretch reflex in spastic muscles and promotes successful development of the previously formed contractures.
  • Detecting such pathological settings as upper and lower extremities, a trunk, a head, and a neck during the patient examination allows taking into account the individual peculiarities of muscle tone disorders in the patient and makes the method effective in treating a broad range of patients with different combinations of pathological settings.
  • scalp zones such as the motor, the balance, the chorea and tremor, and the vision zone with producing a stimulating action on them in accordance with the existing patient's manifestations of cerebral palsy allows to additionally adjust such manifestations of disease as a muscle tone violation of speech apparatus, disequilibrium, hyperkinesis, partial atrophy of optic nerves.
  • the treatment action on the spastic and paretic muscles through the off- meridian points located in the centre of corresponding muscles projection on the cutaneous covering can provide a complex effect upon muscle fibers in the form of reflex and direct relaxing and stimulating treatment of the relevant antagonist muscles. This makes it possible to effectively correct the pathological settings not only due to relaxation of spastic muscles, but also due to restoration of functional activity of paretic muscles, what leads to a substantial increase in the range of active movements.
  • Provision of therapeutic treatment on pathological settings with sedative action on the spastic muscles during the entire course of treatment is necessary because of slow decline in muscle tonus of hypertrophied muscle fibers.
  • Stimulating treatment action on paretic muscles within 4-10 procedures till the restoration of their motion functions can provide a dosage effect on hypotrophic muscle fibers with regard to severity of paresis and atrophy of muscle mass.
  • Selection of the short-circuit direct current intensity in the order of 40-110 mA allows to chose the current treatment parameters with regard to a patient's individual tolerance.
  • the length of positive and negative polarity pulses equal to 2-8 seconds during stimulating treatment is physiologically adequate stimulus of neural structures that can not only improve the microcirculation, but also enhance the functional activity of neurons in the respective sections of the brain.
  • the duration of treatment action on every biologically active point for 40- 120 seconds in guiding sedative therapy and for 40-80 seconds in guiding stimulating therapy allows to undergo the cure with regard to personal features of the patient including the manifestation degree of paresis and spasticity.
  • the duration of one treatment procedure for 40-60 minutes is due to the necessity of spreading therapeutic effect on all manifestations of the patient's disease when applying treatment action both to the central link of pathogenesis and to the peripheral neuromuscular apparatus.
  • the duration of treatment course (12-20 procedures) is individual and depends on the disease severity and the growth rate of positive dynamics, while completion of the treatment course is stipulated by achieving a marked improvement in the patient's condition.
  • a preliminary patient examination included the detection of pathological settings during the dynamic observation of motor acts performance as well as palpatory determination of stressed and atrophic muscle fibers with a more exact definition of spastic and paretic antagonist muscles forming these settings and segmental innervation of spastic muscles using the Atlas of Human Anatomy and in accordance with current international anatomical nomenclature.
  • the treatment action on the spastic and paretic muscles is effected through the off- meridian acupuncture points located in the centre of corresponding muscles projections on the surface of the body.
  • Electroreflexotherapy of the set of selected biologically active points, scalp zones and zones of brain cortex projections on the scalp is effected by direct electric current of negative polarity in the sedative treatment mode (s) and/or using alternate supply of pulses of 2-8 seconds duration in the stimulating treatment mode (t).
  • the magnitude of the short circuit current for both types of therapeutic treatments is selected from the range of 40-110 mcA taking into account individual patient's tolerability.
  • Exposure time for each biologically active point is 40-120 seconds during sedative treatment and 40-80 seconds during stimulating treatment.
  • the number of treatment courses was determined individually according to the severity of clinical presentation, the intervals between treatments courses were 1 month.
  • Example 1 Treatment was effected of the patient L., a girl age 4.
  • Diagnosis infantile cerebral palsy of mixed form, spastic diplegia, ataxic syndrome, delayed development of motor skills, external hydrocephalus. Complaints at admission to the clinic: delay in motor development - the child does not stand on her feet without assistance, does not walk, headaches 1-2 times a week.
