METHOD OF TREATING PROFESSIONAL VEGETATIVE SENSORY POLYNEUROPATHY OF UPPER EXTREMITIES Russian patent published in 2020 - IPC A61N2/00 A61B5/476 

FIELD: medicine.

SUBSTANCE: method refers to medicine, namely occupational medicine, neurology, physiotherapy, can be used for treating professional vegetative-sensory polyneuropathy of upper extremities. Transcranial magnetic stimulation (TMS) of the cerebral cortex is ensured by magnetic stimuli with an individually selected intensity of stimulation. First day involves individual selection of intensity of stimulation. In the patient's sitting position, surface electrodes of electroneuromyograph (ENMG) are applied on the skin of the left hand that records the electrode on the area of a projection of the muscle that removes the little finger (m.abdutor digiti minimi), distal to it by 7–10 cm of the discharge electrode. For registration of cortical evoked motor responses (cEMR) stimulator inductor is located in projection of motor cortex for m.abdutor digiti minimi. TMS is performed by single stimuli with intensity of 70–80 % of maximum power of stimulator inducer, inductor is moved to detect zone with maximal contraction of muscle – response point for left m.abdutor digiti minimi with cEMR with maximum amplitude. Further, several single stimuli are performed with reduction of stimulus intensity 5 % lower than the previous one to obtain a minimum value of cEMR, which is taken as a threshold level of stimulus intensity for treatment. Region of the dorsolateral prefrontal cortex of the right hemisphere (dl PFC (D)) is found by shifting the inductor forward by 5 cm from the response point of the left m.abdutor digiti minimi. Mark is placed on the skull on the found point; the TMS of this zone is stimulated with frequency of 1 Hz, the intensity of the individual threshold level cEMR within 3 minutes. On the following days, TMS is performed from second to fifth, repeating exposure in the area of the label in the same mode as on the first day. Therapeutic course is 5 procedures.

EFFECT: method provides higher rate of somatic sensory nerves, reduced manifestation of vegetative neuropathy, clinical subjective effects in the form of reduction of numbness and pains in hands due to use of TMS for correction of vegetative and sensory polyneuropathy of upper extremities with individual selection of intensity of stimulation.

1 cl, 3 dwg, 7 tbl, 2 ex