Title : Acupuncture-Like Tens (Al-Tens) as a quantitative measure for the feasibility of intracarotid sodium nitroprusside injection in subacute ischemic stroke for physiological recovery from 5th to 21st post stroke day via 10000-fold effect - in 75 cases
Abstract:
Background and Introduction: Intrathecal sodium Nitroprusside (ITSNP) has shown marked recovery in various causes of ACUTE ISCHEMIC STROKE CASES previously when it SNP was given intra-arterial (INTRA CAROTID-IASNP). Until now we were unable to measure the recovery bedside effectively before IASNP. We present our work for prediction for prognosis of IASNP in SUBACUTE ISCHEMIC STROKE (SIS) cases (from 5th day to 21st day post ischemia time) using ACUPUNCTURE-LIKE TENS (AL-TENS).
AL-TENS caused pain relief by well-known gate theory at spinal cord by activating A-ALPHA nerve fibers which activates A-DELTA fibers for muscle spindle then pain fibers are inhibited by RENSHAW cells at spinal cord. The present work uses this cascade of various transmissions of nerves to prognosticate the IASNP effect in these chronic ischemic stroke cases.
Aims/Study-Design: To prognosticate the POST-IASNP effect by AL-TENS in SUBACUTE ISCHEMIC STROKE (SIS) cases, Prospective-study.
Material/Methods: 75 SIS patients (from 5th day to 21st day post ischemia time), {50 male patients and 25 females. The mean time for superfusion was 6.29 DAYS. IASNP administered at a dosage of 0.02 mg/kg bo wt at IPSILATERAL CAROTID ARTERY by 20G VIGGO. Pre and post IASNP were monitored by AL-TENS, clinical NIHSS gradings and MRA/DWI/PWI/fMRI and PRE AND POST IASNP VIDEO RECORDINGS of CLINICAL BENEFITS.
Results: POST-IASNP AL-TENS showed 42.84% benefit overall and 55.32% in NIHSS grading in SIS cases. Complete ISCHEMIC STROKE cases didn’t show any change while partial ISCHEMIC STROKE (MRA/DWI/PWI/fMRI showing partial perfusion) showed 71% recovery in POST-IASNP TENS and 53.34% in NIHSS grading. Thus AL-TENS showed a favorable modality to predict the IASNP feasibility in PARTIAL SIS cases. If PRE-IASNP TENS showed 8 mAmp or more there will be no response to IASNP.
Conclusions: AL-TENS helps us to prognosticate the future outcome FOR IASNP in partial ischemic stroke
Keywords: Subacute Ischemic Stroke; Intracarotid Sodium Nitroprusside; Acupuncture-Like Tens; The 10,000-Fold Effect.