  • MRT magnetic resonance tomography
  • Electroencephalogram revealed no pathology: the cortical rhythm corresponds to the age, dysfunction of the brain-stem midline structures and epileptic activity are not observed.
  • Neurological status the child is calm, comes into contact, has hydrocephalic head shape, venous pattern is reinforced in the frontal region. Cerebral nerves (CN) are without pathology. Motor activity is reduced, the child moves through the house along the wall only after urgent request of the parents. Coordination of movements is disrupted, finger-nose test was performed with the misses and intention tremor. The child takes things indistinctly, stands beside a support irresolutely, walks only with support, her legs being wide apart. The pathological Babinski reflex is positive, foot clonus is evident, tendon reflexes are symmetrical, and legs reflexes are increased. Muscle tone is disordered according to a spastic- paretic type.
  • a survey was carried out according to Nakatani method with the preparation of the patient's diagnostic card.
  • Control acupuncture points were selected according to classical rules of reflexology and the patient's diagnostic card. There were selected the following control points and the sedative (s) and stimulating (t) regimes for impacting on them: the S5s, R5t, P7c Luo points, the IG4t, V64s, GI4t accomplice points, the R3t stimulating point, and the VIt, VC23t connection points.
  • the scalp zone in the form of the balance zone because of dysfunction of the cerebellum as well as the biologically active points located in the center of the projection on the scalp of the brain cortex initiative zone because of decline in motor activity.
  • a daily therapeutic action was effected in the stimulating mode on the balance scalp zone and the initiative zone projection of brain cortex on the scalp as well as to the C5s, R5t, P7c, IG4t, V64s, GI4t, R3t, VIt, VC23t control acupuncture points and the V22c. V31s, V32s paravertebral biologically active points.
  • Therapeutic action in the sedation mode was effected on the following spastic muscles: m. peroneus longus, m. biceps femoris, m. semitendinosus, m. gluteus minims, m. iliopsoas, m.
  • ⁇ ' erector spinae Stimulating action was effected on the paretic muscle during 4 procedures by reason of rapid restoration of functional activity of these muscles. Intensity of the short-circuit direct current used for treatment was 80 mA. The total duration of treatment procedure was 40 minutes, the length of treatment course - 12 procedures. Duration of treatment action on every acupuncture point was 40 seconds during sedative treatment and 40 seconds during stimulating treatment, and duration of the pulses of positive and negative polarity was equal to 2 seconds in the mode of stimulating treatment.
  • MRT Magnetic resonance tomography
  • Example 2 Treatment was effected of the patient K., a boy age 2.
  • Diagnosis infantile cerebral palsy of double hemiparetic form, rough delay in psychomotor development, mixed hydrocephalus, partial atrophy of optic nerves. Complaints at admission to the clinic: evident delay in motor development - the child doesn't keep his head, doesn't sit and walk, has headaches 1-2 times a week.
  • Anamnesis Pregnancy on a background of chronic urogenital infection, chronic intrauterine fetal hypoxia, the threats of fetus wastage in the 1st and the 2nd halves of pregnancy.
  • the boy was born after fourth pregnancy, birth prematurely at 36 weeks, birth weight 210O g, assessment of the child according to Apgar score is equal to 2-4 points.
  • Condition at birth was extremely hard, within 12 days the child was under artificial ventilation of lungs. Later on he was transferred to the department of newborns pathology where he was hospitalized with a diagnosis: the central nervous system affection of hypoxic-ischemic genesis, cytomegalovirus infection, hypertensive-hydrocephalic syndrome, syndrome of movement disorders.
  • diagnosis infantile cerebral palsy of double hemiparetic form, rough delay in psychomotor development, mixed hydrocephalus, partial atrophy of optic nerves.
  • Diagnostic decision the symptoms of mixed hydrocephalus with the signs of cortical atrophy of frontal, parietal, and occipital lobes.
  • the available features also testify to the intrauterine infection.
