RESUMEN
Patients with severe muscular spasticity still represent the most complex and resistant to therapy group of neuro-rehabilitation patients. In a few years, in Russia, intrathecal baclofen therapy has appeared to be the most effective method for such spasticity. For the first time the authors developed and implemented in clinical practice "Prospective register to treat spastic states using intrathecal baclofen therapy in Russian Federation" aimed at therapy classification of spastic patients: to reveal management characteristics, assess treatment outcomes and frequency of occurrence of adverse events that will finally help specify the need for the method employment in real clinical practice. The article presents the findings of a one-year usage of Register, which enabled to make a preliminary evaluation of intrathecal baclofen therapy in Russia.
RESUMEN
A combined approach to neuroreconstructive effects on pathogenesis mechanisms of vegetative state that develops as a result of severe traumatic brain injury (TBI). It is shown that under the influence of chemical transtimpanal vestibular dereception and transcranial micropolarization (TDCS) accelerated and more pronounced therapeutic effect than conventional therapy. Neurophysiological in-depth examination of the dynamics shows that over time in patients in a vegetative state, picking up the intensity, "tension" and "rigidity" of inter-regional cortical interactions in the organization that are beginning to dominate the area TPO cortex of both hemispheres. It is suggested that in the dislocation of the brain stem in severe TBI is vestibulotalamic tract, thanks to its anatomical location, is the least vulnerable. As a result, the prevailing afferentation forming inter-regional cortical interactions is vestibular afferent impulses. On its basis the pathological functional system, blocking the work of other functional systems of the damaged brain. Suggested treatments significantly reduce the amount of vestibular afferent flow and open up the possibility of recovery of more effective interafferential interactions. This greatly facilitates the work of the brain as a multimodal analyzer.