Method for restoring brain function

Abstract

FIELD: medicine.SUBSTANCE: used to treat patients with impaired brain function. The objective of the claimed invention is to restore blood supply to damaged and functionally immature, damaged and / or deficient areas of the brain with subsequent electrical neurostimulation. For this purpose, exponential bipolar currents are used to eliminate possible side effects from the use of rectangular pulses, ensuring highly effective and maximally physiological effects. In addition, the functionality of the method is increased, as intelligence and memory are additionally developed. The patient is interviewed and examined to identify clinical disorders and make a preliminary diagnosis. Instrumental examinations are carried out, namely ultrasound Dopplerography of the brachiocephalic arteries (BCA USDG) and transcranial duplex scanning (TCDS) or angiography of the BCA and TC vessels, MRI of the cervical spine (CS) and / or X-ray of the CS in two projections, to assess the initial state of cerebral circulation in the BCA and TC vessels. The results are analyzed and the degree of cerebral blood supply disorder is assessed, and local corporal reflexology of the selected cerebral cortex area is prescribed. Vacuum therapy of the selected area of the cervical spine and physiotherapy of the cervical spine are performed, and mobility of the cervical spine is excluded. Next, instrumental examinations are repeated, followed by analysis of the results and assessment of the degree of impairment of blood supply to the brain. If the results improve, a course of transcranial electrical neurostimulation is carried out using exponential pulses.EFFECT: method ensures increased treatment effectiveness, which is confirmed by a reduction in the percentage of blood supply disorders according to the results of ultrasound dopplerography.1 cl, 3 ex

Description

[0001] The invention relates to medicine and can be used to treat patients with impaired brain function.

[0002] In the mid-1960s, the first positive clinical results of contact electrical stimulation of the brain were obtained, conducted at the Brain Research Institute under the direction of Academician N. P. Bekhtereva, which also served as the initiating basis for the use of electric current in lesions of the optic nerves. In line with this work, a group of researchers at the Research Institute of Experimental Medicine (V. A. Khilko et al., 1982; A. N. Shandurina, 1985) developed a method of direct electrical effects through electrodes implanted subepinervically in the optic nerves during neurosurgical operations. The most optimal modes of electrical stimulation were identified based on the characteristics of the electrical activity of the optic nerves and visual cortex, recorded during stimulation. The method has proven its effectiveness. Subsequently, various approaches to the optic nerve for chronic implantation of electrodes were proposed. A. N.Shandurina (1985) proposed a transorbital method of electrode insertion and their chronic implantation, which significantly expanded the indications for electrical stimulation. However, the need to remove the electrodes after electrical stimulation by traction did not eliminate the possibility of damage to the nerves and retrobulbar vessels.

[0003] A new stage in the development of electrical stimulation techniques is associated with the creation of non-invasive methods. In 1985, a group of researchers at the Rostov-on-Don Research Institute of Neurocybernetics, led by E. B. Kompaneets, proposed a method of transcutaneous electrical stimulation of the eyes and the ESO device for its implementation. These devices became widely used in ophthalmological practice due to their relative simplicity, convenience, and lack of complications. In 1987, Professor A. N. Shandurina proposed her own version of transcutaneous electrical stimulation using the Chakra device.

[0004] In 1990, Professor A. N. Shandurina patented a method for treating hearing loss and deafness by electrical stimulation of the auditory system with a series of bipolar pulse bursts, with electrical stimulation being carried out transcutaneously using a multi-contact electrode, the contacts of which are located in the behind-the-ear region, and the electrical stimulation mode is selected for each of the contacts depending on the initial state of the auditory function and the patient’s auditory sensations [RU 2102956, published 01 / 27 / 1998].

[0005] A method for restoring the functions of the nervous system in the event of damage has been developed, in which a preliminary determination of the severity of the dysfunction is made and, after establishing the indications for electrical stimulation, a series of sessions of transcutaneous electrical stimulation are carried out by means of multi-contact electrodes, wherein their contacts are arranged in accordance with the localization of the damaged areas of the nervous system that are subject to activation, and the electrical stimulation modes are selected individually for each contact depending on the initial state of the corresponding section of the activated area before each session in order to obtain an effect of weak electrical impulses adequate to the biocurrents of the central nervous system, taking into account the dynamics of the state of the damaged functions, while electrical stimulation is carried out by applying a series of packets of bipolar rectangular impulses to each contact [RU 2001102533, published 27.11.2002].

[0006] In the early 1980s, researchers at the I.P. Pavlov Physiology Department of the Russian Academy of Medical Sciences' Research Institute of Epidemiology and Microbiology, under the direction of Professor G.A. Vartanyan, demonstrated the possibility of reducing experimentally induced epileptiform activity in animals, as well as seizures in humans, using intracranial micropolarization of the amygdala. Analysis of the obtained data prompted the authors to develop a non-invasive method of transcranial micropolarization. It is currently widely used in the treatment of children with cerebral palsy and speech and mental retardation. However, it is known that the mechanism of action of polarizing current on nervous tissue causes a rather harsh effect, which can lead to an increase in excitation symptoms, leading to a seizure. This current, again due to its mechanism of action on nervous tissue, does not have the same targeted local effect as bipolar pulsed current.

[0007] At the same time, techniques for stimulating the optic and auditory nerves, as well as micropolarization, were developed. In 1984, Professor A. A. Gerasimov developed a method of intra-tissue and transcutaneous electrical stimulation, primarily for the treatment of pain syndromes, but also for the restoration of nerve tissue, using a monopolar low-frequency pulsed exponential current. This current is known to be closest to the body's natural biocurrents, is well tolerated, and has virtually no side effects, unlike rectangular current. However, these currents are used primarily in pain management.

[0008] Work was conducted jointly with Prof. R. A. Iskov, a student of Prof. Shandurina, using the Magnon 29D device. Methods were developed for transcranial neurostimulation with low-frequency exponential bipolar currents of damaged or functionally immature areas of the brain in children with speech, mental, and psychoverbal developmental delays, attention deficit hyperactivity disorder, dysarthria, attention, memory, and behavioral disorders, academic failure, cerebral palsy, and motor and coordination disorders. Work was also conducted with adult patients with memory impairment, dysarthria, movement, and coordination disorders resulting from traumatic brain injury and acute cerebrovascular accident. Positive results and a virtually complete absence of side effects were achieved in a significant number of cases, even in patients with epilepsy and severe mental disorders such as dysphoria and dysthymia.However, among patients with the aforementioned pathology, there remained a subset with inconsistent positive results from neurostimulation. An analysis of the literature on research in this field has revealed some complexities and patterns in the development of developmental delay syndrome in children and patients, depending on the state of blood supply to brain structures. Many authors use monopolar or bipolar currents with rectangular pulses when working with patients with developmental delays.

