UKRAINIAN INPUT INTO NEUROOTOLOGY
Trinus K. Kyïv, Ukraine. Inauguration speech 23 May 2018

Ukraine means land in the native language. During the history in different times this land has been called Kimmeria = Scythia = Sauromatae (Sawromathia) = Sumer = Slavia = Rosia = Russ = Ruthenia = Ruthynia = Ross. According to archeological data here lived one nation ALL THE TIMES [Брайчевський М. Ю. 1968]. Today Russia has no relation to our history: Moksel = Moscow = Russia from 1721.

The eldest European human settlement (1.5 mln years) is found in Transcarpathian area, town Korolevo (Kingtown). [Г. А. Вербиленко. 2009, В. М. Гладілін. 2009].

A lot of archeological findings relates to Homo habilis from late paleolith (35-12 millenniums ago), among them first hand-made houses from mammoth bones.

The eldest scripts in Ukraine are gathered in the stone library Rocky Mount. It is considered to be collection of the texts from 12 to 3 millennium before new era (n.e.) about the events from 28 millenium before n.e. the symbols of the scripts sometimes resemble modern letters, sometimes hieroglyphs.

Script № 7 Bull Cave12 mill. before n.e. Bear the judge defeated Taurus with water Event of 28 mill. before n.e. at the same time: Panel № 52 Sorcerer Cave: Defeated Taurus is signed with fire symbol and Goddess Nindara sanctify the Event offering big Bird for city fest. It means that astronomers described 2.000 years comet and already been aware of the Zodiac bodies. Europeans, personally Grecians, have got celestial maps from Hittite with maps and names of the stars, which Hittite got from Sumerians. The Hindu zodiac signs and corresponding Greek signs sound very different, being in Sanskrit and Greek respectively, but their symbols are nearly identical. For example, dhanu means “bow” and corresponds to Sagittarius, the “archer”, and kumbha means “water-pitcher” and corresponds to Aquarius, the “water-carrier”. [Schmidt, Robert H. 2016].

This knowledge has been preserved for thousands years. Later Ukrainian Martin Rusyn has created world first Department of Astronomy at that days Ukrainian Krakow. Among his students have been: Jacob Zalisky, Ivan Broshka, Mykola Shadka, Bernard Wapowsky who has made the calculation of planet movement around the Sun, later used by Copernik. Copernik parents originated from Mnihov Hradisce (White Croatia), moved to Krakow and Lviv (1400-1437). Granddad and farther were born in Lviv. Mykola was born in Torun (White Croatia at that times).

Events of 26 millennium before n.e. are reported at Pannel № 15/15: “Master Anu directed seed to plough” and at Script №1 from the Bull Cave: “Seed of the soul grown at the place of killed Master Anu” and “Great seed of Capricorn though Water Judgment transformed into clever Nindara ancestor”, as well as at Panel №6 “Renaissance of nature at ploughed field”. Reading these scripts we witness the invention of the agriculture and bread.

This appeared to become the basis of the food excess (20 persons produced food for 100). The other members of the community have started invention of the plough. Seeds were milled with millstones, started using water and air mills. Flour was used for tasty bakery. Also they had kaleyards, gardens and vineyards. Prepared vine, honey-vine and beer! Dried fruits were used for drinks preparation. Till today Ukrainian kitchen is rich and tasty. First domesticated animals are found here. Cows, goats, sheep, pigs, domestic birds and horses were attracted by straw. This gave not only meet and skin, but also milk, butter and cheese. These inventions became the basis for uniting people into cities. 8-10 thousand years ago cities in Ukraine counted more than 10.000 inhabitants. These cities contained even temples.

Panel № 26 informs about creation of chariot by hero of Dumusi God, consisting of 60 wooden parts (8 mill. before n.e.). First world domesticated horses (4 millenium before n.e.) were find in Deriїvka village (Ukraine). By the end of 2000 before n.e. it has been distributed through Eurasia [Outram, A.K., et al., 2009,].

In 6 mill. before n.e. starts Trypillia period. Ukrainians have invented pottery wheel and produced lots of utensils, decorated with complicated ornamentals and symbols. Furniture: chairs and tables, beds and boxes are made from wood, stone or metal. Everything is with decorations, curving or colored with patterns. Archeologists discovered dozens of copper and bronze workshops from 5-4 millenniums at the territory of Ukraine. They found hundreds of ceramic forms to make knives, hammers, axes. At that time forgery appears. Silver and gold is used for jewelry preparation. Scythian golden microminiatures are word wide famous. Micro miniature tradition is preceded by Mykola Siadrysty who has created the smallest book, clock, and chess… in the word. For example, his golden boat has 3 mm length and is composed of 337 details. Weaving bench allowed creating nice tissues. Clothes were beautiful variable. Embroidery appears at that time. This tradition is alive till today – at Paris fashion-show Ukrainian embroidery is popular last years.

