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The names of diseases (English) motor neuron diseases Chinese Pinyin alias: atrophy card, flutter card, convulsion, aphasia. Western Classification of Diseases code neurological diseases, traditional Chinese medicine defines disease classification codes Western disease name refers to motor neuron disease spinal cord lesions of anterior horn cells selective violations, brainstem cranial nerve motor nuclei and motor cortical pyramidal cells and pyramidal tract damage a group of progressive degenerative diseases. If the motor neuron disease mainly the following class, called progressive spinal muscular atrophy; if motor neuron lesion above the main stage, called primary lateral sclerosis; if, on the lower motor neuron damage exist, then known as amyotrophic lateral sclerosis. If the lesion in the medulla oblongata mainly by degeneration of motor nerve, is called progressive bulbar palsy. Cancer and degenerative brain diseases (such as Parkinson's disease, dementia, etc.) may be associated with motor neuron disease. Distal extremities of the disease mainly progressive muscular atrophy (about half were cases of early upper hand side of the size of thenar muscle atrophy, later extended to the forearm muscles, and even pectoralis major muscle, back muscles can atrophy, calf muscles may atrophy), weakness, muscle tension high, muscle bundle vibration, movement difficulties, breathing and swallowing disorders and other symptoms, most cases of the disease have no obvious pain, mus


cle atrophy acid, no sensory dysfunction, the disease is not rare. Western medicine causes release name of unknown etiology. May be related to the virus (or slow virus) infection, immunity, heavy metal poisoning, metabolic disorders and endocrine factors, enzyme deficiency, and hypoxia and other factors. 5% to 10% of cases with a familial genetic predisposition in some areas (Guam's Chamorro and the Japanese Kii Peninsula), the incidence of abnormally high. Also considered to be a drug addicted anterior horn cells caused toxic diseases. The primary obstacle in the spinal gray matter, after the disease continues to spacross the synapses, and violations of pyramidal tract fibers. This hypothesis could explain the segmental macular degeneration of pyramidal tract distribution, indicating that pyramidal tract damage was not secondary to cortical motor neuron disease, but the toxins of unknown nature. TCM etiology of the disease was mainly dry and hot disability allowance, liver and kidney yin deficiency, spleen and kidney, essence and blood depletion and other factors. In the "atrophy of Plain Questions" Although specified in the atrophy is "Hyperactivity leaves coke," which, but the disease slow, even if there had previously been suffering inflammation of spinal cord gray matter, or history of exposure to metal, but have over many years, the Department of outstanding after the evil heat disease, hot flashes caused by burning Tianjin. Season to the patient population with this disease for many middle-aged, but also in childhood and onset after 70 years. More men than women. Intensity and spof disease incidence rate is about 1.2-7/10 million. TCM pathogenesis of the disease to liver and kidney essence and blood depletion as the main pathogenesis. Cover liver stores the blood, reinforcement; kidney essence, the main bone, as strong as the officer. Physically weak and ill for a long time, essence and blood loss, or because of excessive labor room. Obscenity on the outside and other causes, liver and kidney injuries, precision irrigation and not empty, blood can not nutrition, re-heat due to yin deficiency, and even burning consumption of fluid, tendons and muscles loss of Ru Yang, muscles wither cut of meat, and even contracture of the tongue is withered, and the wind, see Yin tremor, just as "Treatment of the criterion": "tendons and constraints could not hold any of the monensin, and the wind like it." Wangken Tang pointed out that the flutter card, "the prime of life rare, middle age, there is the beginning of the elderly in particular and more", but also with most of the disease after the age of onset in the middle of step 40, the liver and kidney essence and blood depends on the taste of life, limbs are the endowment of the stomach, the stomach capacity of this line of the spleen is not fluid, not intrinsic Mizutani gas limbs, aching muscles are not the raw meat without atrophy, so the symptoms of the disease in order to permit more common in the extremities, and the spleen is clearly related to liver, spleen, kidney qi deficiency Yin-chun, the main pathological honesty disease, it