[0009] A method for treating cerebral palsy in children is known [RU 2582873, published 04 / 27 / 2016], which used the Brain Port device and electrical impulses with a rectangular current shape, which in some cases was accompanied by increased sensitivity of patients to microcurrents and increased excitability of nerve centers.

[0010] A method of non-invasive low-current electrical stimulation of brain structures is known [RU 2820133, published 05 / 29 / 2024] describes a method for the rehabilitation of people with brain injuries, which also uses currents with a rectangular pulse shape, which in some cases was also accompanied by side effects in the form of increased excitability of certain brain areas with corresponding negative symptoms.

[0011] Grossman et al. (2017) used the principle of interference to influence the brain and developed a technique for electrical stimulation of brain regions [Electronic resource Frontiers | A novel non-invasive brain stimulation technique: “Temporally interfering electrical stimulation”]. The principle of TI electrical stimulation was based on the use of two waves. Two high-frequency sine waves (f1 and f2) of slightly different frequencies were applied, after which a low-frequency envelope wave with a frequency of Δf was generated inside the brain, which functioned as a direct modulation of an alternating current with a frequency of Δf. In the first in vivo study, TI electrical stimulation effectively activated neurons in the hippocampus of mice using electrodes attached to the skull. This was the first time that non-invasive and targeted stimulation of deep brain regions was confirmed, which opened a new direction in the field of brain stimulation.Given the importance of deep brain stimulation of pathological areas in the treatment of neurological and psychiatric disorders such as Parkinson's disease, stroke, depression and obsessive-compulsive disorder, the prospect of targeted stimulation without surgical intervention looks attractive.

[0012] A method for restoring impaired functions of the brain is known [RU 23554400, published 20.05.2009], which includes determining the electrical lability of the visual system and conducting electrical stimulation from electrodes, one of which is installed on the eyelid with a frequency of electric current pulses that does not exceed the value of electrical lability of the visual system, while additional electrodes are installed in the projection of the affected system of the brain, and when conducting electrical stimulation, the upper value of the electric current frequency corresponds to the value of electrical lability of the visual system, the lower value is selected from the range of 3-20 Hz.

[0013] Furthermore, it is important to note that while current research on neuromodulation and brain stimulation in children with developmental delays, cerebral palsy, hypermobility syndrome, and cognitive and behavioral disorders is primarily conducted using the technique of polarizing molecules in liquids—so-called micropolarization—we compared the results of our study primarily with those of authors using transcranial micropolarization (TCMP) with sections of direct current. However, a number of authors have used alternating pulsed currents in the treatment of children with attention deficit hyperactivity disorder (ADHD) and comorbid disorders, as well as enuresis.

[0014] Thus, a group of authors Knyazeva O. V., Belousova M. V., Prusakov V. F., Zaykova F. M., in the article "Application of transcranial micropolarization in the comprehensive rehabilitation of children with expressive speech disorder", published in the "Bulletin of Modern Clinical Medicine" for 2019, note that after the treatment, patients of both groups (the first group received TCMP as part of complex therapy, the second - not) noted positive dynamics. In 12 (40%) children of the first group, positive dynamics were registered already 1 month after the start of treatment (p < 0.05). By the end of the second month, parents and speech therapists noted an increase in active vocabulary, the appearance of words consisting of 2-3 syllables, improved pronunciation and onomatopoeia in 18 (60%) children (p < 0.05). In 7 (23%) children of the first group, improvement in articulation, visual-motor coordination and fine motor functions in general was observed.Six months after the rehabilitation course using transcranial micropolarization, 19 (63.3%) children in the first group demonstrated verbal expressive speech skills consistent with the lower limit of the age norm (p < 0.05). In the second group, by the end of the therapy course, positive changes in speech symptoms were noted by 5 (16.7%) parents. After 2 months of treatment, parents of 11 (36.7%) children noticed an improvement in understanding addressed and common speech (p < 0.05). Ten (33.3%) children began attempting to participate in primitive dialogic communication, alternating verbal forms with pantomime. Articulatory motor skills became more active, adequate and controllable in 4 (13.3%) children. Six months after the rehabilitation course, 12 (40%) children in the second group demonstrated verbal expressive speech skills consistent with the lower limit of the age norm (p < 0.05). Conclusions.The study demonstrated that comprehensive treatment of expressive speech disorder using transcranial magnetic resonance (TMR) stimulation promotes positive therapeutic effects after the first course of treatment. This method has proven effective as a complement to medication and psychological, educational, and speech therapy techniques. Follow-up observation revealed a persistent and long-lasting effect of TMR not only on the nominative function of speech and active vocabulary, but also on articulatory motor skills and the development of dialogic communication.

[0015] According to O.A. Kovaleva et al., when analyzing the effectiveness of TCMP in 96 children with cognitive impairments aged 6 to 10 years, positive dynamics were found in 80% of children, and normalization of blood flow indicators, assessed using transcranial Doppler ultrasound, was maintained in 75% of children.

[0016] Authors L.M. Kuzenkova, A.V. Lashkova, O.M. Konova, and T.G. Petelguzova present the following data in their 2021 article, "Experience with Transcranial Micropolarization in Children with Autism Spectrum Disorders." Following TCMP, all groups showed positive dynamics using the ATEC test, including a decrease in the number of cases with severe autism and a shift toward milder forms. Thus, in the group of children with autism (childhood autism), the number of cases with severe autism decreased from 8 to 5, while those with mild / moderate autism increased from 2 to 5. The number of patients with moderate autism remained unchanged. In the group of children with AA (atypical autism), a decrease in cases with a severe degree from 4 to 2 was recorded, the number of patients with a moderate degree did not change, and in 2 observations a shift towards mild / moderate severity was noted.In the group of patients with DD (other pervasive developmental disorders), the number of children in the "no autism" category increased from 3 to 4, and the number of children with mild / moderate autism decreased. Analysis of clinical data showed that before TCMP, 12 (48%) children had a severe degree of autism, 7 (28%) had a mild / moderate degree of autism, and only 3 (12%) cases had a moderate degree of autism according to the ATEC test. The lowest scores were noted in the groups of children with AA and DA: the severity of disorders ranged from moderate to severely impaired (3 points or more) on most subscales ("attitude towards people", "emotional response", "auditory response", "verbal communication", "level of coherence of intellectual response", "general impression").In the group of children with AD, a mild degree of autistic manifestations (2 points) was initially observed on almost all subscales. After TCMP, similar changes were found in the groups of children with AD and AA: a shift to a moderately pathological degree (2.5 points) on the subscales that previously showed a moderate degree of ASD severity. The exception was the "level and consistency of intellectual response" subscale, which showed minor positive dynamics, which is likely due to the presence of intellectual disability in the majority of the examined children. In the group of patients with AD, positive dynamics were found in the form of a shift to a mild deviation from the norm on almost all subscales, which is due to the initially higher level of development in the analyzed group.It is important to note that children with AD and AA initially had the lowest scores across all ATEC test categories, while the highest scores were recorded in patients with DR. Following TCMP, the AD and AA groups demonstrated the most pronounced positive dynamics (a decrease in scores) across all ATEC test categories, particularly in the categories of "socialization," "sensory skills / cognitive abilities," and "health / physical development / behavior." Improvement in the third category was noted primarily due to sensory skills, while in the intellectual sphere, a greater interest in the environment emerged, activities became more purposeful, but no significant changes were observed, which is due to the presence of intellectual disabilities in the majority of children in these groups. Improvements in the fourth category occurred due to a reduction in undesirable forms of behavior.Significant dynamic changes in these groups can be explained by the initially higher severity of autistic manifestations in children. In the group of patients with DD, less pronounced positive dynamics in quantitative indicators were observed in all categories, which is associated with a higher level of mental development and a lower degree of autistic manifestations in them.

