Biomedical subjects
Publications and source records attributed to S A Likhachev.
The authors analyze literary and own findings on complications of manual therapy. The causes and clinical picture of possible complications are discussed. An original classification of complications due to manual therapy of cervical spine disorders is presented.
The authors have analyzed the anamnestic, clinical and laboratory data in 44 patients with Parsonage-Turner syndrome. Two forms of the disease were distinguished: radicular ischemia of vascular genesis, and the local form of infectious allergic polyradiculoneuritis associated with injury to the shoulder girdle of infectious genesis.
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A case of opsoclonus, myoclonic hyperkinesis of the eyes, is described. The causes of the occurrence of such a rare phenomenon are analyzed. A hypothesis is advanced, according to which in the mechanism of oculomotor abnormalities, of great importance are anatomic formations in the oral parts of the brain stem.
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In 57 patients with various forms of neurological manifestations of cervical osteochondrosis the authors examined the suppression of the vestibulo-ocular reflex (VOR) by asking the patients to fix their gaze on the object moving together with the armchair. Under normal conditions VOR suppression was complete. In unilateral involvement of the peripheral portion of the vestibular system VOR were not suppressed if the patient was moving according to a sinusoidal programme with the armchair rotating at a speed of 60 degrees/s in the direction of the healthy labyrinth. Patients with dysfunction of the brain stem-cerebellum portions of the vestibular system showed impairment of VOR suppression when they were rotated into both sides.
Hyperventilation has been employed in the examination of 36 patients with brain stem injuries of various origin in order to identify and record nystagmus. The use of this method has increased the rate of visualization of the abnormality.
Vestibular-ocular relations were studied in 30 patients with central vestibular affections varying in origin. Use was made of sinusoidal rotation with eyes closed and glance fixation tests. Symptoms of vestibular-ocular dysregulation typical for stem-cerebellar abnormalities were identified.
The vestibular-ocular reflex (VOR) was investigated in 40 patients with unilateral injury of the peripheral compartment of the vestibular system during their sinusoidal rotation and gaze fixation at a stationary object. At the stage of vestibular dysfunction decompensation the VOR coefficient showed a significant asymmetry and a decrease during rotation towards the injured side. As the dysfunction was compensated this asymmetry disappeared.
This paper gives a description of the mechanisms of inhibition of the vestibulo-ocular reflex by the gaze mechanisms in patients with unilateral lesion of peripheral compartments of the vestibular system at the stage of decompensation and subcompensation.
In 40 patients with unilateral injury of the peripheral compartment of the vestibular system in the stage of decompensation (Group 1) and subdecompensation (Group 2), the vestibulo-ocular reflex (VOR) was investigated during sinusoidal rotation with the eyes closed. Group 1 patients showed a significant asymmetry of the VOR coefficient and a distinct shift of the VOR displacement towards injury during sinusoidal stimulation of any intensity. Group 2 patients displayed similar but less significant changes.
The oculovestibular reflex is characterized by the reactivity coefficient and phase shift. The reactivity coefficient is a relative value which makes it possible to evaluate oculovestibular interaction and to describe the normal reactivity of the vestibular system which is far less variable than the vestibular nystagmus norm. Phase shift is defined as a delay or lead of the oculomotor reaction (in degrees) when compared to the stimulus generating it. Methods for measuring the reactivity coefficient and phase shift of the oculovestibular reflex are described.
Vestibulo-ocular interaction was investigated in 25 healthy subjects, aged 16-48 years. They showed a nearly complete inhibition of the vestibulo-ocular reflex (VOR) during rotation and gaze fixation at a target rotating together with the chair; the reactivity coefficient was no more than 0.05. During rotation with the eyes closed a specific type of the VOR phase shift was detected. These observations on normal subjects can be used for reliable interpretation of vestibulo-ocular interaction in patients with vestibular disorders.
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