Biomedical subjects
Publications and source records attributed to V E Grechko.
The authors describe the results of immunological examination of patients suffering from vegetative prosopalgias. A study was made of the initial status of immunity and of its dynamics after treatment. The majority of patients manifested an increase of immunoglobulin A concentration and activation of local humoral immunity. The treatment brought about a reduction of immunoglobulin A concentration in blood serum.
The authors describe a new method of the treatment of patients with trigeminal neuralgias using electroconvulsive therapy. The method is based on the increase of beta-endorphin concentration as a result of electroconvulsive treatment. The treatment of 12 patients in accordance with the suggested method provided beneficial results and significant enhancement of the efficacy of therapy as compared to patients undergoing conventional treatment.
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As many as 145 patients with painful syndromes in the face and head underwent immunologic examination. They manifested certain changes in cellular and humoral immunity. An increase in the content of secretory IgA in the saliva and in the serum and a decrease of the concentration of IgM and IgG in the serum were detected in the majority of patients. In patients with NTN of mainly peripheral genesis and with Horton's syndrome, the concentration of IgE in the serum was significantly (P less than 0.01) elevated. The changes in the immunologic status, seen in patients after the treatment are discussed.
These are results of comparison of clinical data and parameters of early components of somatosensory evoked potentials (SSEP) in patients with various pathological disorders in the trigeminal nerve system. The investigations evidenced that neurologic patients have different degrees of disorders in structural-functional organization of trigeminal nerve system resulting from the disease itself and previous therapeutic interventions. Some of the peculiarities of SSEP changes, e.g., their amplitude and/or temporal asymmetry under stimulation of the sites of intact and afflicted sides of the face are believed to correspond to pathological changes in trigeminal nerve system. These features can serve as diagnostic and prognostic tests.
On the basis of an analysis of evoked potentials (EPs) the authors have studied alterations in the bioelectrical activity in experimental trigeminal neurites (neuropathies). The results have shown that the most important electrophysiological signs of experimental trigeminal neurites is a decrease in the amplitude of the positive phase of the vertex potential. This appears to reflect a weakened conductivity function of the nerve due to its pathomorphological changes and a higher amplitude of the negative phase of evoked potentials indicating hyperactivation of the nonspecific system.
Neuropathic, stomatological and instrumental examination was performed in 86 patients with trigeminal neuropathies admitted to a specialized dental neurological department. The disease was found clinically heterogeneous, requiring a systemic approach to its treatment based on current knowledge of the disease etiology.
A total of 66 patients with dental plexalgia have been examined and treated at the neurological dentistry department. A multiple-modality scheme for the treatment of this condition is suggested, whose basic methods are physiotherapeutic ones: longitudinal physiotherapy, diadynamic currents with a narcotic mixture, trimecain or lydase + analgin electrophoresis. The treatment was effective in the majority of patients.
Fifty-two patients (aged 15 to 78 years) suffering from facial hemispasm were treated by transcutaneous electric nerve stimulation (TENS). For this purpose electric-impulse apparatuses generating bipolar nonsymmetrical impulses were employed. The employment of TENS eliminated hyperkinesis for a period of several minutes to several hours. Interparoxysmal intervals lengthened and hyperkinesis became less pronounced. After a TENS session EMG showed no spontaneous activity in the form of "volleys of oscillations". A possible mechanism of TENS therapeutic effect in facial hemispasm is discussed.
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Examinations of the muscle blood flow in the face have shown that this method may be used as one of the criteria in the objective evaluation of pain and for the follow-up of its severity in patients with trigeminal injury.
A total of 104 patients with bilateral facial pain were examined at a specialized neurostomatological department. The authors analyze the main mechanisms of the development of bilateral facial pain in patients with an impaired system of the trigeminal nerve (trigeminal neuralgias, dental plexalgia, syndrome of the nosociliary nerve), as well as the characteristics of their clinical manifestations. A classification of bilateral prosopalgias is proposed. The criteria of their diagnosis with the use of clinical and electrophysiological methods of examination (EEG, REG, EMG, electrothermometry, esthesiometry, electrical excitability of the exit sites of the trigeminal nerve branches and radioisotopic examination of the muscular blood flow in the face with the help of 133Xe) are also presented. The main principles of the treatment of bilateral prosopalgias are outlined.
The article considers characteristics of clinical manifestations of dental plexalgia, a new form of the disease related to impairment of dental plexuses. In a clinicophysiological study of 56 patients with dental plexalgia conducted at a neurostomatological department the authors used rheofaciography, thermometry and thermography of the face skin, esthesiometry, and electrodiagnosis of the oral mucosa. Electrodiagnosis of the oral mucosa helps to specify the diagnosis of dental plexalgia. The authors describe differential diagnosis criteria reflecting the peculiarities of the clinical picture of dental plexalgia which is characterized by the persistent pain in the area of the damaged plexus with peculiar irradiation which may be used for the diagnosis, rational etiopathogenetic therapy, prophylaxis, and prognosis of the disease.
Acupuncture was used in 82 patients with trigeminal neuralgila. In 17 patients trigeminal neuralgia was predominantly of the central and in 65 of the peripheral genesis. Selection of points for acupuncture was based on the findings about electrical conductivity of symmetrical acupuncture points on the patient's face. The study has shown that the method of acupuncture in patients with trigeminal neuralgia should be used differentially. It is effective only in patients with peripheral trigeminal neuralgia.
Differential diagnostic criteria of trigeminal neuralgia predominantly of the central genesis and of odontogenic affections of the trigeminal nerve system have been worked out on the basis of studies of electric conductivity of acupuncture points of the face in 85 patients with affections of the trigeminal nerve system.
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The authors examined 48 patients with hemorrhagic and 72 with ischemic strokes as well as 29 patients of the control group. The study of conduction (rho) and complex relative dielectric permeability (CRDP) of red blood cells and platelets with the help of the Soviet apparatus RIP-10 showed that in the control group, the CRDP was 24.3 +/- 0.2 relative units and rho was 35.1 +/- 0.2 cm. In patients with hemorrhagic strokes, there was a sharp increase of rho (up to 100-112) and CRDP (up to 32-40 relative units). In patients with ischemic strokes, the CRDP and rho also differed from the control data constituting 14-20 relative units and 40-80 cm, respectively. Correlation between the biophysical and the clinical data helped to differentiate between hemorrhagic and ischemic strokes with a sufficient degree of accuracy.