[0017] Kovaleva O. A., Ventsova A. G., Ligunova D. M., Pustovet E. N., and Gutsalova V. P. in their paper "Comparative Analysis of Transcranial Doppler Ultrasound Data of Cerebral Vessels Using Transcranial Micropolarization in Children with Cognitive Impairments," published in the Almanac of Modern Science and Education Tambov: Gramota, 2017, provide the following data. In the group of patients receiving TCMP, a tendency toward normalization of indicators was observed in 80% of children, whereas in children who underwent treatment without neurotherapy, blood flow indicators improved in only 68% of cases. The examination results were also confirmed by changes in the clinical picture of the patients. Almost all children showed a decrease in the manifestations of pathological symptoms: attention deficit decreased, hyperactivity decreased, and emotional lability diminished.Furthermore, most patients experienced improvements in all types of memory, as well as increased motivational and volitional behavioral components. This was particularly noted in school-going children, as positive dynamics were observed in only 59% of patients after six months. At the same time, ultrasound data fully confirmed the clinical picture: improved cerebral blood flow indicators coincided with clinical improvement and EPI data, as their academic performance and behavior improved. A similar picture was observed during delayed examination in both groups. At examinations after 6-8 months, normalization of blood flow indicators was also largely maintained in the group of patients receiving TCMP (75%); in the group of children who underwent treatment without neurotherapy.

[0018] L. S. Chutko, Yu. D. Kropotov, V. P. Lebedev, E. A. Yakovenko, V. A. Grin-Yatsenko, and S. Yu. Surushkina used rectangular monopolar pulses in their study, "The Use of Transcranial Electrical Stimulation in the Treatment of Attention Deficit Hyperactivity Disorder and Comorbid Disorders in Children and Adolescents." They present the following findings.

[0019] After a course of transcranial electrical stimulation (TES), a reduction in tics was noted in 40 patients from the study group (85%). A reduction in transient tics was recorded in all cases, chronic tics in 21 cases (77.8%), and tics associated with Gilles de la Tourette syndrome in five cases. A decrease in the average tic frequency of 2.7 points was recorded, indicating a reliable improvement (p < 0.01). The average tic frequency on a five-point Tourette's Syndrome Global Scale (TSGS) after a course of TES was 1.1 points (with a maximum frequency of 5 points).

[0020] After a course of ETS, a significant reduction in tension-type headaches was observed in 33 patients from the observed group (86.8%). Moreover, a reduction in episodic TTH was recorded in 20 cases (87%), and a reduction in chronic TTH in 13 cases (86.7%). A repeat psychophysiological study conducted using the TOVA test revealed statistically significant changes: a decrease in impulsivity by an average of 13.9% (p < 0.01). Significant dynamics in attention and response time indicators were not observed. Thus, the results of the psychophysiological study confirm the clinical data on a decrease in impulsivity after a course of ETS. A repeat psychological study shows a decrease in anxiety indicators to an average of 12.2 ± 5 (p < 0.01). Observation of these patients for 5-6 months showed that the obtained clinical results did not decrease in 74.2% of children.Follow-up studies show that positive changes following a course of ETS were maintained for 12 months in 36.4% of cases. Twenty-two patients with ADHD who underwent a course of ETS were followed for over 24 months. Follow-up studies showed that positive changes following a course of ETS were maintained for 24 months in 18.2% of cases.

[0021] From this, it was concluded that the obtained results indicate high efficacy of drug-free treatment with transcranial electrical stimulation (TES) in children suffering from attention deficit hyperactivity disorder with a predominance of hyperactivity and impulsivity, as well as with a mixed type of the disease.

[0022] The use of EFT is ineffective in cases where inattention predominates. The method is also effective in treating comorbid ADHD tics, tension headaches, and anxiety disorders.

[0023] Yu. M. Raigorodsky, S. M. Sharkov, S. I. Urnyaeva, and A. L. Malykh used bipolar rectangular pulses in burst mode in their study "Transcranial Electrical Stimulation in the Treatment of Children with Enuresis." They noted that this technique is superior to standard drug therapy in terms of efficacy, safety, and clinical sustainability, achieving a therapeutic effect of 80% without the need for medication. Along with the relief of symptoms of the underlying disease, normalization of psychovegetative reactions, sleep, and mood were observed, as well as improved academic performance.

[0024] All authors, except the last study, used constant or pulsed unipolar currents. Only Yu. M. Raigorodsky, S. M. Sharkov, S. I. Urnyaeva, and A. L. Malykh used pulsed bipolar currents, but with a rectangular waveform, which distinguishes their work from ours. The exponential currents we use have good stimulating activity but are closer to the body's natural biocurrents, making the procedure even safer and more tolerable.

[0025] The objective of the claimed invention is to restore the blood supply to damaged and functionally immature, damaged and / or suffering from insufficient blood supply areas of the brain, followed by their electrical neurostimulation, using exponential bipolar currents to eliminate possible side effects from the use of rectangular pulses, providing effects with high efficiency and maximum physiologicality.

[0026] The technical result of the claimed method is increased treatment effectiveness, as evidenced by a reduction in the percentage of blood flow disturbances according to ultrasound Doppler imaging. Furthermore, the method's functionality is enhanced by additionally developing intelligence and memory.