18-15 millennium before n.e. Black Sea was lake. Then ocean water rose up because of ices melting and big masses of water came from Sea of Marmara connecting Black Lake to the ocean waters. The flood forced the people to leave their houses and move to other lands. Genetic studies data inform that #1a1a1 gene from Ukraine disseminated throughout the world. These people have brought knowledge with them and initiated civilizations wherever they came.

Etruscan civilization (768 n.e.-264 n.e.). Etruscan inventions: stone buildings, agriculture, metal industry, aqueduct. Etruscans named themselves Rossini, just as Ukrainians before 1917. Till today we meet in Italy names: Rossi, Rossini, Rossinioli. Ukranenland is an archeological village-museum in Torgelow in north-east Germany. The name comes from an old Slavic tribe, the Ukri (Ukrani).

Bow and arrows were invented by Scythians about 30 centuries ago. They consider arrow heads to be the first convertible coin, currency of the ancient ages.

Mavro Orbini (1563–1614) Ragusa chronicler, The Realm of the Slavs (1601): “Vandals… Goths, Ostrogoths, Visigoths, Gepids, Getty, Alani, Verli or Heruli, Quadi…Dacians… Marcomanni… Thracians and Illyrians who all belong to the same Slavic people and speak the same language”. “Macedonians are spoke Slavic language” “in these areas live Slavic people called Venedi or Veneti”. “In addition so many learned men and celebrated writers, which we have shown that all the aforementioned nations, belong to the Slavic nation, the same that can be proved by studying the names and the same people, which are read from the author of Acts of the Goths and the other northern nations. We think the names like; Vujdimir, Valamir, Sižimir, Teodomir, Frigimir, Svevlad or how other distorting say; Sisvald, zatim Selimir, Gelmir, Radagast or Radagazije, Rahimir, Rajmir and Sanko, one of which (according to Giovanni Nicolò Doglioni, 1548.-1629.) reigned in Spain around 823. and the second about 1064. There were then; Sižismir, Vujsumar, Vitiša, Mizislav or Mislav, Otokar (Odoakar), Vižislav, Sindžiban, Predimir and Obrad. All these names are indisputably Slavic”.

Ruthynia V-XIII century – union of Rus, Checz and Croatians against Germans and Rome. But slowly Kyiv Kings start to make dynastic links with Kings’ houses of Europe, almost all of them had relations with Kyiv descendants.

Father of history Herodotus in Book IV (Melpomene) has described the inhabitants of regions beyond Scythia and among them Androphagi (man-eaters). Their manners are more savage than those of any other race. They neither observe justice, nor are governed by any laws. Unlike any other nation in these parts, they are cannibals. Historian Marija Gimbutas has hypothesized that “Androphagoi” is a Greek translation of *mard-xwaar “man-eater” in the old Finno-Ugrian Erzya and Moksha (Moscow) originates from this word (Wikipedia). Till today world has problems with Moscow.

First written report about doctor (10 millennium before n.e.) is at Rocky Mount (Ukraine). Script № 4 “great judge doctor-renaissor through seeds milled and water wash recreated people” [Кифишин. 2001]. Agastya Samhita lived in УІ millennium b.n.e. His activity started in Ukraine, promoted high living culture, harmony with nature. His poem “Rikta-Vedi” (know and tell) accumulated oral knowledge of that time. [Бібліоґрафічний словник. 1997]. The next is Vojnych manuscript, 4100 before n.e. where the properties of the herbs and anatomical descriptions of the human body are presented. The events in it are related to the territory of today Ukraine. Tsaraka (Caraka Samhita) is the Author of the medical “Yajur-Veda” (knowledge of life), which is used in India till today as an ancient medical handbook. Tsaraka has described inherited diseases. Agatya and Tsaraka created their own schools in medicine. Ukrainian “likar (doctor)” in Sanscrit means wise artist. 6 books written by Caraka Samhita and his scholar, Susruta, based on an oral tradition passed down over generations. Susruta Samhita discusses 76 visual disorders, 51 of which were treated surgically. In addition, the author lists 101 blunt and 20 sharp surgical instruments that are very similar to instruments used today – the human hand is even included as one of the instruments, as well it should.

