RU2665971C1 - Method of treatment of neuropathy of the lingual nerve - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to dentistry, and can be used to treat the neuropathy of the lingual nerve. To do this, physiotherapy is carried out using dynamic electro-neurostimulation with the help of the DENAS device and drug therapy. In this case, inject nicotinic acid 2 ml intramuscularly, daily number 10. Apply moomiyo 0.2 g in the morning on an empty stomach 15 minutes before eating. Use the moomiyo solution in the form of an application on the tongue, spend 20 minutes 3 times a day after meals. To do this, 0.2 g of moomiyo is dissolved in 50 g of water. Neuromidine is also administered 10 mg 3 times a day. 3 weeks after the course of treatment, a control examination is performed to determine the parameters of stereognosis and estesiometry. If 3 or more negative answers are received in the control examination of stereognosis and the esthetic indicator exceeds 12 mm on the tongue, a second course of treatment is performed using only the DENAS device.EFFECT: method provides increase in the effectiveness of therapeutic measures while reducing the use of pharmacotherapy.1 cl, 1 tbl, 1 ex

Description

The invention relates to medicine, in particular electrotherapy, and can be used in dentistry for the treatment of neuropathy of the lingual nerve.

Patients with lingual nerve neuropathy, in contrast to patients with a diagnosis of “To 14.6 Glossodynia,” complain of pain and paresthesia in the anterior 2/3 of the right or left half of the tongue, decreased or lack of tactile and pain sensitivity in this area. The nature of pains and paresthesias is different: "soreness", tingling, "creeping goosebumps." Moreover, during meals, with prolonged conversation, smoking, pain and paresthesia intensify. The vast majority of patients - 57 people (96.61%), associated the onset of the disease with dental manipulations in the oral cavity and only 2 people (3.39%) - a lower jaw injury.

The use of non-medications is known, such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) for the treatment of pharmacologically resistant non-paroxysmal prosopalgia, such as trigeminal neuropathy, glossodynia, dental plexalgia (Fischenko, O.N. therapy and transcranial magnetic stimulation: abstract ... Candidate of Medical Science, 01/14/11, Moscow, 2011). The author found that ECT has a significant positive effect on the clinical picture and the severity of pain in patients with glossodynia and psychogenic prosopalgia.

Disadvantages of the work: the authors use the method for the treatment of glossodynia, however, the methods of treating neuropathy of the lingual nerve are not considered in the work.

The positive effect of dynamic electroneurostimulation (DENS) on the functional state of sensory formations of the oral cavity during treatment on an outpatient basis (Borisova, EG. The effect of dynamic electroneurostimulation (DENS) on the functional state of sensory formations of the oral cavity is known // Reflexotherapy. - 2007. - No. 2 (20). - P. 29-30; Borisova, E.G. Diagnostics and treatment of pain syndromes of the face and oral cavity on an outpatient basis // Voronezh: Publishing house-polygraph center of Voronezh State University. - 2011. - 128 p.). But in these works, the treatment of neuropathy of the lingual nerve is not developed.

EFFECT: development of a method for treating neuropathy of the lingual nerve, which allows to increase the effectiveness of therapeutic measures, reduce the use of pharmacotherapy by expanding the arsenal of physiotherapeutic effects in dentistry.

The technical result is achieved by the fact that in the method of treating neuropathy of the lingual nerve, including physiotherapy and drug therapy, dynamic electroneurostimulation is performed as a physiotherapeutic effect, and this affects the painful zones of the tongue that have lost sensitivity, in accordance with the complaints for 20 minutes the course of exposure is 12 sessions; in parallel with electroneurostimulation, drug therapy using nicotinic acid 2 ml intramuscularly, daily No. 10; a mummy of 0.2 g in the morning on an empty stomach 15 minutes before eating, as well as in the form of an application on the tongue of a mummy solution, for which 0.2 g is dissolved in 50 g of water, for 20 minutes 3 times a day after eating; neuromidine 10 mg 3 times a day. 3 weeks after the course, a control examination is carried out with the determination of stereognosis, esthesiometry, registration of the severity of pain on a visually analogue scale, the results of which determine the need for a second course of DENS therapy only, without the use of drug therapy, which confirms the technical result of the treatment method.