[0027] The specified result is achieved due to the fact that the method of restoring brain functions includes interviewing and examining the patient in order to identify clinical disorders and establish a preliminary diagnosis, prescribing instrumental examinations, namely ultrasound Dopplerography of the brachiocephalic arteries (USDG BCA) and transcranial duplex scanning (TCDS) or angiography of the BCA and TC vessels, MRI of the cervical spine (CS) and / or X-ray of the CS in two projections, to assess the initial state of cerebral circulation in the BCA and TC vessels, analysis of the results and assessment of the degree of impairment of blood supply to the brain, prescribing local corporal reflexology of the selected area of ​​the CS, prescribing vacuum therapy of the selected area of ​​the CS, prescribing chondroprotectors of the CS, prescribing physiotherapy of the CS, prescribing the exclusion of cerebral mobility,repeat the instrumental examination with subsequent analysis of the results and assessment of the degree of impairment of the blood supply to the brain; in case of improvement of the results, prescribing a course of transcranial electrical neurostimulation using exponential pulses, subsequent prescription of medication for a specified period, appointment of a control instrumental examination.

[0028] Thus, thanks to this combination of essential features, it was possible to increase the effectiveness of restoring brain function, thanks to the fact that treatment of pathologies and decreased functional output of the brain is carried out in two stages. In one stage, a set of procedures is performed aimed at treating the joint and ligament apparatus of the cervical spine to normalize blood flow in the BCA and TC vessels. In the second stage, transcranial electrical nerve stimulation is performed. These two stages can be performed simultaneously or sequentially, and the physician selects their sequence depending on the severity of the patient's condition.

[0029] The inventive level of the claimed method is substantiated as follows.

[0030] While working with patients with central nervous system (CNS) pathologies (e.g., memory impairment and attention deficit), the authors noted that, despite identical pathology manifestations and similar ages, treatment outcomes and recovery rates varied among patients. Sometimes, there were unstable trends of improvement and breakdowns or unsatisfactory results. The authors took into account the nature of the patients' workloads, the duration of workloads during the workday, and similar habitual positions during work (study, play, and in cases of young children). The authors studied the activity of brain structures during workloads (EEG, auditory and visual evoked potentials, brain MRI, etc.). No significant differences were found. However, not all patients achieved sustainable positive results from neurostimulation in the long-term period. In some cases, repeated courses of stimulation produced a temporary effect.And only the study of the initial state of cerebral circulation in the BCA and TC vessels made it possible to identify the problem of unstable results of neurostimulation associated with impaired cerebral circulation and its individual zones, to varying degrees.

[0031] It is known that the most rapid growth of the body and brain in children occurs before the age of 1 year. After this, the rate of maturation and development of the brain slows, but remains high even hourly and cyclically (from birth to 1 year, from 1 to 3 years, from 3 to 7 years, from 7 to 12 years, etc.). And each hour of a child's maturation is accompanied by uneven nutrition of the brain centers of the right and left hemispheres of the brain, for example, in cases of narrowing of the vertebral artery on one side and maintaining blood flow within normal limits on the other. In such cases, among other etiological factors, such as birth hypoxic trauma or a genetic defect, such asymmetry of blood supply may be accompanied by the development of various developmental delays in the child (dysarthria, dyslalia, ADHD, memory impairment, attention deficit, etc.).), and in the presence of consequences of birth hypoxic trauma, or genetically determined dysrhythmia of the central nervous system maturation, it will significantly worsen the course of the disease.

[0032] A neurophysiologist, considering the need to stimulate a particular center with reduced functional capacity, prescribes a course of neurostimulation using well-known techniques. However, the results are not always positive, or the treatment effect is lost after a short time.

[0033] During the study, the state of cerebral blood flow was taken into account. Consistent patterns and correlations were found between positive neurostimulation results and baseline normal blood flow levels in the brachiocephalic and transcranial vessels.

[0034] The most unstable results of transcranial neurostimulation were found in patients with significant disruptions in cerebral blood flow in the brachiocephalic and transcranial vessels (based on the results of ultrasound Doppler imaging of the brachiocephalic arteries and transcranial vascular dissection). This led to the conclusion that for successful and rapid recovery of damaged brain areas with limited functional output, adequate blood supply is essential.

[0035] Based on these observations, the standard examination of patients with brain pathology (for example, with mental and speech retardation) was introduced to include mandatory testing of the state of blood flow in the vessels of the cervical spine (vertebral arteries, brachiocephalic and transcranial) by ultrasound dopplerography of the BCA and transcranial duplex scanning, as well as examination of the cervical spine (X-ray of the cervical spine in 2 projections or MRI), to exclude vascular compression and chronic ischemia of the stimulated areas of the brain.

[0036] Since 2023, work has been carried out using the "Elesculap-2" device, with mandatory assessment of the state of the brain's blood supply and the condition of the cervical spine. This made it possible to correct chronic ischemia in the stimulated areas of the brain by incorporating appropriate techniques into the treatment course.

[0037] As a result, the combined therapy began to produce consistent and faster results than previously achieved with monotherapy—neurostimulation alone. By dynamically studying the results of ultrasound dopplerography of the brain and cervical spine, X-rays of the cervical spine in two projections, and EEG during wakefulness and sleep, we concluded that the consistent positive results were due to the restoration of blood flow to the brain and its individual areas.

[0038] Thus, effective treatment of brain pathologies associated with developmental delays or trauma requires a comprehensive approach, including first directly restoring blood flow to damaged brain areas and functionally immature regions, followed by activation and neurostimulation of these areas. Low-frequency exponential bipolar currents were used in this study, as they are most closely related to the natural biocurrents of the human nervous tissue.Indeed, for the successful restoration of lost or undeveloped function of the brain center, especially in children, it is necessary to initiate the process, on the one hand, by normalizing the blood supply to the brain area, ensuring access to this area of ​​the brain of nutrients and oxygen in sufficient quantities, and on the other hand, by stimulating the corresponding area of ​​the brain, by imposing a certain rhythm of work on the remaining living neurons and triggering the processes of axonal growth with the formation of additional connections between them (transcranial neurostimulation).

[0039] To normalize and improve blood supply to a sufficient level, it is necessary to evaluate the results of the ultrasound examination of the vessels of the neck and brain, the data of MRI angiography and other research methods and identify the causes of the blood supply disorder, which often occurs in children with the consequences of birth injuries, torticollis and the consequences of injuries to the head and cervical spine.