In Ukraine surgery has been well developed in the Scythian epoch. Vertigo has been treated with successful trepanation, giving the way out for evil ghost.

In the Middle ages the knowledge accumulated in ancient times has been used in the Kings era – in 10 cent. n.e. at the court of Great Kyїv King the doctors being present. “Statute of Great King Wolodymyr” report about monastery hospitals. Hospital in Kyїv-Pechersk Lavra has been constructed, found by St. Theodosij. The names of the most popular church doctors are well known: Agapith (?-995), Antonij (983-1073), Damian-healer, Pymen-fainter, Markel and civil doctors – Ioan Smera (980-1015), Petro Syrianin, Theuronia.

Vertigo is considered to originate from Latin vertigo “dizziness”, originally “a whirling or spinning movement”, from vertere “to turn”. But in Latin we do not find many words with this root and in Ukrainian dictionary there are 33 words with it. Moreover, back translation from Ukrainian to Latin presents us opponere, glomus, oppono, roto – but not vertere. All this supports the hypothesis that vertigo has Ukrainian origin.

Then the question comes about the origin of the name of the Nobel Prize winner Robert Barany. He was born in Vienna. Bárány’s family settled in Várpalota, Hungary, in 1750. His father was the manager of a farm estate and his mother, Maria Hock, was the daughter of a well-known Prague scientist. In Jewish German, Hebrew, Latin, Austrian, German or English you will not find word or root Barany. In Hungarian it means lamb. At the same time in Ukraine there are a lot of names Baranij, which might be transliterated as Barany. In Ukrainian baran is mutton – Baranij is a person related to mutton industries. Considering that before 1848 most Hungarian population consisted of White Croatians, which were part of ancient Ukrainian confederation [Семенюк. 2010], we have the right to assume that name Barany has Ukrainian origin. It’s difficult to establish whether they mixed with native inhabitants or simply accepted Ukrainian name.

Prof. Dr. Nils Gunnar Henriksson was a student of Robert Barany. Prof. CF Claussen is a student of Prof. Henriksson and my teacher.

According to Cochrane reports [Lampert and Neuhauser] a nationally representative sample of 4869 adults living in Germany being screened for dizziness, and 1003 individuals with dizziness underwent validated neurootologic interviews to differentiate vertigo from dizziness according to explicit diagnostic criteria. Dizziness/vertigo have a prevalence of 22.9% in the last 12 months and an incidence of 3.1%. For vertigo, the prevalence is 4.9% and the incidence is 1.4%. Only 1.8% of unselected adults consulted a physician in the last 12 months. Long-lasting monitoring of the patients has shown that initial pathological vestibular reaction is manifested with coordination disturbances, complaints of dizziness, nausea and headache. Two years imaginable wellbeing has lasted. After 4-5 years headache, tinnitus, nausea appeared. After 7-8 years peripheral dysfunction has spread at higher nervous centers involving motor, vegetative and limbic projections. Nervous, cardiovascular, psychological problems have appeared. 10 years later vestibular symptoms have integrated into neurotic syndrome, indicating misbalance of excitation-inhibition processes in the cortex. Immune failure has happened after 12-20 years – infections, metabolic impairments, onco diseases have been increased. Etiology of vestibular disorders: factors of progress, technogenic catastrophes, humanitarian catastrophes, informational overloading. Concept of vestibular system has been proposed: vestibular peripheral sensors, space orientation tetrad, vestibular projections in the brain and vestibular presentations in the brain cortex.

Literature data reveals that Vestibular periphery consists of six sensors:

  1. Gravitation,
  2. Accelerations,
  3. Vibrations,
  4. Intensive sounds,
  5. Magnetic impulse,
  6. Metabolic.

CF Claussen has formulated the idea of sensory tetrad, i.e. four sensory systems providing space orientation: vision, hearing, somatosensory and vestibular. Our results have shown that visual stimulation might cause overexcitation of vestibular nuclei with intact visual ones.

Vestibular projections (groups of pathways between two structures in the brain) are:

  1. Cortical,
  2. Motor,
  3. Vegetative,
  4. Limbic.

Vestibulo-cortical projection is responsible for space orientation, cognition of head position and movement perception, gravitation axis and head movement sensation. In pathology it forms vertigo and dizziness sensations. In the caloric test investigation in patients it has appeared that during vertigo sensation nystagmus frequency is significantly higher than in dizziness. Cortical vestibular representations besides vestibular itself are also found in visual acoustic and somatosensory cortex. Cooperating they form three-dimensional Dekart coordinate system in our brain, based at the vertical gravitation sensation.