only made the latent disease, and protracted course of time, the prognosis is poor, just as "Su Wen-yu really dirty on the machine," said : "Big Bone haggard, big meat trap, the shoulder intramedullary consumption, action benefits decline, real Tibet to see, on the one-year-old death." Pathological changes in the naked eye see the spinal cord was not significant, and sometimes small changes can be seen the whole spinal cord, ventral root atrophy; horn in the spinal cord gray matter in parts of the front section is smaller than normal. See supra horn cells under the microscope showed severe degeneration. Cell chromatin dissolved, first started in the Department of Nuclear around; reduce the total number of nerve cells, neurofibrillary disappeared, and composure common lipid pigment granules. Anterior horn damage in each group equally. And nerve cell degeneration also associated with mild proliferation of glial, occasional perivascular mononuclear cell infiltration. Qualitative change of the spinal cord lateral white-based, pyramidal tract is most obvious. Spinocerebellar tract often show degeneration. Lesions often inconsistent with each segment to the most obvious cervical enlargement, thoracic and lumbar roll under the second paragraph, the lightest is the upper thoracic. Motor nucleus of the medulla oblongata of the nerve cell degeneration and similar changes in the spinal anterior horn cells, especially in the hypoglossal nucleus. Dorsal vagal nucleus. Nucleus ambiguus and the trigeminal motor nucleus is significant. Damage to the facial nucleus is smaller. Oculomotor nucleus in the brain and the trochlear nucleus often not compromised. Hemisphere lesions in medial frontal gyrus most significant, showing degeneration of nerve cells and nerve fibers, glial proliferation. Traditional Chinese Medicine diagnostic criteria for pathological diagnosis of the physiological 1. SyndromesSyndrome: hand cut of meat, dry skin, tendon groove between the present, hold the weakness, or see muscle trembling, upset with thirst, bad throat, thin yellow tongue coating, dry tongue, low-chun, reddish tongue, pulse to fine astringent.Syndrome: limb muscle atrophy, especially in the remote hand-based, solid grip weakness, limited mobility, fraudulent claims can be presented claws or ape palm, when muscle bundle vibration, or shaking hands, especially hands solid grip when obvious. There are mood swings, sleepless nights dream more, emaciation, or see the afternoon zygomatic red, dry stool, moss little red tongue, tongue atrophy, thin thin thin pulse string.
(3), spleen and kidney deficiency:
Syndrome: physical atrophy, activity, fatigue, muscle thin, loose skin, mental fatigue, pale mouth pay less, shortness of breath floating face, looking not China, or with impotence, premature ejaculation, thin white tongue, tongue pale, pulse to Shen Fine. Western diagnostic criteria 1. Insidious onset, slowly progressive upper and lower motor neuron paralysis;
2. Muscle atrophy and muscle bundle tremor, another tendon hyperreflexia and pathological reflex, and more without radicular pain and sensory disturbances;
3. Tongue muscle atrophy may be associated with swallowing and speech difficulties lower cranial nerve damage symptoms;
4. EMG: the next motor neuron lesion area, showing neuronal expression of EMG muscle atrophy;
5. The exclusion of other diseases (myasthenia gravis, spinal cord air conditioning disease, cervical spondylosis, the median nerve or ulnar nerve palsy), the can be diagnosed. Western medicine diagnosis is based on the clinical features of the disease according to the slow progress of the upper and lower motor neuron paralysis, both muscular atrophy, also associated with muscle bundle fibrillation, without sensation, EMG revealed motor unit under the lesion, the outer Week normal nerve conduction velocity, a typical case diagnosis is not very difficult. A history of slow onset of disease symptoms and signs, also showed subacute course. By the early symptoms may be the site of injury. Some of the earliest symptoms more common in hand, the sick sense of finger movement, weakness, stiffness, clumsiness, hand muscles gradually shrink and visible muscle bundle tremor. If the movement of the early lesions in the medullary nucleus, the structure appears sound and difficulty in swallowing, tongue muscle paralysis, atrophy, tongue tremor visible muscle bundle. Such as early lesions of the bilateral pyramidal tract, can be a double spastic paraplegia. Motor neuron disease including amyotrophic lateral sclerosis, progressive spinal muscular atrophy, progressive bulbar palsy and four patients with primary lateral sclerosis type.