[0040] As a result of birth and postnatal injuries and in the first years of life, instability and displacement of the vertebrae in the cervical spine develop. At an older age, especially in children actively and professionally involved in sports, damage to the intervertebral cartilage occurs, leading to the formation of herniated discs. Static disorders with vascular compression also occur in modern children who spend a lot of time with various gadgets in positions with their heads bent low. This cervical spine pathology (herniated discs of damaged intervertebral discs, impaired statics, and vertebral displacement) leads to compression of the cervical vessels that supply the brain, leading to chronic brain ischemia. This, in turn, leads to delayed development of certain areas of the brain and brain damage, accompanied by secondary symptoms of irritation, such as insomnia, dysphoria, nocturnal enuresis, etc.

[0041] Thus, after evaluating the results of instrumental examinations: ultrasound dopplerography of the brainstem and transcranial tract, MRI and / or X-ray in two projections, as well as an EEG to assess brain electrogenesis, complex therapy is prescribed. This complex treatment is performed in a specific sequence. First, a course of treatment for cerebral blood flow disturbances is administered, followed by the first course of neurostimulation 1.5 to 2 months later. Patients with mental and speech delays are then prescribed medication at home. Only this sequence of therapy yields lasting positive results in the long term.

[0042] The claimed method is carried out as follows.

[0043] The patient is interviewed and examined in order to identify clinical disorders and make a preliminary diagnosis, including a topical one.

[0044] To assess the initial state of cerebral circulation in the brachiocephalic and transcranial vessels, the following instrumental examinations are prescribed: ultrasound dopplerography of the brachiocephalic arteries and transcranial vessels / angiography of the brachiocephalic arteries and transcranial vessels, MRI of the cervical spine and / or X-ray of the cervical spine in 2 projections.

[0045] After analyzing the results and assessing the degree of cerebral blood supply impairment, complex therapy is prescribed.

[0046] If the patient shows signs of impaired blood supply to the vessels of the neck, namely, narrowing of the vessel, tortuosity of the vessel, anomaly in the development of the vessel, an atherosclerotic plaque of the vessel or diffuse changes in the vessel wall due to atherosclerotic disease, and the level of damage, a course of treatment is prescribed.

[0047] For example, when a diagnosis of vertebrogenic vascular compression is established, complex treatment of the spine and blood vessels is prescribed in order to restore blood flow to the brain.

[0048] First, a course of 10-12 treatment days aimed at normalizing the blood supply to the brain.

[0049] This comprehensive treatment course includes: corporal reflexology to relieve hypertonicity and balance muscle tone in the cervical spine. Local application. Duration: 20 to 40 minutes.

[0050] Next, vacuum therapy is performed to improve microcirculation and reduce swelling in the cervical spine muscles. 5-15 minutes, changing after 3-5 minutes.

[0051] And only after this, paravertebral injections of chondroprotector are performed in the areas of instability of the cervical spine in case of instability, displacement, intervertebral protrusions and hernias and other pathologies of the cervical spine.

[0052] Following this, laser therapy and magnetic therapy are prescribed to the cervical spine to accelerate connective tissue regeneration processes. Follow the device instructions.

[0053] To eliminate instability of the cervical spine, electrophoresis with Karipazim is prescribed in the amount of 10 procedures.

[0054] The final procedure is performed in courses of 10 sessions, 3-4 times per year. After this comprehensive treatment, a follow-up examination of the cervical spine is performed 6-8 months later.

[0055] Next, immobilization of the cervical spine is used at home (Schanz corset, for example).

[0056] Repeat ultrasound of the brachiocephalic arteries and transcranial venous dissection / angiography of the brachiocephalic arteries and transcranial vessels, MRI of the cervical spine and / or X-ray of the cervical spine in 2 projections are prescribed to monitor the state of blood circulation in the brachiocephalic and transcranial vessels.

[0057] If the results improve, the patient’s speech functions, memory, and mental status are assessed using speech therapy tests.

[0058] In order to assess the initial state of the brain and electrogenesis, additional examination is prescribed, including MRI of the brain / MRI in vascular mode, with contrast, EEG in the waking and sleep states.

[0059] After analyzing the obtained results, a course of transcranial electrical neurostimulation is prescribed, with the aim of aligning the brain zones according to electrogenesis and activating dormant and damaged neurons in areas damaged and with reduced functional output.

[0060] The course is designed for 10-15 treatment days, with intervals ranging from daily to a maximum of 2 days between sessions. The contact projections are selected based on the location of the affected areas of the nervous system to be activated, and the electrical stimulation modes are individually selected for each contact, depending on the initial state of the corresponding area of ​​the activated region.

[0061] A distinctive feature of the described method is the use of exponential pulses.

[0062] The pulse stimulation mode is selected to bring the stimulating effect closer to the physiological conditions of nerve impulse conduction.

[0063] Bipolar electrical stimulation avoids the negative effects associated with the polarization of molecules in biological tissues and body fluids. The procedure is painless, non-invasive, and does not cause fear in children.

[0064] Conducting electrical stimulation with exponential pulses allows the effect to be brought as close as possible to the body's natural biocurrents, while still maintaining a good stimulating effect.

[0065] Conducting electrical stimulation percutaneously eliminates any surgical intervention during treatment, thereby making the method atraumatic and allowing treatment to be carried out on a wide range of patients.

[0066] Followed by a prescribed 2.5-month home treatment regimen, medication is prescribed to provide nutrients to the stimulated areas (peptide complexes, vitamins) and to overcome the difference in effectiveness between direct and indirect neurostimulation by activating neurotransmitter production in the target area with agonists (neuromidin, amantadine). Nootropics are also used to stimulate and accelerate metabolic processes.

[0067] After 2.5-3 months, the patient returns for a checkup. Follow-up instrumental examinations are prescribed (ultrasound Doppler of the brain and transcranial dorsal plexus / angiography of the brain and tricuspid vessels, MRI of the cervical spine and / or X-ray of the cervical spine in two projections, MRI of the brain / MRI in vascular mode with contrast, EEG in the waking and sleep states). A repeat assessment of speech function, mental status, and memory is performed. If abnormalities are detected, a repeat course is prescribed.

[0068] Example 1.

[0069] Patient M., a boy, 3.5 years old. According to his mother, he does not speak. He cannot form sentences. He cannot pronounce individual long words. He often pronounces the initial syllables of words (ma..., ba..., dai..., ho..., etc.). He often shows anxiety, supplements his comments with hand gestures and sounds, or cries. He draws meaningless objects with a single-color pencil. He can count on his fingers, but cannot fully pronounce numbers or pronounce the letters r, s, and sh. When addressed, he consciously reacts to the doctor's instructions.

