Scientific contributions

  • I am the author of a method that I have introduced in global medicine for determination of the individual pathophysiological mechanism of spasticity, which provides a possibility for individual treatment.
  • I have extended the method by determining the pathophysiological mechanisms on which the main myorelaxants act. This enables the individual treatment of patients according to their pathophysiological profile. This is established in global practice as gold standard of behaviour towards such patients.
  • I have introduced for the first time the F-wave method for evaluation of the motor neuron activity. The method has gained ground and is now commonly applied by the global neurological community.
  • For the first time I have registered complex changes in the parameters of the flexor reflex in cases of spasticity. The method has gained recognition in world practice and is extensively used.
  • I have developed an algorithm for diagnostic and control of tremors treatment, which is included in the consensus of the Movement Disorder Society. It is based on a large-scale clinical and electromyography comparative study of the majority of tremor types encountered in neurological practice.
  • I have introduced for the first time a method for prospect elaboration in respect of Parkinson’s disease patients, which has been adopted by the Movement Disorder Society. This method is based on subdivision of the disease into four subtypes differing in terms of their clinical, prospect, pharmacological and electromyography features.
  • I have contributed to finding the answer to one of the main issues of dispute in global neurology as I have identified proofs for common etiopathogenesis of the static and postural Parkinson’s tremor.
  • I have introduced for the first time a method for prospect elaboration in respect of patients with essential tremor. It is based on subdivision of disorders into subtypes with various clinical progressing, pharmacological response, and prospects.
  • For the first time I have presented data evidencing the shared pathophysiological mechanisms between essential tremor and Parkinson’s disease.
  • For the first time I have presented data evidencing the involvement of certain spinal cord pathophysiological mechanisms in tremor genesis.
  • For the first time I have published the complete electromyography and clinical characteristic of the psychogenic, rubral, orthostatic and cerebellum tremor.
  • I have first indentified a shared pathophysiological mechanism and clinical progress of tremors having different ethology: depression, anxiety, abstinence syndrome and intoxication. I have described the clinical and electromyography characteristics of these diseases.
  • I have been the first to prove by way of state-of-the-art epidemiological studies that the spreading of two socially significant diseases – Parkinson’s disease and multiple sclerosis in Bulgaria does not differ from that in other countries.
  • My global contribution to clarification of the etiopathogenesis of the Parkinson’s disease and multiple sclerosis is supplemented by their lower incidence among the Roma population, which I have established jointly with a team of American scientists.
  • I have contributed to extending the clinical picture of multiple sclerosis patients through description of a number of rarely occurring symptoms: epileptic seizures uncus crises, headache and focal dystonia.
  • Jointly with a team of Italian scientists from one of the most renowned universities in Italy in the town of Pavia, I have developed new options for headache diagnostics by way of neuro-physiological methods.
  • I have introduced a standard for studying the trigemino-cervical reflex, which contributes to differential diagnosis of headache.
  • My authored set of neurophysiological methods for determining the brainstem motor neuron and inter neuron activity. They have been applied for the first time in patients with headache and have contributed to clarifying the brainstem mechanisms of primary headaches.
  • Within an authorship team with Italian researchers, I have described the action mechanisms of hypnosis, dream and naloxone on suppressing pain.
  • I have proven the existence of the POEMS syndrome in Bulgaria, which up to that time has been considered as spread among the Asian population only. I have contributed to extending the clinical picture of the disease through a detailed description of the clinical progress in dynamics. 
  • For the first time I have described the early affecting of the central nervous system in patients with diabetes.
  • I have contributed to achieving the completeness of the clinical picture of movement disorders, parkinsonism, the syndrome of Guillain-Barre and certain other rare heredodegenerative disorders through description of a number of rare cases.
  • I have been the first to introduce as standard in clinical neurological practice the neurophysiological study of tremor through electromyography and accelerometry.
  • For the first time I have introduced new methods for a more accurate diagnostics of Parkinson’s disease – the pharmacological diagnostic sample with levodopa and SPECT imaging with radioligands. These methods have gained ground as a standard of behaviour among neurological community by which we have aligned our practice with the diagnostic practice being applied worldwide.
  • For the first time under my guidance a screening was performed of patients already diagnosed with Parkinson’s disease. We have established a great deal of hyperdiagnostics (over 50%), after which I have initiated an introduction of algorithm for diagnosis determination.
  • For the first time, in support of global neurological practice I have validated and introduced into clinical practice assessment scales for the quality of life and the severity of Parkinson’s disease.
  • For the first time I have launched and implemented in practice the thesis of levodopa sparing therapy, which prolongs the patients’ life. New medicines were introduced into clinical practice enabling the postponement of levodopa treatment.
  • For the first time under my guidance the modern immunomodulating therapy of multiple sclerosis has been introduced, which placed our patients in equal position with that of the patients worldwide.
  • I was the first to introduce a method for testing the trigemino-cervical reflex and of the facial muscles’ F-wave, thus contributing to the differential diagnosis of headache.
  • I am an innovator in the treatment of the tension type of headache with myorelaxants, antidepressants, botulinum toxin and electromyography biofeedback. For the first time I have also introduced migraine treatment with triptans and anti-epileptic medicines.
  • I have been the first to introduce global experience in using the method of the F wave for early and precise diagnostic of peripheral nervous system damages.
  • For the first time I have introduced a treatment for waist pains with myorelaxants and of the peripheral nerves damages with electromyography biofeedback.
  • For the first time I have introduced into practice the treatment of dystonias with botulinum toxin.
  • I am an author of national consensuses on diagnostic and treatment of early and late Parkinson’s disease, multiple sclerosis, polyneuropathies, headache and neurological pains. I have taken part in the elaboration of national consensuses on primary prevention of brain strokes and for diagnostic and treatment of epilepsy. They have been adopted as a model of behaviour in the neurological community’s clinical practice.
  • I have developed and described in detail a multitude of theoretical aspects of significant neurological diseases, such as multiple sclerosis, Parkinson’s disease, movement disorders, tremor, headache, spastically increased muscle tone, back pains and their diagnostics by way of clinical neurophysiology. They are published in monographs and scientific literature reviews in Bulgaria and abroad.
  • For the first time I have reflected in neurology textbook the contemporary concepts regarding muscle tone, tremor, Parkinson’s disease, movement disorders, clinical neurophysiology and back pains.
  • I have created the first neurophysiology glossary as an aid to practicing neurophysiologists.