RU2062098C1 - Method for restoring motor function - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves finding muscles being in atonic or spastic state in babies. The spastic muscles are treated by injecting sodium hydroxybarbiturate or midocalm in arbitrary way the whole zone along a muscle. EFFECT: enhanced effectiveness of treatment; persistent effect.

Description

 The invention relates to the field of pediatrics, and in particular to methods of treatment and use of drugs to restore the functions of the musculoskeletal system of children, for example, as a result of birth injuries.

 There is a way to restore motor functions in spastic hemiparesis and paralysis in pain syndromes by administering novocaine in an amount of 0.2-0.5 ml to each of certain acupuncture points (see: Tykochinskaya ED, Acupuncture of Acupuncture. M. Medicine, 1979, p. .44). The specified method is impractical to use in the treatment of young children, since the method of its use requires leaving the needle in the tissues at a depth of about 1 cm and in the range of 30-45 minutes in time.

 There is a method of restoring motor functions, which consists in determining the localization of motor disorders, symmetric or one-sided chipping of the excitation zones and amino acid preparations in combination with chipping of paravertebral points at the level of the nerve roots of the segments of the spinal cord (see A.S. USSR N 1641348, class A 61 K 31/00, 1988. This method is effective for atonic forms of paresis of skeletal muscles and to a lesser extent for spastic syndromes (see ibid.) In addition, this method does not solve the problem restrictions on movements in the knee and ankle joints, and the use of cerebrolysin does not give a lasting effect when chipping spastic muscles in a limited number of points, namely the projection of the elbow and popliteal fossa, and several paravetebral points. a limited contingent of children with modifications of motor disorders.

 The invention is aimed at reducing the duration of treatment and expanding the contingent of children with various forms of motor impairment, to increase the durability and effectiveness of treatment, as well as to eliminate more severe defects of the child's body.

 This is achieved by preliminarily determining the anatomically locomotor points of the atonic muscles corresponding to the lost movements (Triumfov V.N. Topical diagnosis of diseases of the nervous system. L, 1974, p.15). Actovegin is introduced into them, which, depending on the nature of motor disorders, is combined with the introduction of sodium oxybutyrate and / or vitreous body. In this case, instead of sodium oxybutyrate, midocal can be used.

 The method is as follows.

 Neurological examination reveals affected muscles and the nature of their violation. Then, using the monograph (Triumph VN Topical diagnosis of diseases of the nervous system. L, 1974, p.15), the motor points of the atonic muscles are determined, and 0.1 ml of Actovegin prepared by diluting 0.15 is injected into each point along the muscle -0.40 ml of the drug with water to 1.0 ml. Moreover, depending on the age of the child, the following amounts of Actovegin are used for breeding: 1-2 years 0.15-0.22 ml; 2-4 years 0.2-0.25 ml; 4-6 years - 0.25-0.3 ml; 5-10 years old 0.3-0.4 ml; 10-15 years 0.35-0.4 ml.

 Then, the entire complex of spastic muscles is determined and, along with each muscle, 0.1 ml of sodium oxybutyrate is introduced at a distance of 2-5 cm at a dilution of 0.3-0.4 ml of the drug to 1.0 ml with water.

 The total dose of the drug is from 0.9 to 1.5 ml.

 In the case of severe spasticity, midcalm is also used in microdoses or the administration of sodium oxybutyrate with midcalm is combined.

 After that, the presence of contractures and / or stiffness in the joints and in the places of muscle transition into the tendon and interphalangeal spaces is determined to enter the vitreous body with a total volume of up to 1.0 ml, 0.1 ml per injection.

 The course of treatment includes 5-7 sessions.