[0070] From the mother's medical history, it was determined that the baby was born full-term. However, due to the mother's illness (kidney disease with hypertension), the birth was performed by cesarean section. During the birth, the baby sustained a neck injury, which is documented.

[0071] The child's speech development was delayed during the first year of life. By the age of 1.5 years, the child had only begun to consciously address his mother and grandmother. He began to understand spoken language only by the age of 2 years. He began to speak only in single syllables by the age of 2.5 years.

[0072] Due to a diagnosis of mental and speech delay, the mother repeatedly sought help from local pediatricians, speech therapists, and the Prognoz Medical Center, where she underwent several courses of treatment. The child also received treatment from several traumatologists and osteopaths. Specialists repeatedly advised the mother that the most likely cause of this delay was a birth injury to the cervical spine following a cesarean section. The child underwent an MRI of the brain (the report indicated that no pathological changes, traumatic sequelae, cyst formation, or space-occupying processes in the brain tissue were detected). The patient also underwent an EEG (no signs of epileptic activity were detected, and no focal activity in the cerebral cortex was detected). According to the mother, the osteopath noted muscle spasms at the base of the child's skull and along the lateral surface of the neck on one side.Repeated courses of treatment by specialists did not produce significant results.

[0073] We managed to clarify from the mother that, apart from colds (ARI, rhinitis), her son had not been sick with anything.

[0074] The child's epidemiological history is unremarkable. The child has not undergone any surgeries. Regarding injuries, the mother specified that there were falls without head injuries, no loss of consciousness, no hospitalization, and no referrals to traumatologists.

[0075] On objective examination, the child is active. He understands spoken language, but does not speak in words or sentences, only syllables and incomplete words, and is mostly silent.

[0076] A noteworthy finding was increased reflexes in the upper extremities and a pronounced muscle spasm along the left lateral neck at the C3-C7 level. The child actively demonstrated defensive reactions during palpation of the cervical spine. Furthermore, signs of lax posture were detected. Moderate tenderness was noted in the right shoulder joint. The examination confirmed the previously established diagnosis of speech delay. During testing, the child demonstrated poor color perception and drew unconscious figures with a single pencil. He was unable to pronounce words fully.

[0077] The patient is suspected of having post-traumatic postpartum cerebrovascular accident in the vessels of the cervical spine, as a complication of a cervical injury to the child during a cesarean delivery.

[0078] A preliminary diagnosis was made: Vertebrobasilar insufficiency (cerebrovascular accident) due to instability of the cervical spine at the C3-C7 level? Speech development delay.

[0079] The child's mother was offered the following examination plan:

[0080] 1 X-ray of the cervical spine in 2 projections with functional tests (flexion and extension);

[0081] 2 Electroencephalography;

[0082] 3 Ultrasound Dopplerography with duplex scanning of the vessels of the cervical spine with functional tests (flexion and extension);

[0083] 4 Ultrasound of the thyroid gland, complete blood count and complete urine analysis;

[0084] 5 MRI of the brain (repeated due to the age of the previous study.

[0085] Following further examination, the following data was obtained. An MRI of the brain confirmed the previously obtained findings: no pathological changes in brain tissue were detected.

[0086] X-ray examination revealed signs of instability in the cervical spine at levels C2-C5 with displacement of vertebrae at the C2-C3 level by 1 mm, at the C3-C4 level by 1.5 mm, and at the C4-C5 level by 1.5 mm during flexion. Rotational displacement of the C4 vertebral body to the left and correction of the physiological lordosis in the cervical spine were also determined.

[0087] According to ultrasound data of the cervical spine and brain vessels, a "small diameter" of the right vertebral artery (2.6 mm) and tortuosity of the vertebral arteries at the instability and rotational displacement levels are detected. Functional tests revealed a significant decrease in blood flow in the vertebral arteries with flexion of up to 38% on the left and 32% on the right, as well as a decrease in blood flow velocity in the cervical vessels of up to 43%.

[0088] Electroencephalography revealed no signs of focal activity. No evidence of epilepsy was found in the child.

[0089] The thyroid ultrasound revealed no abnormalities. Blood and urine tests were normal.

[0090] After receiving additional research data, as well as taking into account the patient's life and disease history data, an objective examination of the patient, a final diagnosis was established.

[0091] Diagnosis: Main: M53.22 Post-traumatic instability of the cervical spine at the level of C2 - C5. Flaccid posture. G45.0 Vertebrobasilar insufficiency.

[0092] Complication F80 Delayed speech development.

[0093] After clarifying the diagnosis, patient M. was prescribed complex treatment:

[0094] 1 Reflexotherapy using microneedles locally on the cervical spine;

[0095] 2 Laser therapy of the cervical spine according to standard medicine;

[0096] 3 Magnetic therapy for the cervical spine using standard methods;

[0097] 4 Acupressure of biologically active zones of the cervical and thoracic spine;

[0098] 5 Electrophoresis of the cervical-collar zone with caripazim at the level of C3 - C7 - Th1;

[0099] 6 Transcranial neurostimulation on the ELESKULAP-2 Med TeKo device with a session duration of 10 minutes with a standard change of electrodes.

[0100] The treatment plan is based on 12 repeat sessions, with all of the above procedures performed on the same day for 1.5 months, repeated every 2-4 days. After 2 months, the patient is recommended to repeat the transcranial neurostimulation course for 10 sessions. Subsequently, for six months, the patient is recommended to undergo a repeat course of 10-12 sessions of electrophoresis with Caripazim at 3-4 month intervals to eliminate instability in the cervical spine.

[0101] Recommendations for homework for mom:

[0102] 1. Categorically exclude the child from using a smartphone. Do not use TV, loud music, monitors, or tablets with the child;

[0103] 2 Monitor the child's posture and recommend wearing a Shants collar, especially during games, drawing, and activities with the child. Ensure that the child does not jump from heights, stand on their head, somersault, or jump on trampolines, etc.

[0104] 3 Rub the child's spine paravertebrally 2-3 times a day for 5 minutes until moderate hyperemia appears with Voltaren ointment;

[0105] 4 Perform the spinal traction exercise according to the established method every 2 hours, repeating 5-6 approaches per day;

[0106] 5 tablets. Glycine. Child should take 2 times a day for 2 months;

[0107] 6 A follow-up consultation with a neurologist to assess the initial treatment results 7-10 days after the start of treatment (after 3-5 procedures). A follow-up examination is then scheduled after 8-9 procedures. And at the end of the first course of treatment.