  • the EEG examination showed increased convulsive readiness, dysfunction of the mid-stem structures, delay of the age- related cortical rhythm formation.
  • Ophthalmologist examination revealed the following signs of hydrocephalus and partial atrophy of the visual nerves: disks of the visual nerves were pale-pink with a grayish tint, the arteries were narrowed, veins - full and tortuous.
  • Neurological status the child is restless, there is motiveless weeping, hydrocephalic head shape, venous pattern is reinforced in the frontal and temporal regions. Prefontanel is closed .
  • Cranial nerves the patient does not fix his eyes, has permanent horizontal nystagmus, hearing is preserved, has increased muscle tone of the articulatory apparatus, chokes on pieces of food, has synkinesis of facial musculature by the forced opening of the mouth type. There are dysautonomic attacks up to 4 times a day during crying. The pathological reflexes of Babinski and Moro groups are observed, as well as the foot and knee cups clonus, tendon reflexes of hands and feet are symmetrical and greatly increased.
  • Muscle tone is disordered according to a spastic-paretic type. Contractures at the ankle joints are revealed. Delay in motor development is evident: the child doesn't hold his head, does not sit, does not attempt to crawl, does not stand, does not commit stepping movements when verticalized, does not stretch to things. Motor skills are not produced in connection with the negativism expressed to exercise therapy and slow elaboration of motor stereotypes. Mental and speech development of the child is grossly delayed: speech activity occurs at the level of rare childish prattle, he doesn't recognize close relations, is not interested in toys, gaming activity is absent.
  • a survey was carried out according to Nakatani method with the preparation of the patient's diagnostic card.
  • control points There were selected the following control points and the sedative (s) and stimulating (t) regimes for impacting on them: the VB39t, E40s, R5s, VB37t Luo points, the RP3t, V64t, F3c accomplice points, the V64t, RP2t stimulating points, and the VC4t, TR22t, VGl 4t connection points.
  • a daily therapeutic action was effected in the stimulating mode on the motor and the optical zones of the scalp, on the projections zones of the brain cortex on the scalp such as the active thinking zone and the zone of movements sequence as well as on the VB39t, E40s, R5s, VB37t, RP3t, V64t, F3c, V64t, RP2t, VC4t, TR22t, VG14t control acupuncture points and the V23c, V24s paravertebral biologically active points.
  • Therapeutic action in the sedation mode was effected on the following spastic muscles: m. gastrocnemius, m. soleus, m. vastus lateralis, m. vastus medialis, m.
  • Duration of treatment action on every acupuncture point was 120 seconds during sedative treatment and 80 seconds during stimulating treatment, while duration of the pulses of positive and negative polarity was equal to 8 seconds in the mode of stimulating treatment.
  • the total duration of treatment procedure was 60 minutes, the length of treatment course - 20 procedures. Because of the severe condition of the child there were carried out 3 courses of treatment with an interval between courses of 1 month.
  • the muscle tone has stabilized and the severity of pathological settings decreased: when verticalized he commits stepping movements, supports on the whole foot, he began to bend his legs at the knee joints while carrying out steps, reaches for toys in front of him and tries to take them, at the same time he began to bend his arms at the elbows. Emotional reactions became more alive, recognize close relations and smiles at them, actively prattles in response to a talk.
  • the available symptoms also point to an intrauterine infection.
  • the EEG examination revealed increased convulsive readiness.
  • the signs of the brain-stem midline structures dysfunction are not revealed, the cortical rhythm corresponds to the age.
  • Ophthalmologist examination didn't reveal the signs of partial atrophy of the optic nerves - the optic nerve disks were pale-pink.
  • Example 3 Treatment is effected of the patient P., a boy age 10.
  • Diagnosis infantile cerebral palsy of mixed form, right-sided hemiparesis with a marked disturbance of motor function of upper extremity, hyperkinetic syndrome, internal asymmetric hydrocephalus of subcompensated form.
