Abstract

In this paper possible mechanism of improvement of the functional state of the brain areas, maintaining movement, visual, auditory, and higher functions of the brain during correction of generalized spastic syndrome (botulinotherapy with Xeomin) in patients in a vegetative state (VS) is discussed. If to consider the vegetative state as stable pathological condition (SPC) of the brain, then from the perspective of the theory of structural and functional organization of the brain with systems with rigid and flexible elements (N.P. Behtereva), the therapy led to an unbalance of SPC, "functional release" of neurons and redistribution of their functions to provide other activities, the formation of new interneuronal connections. Taking into account the functional variability of neurons (S.V. Medvedev), blocking neuromuscular transmission in spastic muscles leads to a reduction of abnormal afferent and efferent hyperactivity of motor and sensory neuronal circuits, which releases the brain for other activities. This allows to consider botulinotherapy of pharmacoresistant muscle spasticity in patients in VS and minimal consciousness, not only as a symptomatic treatment, but also as a "indirect neuroprotection".

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