Back pain and insomnia (insomnia) significantly impair the quality of life of patients. Pain contributes to the development of sleep disorders and vice versa, poor quality sleep increases pain. Sleep disorders are widespread in the population, and in chronic pain syndrome, almost 70% of patients suffer from insomnia. The National Sleep Association singles out pain as one of the leading causes of sleep disorders. The article discusses a typical clinical case of the combination and interaction of chronic pain syndrome and insomnia. A patient with acute back pain developed a sleep disorder for which therapy was not carried out. The prescribed standard therapy for back pain, which included a non-steroidal anti-inflammatory drug, muscle relaxant, made it possible to relieve pain in a short time. However, the patient’s insomnia not only persisted, but also progressed, which led to the appearance of symptoms of asthenia in the form of fatigue, irritability, decreased performance, and ultimately significantly reduced the quality of life. In order to normalize sleep, the patient was prescribed a histamine H1 receptor blocker from the ethanolamine group, namely the drug Doxylamine. Follow-up observation for 1 year showed no exacerbation of back pain and sleep disturbances. In the treatment of patients with chronic back pain, it is necessary to pay attention to the presence of sleep disturbances and provide appropriate therapy. Today, three groups of hypnotics are used in clinical practice: melatonin receptor agonists (insufficient effectiveness in acute sleep disorders), benzodiazepines (addictive and addictive), and antihistamines. The modern drug Doxylamin belongs to the group of antihistamine hypnotics, has a good efficacy and safety profile and is included in the domestic recommendations for the treatment of insomnia.
Introduction. According to the data of various authors Cervicogenic headache (CH) is met in 2.5 to 70% of population. Diagnostic criteria are described at The International classification of headache (3d revision). CH represents a heterogeneous group of headaches based on functional and organic changes of various anatomical structures of the cervical spine. There are no clinical recommendations for the treatment of patients with CH to date.The purpose of this clinical study is the assessment of the effectiveness of use of Traumeel® S in cervicogenic headache treatment.Materials and methods. 60 patients at the age from 18 to 45, divided into 3 groups were examined. Therapy in various combinations was applied to these patients of all the groups. The 2nd and the 3d groups were treated with the Traumeel® S local injection therapy. The patients of the 4th group were additionally given Traumeel® S in sublingual pill form. The visually analogue scale (VAS), the grading scale of the vertebral neurological symptoms, relapse rate of the CH during a year were applied.Results. The most effective treatment was observed in the 2nd group patients. This was manifested in Better dynamics of pain syndrome and the final result. The CH relapse rate during the year of patients treated with Traumeel® S was significantly lower.Conclusions. Traumeel® S inclusion into combined therapy of CH increases the effectiveness of treatment, helps reduce severity of pain, accelerate the appearance of positive therapeutic effect, operates to reduce severity of vertebral neurological symptoms, reduces frequency of recurrence.
had reconstruction of the arcuate fasciculus while 58.8% had not, as proved by the DTI of arcuate fasiculus. Fifty five percent of patients with perilesional fMRI activation showed favourable outcome on AHS compared to 80% of patients with bilateral activation. Patients whom developed reconstruction arcuate fasiculus achieve significantly lower score on AHS (Pb0.05). ConclusionAphasia outcome influenced by lesion-related factors.
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