Now in an arsenal of neurologists and psychiatrists there is a large number of instrumental methods of the researches allowing to estimate the functional condition of both central, and peripheral nervous system. For the choice of the right diagnostic direction, the exact treatment, assessment of prospects of therapy, the forecast of a course of a disease the doctor-clinical physician has to be guided in methods of the functional diagnostics, have an idea of results which can be received by means of this or that method.
Brain electroencephalography: carrying out technique
The electroencephalography (EEG) is a research technique of activity of a brain by record of electric impulses, its coming from various areas. This diagnostic method by means of the express device, an electroencephalograph is carried out, and is high-informative concerning a set of diseases of the central nervous system.
Electroencephalographs happen stationary (allowing to conduct a research only in expressly equipped office) and portable (give the chance of diagnostics immediately at the patient’s bed). Electrodes in turn divide on lamellar (have an appearance of metal plates with a diameter of 0.5-1 cm) and needle.
Why do we use an EEG?
The electroencephalography records some states and gives to the expert the chance:
-to find and estimate the nature of violation of functioning of a brain;
-to define in what area of a brain the pathological center is located;
-to find epileptic activity in this or that department of a brain;
-to estimate functioning of a brain at the period between attacks of spasms;
-to find out the reasons of faints and the panic attacks;
-to carry out differential diagnostics between organic pathology of a brain and its functional violations in case of presence at the patient of symptoms, the characteristic of these states;
-to estimate effectiveness of therapy in case of earlier established diagnosis by comparison of an EEG before treatment and against the background of it;
-to estimate dynamics of process of rehabilitation after this or that disease.
With caution it is necessary to conduct a research at persons with mental diseases as they can not always correctly follow instructions of the doctor (in particular, to be during the procedure blindly and not to move) and also violent patients as both the device, and a hat with electrodes can cause in them even feeling of rage. In need of carrying out an EEG at such patients it beforehand inject sedative drugs which at the same time distort results of a research, that is, do it to less informative.
So, the EEG is appointed at:
disorders of falling asleep and dream (insomnia, a sleep-walking, frequent awakenings in a dream);
attacks of spasms;
craniocereberal injuries;
neurocirculatory dystonia;
frequent headaches and dizzinesses;
diseases of envelopes of a brain: meningitis, encephalitis;
intense violations of brain blood circulation;
brain tumors;
restitution after neurosurgical operations;
faints (more than 1 episode in the anamnesis);
panic attacks;
constant feeling of a fatigue;
diencephalic crises;
autism;
to speech arrest of development;
to delay of mental development;
stutter;
tics at children;
Down syndrome;
CEREBRAL PALSY;
suspicion on the death of a brain.
Rheoencephalography of vessels of a brain: essence of a method, indication, contraindication
REG is a noninvasive method of the functional diagnostics. By means of it measurement of resistance of tissues of the head to electric current is carried out. All know that blood is electrolyte. When the vessel of a brain is filled with blood, values of electrical resistance of fabrics decrease, it also records the device. Then, is more narrow on the basis of the speed of change of resistance, draw conclusions about blood current speed in this or that vessel and also other indexes estimate.
REG provides data on the following parameters of a blood-groove:
tone of vessels;
degree of a krovenapolneniye of this or that site of a brain;
blood-groove speed;
viscosity of blood;
collateral blood circulation and others.
Reoentsefalogramma has a wavy appearance, and each segment of this wave has the name:
the ascending its part – an anacrotism;
descending – a catacrotism;
between them – the intsizura (actually, a bend – transition of the ascending part in descending), at once behind which is defined the little dicrotic wave.
Deciphering REG, the doctor estimates her such characteristics:
waves are how regular;
as the anacrotism and a catacrotism look;
character of a curving of a wave crest;
arrangement of an intsizura and dicrotic wave, depth of the last;
existence and type of padding waves.
Electroneuromyography (ENMG) – the modern and high-informative instrumental method of the analysis of a function of state of peripheral nervous system.
The research can consist of conduction assessment on nerves by means of giving of small electric impulses and filing of answers from nerves and muscles is what is usually called by a stimulation electroneuromyography or ENMG.
Besides, depending on a clinical situation the analysis of a condition of muscles by means of a thin needle electrode can be carried out – it is called by a needle electromyography or an EMG.