  • Anamnesis pregnancy on a background of toxicosis during the 1st and 2nd halves, rhesus incompatibility, the threat of fetus wastage in the 2nd half of pregnancy.
  • the boy was born from the third pregnancy, the birth was given by Caesarean section because of the deteriorating condition of the fetus at 39 weeks, birth weight 380O g, assessment of the child according to Apgar score was equal to 2-4 points. Condition at birth was extremely hard.
  • Neurological status the child is calm, hydrocephalic head shape, venous pattern is not evident.
  • Cerebral nerves hearing and vision are without pathology, a hyperkinesia of facial muscles arises when trying to implement the conscious movements.
  • the pathological Babinski reflex and ankle clonus are caused from the right side, tendon reflexes of hands and feet are increased, from the right side more than the left.
  • Muscle tone is disordered in the right extremities according to a spastic-paretic type. There were revealed contractures of the wrist and elbow joints. Gait is spastic-paretic, the boy drags his right foot when walking. Feet motor skills correspond to the age: standing, walking, running.
  • a survey was carried out according to Nakatani method with the preparation of the patient's diagnostic card.
  • Control acupuncture points were selected according to classical rules of reflexology and the patient's diagnostic card. There were selected the following control points and the sedative (s) and stimulating (t) regimes for impacting on them: the RP6c, E40t, VB37t Lo-points, the RP3c, F3c accomplice points, the VB43t stimulating point and the VC18t, VC12t, MCIt 5 Pit connection points.
  • the scalp zones in the form of the chorea and tremor zone for arresting hyperkinesia of the facial musculature as well as the biologically active points located in the center of the projection on the scalp of the brain cortex initiative zone to increase motor activity in the right hand and the zone of movements sequence to increase the speed of motor stereotypes acquisition by the right hand.
  • a daily therapeutic action was effected in the stimulating mode on the chorea and tremor zone of the scalp and the projection on the scalp of the brain cortex initiative zone and the zone of movements sequence as well as on the RP6s, E40t, VB37t 5 RP3s, F3s, VB43t, VC18t, VC12t, MCIt, Pit control acupuncture points and the V32s, V33s, Vl Is paravertebral biologically active points.
  • Therapeutic action in the stimulating mode was effected on the following spastic muscles: m. flexor digitorum, brevis, m. biceps femoris, m. semitendinosus, m.gluteus maximus, m.
  • flexor carpi radialis m. flexor carpi ulnaris, m. pronator teres, m. biceps brachii, m. brachioradialis, m. pectoralis major have a mode of sedation, but on the paretic muscles: m. extensor digitorum longus, m. vastus lateralis, m. vastus medialis, m. rectis femoris, m. sartorius, m. extensor carpi ulnaris, m. supinator, m. triceps brachii m. deltoideus.
  • Stimulating action was effected on the paretic muscles during 10 procedures in connection with the slow recovery of functional activity of these muscles.
  • Intensity of the short-circuit direct current used for treatment was 100 mA.
  • Duration of treatment action on every acupuncture point was 60 seconds during sedative treatment and 60 seconds during stimulating treatment, while duration of the pulses of positive and negative polarity was equal to 5 seconds in the mode of stimulating treatment.
  • the total duration of treatment procedure was 50 minutes, the length of treatment course - 15 procedures because of the moderately marked clinical manifestations.
  • Diagnostic decision the symptoms of internal asymmetric hydrocephalus, positive course of disease.
  • the EEG examination revealed no pathology - the cortical rhythm corresponds to the age, symptoms of epileptic activity and dysfunction of the brain-stem midline structures are absent.
  • Ophthalmologist examination also noted positive dynamics: veins are moderately full-blooded and tortuous.
  • the proposed method of cerebral palsy treatment provides treatment for children with a wide (16 and over) range of pathological settings.
  • the treatment action on spastic and paretic antagonist muscles is strictly individual and in accordance with pathological settings detected in the course of dynamic observation of the patient.