(A) of amyotrophic lateral sclerosis (amyotrophic lateral sclerosis) often onset in 30-50 years. Men about women 2-3 times. Insidious onset. Often remote from the upper side of the forearm or hand muscle twitching, weakness, motor not working, muscle atrophy begins. Gradually to the proximal and contralateral development. Often before the affected limb muscle atrophy pain, muscle twitching, crawling insects, ants walking or numbness. Sensory symptoms disappeared after muscle atrophy. With the increased upper limb muscle atrophy, a "monkey-shaped hand" and the "square shoulder" and other deformities, arm lift difficult. The gradual emergence of the neck, lower extremity muscle and tongue muscle atrophy, rise, swallowing, voice and walking difficulties structure. Brainstem motor nuclei and tracts genioglossus fibrillation after involvement, atrophy, paralysis of soft palate, perioral muscle atrophy, strange facial expressions, strong cry laughing so strong. No positive throughout the course of sensory loss and bladder dysfunction. From the upper limb muscle atrophy such a start, gradually involving the lower limbs, bulbar muscles of the classic type of development are referred to as charcot amyotrophic lateral sclerosis. Neurological examination revealed muscle bundle limbs trembling, muscle atrophy, increased muscle tone, tendon hyperreflexia, pyramidal tract signs were positive. Involving the brain stem can be seen when the lower jaw hyperreflexia, palm chin reflex positive. Resting EMG examination showed fibrillation potentials, reduced motor unit potential. Volatility increases, the occasional giant action potentials. Some patients have mild CSF protein can be increased and monoclonal antibodies.
(B) The spinal muscular atrophy (progressive spinal muscular atrophy) lesions confined to the spinal anterior horn cells. By cause and age of onset can be divided into:
(1) adult progressive spinal muscular atrophy type: onset usually in the 50 years of age. More common in men. The most common side or both sides of onset of symptoms of distal upper extremity (hand or forearm) numbness, weakness, muscle twitching, called distal. With the gradual development of the disease involving the upper arm, shoulder muscles, lower limb and neck muscles. Muscle contraction affected area, reduce muscle tension, tendon reflexes, but no pyramidal tract sign. Some patients may be remote from the lower limb onset, there toe weakness, pedal and so on. Gradually to the lower legs, thighs, trunk, upper extremity, cervical muscle development, known as the class type of peripheral neuritis. Muscle atrophy is often accompanied by muscle vibration in Cambodia. While in paralysis. No sensory and bladder dysfunction. Even may have increased in cerebrospinal fluid and serum protein activity increased.
(2), juvenile spinal muscular atrophy were: also known as Kugelberg-Welander disease. Autosomal dominant or recessive inheritance. Mostly young onset. First, shoulder girdle or pelvic girdle muscle weakness and atrophy, also known as the proximal type. Rise lifter arm, from squatting difficult. May have winged shoulder, duck false step and gastrocnemius hypertrophy and slightly elevated serum enzyme activity and so on, is extremely difficult and limb-girdle muscular dystrophy identified.
(3) Infantile progressive spinal muscular atrophy: also known as Werdnig-Hoffmann disease. Autosomal dominant or recessive inheritance. Intrauterine or postpartum maternal morbidity within 6-12 months. Gender no difference. Several clinical features of infant crying for the weak, stand up, Teng Chiao and other actions can not, lower body muscle tone, tendon reflexes. Often due to respiratory paralysis and suffocation and death.
