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Neural Therapy- Huneke

Neural Therapy- Huneke. A truly wholistic method since 80 years. Dr. Ferdinand Huneke 1928. 1925 Ferdinand Huneke’s sister with severe migraine

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Neural Therapy- Huneke

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  1. Neural Therapy- Huneke A truly wholistic method since 80 years

  2. Dr. Ferdinand Huneke 1928 • 1925 Ferdinand Huneke’s sister with severe migraine • Accidental (or was he just desperate ?) injection of Procaine/Novocaine (local anaesthetic) intravenous - sudden improvement of migraine and other symptoms - a “wonder drug” ? • Ferdinand and Walter Huneke - research

  3. Huneke/Flash Phaenomen • 1940 Huneke - or “Flash” phaenomen - shoulder injected - flare up and reddening of osteomyelitic leg scar - amputate ? - local injection - shoulder pain immediately gone ! • “Stoerfeld” /Interference zone theory - any scar or traumatised/dysfunctional tissue may cause symptoms, distant from site of pain

  4. Interference zone/Stoerfeld/Spina Irritativa • ~50 % in ENT region, usually teeth

  5. Stoerfeld/Interference Zone • Ernesto Adler * 1906 - German expatriate dental technician then dentist in Lloret del Mar/Barcelona ~1926 • “miracoulous” improvements after extractions • relation cervical spine problems and teeth noted - Vogler pressure points • ~1950ies close cooperation with and many visits by Ferdinand Huneke

  6. Two minds - same problem • Two doctors , a dentist and a GP/surgeon, in two countries are working about the same phaenomenon for many years before and after WW II • Huneke/Flash Phaenomen • Dr. Adler, a dentist who cooperates with a local GP in Loret del Mar

  7. Definition of Huneke or Flash Phaenomenon • Suspected Interference Zone (scar, tooth, tonsil..) is injected with local anaesthetic, usually Procaine 1%, short acting - gone after ~20 minutes • if symptoms improve at least 8 hours after tooth injection, 20 hours elsewhere and repeat injection gives the same response, e.g. tonsils - hip pain, then the underlying cause is identified

  8. Flash phaenomen • Response sometimes delayed by one or several days • provocation of secondary Interference zone is possible - ”initial worsening” and emergence of new symptoms • “Drainage” symptoms may occur, e.g. chronic sinusitis/”stuffy nose” changes to runny nose

  9. Flash phaenomen - responses • If infected/dead tooth is extracted often allergic symptoms, Urticaria, rheumatoid symptoms, hormonal problems vanish • from a NT point of view there isn’t any chronic condition that is not due to a Interference zone - Exzema- Arthritis - period problems - unexplained infertility...

  10. Somato-psychic conditions • The term psycho-somatic or “functional” illness is misleading - mental health often improves after Interference Zone sanitation; severe mental conditions and trauma have somatic effects - Lymphoc. downregulated • emotional and autonomous responses (weeping, laughing, fainting, sweating) often accompany Flash phaenomaenon

  11. Theories • Pischinger “Grundsystem” - complex interaction of micro-currents in interstitial space - ends of autonomous nerves • Autonomous nervous system - Gate control theory- fibres accompany blood vessels and motoric nerves - all connects to all • Acupuncture meridians ?

  12. Theories • NT is empiric and individual but experience from >80 years shows where to look first • see also Head’s zones, e.g. gall bladder-shoulder pain; Simmons and Travell’s work about trigger points and pain projections • = referred pain; myofascial pain concept • simple “Where does it hurt” ? approach

  13. Techniques • Doctor only complex set of injection skills: • intracutanous blebs around painful areas, e.g. arthritic knees, often followed by intramuscular injection • segmental approach in Dermatome or Myotome, e.g. bladder symptoms, menorrhagia, delayed delivery - Laimer triangle/bladder meridian • specific nerve blocks, e.g. Trigeminal ends

  14. Techniques • Autonomous ganglia e.g. local anaesthetic depot around pterygo-palatine ganglion for trigeminal neuralgia • Stellate Ganglion block for asthma and CNS conditions • trigger point intra - muscular injections for musculo-skeletal conditions

  15. Indications for Neural Therapy • 1.: Prophylactic - e.g. intra - operative infiltration of wound layers helps to limit post-op oedema and pain; fracture cleft anaesthesia limits need for tablets • 2.: Diagnostic in neurologic and musculo-skeletal medicine - radicular or pseudo-radicular pain ? Trigger point or lumbar disk ? Trigeminal Neuralgia or tooth ?