[0108] The child's mother decided to undergo the first 12-session treatment course for her son. The child completed the course without complications. Within the first month, the mother noticed positive changes. The child became calmer, and his speech began to improve. He began pronouncing full words, and after a month, he began constructing sentences of 2 and 3 words. The mother also noticed that he actively asked to read books and drew simple characters. The mother also reported that the family was trying to follow all the home recommendations. Two months after the start of treatment, when patient M. was admitted for the second course (transcranial neurostimulation only), the mother reported that her son had "verbal diarrhea." He began talking about everything constantly, even at rest and during sleep. Upon entering the clinic, the doctors didn't recognize the quiet boy M.

[0109] Further, six months after the start of treatment and following all prescriptions, the child was offered a follow-up examination of the cervical spine and head vessels (ultrasound Doppler imaging of the cervical spine and brain vessels with functional tests). The examination revealed the following changes. The diameter of the "small vertebral artery" on the right increased to 2.9 - 3.0 mm. Functional flexion-extension tests revealed a decrease in the blood flow deficit to the brain on the right and left, respectively, to 19% on the right and 23% on the left. The decrease in blood flow velocity indicators changed, decreasing to 25%. The treatment results after the first course of complex therapy were considered satisfactory. It was decided to continue the treatment jointly with the child's mother.

[0110] Over the course of a year, the child completed the entire comprehensive treatment course. After follow-up examinations with cervical spine X-rays, the diagnosis of cervical instability remained at only one level, C3-C4, up to 1 mm. The diagnosis of speech delay after treatment was removed after a standard examination at the clinic. Recommendations for further therapy have been given to the mother.

[0111] Example 2

[0112] Patient K., 18, presented to the Clinic complaining of severe headaches, neck pain, weakness, difficulty concentrating due to pain, and difficulty studying. The headaches began at the beginning of the school year and were related to the academic and stressful workload at a new educational institution. According to the patient, in August, while on vacation, he jumped into the water from a pier and collided with another person. He sustained a neck and head injury during the collision. He remained conscious, but his head and neck pain at the sites of the injuries persisted for a week. He did not seek medical attention. The pain subsided after a week. However, with the start of the academic year at the institute, due to the intense academic workload and stress, Patient K. began experiencing headaches, weakness, fatigue, eye pain, and difficulty doing homework.Due to the increasing pain syndrome within a month after the start of the school year and difficulties with studies, the patient sought help from a neurologist.

[0113] Upon admission, examination revealed no signs of traumatic injury to the cervical spine or scalp. However, palpation revealed severe tenderness and swelling in the cervical spine at the C3-C7 level, with muscle spasm along the left lateral surface of the neck and base of the skull. Furthermore, cervical movements when turning the head to the left were accompanied by pain and limited mobility.

[0114] When examining tests for dysfunction of coordination centers, positive tests for vestibulopathy were noted.

[0115] In addition, the patient showed signs of developing kyphoscoliotic deformity of the spine with a scoliosis arc to the right.

[0116] Based on the patient's complaints, medical history, life history, and objective examination data, patient K. was suspected of developing headaches against the background of post-traumatic changes in the cervical spine and the development of vascular compression syndrome, accompanied by impaired blood supply to the brain.

[0117] To clarify the diagnosis, additional examination was prescribed: MRI of the brain, MRI of the cervical spine, X-ray of the cervical spine in 2 projections with functional tests, ultrasound of the vessels of the cervical spine with functional tests, ultrasound of the thyroid gland, a complete blood count and a biochemical blood test.

[0118] The following data were obtained as a result of the additional examination.

[0119] During examination of the brain, no data were obtained for space-occupying lesions or focal changes in the brain.

[0120] A cervical spine MRI revealed multiple intervertebral disc protrusions at the C3-C4 and C5-C7 levels, as well as a herniated disc at the C4-C5 level measuring up to 3 mm. Physiological lordosis is straightened. Static function is impaired.

[0121] A cervical spine X-ray revealed signs of static imbalance at levels C2-C7, with a displacement of up to 1.5-2 mm in flexion and extension. Stage 1 kyphoscoliosis of the spine was diagnosed.

[0122] A Doppler ultrasound and duplex imaging of the cervical spine and brain vessels were performed. The examination revealed that flexion-extension tests revealed a decrease in blood flow velocity in the right vertebral artery (VA) at maximum flexion of up to 32%, and a decrease in blood flow velocity in the left vertebral artery (VA) of up to 45%. A decrease in the diameter of the left vertebral artery to 2.8 mm was also noted, with signs of extravasal compression during functional tests.

[0123] In addition, signs of venous discirculation in the cerebral vessels were detected

[0124] Thus, the assumption about the vascular nature of the patient’s headache was confirmed after additional examinations.

[0125] Ultrasound examination of the thyroid gland and laboratory blood tests revealed no pathology.

[0126] Taking into account the above data, patient K. was given the final diagnosis:

[0127] Diagnosis: Main: M50.1 Post-traumatic lesion of the cervical intervertebral discs at the level of C2-C7 with the formation of protrusions, intervertebral hernia at the level of C4-C5 and radiculopathy. M53.22 Post-traumatic instability of the cervical spine at the level of C2 - C5. G45.0 Vertebrobasilar insufficiency complicated by vestibulopathy, cephalgia.

[0128] After clarifying the diagnosis, patient K. was prescribed complex treatment:

[0129] 1 Local reflexotherapy on the cervical spine;

[0130] 2 Laser therapy of the cervical spine according to standard medicine;

[0131] 3 Magnetic therapy for the cervical spine using standard methods;

[0132] 4. Pharmacopuncture with the introduction of chondroprotectors paravertebrally at the level of C3-C7 of the cervical spine;

[0133] 5 Electrophoresis of the cervical-collar zone with caripazim at the level of C3 - C7 - Th1;

[0134] 6 Transcranial neurostimulation on the ELESKULAP-2 Med TeKo device with a session duration of 10 minutes with a standard change of electrodes.

[0135] The treatment plan is 12 repeat sessions, with all of the above procedures performed on the same day for 1.5 months, with repeats every 2-4 days. After 6-7 months, a repeat course of 10 procedures is recommended. Subsequently, throughout the year, to eliminate cervical instability, the patient is recommended to undergo a repeat course of 10-12 procedures with Caripazim electrophoresis at 3-4-month intervals.

[0136] The following are recommendations for homework:

[0137] 1 Watch your posture, work only at a table;

[0138] 2 It is recommended to wear a Shants collar when working in a bent position;

[0139] 3 Rub the cervical spine with Chondroxide ointment 2-3 times a day;

[0140] 4 Perform the spinal traction exercise according to the established method every 2 hours, repeating 5-6 approaches per day;

[0141] 5 Dosage: Tanakan 40 mg tablets, 1 tablet 3 times a day after meals. Ipidacrine 20 mg tablets, 1 tablet 2 times a day after meals; Mexidol 125 mg tablets, 1 tablet 2 times a day after meals.