(C) progressive bulbar palsy (progressive bulbar palsy) disease limited to the brainstem, especially the medulla oblongata of the motor nucleus. Genioglossus showed fibrillation, atrophy, dysphagia, dysarthria. Early tear less, perioral tingling, pharyngeal reflex. With the development of the disease can also occur involving the corticobulbar tract and strong crying, strong laugh. Normal intelligence. Limbs may be associated with increased muscle tone, tendon hyperreflexia, pyramidal tract signs were positive.
(D) primary lateral sclerosis (primary lateral sclerosis) Selective involvement of the spinal cord lesions without involvement of the Cambodian side of the spinal anterior horn cells. Men over the age of onset of 50 are most welcome. Slow progress in the clinical characteristics of the two lower limbs or limbs weakness, increased muscle tone, spastic gait scissors, tendon hyperreflexia, pyramidal tract signs were positive. According to clinical manifestations of this disease selective motor neuron damage and no feeling of bladder dysfunction and other features, diagnosis is not difficult. Saw with EMG fibrillation potentials, reduced motor unit, such as a huge potential for diagnosis, medical electronic diagnostic imaging diagnostic laboratory diagnosis (a) of the EMG showed muscle denervation changes, that is free to vibrate under the control of a muscle fiber, exercise potential to reduce the number of units, sometimes with muscle bundle fibrillation. Anterior horn cell damage in the free exercise has a huge motor unit potentials.
(B) of the cerebrospinal fluid are about 1 / 3 of patients had mild protein and blood.
(C) Determination of trace elements in serum, plasma copper (Cu) content was significantly increased, serum zinc (Zn), serum magnesium (Mg) levels were also increased, copper / zinc ratio also increased. Calcium (Ca) decreased.
(D) muscle biopsy showed denervation atrophy of the typical muscle pathology, contribute to the diagnosis, but no characteristic.
(E) reduction of urinary creatinine excretion, creatinine excretion increased. Blood CSF Urine feces immunological histology other diagnostic tests in early differential diagnosis of Western medicine is easy to misdiagnosis of other diseases, disease-oriented, should pay attention to the phase with the following identification:
1. Cervical osteoarthritis of the disease also contributed to the lower limb weakness with ipsilateral upper extremity tonic lower motor neuron type of weakness rather common disease, sometimes in combination with the disease, identification will be difficult, but usually the symptoms of cervical disease in upper limb pain and objective sensory dysfunction, no bulbar symptoms, it is sometimes paralysis until disease progression occurs only with the diagnosis.
2. Myasthenia gravis myasthenia gravis are also in the primary performance, especially in spinal muscular type, bulbar type visible on the limb muscle weakness and dysarthria, easy and motor neurons of the early symptoms of confusion, but the age of onset of myasthenia gravis lighter, more women than men, can be discerned, motor neurons appear later muscle atrophy, fibrillation embolism when this disease myasthenia gravis had no feelings, you can be identified.
3. Syringomyelia can also be found in this disease and muscle weakness and atrophy, slow progression, can be misdiagnosed as motor neuron disease, but there are segmental syringomyelia dissociated sensory disturbances, muscle bundle small and light tremors, and motor neuron disease in general no sensory dysfunction, can be identified.
4. Median nerve or ulnar nerve palsy may also occur in this muscle atrophy, the main point of difference is the motor neuron disease without sensory dysfunction and muscle atrophy, and peripheral nerve does not comply domination. Certificate in Traditional Chinese Medicine to cure the standard identification evaluation standard
This disease is a chronic progressive motor neuron degenerative disease, poor prognosis. Some patients have persistent symptoms and signs to stop the development or natural persons, it is difficult to assess for the cure. Prognosis of the general course of the disease an average of 2 to 3 years, often due to bulbar palsy, dysphagia, or pulmonary infection died; but no damage to the medulla oblongata, the course can be extended to 5 to 7 years are not uncommon clinically. Overall though this disease is not very common, but the prognosis is poor. Western medicine treatment of complications 1. Vitamin E20 ~ 40g, three times daily.
