[Localized transcutaneous electric nerve stimulation with high voltage impulses in functional chronic headache and migraine].
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Biomedical subjects
Publications and source records attributed to A Heydenreich.
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Cerebrovascular insufficiency is of great importance from the aspect of social medicine. Using a range of self-assessment conceived for ambulatory use, the authors tried therefore to detect it in an early stage to make prophylactic provisions possible. The range of self-assessment comprises 25 questions pertaining to specific symptoms. The patient indicates the replies on a five-grade verbal and digital scale. In addition to the evaluation of the content, the total value which can be easily calculated indicates the grade of manifested psychosyndrome as the basis for a reduced performance of the brain. The evaluation takes age-dependence into account. In the submitted paper results of a comparative examination are presented. The authors compared subjects with confirmed organic psychosyndrome (psychometry, PEG, CT etc.) with a control group of subjects without reduced brain performance. Both groups differed significantly at the 1% level of significance. The authors selected as the third group neurotic subjects who reported similar difficulties but their intensity was significantly smaller than in subjects of the examined group. Finally the results of the range of self-assessment were compared with differential therapeutic results (vasodilatating agents, nootropic agents).
In recent years the true incidence of impotence due to organic diseases in comparison with psychogenic disorders could be verified. New diagnostic tools as penile Doppler ultrasonography, PBI estimation, NPT measurement, invasive SKIT's, neurophysiological methods, selective phalloarteriography, artificial erection and dynamic cavernosography are introduced and are the guide to therapeutic approach.
PEMF treatment was studied in 10 patients with multiple sclerosis and 10 patients with migraine. In both patients' groups a single treatment induced a significant rise of yeast particle uptake by blood granulocytes. The percentage of phagocytizing cells was increased in migraine patients only. In both patients' groups 20 PEMF treatments caused a reduction of particle uptake, whereas the percentage of phagocytizing cells remained unchanged. In migraine patients the opsonic capacity of serum and the mean cell volume of erythrocytes, lymphocytes and granulocytes were initially reduced, but increased during the course of 20 PEMF treatments. The biphasic changes of cell volume and phagocytic activity are interpreted as a result of counter-regulation of the organism in response to the primary PEMF effect.
On the basis of lang term therapeutical and experimental experience with acupuncture and punctual transcutaneous electrical nervestimulation (PuTENS) and in connection with the present neurophysiologically knowledge the results of reflextherapy and stimulatory-therapy in migrain are discussed. The established analgetic, vascular, musclerelaxing and reflectory effects of acupuncture may in part explain a causative influence on migraine. Trigger mechanisms siderably reduced and the vegetative state are favourable influenced.
Myo-vertebrogenous syndromes are the most frequent painful diseases. In physiotherapy methods of adjusted reflex-therapy like manipulations, neural therapy (therapeutic local anaesthesiology) and acupuncture in case of functional disturbances have been proved. We achieved an improvement in 93% of 1167 patients with acquired functional myo-vertebrogenous pain syndromes with the combination of this methods. In a prospective randomised study the superiority of combined reflex-therapy to the usual ambulant medicamentous physiotherapeutic treatment of low back pain syndromes is significant. Therefore special reflex-therapeutic consultations are recommended.
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Chronic and frequently relapsing headaches as well as myalgic-vertebragenic pain syndromes belong to the most frequent pain diseases. Among the non-medicamentous methods the techniques of the aimed reflex and stimulation therapy such as acupuncture, neural therapy and manual medicine particularly stood the test. As a non-invasive alternative we try to replace the needle acupuncture by punctuate transcutaneous electric nerve stimulation. With the help of self-constructed pocket stimulating current devices we treated 740 patients suffering from pain (420 with myo-vertebragenic and 320 with primary headaches) and achieved 90% of immediate successes and 70-80% improvement after 6 months. The treatments could be objectifie thermometrically. Own prospective randomized studies of placebo-treatment and medicamentously controlled studies of treatment and changes of the pain threshold by means of the PuTENS were briefly represented and the mechanism of action was discussed. The application of this effective, free of side effects, undangerous, economic method easily to be learned which is suitable for the autotherapy and sanatory therapy is recommended for the alleviation of pain.
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Pharmacotherapy of migraine is not satisfying at present, especially in case of frequent attacks of headache. Therefore alternative methods of treatment gain increasing relevance. Based upon many years of experience with specific reflexotherapy and conventional stimulation therapy for treatment of pain we started a clinical study in migraine applying the punctual transcutaneous electrical nerve stimulation (PuTENS) performed with self-made pocket electrostimulators (TRG I-III). The study includes self-treatment of patients at home. After more than 6 months PuTENS was prophylactically effective in 225 out of 282 patients, i.e. in 80% of cases the frequency of attacks and the use of drugs were reduced to at least 50%. In 90 patients treated by the physician the rate of improvement was 86% compared to 76% in 192 patients, which performed self-treatment according to the physician's instruction and under medical supervision. 96 out of 160 patients with migraine could alleviate their acute headache by PuTENS applying the pocket electrostimulator at home. In conclusion, PuTENS is superior to drug therapy and conventioned electrotherapy in the treatment of migraine. Its effectiveness is similar to needle acupuncture. The method can therefore be regarded as a valuable alternative and help for patients with frequent headache.
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Twelve patients with extremely severe uveitis and two patients with necrotizing (chorio-)retinitis were treated with a combination of antibiotics consisting of penicillin G, gentamicin and metronidazole. The antibiotics were administered in 5 cases (all uveitis patients) after unsuccessful long-term treatment with other drugs, in nine cases after short-term treatment with other drugs or immediately. The treatment was effective in 10 of the uveitis patients, including all 5 cases in which the previous treatment had been unsuccessful. In 2 cases it was ineffective. It was effective, however, in both of the cases of necrotizing (chorio-)retinitis. The duration of the required treatment with antibiotics was not significantly prolonged in cases which had previously undergone long-term treatment with other drugs. However, the clinically detectable onset of improvement of vision and of the findings was significantly delayed. Despite some cogent connections between the antibiotics therapy and the improvement in the clinical picture, no well-founded conclusions as to etiology can be derived for the uveitis or necrotizing (chorio-)retinitis patients in question. The successful treatment of problematic cases identifies therapy with antibiotics as a therapeutic alternative.
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At present the eye tuberculosis still occurs only in its reactive form. But also these pathological processes may quite considerably disturb the vision. In the first place are chorioiditis (uveitis posterior), iritis and iridocyclitis (uveitis anterior), uveitis totalis and periphlebitis retinae are by far less frequent. Number and severity of the pathological processes considerably decreased during the last years, above all also the new diseases. Relapses are still increasedly observed. The problems of diagnostics and the necessary therapeutic measures are described.
Since 1966 photocoagulation has been performed in 52 cases and 54 eyes of choroiditis located on the posterior pole. The course of the cases treated is compared with a control group treated with drugs. Photocoagulation shortens the duration of the acute inflammatory process, decreases the frequency of recurrences by about 40% and improves the visual prognosis. The follow-up 1 year to 9 years later (average 7 years) showed in the control group a visual function of 0.5, in the treated group of 0.8.
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