  • Treatment of the antagonist muscles forming the pathological settings by electric current action in the sedative and the stimulating modes provides both reflexive and straight impact on the muscles: for spastic - relaxing, and for paretic - stimulating, what leads to the abolishment of pathological settings.

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  • Electrotherapy Devices (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Abstract

La présente invention concerne un médicament, en particulier pour la neurologie et la réflexothérapie. Le procédé selon l’invention comprend un examen de patient avec détection de symptômes pathologiques et une définition plus exacte d’antagonistes de muscles spastiques et parétiques formant ces symptômes. Les mesures de conductivité électrique sont en outre conduites des points biologiquement actifs sur les méridiens C, F, RP, V selon le procédé de Nakatani. L’identification de l’hyperfonction du méridien C avec celles-ci atteste des effets résiduels de l’hypoxie périnatale du cortex cérébral. L’hyperfonction du méridien F atteste du dysfonctionnement des structures de ligne médiane du tronc cérébral. L’hypo- ou hyperfonction de méridien RP atteste des troubles dynamiques liquides, et l’hypo- ou hyperfonction du méridien V atteste d’une diminution de l’adsorption de liquide. Une action de traitement est appliquée à la liaison centrale de la pathogenèse par action sur des points biologiquement actifs de méridiens classiques tel que des points Luo, des points complices, des points de stimulation, et des points de connexion. Par ailleurs, des actions additionnelles sont appliquées sur des zones du cuir chevelu telles que la zone d’initiative, la zone de pensée active, et la zone de séquence de mouvements. L’action du traitement via des points biologiquement actifs sur la liaison centrale de pathogenèse et sur l’appareil neuromusculaire périphérique est effectuée par un courant électrique continu de polarité négative dans le mode de traitement sédatif et/ou en utilisant des impulsions de courant électrique continu avec une polarité alternative dans le mode de traitement de stimulation. L’action de traitement sur l’appareil neuromusculaire périphérique est conduite par action sédative sur les muscles spastiques et action de stimulation sur les muscles parétiques ainsi que par action sédative sur les points paravertébraux en ce qui concerne l’innervation segmentée de muscles spastiques. Le procédé selon l’invention revendiquée augmente l’efficacité du traitement de la paralysie cérébrale due à la production d’une combinaison d’effets réflexes et directs sur des fibres musculaires d’antagonistes de muscles spastiques et parétiques, réduisant le réflexe d’étirement, et supprimant une large gamme de symptômes pathologiques. Le procédé est également efficace pour traiter la paralysie cérébrale chez des patients avec des formes graves d’hydrocéphalie et des lésions cérébrales organiques par action de traitement sur des combinaisons individuelles d’éléments de pathogenèse.
PCT/RU2010/000434 2009-08-13 2010-08-10 Procédé pour traiter la paralysie cérébrale WO2011019301A2 (fr)

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RU2009130932/14A RU2401097C1 (ru) 2009-08-13 2009-08-13 Способ лечения детского церебрального паралича

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RU2504329C1 (ru) * 2012-10-02 2014-01-20 Федеральное государственное бюджетное учреждение "Научный центр неврологии" Российской академии медицинских наук Способ выявления в коре головного мозга сенсомоторных зон, ответственных за локомоцию
RU2604819C1 (ru) * 2015-05-21 2016-12-10 Федеральное государственное бюджетное образовательное учреждение высшего профессионального образования "Чувашский государственный университет имени И.Н. Ульянова" Способ лечения церебральной ишемии новорожденных
RU2646571C2 (ru) * 2016-03-01 2018-03-05 Общество с ограниченной ответственностью "НИИ педиатрии и неврологии "Дети Индиго" Способ лечения задержки психоречевого развития и двигательных нарушений при нервно-психических заболеваниях больных
RU2732345C1 (ru) * 2019-11-20 2020-09-15 Федеральное государственное бюджетное образовательное учреждение высшего образования "Амурская государственная медицинская академия" Министерства здравоохранения Российской Федерации Способ активации проприорецепторов при детском церебральном параличе

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