When registering during the control examination of hypertension exceeding the number of negative answers 3, EM exceeding 12 mm on the back of the tongue, a second course can be prescribed only with the DENAS apparatus.

Taking into account the anamnestic data of patients with NJA, taking into account the hypoxic and degenerative changes in the fibers of the lingual nerve with a traumatic nature, and based on our clinical experience, 59 patients who were under our supervision with this pathology were treated with medication. Patients were divided into 2 subgroups. The first group included 15 people (25.42%) who received only drug therapy (MT), the second group included patients (44 people - 74.58%) who received, in addition to drug therapy, sessions of electroneurostimulation with the DENAS apparatus (MT + DENAS) .

The therapeutic effect of DENAS is based on multilevel reflex and neurochemical reactions that trigger a cascade of regulatory and adaptive mechanisms of the body. The healing factor in these devices is energy-information impulses, which act as a physiological stimulus of nerve endings. As a result, the pain syndrome is eliminated, microcirculation improves, the formation of biologically active substances and metabolic processes in tissues are activated, the tone of muscles and blood vessels is normalized. Sessions were carried out daily, in the “Therapy” mode with a pulse frequency of 60 Hz to the affected areas to the affected areas of the tongue, in a labile way, the current strength was selected individually. The exposure time is 20 minutes. Comparative results of therapy are presented in table 1.

As follows from table 1, before treatment in patients with NJS, the YOUR (visual analogue pain scale), EM (esthesiometry) and SG (stereognosis), electrogustometry (EGM) indices significantly differed from normal indices in these parameters. After the drug therapy, the indicators improved on average by 42.51% (p <0.05), and after the combination, using electroneurostimulation (DENAS), they increased on average to 63.83%. Therefore, the inclusion of electroneurostimulation in the treatment complex significantly increases its effectiveness.

The implementation of the method illustrates a clinical example.

Example 1. A 47-year-old patient of K-n applied for specialized help with complaints of “numbness” of the right half of the tongue, “disappearance” of the papillae from the tip of the tongue after 4.8 removal. a tooth. Considers herself ill for about 4 months. After the examination, the diagnosis was "Neuropathy of the lingual nerve on the right of the traumatic genesis." Prescribed: Nicotinic acid (2 ml intramuscularly, daily No. 10). Mumiye 0.2 g in the morning on an empty stomach 15 minutes before meals, applications on the tongue of a mummy solution (0.2 g was dissolved in 50 g of water) for 20 minutes 3 times a day after meals. Neuromidine 10 mg 3 times a day. DENAS sessions on the right half of the tongue. Duration 20 minutes. Therapy mode, frequency 60 Hz. General course - 12 sessions of 20 minutes. After the course of treatment, the discomfort in the tongue and the feeling of numbness were significantly reduced. It is recommended to take a second course only with the DENAS apparatus. The patient was observed after a repeated course for 12 months. There are no complaints.

Claims (1)

A method for the treatment of neuropathy of the lingual nerve, including physiotherapy using dynamic electro-neurostimulation using the DENAS apparatus and drug therapy, including the use of nicotinic acid 2 ml intramuscularly, daily No. 10; a mummy of 0.2 g in the morning on an empty stomach 15 minutes before eating, as well as in the form of an application on the tongue of a mummy solution, for which 0.2 g is dissolved in 50 g of water, for 20 minutes 3 times a day after eating; neuromidine 10 mg 3 times a day, characterized in that 3 weeks after the course, a control examination is carried out with determination of stereognosis and esthesiometry indicators; if during the control examination of stereognosis 3 or more negative answers are received and the esthesiometry exceeds 12 mm on the back of the tongue, a second course of treatment is prescribed using only the DENAS apparatus.