 Examples. Mining K, 6 years old, was admitted with a diagnosis of right-sided hemiparesis. In the history of weakness of labor, entwining of the umbilical cord around the neck. Upon admission in neurological status: muscle tone of the right lower limb is increased, tendon reflexes are enlivened, stiffness in the right ankle joint, standing, leaning on a sock, atrophy of the leg muscles. In the area of the right upper limb, the tone of the flexors is increased, the reflexes are animated. The Actovegin solution was injected into the child in the motor points with a total volume of 0.4 ml, 0.1 ml per injection and in the area of the flexor muscles m. bi-ceps brachii, m. triceps brachii with a total volume of 0.6 ml, 0.1 ml per injection with an injection interval of 2-3 cm between points. Back of thigh and lower leg m. semitendinosus, m. gastrocnemius was injected with a solution of sodium oxybutyrate with a total volume of 1.0 ml of 0.1 ml per injection with an injection interval of 2-3 cm between points. In connection with the revealed stiffness in the ankle joint, the vitreous body up to 1.0 ml was introduced into the Achilles tendon and ankle joint. After the 3rd chipping, the spasticity of the muscles of the lower limb decreased, the range of motion in the ankle joint increased, and the foot dropped. When viewed after three months: walks on his own, the range of motion in the upper and lower extremities is fully restored.

 Example 2. Olya Zh. 2.5 years old, was admitted with a diagnosis of generic plexitis on the right, total form. In the anamnesis: from 1 pregnancy, 1 childbirth, accompanied by a weakness of labor, drug-induced rhodostimulation was performed. Upon admission to the department: the hand hangs along the body, muscle tone is reduced, a small range of movements is preserved in the II, IV, V fingers of the right hand. Tendon areflexia in the right hand. The treatment was carried out by chipping the muscles of the upper shoulder girdle with Actovegin solution. Actovegin 0.3 ml of 0.1 ml per injection was injected into the motor points, and m along the muscles. deltoideus, m. brachioradialis 0.7 ml with an injection interval of 3 cm. The vitreous body was introduced into the region I, II of the interphalangeal spaces, II, IV, V fingers. After each chipping session, new movements appeared in the hand, the hand began to work (the patient began to hold objects in her hand), the improvement of static-motor functions was persistent.

 The specified method treated 40 children from 1 year to 10 years, 30 children, 10-13 years old 10 children. Children with the consequences of perinatal damage to the nervous system, atonic or spastic motor syndromes prevailed.

 The effectiveness of the treatment was evaluated by the appearance of new motor skills in the child (the ability to hold the head, sit, stand without support, elements of fine motor skills), increase the range of movements in the knee and ankle joints.

 A positive effect was observed in 36 of 40 cases (90). The absence of positive dynamics was observed in children with brain atrophy.

 When treating with this method, the restoration of motor functions occurs after 3-4 sessions of chipping. A persistent positive effect after 6 sessions of chipping is also ensured by the inclusion of manual therapy elements, microwave stimulation, and a set of special physical exercises in this method of treatment.

 The described method of treatment is effective for restoring lost motor functions after birth injuries, as well as for the formation of proper motor skills in children with a delay in psychomotor development.

Claims (4)

 1. A method of restoring motor functions, including determining the affected muscles and chipping them with an amino acid preparation in microdoses, characterized in that the motor points of the atonic muscles are preliminarily determined, actovegin is administered at each point and along the muscle, which in cases of detecting spastic muscles is combined with the administration of oxybutyrate sodium and / or midocalmus, and in cases of contractures and / or stiffness in the joints, the vitreous body is additionally introduced.  2. The method according to claim 1, characterized in that actovegin is administered in 0.1 ml of a solution prepared by diluting 0.15 0.40 ml of the drug with water with a total volume of up to 1 ml, while the following amounts are used for breeding, depending on the age of the child Actovegin: 1-2 g 0.15 0.22 ml; 2-4 g - 0.20-0.25 ml; 4-6 years old 0.25 0.30 ml; 6-10 years 0.30 0.40 ml; 10-15 years - 0.35-0.40 ml.  3. The method according to PP. 1 and 2, characterized in that the sodium oxybutyrate and / or midcalm are administered along the spastic muscle.  4. The method according to PP. 1 to 3, characterized in that the vitreous body is introduced into the place of transition of muscles into the tendon and interphalangeal spaces.