2. Vitamin B1100 ~ 200mg, 1 or 2 times per day, intramuscularly.
3. Vitamin B12200 ~ 500mg, day 1, intramuscular injection.
4. ATP20 ~ 40mg plus 50% glucose 500ml, intravenous infusion once a day.
5. Nandrolone phenylpropionate 25mg, twice a week, intramuscularly.
6. Coenzyme Q105mg, three times daily.
-Aminobutyric 0.5g, three times daily.
8. Allosteric venom (MN A 81) in the treatment volume of 2ml (including venom per ml 500mg), 1 day, intramuscularly. Saline injection prior to the 1:10 dilution for the allergy test, for the first time after 0.1ml and 2.0ml daily by intramuscular injection of 0.3,0.5,0.7,1.0, to 2.0ml When no adverse reactions, can continue to injection, 3 weeks to 4 weeks for a course of treatment. Two courses of 2 weeks each space, the beginning of a new treatment for allergy testing needed. Chinese medicine treatment 1. Differentiation and TreatmentGoverning Law: nourishing Yin, moistening fluid.
Recipe: Qingzao soup. Qingzao save lung Decoction. If the heat than the worse, can be added Cork, Silver Flower of dry heat; if fascicle fibrillation, could add antelope horn, Uncaria Pinggan Xifeng.Governing Law: Yin and soft ribs, liver and kidney tonic.
Recipe: Decoction myogenic marrow, or tiger potential pill, Rehmanniae. If the limb weakness Ma, could add Tianma, Gui Tong Yang Roujin; if the limb was trembling, could add antelope horn. Uncaria Pinggan Xifeng; if acute physical twin, could add to the dragon, silkworm spasm meridians; if limbs withered dry, could add Dendrobium, Ligustrum lucidum Yin Runzao; if zygomatic red hot palm, could add Scrophulariaceae Ziyinqingre; if yin and yang, could add Cuscuta, Cistanche, Huang Jing yin and yang dual complement, if the tongue wither language Jian, could add white tuber, scorpion Shu by-pass network, or add calamus, turmeric, Musk resuscitation pure heart. (3), spleen and kidney deficiency:
Governing Law: spleen and kidney, blood Rong Yang muscle.
Recipe: marrow soup or Bu Zhong Yi Qi Decoction, if the soft muscle weakness, could Guizhi, Cimicifuga Tong Yang Wenjing; if those mental fatigue, reuse parameters, the temperature in Qi Qi; if less satisfied mouth pale could add yam and medicine, lentils spleen appetite; If the panel is floating shortness of breath, could Jiamai winter, Schisandra, Poria tonic cardiopulmonary; if meat atrophy Xingshou, could add Polygonatum, wolfberry fruit, Rehmannia Yin Rong muscle; If the bone may increase wilt limb soft bones, tendons Zhuanggu Duzhong Jiang; if impotence premature ejaculation, could add Epimedium, Morinda kidney yang; if kidney decline significantly, could add aconite, cinnamon.
The incidence of bradycardia and multiple disease in old age in the period, it is more common clinical deficiency, disease involving the liver, spleen, kidney three dirty, liver and kidney may both signs of heat, spleen deficiency may both wet together, the stasis of waiting, but are relying on the certificate and the clinical type of small stand alone card, based on clinical symptoms of the disease similar to traditional Chinese medicine, it has made to medicine or pills slowly figure rule.
2. Treatment of simple: fumigation method:
shop with plenty of fresh Ai on the bed, cover a sheet, so that's clothes were naked, covered with blankets, so heat generated, fumigation body sweating.
Daozhi with fresh ginger and pour bath basin, against the hot water bath so patient. Chinese (1) strong Gastrodia Eucommia pill: a pill every time, three times daily.
(2) Ginseng Zaizao pill: a pill each time, the second day.
(3) Shiquandabu pill: a pill each time, three times a day.
(4) Ho-creating a big pill: a pill each time, three times a day.