[0142] 6 A follow-up consultation with a neurologist to assess the initial treatment results 7-10 days after the start of treatment (after 3-5 procedures). A follow-up examination is then performed after 8-9 procedures. And at the end of the first course of treatment.

[0143] Patient K. decided to undergo the first 12-session treatment course. The course proceeded without complications. Within the first week, the patient noted a reduction in headaches and an improvement in his well-being. Subsequently, after the course of treatment, the pain was relieved, and dizziness ceased. Cervical pain disappeared. Three months after the start of treatment, the patient underwent a follow-up ultrasound examination of the neck and head vessels with functional tests. The results revealed that the diameter of the vertebral arteries corresponded to normal values: 3.2 mm on the right and 3.0 mm on the left. Blood flow impairment during flexion and extension tests decreased: 22% on the right and 28% on the left. The patient was advised to strictly continue to follow home recommendations. A repeat course of treatment is recommended in 3-4 months.

[0144] Six months after the start of the first course of treatment, the patient underwent a follow-up MRI. According to the MRI results, the intervertebral disc herniation had healed and decreased in size to 1.5 mm after the treatment course. Cervical disc protrusions remained at the C5-C6 level, measuring up to 1.3 mm. A decision was made to repeat the course of treatment to consolidate the results.

[0145] Example 3

[0146] A mother brought her child (boy S., 8 years old) with complaints of hyperactivity, difficulty concentrating, poor academic performance, and tic syndrome, manifested by repetitive neck movements and head rotation. The child is in the second grade of middle school. According to the mother, he had no academic problems in the first grade. He graduated with good and excellent grades. During vacation in the village, the child jumped awkwardly from the shore into a lake and hit his head on the bottom. After the injury, he experienced a headache for some time, but did not lose consciousness. The pain eventually subsided, and no further examinations were performed. Six months later, during the second grade, the teacher noted the child's lack of concentration, constant distractions in class, poor concentration, and declining academic performance. He also noticed periodic tic movements of the neck and head during stress. The mother decided to seek help from a psychologist. The psychologist referred the child to a neurologist.

[0147] During examination and history taking, patient S.'s tic movements increased in frequency. Pain and muscle spasms in the cervical spine, especially on the left side, were noted, as well as difficulty turning the head to the left. Signs of a previous concussion with right-sided nystagmus were noted. Tests for vestibulopathy were positive. Tendon reflexes in the upper extremities were increased. A physical examination revealed signs of a cervical spine injury with impaired cerebral circulation through the cervical vessels. A series of tests was prescribed to determine the nature of the injury.

[0148] The mother was advised to undergo further examination:

[0149] 1. MRI of the brain;

[0150] 2 MRI of the cervical spine;

[0151] 3 Ultrasound Doppler imaging of the cervical vessels with functional tests;

[0152] 4 X-ray of the cervical spine in 2 projections with functional tests (flexion and extension);

[0153] 5 Consultation with a neurologist neurophysiologist.

[0154] The mother followed the recommendations for additional examination of the child. The following additional examination results were obtained. The brain MRI revealed no focal pathology.

[0155] Conclusion based on MRI data of the cervical spine: a violation of statics in the cervical spine at the level of the C3-C7 vertebrae with straightening of the physiological lordosis and spondylolisthesis anterior to the body of C4 by 2.5 mm was revealed.

[0156] A study of the cervical and cerebral vessels (ultrasound dopplerography) performed with functional tests of flexion and extension, as well as head rotation to the right and left, revealed severe cerebral circulatory insufficiency with 37% head flexion and 32% head extension. Significant blood flow asymmetry was also noted, with increased leftward blood flow of up to 45% along the left vertebral artery.

[0157] A cervical spine X-ray reveals an anterior displacement of the C4 vertebral body by 2.5 mm in the lateral projection and a displacement of 1-1.5 mm during flexion of the C3, C5, and C6 vertebral bodies, as well as a displacement of 1-1.5 mm during extension of the C3, C5, C6, and C7 vertebrae. Conclusion: impaired statics in the cervical spine at the level of the C3-C7 vertebrae, anterolisthesis of the C4 vertebral body.

[0158] A child was examined by a neurologist-neurophysiologist regarding the indication for a course of neurostimulation to improve concentration and enhance memory and cognitive functions of the brain after correction and improvement of cerebral blood flow. Conclusion: The child has a residual period of closed craniocerebral and cervical spine syndrome, manifested by volitional-motivational dissociation with secondary paroxysmal syndrome, manifested by hyperactivity and attention deficit. Complex therapy with transcranial neurostimulation of the frontal lobes and subcortical structures is indicated.

[0159] After further examination, a final diagnosis was established.

[0160] Post-traumatic juvenile osteochondrosis of the cervical spine with damage to the articular-ligamentous apparatus and impaired statics at the C3-C7 level with anterolisthesis of the C4 vertebral body up to 2.5 mm, complicated by compression radicular and vascular syndrome. Vertebrobasilar insufficiency complicated by vestibulopathy, vegetative-vascular dystonia, asthenic syndrome with volitional-motivational dissociation, complicated by hyperactivity syndrome and tic syndrome. Flaccid posture. Cervicalgia.

[0161] In order to correct and treat the identified disorders, a comprehensive treatment was proposed:

[0162] 1 Reflexotherapy using a sedative technique to relieve spasms of the muscle corset of the cervical and thoracic spine;

[0163] 2 Vacuum gradient therapy of the collar area with the inclusion of the cervical and thoracic spine;

[0164] 3 Laser therapy of the cervical spine;

[0165] 4 Magnetic therapy of the cervical spine;

[0166] 5 Acupuncture point massage of the cervical spine;

[0167] 6 Neurostimulation;

[0168] 7 Electrophoresis with the drug caripazim.

[0169] The patient completed a 12-day comprehensive treatment course with the above-mentioned procedures. The patient tolerated the comprehensive treatment well. By the end of the course, after 7-8 procedures, the patient's mother noted that the child had become noticeably calmer and that his sleep had improved. Dysthymic and dysphoric outbursts were less frequent. Perseverance and diligence during homework improved. Tic attacks became significantly less frequent. Three months after the first course of treatment, a 10-procedure neurostimulation course was completed. Three months later, the full 10-day course of treatment was repeated.

[0170] According to the mother, the treatment was successful. The child completed the school year with flying colors, and the tics stopped. The hyperactivity disorder has been eliminated.