  16. Indications • Most effective for head, neck, shoulder, spine conditions, migraine and its differential diagnose; often related to pelvic area/female problems • “Osteopathy helped, but only for a short time” - “Interference Zone” ? Vascular migraine or migraine cervicale - difference is clearer in text books than in reality, often multi causal

  17. Indications • Therapeutic Local Anaesthesia - Neuralgias, musculo - skeletal conditions - no limit for repeats, unlike Cortisone injections • “Depression/Anxiety” - thyroid and I.v. injection of Procaine 1 % • Difficult wounds: Procaine helps, antiinflammatory effects - Vit C…, nutrition

  18. Indications • Key indication is search for Interference zone/underlying problem of a condition • Complimentary to standard therapy and e.g. osteopathy…!? • Orthomolecular Medicine/Micro-nutrients -constipation ? • Limited response if immuno-suppressant Rx

  19. Indications • Neural Therapist/Odontologist should be consulted first and referrals made from there instead of “odyssee” to “-ology” one problem specialists • Wholistic approach first - good old family GP’s in the UK are replaced by “nurse practitioners !”

  20. Could it be done without needles ? • Many measuring devices - best is probably Thermography (Rost); Electro-Acupuncture (Voll) - expense and time ? • I rely on my finger tips/palpation skills and intuition plus clinical findings and history • sometimes I use Acupuncture/dry needling or Reflexology but NT is more effective

  21. Amalgam-Toxicity ? • One of the indications for those tests - first avoid different metals in the mouth • OPG Xray always helpful • bottom line: a sensitive doctor has very fine natural senses and ultra-fine 0,4mm needles are almost painless !

  22. Needles or not • A motivated patient with distressing symptoms will accept a needling approach - patient selection !

  23. Contraindications • Patient unable to consent/cooperate • active psychotic illness • advanced Dementia • Hyperthyroid/uncontrolled thyroid disease • Bleeding disorders and blood thinning medicines • Myasthenia Gravis

  24. Contraindications • Severe cardio-vascular conditions - uncontrolled hypertension, congestive cardiac failure stage III-IV; end stage COPD; any end-stage organ failure - sometimes surprises with e.g. arthrotic hip pain - “Interference zone” • Cancer other than palliative/pain management

  25. NOT a “Cure all” • Neural Therapy is not a “cure all miracle therapy” - there are limits in the doctor’s ability , resources and set up as well as within the method • However: • Who has experienced a “Flash Phaenomaenon” often will call it a miracle ! Very rewarding for patient and doctor

  26. How long - how often • Usually some response in first session, but 3 to 8 may be needed, mostly, if no response at all after 3 sessions - re-assess = limited cost and time; top-ups in increasing intervals • the more acute the condition the easier it is • beware of “shopping lists” with 25 symptoms and long years history

  27. Key to success • Careful history by experienced physician, focusing on key physical and mental traumas, injuries, infections; conventional general exam, work up of bloods with inflammatory markers, BM, Urine, Xrays • Manual exam - lay hands on patient ! • Patient to take responsibility and keep diary of symptoms -pain - sleep - mood...

  28. Ideal setting • Written consent • open minded fellow doctors/dentists • Dentist in clinic to talk to • psycho-therapist • nutritionist

  29. Risks • Allergic reaction - rare - reddening and itch ~1cm is normal with Procaine as vaso-dilating, possibly more pronounced in scars etc., some allergy 1:3000 • severe allergic reaction (shock, asthma) very rare, probably < 1:10 000 • infection - very rare - ultra-thin needles 0,25-0.4mm, Procaine is bacteriostatic

  30. Risks • Nerve irritation may persist for a few days, permanent nerve damage is very rare as very thin single use needles are used • Bleed - a few drops from injection site is normal, severe bleed very rare • injury of organs e.g. lungs, blood vessels • We train all techniques on fellow doctors !

  31. Professional bodies and training • Training as of now in German or Spanish only • 120 hours of lectures and hands-on training with fellow practitioners as “Guinea pigs”- case studies - final exam • English language Textbooks by Dosch and Barop • But:

  32. Any doctor can do it • .. So long as a patient consents and the doctor feels confident about anatomy and injection skills - “Do not underestimate a I.c. bleb” - try it - primum nil nocere ! • vastly popular in Germany, only a minority undergo formal training, so lots of unreported cases since it is part of daily practice, sometimes job description in rehab clinics

  33. Evidence for efficiency • Randomised double blind not possible as individual approach • Huneke/Flash phaenomenon must be reproducible; countless case reports since 80 years, growing rapidly - societies in most Spanish speaking all German speaking countries

  34. The Future • Now Drs. Maik, Hagen, Holger and Juergen Huneke continue, 2 German societies, Austria, CH, ~ 3500 members, vets in Austria, independent societies in Spain, Argentina, Mexico, Columbia... • Acupuncture most recently was Chinese only, then French and German, English since Nixon’s 1972 visit in China

  35. Beware of I.M. Diclofenac ! • I.M. Diclofenac/Voltarol causes sterile necrosis in injection canal and may cause abscess - try at least I.c. blebs first ! • Oral NSAID’s: gastric erosion/bleed, renal failure, CCF - switch to safer methods ? • -triptans for migraine may provoke heart attack...

  36. Rainer Kumm • R.Kumm@doctors.net.uk • 079 500 333 61 • communication most welcome, further literature on request • http://www.ignh.de • http://www.terapianeural.com - see links

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