Neural Therapy- Huneke

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Neural Therapy- Huneke

• A truly wholistic method since 80 years

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Dr. Ferdinand Huneke 1928

• 1925 Ferdinand Hunekes 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

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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

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Interference zone/Stoerfeld/Spina Irritativa

• 50 in ENT region, usually teeth

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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

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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

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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

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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

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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 isnt any chronic
  condition that is not due to a Interference zone
  - Exzema- Arthritis - period problems -
  unexplained infertility...

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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

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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 ?

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Theories

• NT is empiric and individual but experience from
  gt80 years shows where to look first
• see also Heads zones, e.g. gall bladder-shoulder
  pain Simmons and Travells work about trigger
  points and pain projections
• referred pain myofascial pain concept
• simple Where does it hurt ? approach

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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

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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

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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 ?

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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

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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

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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

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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 GPs
  in the UK are replaced by nurse practitioners !

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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

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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 !

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Needles or not

• A motivated patient with distressing symptoms
  will accept a needling approach - patient
  selection !

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Contraindications

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

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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

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NOT a Cure all

• Neural Therapy is not a cure all miracle
  therapy - there are limits in the doctors
  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

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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

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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...

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Ideal setting

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

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Risks

• Allergic reaction - rare - reddening and itch
  1cm is normal with Procaine as vaso-dilating,
  possibly more pronounced in scars etc., some
  allergy 13000
• severe allergic reaction (shock, asthma) very
  rare, probably lt 110 000
• infection - very rare - ultra-thin needles
  0,25-0.4mm, Procaine is bacteriostatic

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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 !

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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

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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

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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

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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 Nixons 1972
  visit in China

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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 NSAIDs gastric erosion/bleed, renal
  failure, CCF - switch to safer methods ?
• -triptans for migraine may provoke heart attack...

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Rainer Kumm

• R.Kumm_at_doctors.net.uk
• 079 500 333 61
• communication most welcome, further literature on
  request
• http//www.ignh.de
• http//www.terapianeural.com - see links