Vestibulo-motor projection means fine tuning of movement coordination. In pathology these are coordination disturbance, disequilibria, swaying, staggering (R26-29) and nystagmus (H55). Nociceptive reflexes act at the brainstem level and involve vestibular system this mechanism is strictly determined like other vital reflexes [Mackert A., et al., 1983].

Vestibulo-vegetative projection in adequate vestibular stimulation optimizes vegetative function in patients and healthy persons; enhances physical and intellectual development in children. In pathology it happens at vestibular overstimulation, kinetosis, poisoning, and neurosis. This happens because vital vegetative centers surround vestibular descending nucleus forming thus the computer which redistributes the blood when we stand up or sit down.

Vestibulo-limbic projection stimulation in normal conditions improves mood, quality of life and in pathology disturbs emotional, feeding, drinking, sexual behavior, elicits panics, phobia, and nightmares… up cognitive disorders.

Chornobyl power plant has exploded 26 April 1986… That year I was signing permission to work at high places for the clean-uppers. Then in 1989 stuff of the plant have started complaining of dizziness/vertigo episodes. No test has revealed pathology. Vestibular evoked potentials (Vest EP, not VEMP) in 1990 appeared to be the only method to document the disorder. Р1 changes have become significant in 1991, N1 – in 1992, and Р2 latencies have increased significantly only in the year of 1994. This data indicate that pathology is initiated at periphery and step-by-step involves into the process higher brain levels. In 1992 motor projection has demonstrated light pathological changes. Blood pressure (BP) monitoring has shown its significant increase to the level of high normal (135/87 mm hg) in 1994. Rate of hypertension in clean-uppers, and general public of Kyiv started increasing in 1998, according to Prof. A.M. Kravchenko data.

Dizziness studies need to consider:

  1. vestibulo-sensory projection:

– а) anamnesis and questionnaires

– b) evoked potentials

  1. vestibulo-motor projections:

– а) vestibulo-spinal postural

– b) vestibulo-spinal locomotor

– c) vestibulo-ocular

  1. vestibulo-vegetative:

– а) vestibulo-cardial

– b) vestibulo-pupillar

  1. vestibulo-limbic

Dizziness has functional and not organic character, so sensitivity of CT – 29%, МRI – 40% [Ojala M., et al., 1988]. Dopplerography: obstructions find in 0.3% out of 6400 patient brains sections; statistics proves lack of correlation between vertebral artery flow alterations and presence of dysfunction at the brainstem [Bertora G., Bergmann J. 1986].

Vestibular evoked potentials Sensitivity – 90.57%, (n=912 examinations, 672 patients and 70 controls), specificity – 98,57%. [NASA Contractor Report 3922, №№ 13 & 23. USSR Space Life Sciences Digest, 1987 & 1988].

Vestibulo-motor projections

Posturography does not consider patient movement strategies in his desire to keep the balance: hands, body movements, knees flexions and steps. The only evaluation point is displacement of mass center. Sensitivity between 35 and 54%, specificity up to 90%. Rotation tests Sensitivity – 33.5%, specificity – 92.5% [Olsson J.E. 1988]. Caloric test sensitivity for statoacoustic neurinom up to 15 mm – 70%, specificity over 90% [Bergenius J., et al., 1983]. Cranio-corpography (ССG) has sensitivity 82.89%, specificity – 99.78% (n=912), Cranio-corpography+nystagmography sensitivity – 98.15%, specificity 98.90%.

Terminology is extremely important for the management strategy:

R42 Dizziness and giddiness – belongs to cognitive disorders, sensation of space and movement disturbance.

Н81 Vertigo – belongs to ear disturbances, illusion of the non-existent movement, often turning [ICD-10, 1992].

Critical differentiation question: if the patient can identify speed and direction of movement. Nootrops are especially effective at the symptoms of dizziness, while in the case of vertigo vestibular blockers are more effective.

In reality the complaints distribution is much more variable with the amount of combinations reaching 2.43×1018 In the case of combination of vertigo, dizziness and vestibular migraine medication of choice appeared to be Betahistine.

Our principal proposal is to initiate creation of General register which involve

  1. Family physician,
  2. Neurologist and ENT,
  3. Dizziness center, –cooperation.

You are welcome to participate in the activity of our International Dizziness Clinic.

UKRAINIAN INPUT INTO NEUROOTOLOGY