(5) marrow atrophy pills Complex: Composition: antler pieces 150g, Rehmannia, Loranthaceae, Epimedium, Cynomorium, Morinda officinalis, cassia twig, red peony root of the 100g, Astragalus 200g, the system Shouwu, psoralen, Drynaria, Dipsacus, Codonopsis, Atractylodes each 120g, centipede 10, the system Strychnos 150g, for a total fine, refined honey for 300 pills.
Usage: one 2 times, each time a pill.
Note: This pill contains brucine, brucine poisoning observed the first harbinger of a muscle tremors, mental euphoria, perceptual sensitivity, reduction in time at this time, symptoms quickly disappear.
(6) Tiger vigorous potential pill Modified: Composition: Astragalus, Epimedium, antlers each 100g, Dragon, hippocampus, ginseng, tortoise plastic, Angelica, Hang Shao, Moreover, Qi Zi, Eucommia, Sichuan off, Dodder, Cynomorium , Atractylodes, yi m, dried tangerine peel, Achyranthes, papaya, Gentiana each 30g, Agkistrodon 3, Sunburn leopard bone 9g, psoralen, Anemarrhena, Treats, Gui, Notopterygium, independent living, wind the 15g, total research extremely fine, water pan for the pills.
Suggested Use: Each serving 3 ~ 9g, 2 or 3 times a day. Note: Yin Huo-wang caution. Acupuncture (1) Body Acupuncture: Point Selection: upper: Hegu, foreign relations, Yang River, Qu pool, shoulder??. Lower extremity: Kunlun, the solution stream, the full three years, Yang Ling Quan, Liang Qiu, thigh clearance. Techniques: the needle 20 to 30 minutes, with the reinforcing-reducing method, and the virtual image was applied to acupuncture.
(2) Scalp: acupoints: bilateral motor areas on the 1 / 5, 2 / 5. Head, face or tongue muscle contraction may increase motor area of 2 / Methods: 20 ~ 30, stainless steel needle in the scalp, the needle up to the required depth, using pulsed electric acupuncture device is powered on, the frequency of 120 to 150 times per minute or so, through electricity for the degree of the patient can tolerate 20 minutes 1 times, day (3) Ear Acupuncture: acupoints: liver, spleen, kidney, Vital, endocrine.
(4) point injection: drugs: upper: Qu pool, outside the customs points; lower extremity: the full three years, Yang Ling Quan, Huantiao.
Methods: The prevalence of lower limb position on the choice of 1 point to 2 points, respectively, Yong Hong injection into the 2ml, 1 day, alternating selection of acupuncture points. Massage massage the distal end from the body into the proximal end, made of light weight, is generally used in law back to Morocco, and gradually increase, respectively, can take, kneading, point by way of the muscle atrophy lies mainly with the rubbing method, such as kneading fingers, kneading and other thenar muscles, proximal muscle atrophy in the shoulder, arm, can take the method, rubbing method, rubbing method, stimulation should be light and smooth. Integrative Medicine of the disease no special drugs, modern medicine and more interferon with antiviral drugs, but the effect is not sure. Supportive care and symptomatic therapy, since some cases may alleviate the effect of the disease. Losses by the five organs of Chinese medicine, hot burning consumption of vaginal atrophy permit issued to, the use of solid-air righting, nourishing fluid, gluten bone health principles and methods of treatment and achieved encouraging results. Care and rehabilitation to prevent the etiology of this disease is unknown, no special precautions. All of the relevant factors of the disease caused by heavy metals such as s, regular medical check-ups, with particular attention to changes in muscle strength for early detection, early treatment to be. Usually you should pay attention to physical exercise and emotional regulation, maintaining a good mood and avoid the bad Huinu Concerned mental stimulation, middle age, living alone is more desirable mild, reducing sexual intercourse, food should be light, cream beam Atsumi, spicy None of the products which should prevent the resulting spleen deficiency, kidney yin deficiency and other adverse factors. Historical research


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