Mariam Garifianova, Mikhall Kiselev.
The Kasan Medical Academy,420043,Lesgaft St., 18-22,Kazan, Russia
Purpose.The algesic syndrome, caused by myogenic trigger points(TrPs) ,in mimetic muscles, is most important in patients with secondary contracture as complication of Bell’s palsy; the morphological characteristics and methods of treatment this clinical phenomena were not studied.
Methods. Small pieces / 1 X 1 mm/ of MM were obtained from area of TrP by needle biopsy in 15 patients and 4 cadavers. The sections were examined in electronmicroscope «Gem-7». Blink reflex was studied on electromyograph «Counterpoint» /Denmark/ . At the same time needle biopsy removes pain and we may consider it as the treatment. The area of TrP was punctured by the needle Tru-cut /Germany/. In 5-10 minutes the auriculoacupuncture (AP) was made in the representative for the facial nerve points. The method was tested on 80 patients with EMG control.
Results. The muscle biopsies from 15 patients revealed similar morphologic findings characterised by «ragged-red and moth eaten fibers», degeneration, splitting and fragmentation of fibers, enlarged mitochondria. Results of the treatment allowed to come to the conclusion that the method greatly influenced the mimetic muscles in decreasing the algesic syndrome in all 80 patients. The EMG examination of blink reflex on electromyograph «Counterpoint» /Denmark/ showed the reduce of reflex excitability after that. The difference in latency R2 of direct response in comparison with control was significant p<0,05.
Conclusion. Our results support the occurrence of muscle disorder and may emerge as the key to treatment. The method of treatment was noted to exclude the nociceptors from area of TrP and to provide the afferentation to visceral brain and brain stem. It was recommended to be employed in patients with contracture of mimetic muscles.