When carrying out a research the patient can feel feelings in the form of a pricking in various parts of the body when giving electric impulses, feel in a stake of a needle electrode. In spite of the fact that these feelings can be several diskomfortna, most of patients well postpone a procedure.
Carrying out ENMG includes:
– neurologic survey;
– instrumental assessment of function of sensing fibers of peripheral nerves;
– instrumental assessment of function of motive fibers of peripheral nerves;
– specification of extent of defeat and volume of involvement in pathological process of muscular tissue by means of a needle electrode;
– the analysis of the obtained information and writing of the conclusion.
In the conclusion localization, degree, and pathogenetic type of defeat of peripheral nervous system will be specified if that is available.
Polisomnografiya (Party of Free Citizens) — a method of the long-lived filing of various functions of an organism during all dream. The method includes monitoring of biological potentials of a brain (EEG), electrooculogram, electromyogram, electrocardiogram, heart rate, an airflow at the level of a nose and a mouth, respiratory efforts of chest and belly walls, fluctuations of oxygen in blood, a physical activity in a dream.
The method allows to study all pathological processes arising during sleep: syndrome апноэ, violations of a rhythm of heart, change of arterial blood pressure, epilepsy. First of all the method is necessary for diagnostics of insomniya and selection of adequate methods of therapy of this disease and also at syndromes апноэ in a dream and snore. The method is of great importance for detection of epilepsy of a dream and various motive frustration in a dream. For adequate diagnostics of these violations night video monitoring is used.
Methods of duplex and tripleksny scanning are the most modern research techniques of a blood-groove and also a condition of a vessel. In the conditions of two – and the three-dimensional image it is possible to see an artery, its form and the course, to estimate a condition of its gleam, to see plaques, blood clots and also a stenosis zone. Methods are irreplaceable at suspicion on existence of atherosclerotic defeats.
It is necessary to remember that often the clinical physician waits from the doctor of the functional diagnostiya of the concrete diagnosis, and that, in turn, has no right of diagnosis. It follows from this that any clinical physician has to have a particular level of knowledge necessary for interpretation of the received results. Also it is impossible to forget that methods of fundamental diagnostics are auxiliary, and have to be estimated by the doctor-clinical physician in relation to the specific patient. At the same time the neurologist has to lean on the available clinical picture, the anamnesis and the course of a disease.
Dopplerography of vessels of a brain.
Ultrasonic research technique of blood circulation in turnpike arteries of a brain. UZDG is a new, informative method of diagnosis of diseases of vessels of the head and neck. The technique includes a research of carotids, subclavial and vertebral arteries and also turnpike arteries of a brain.
UZDG – allows to determine blood-groove speed by turnpike arteries of the head and a neck, expressiveness of atherosclerotic changes in them, vessel stenosis degree, change of a blood-groove on vertebral arteries at cervical osteochondrosis, is used for diagnosis of aneurysm of vessels of a brain. It is applied at vascular diseases, to definition of the reason of dizziness, instability when walking, a sonitus.
Defeat the brakhio-tsefalnykh of arteries most often meets at people 40 years at atherosclerotic process, an idiopathic hypertensia, a diabetes mellitus and other pathology are more senior. A specific place is held by a research of vertebral arteries at manifestation of a vertebro-bazillyarny failure (dizzinesses, unsteadiness during the walking, front sights in eyes at change of position of a body in space, weight in the head in the mornings etc).
Well-timed following of vessels allows to reveal the contributing factors for development of the intense violations of brain blood circulation resulting in disability.
Magnetoencephalography (MEG)- is a functional neuroimaging technique for mapping brain activity by recording magnetic fields produced by electrical currents occurring naturally in the brain, using very sensitive magnetometers. Arrays of SQUIDs (superconducting quantum interference devices) are currently the most common magnetometer, while the SERF (spin exchange relaxation-free) magnetometer is being investigated for future machines.[1] Applications of MEG include basic research into perceptual and cognitive brain processes, localizing regions affected by pathology before surgical removal, determining the function of various parts of the brain, and neurofeedback. This can be applied in a clinical setting to find locations of abnormalities as well as in an experimental setting to simply measure brain activity
