Brain and nerve = Shinkei kenkyū no shinpo
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Although non-destructive neuromodulation is becoming popular, ablative neurosurgical procedures still play a very important role in the management of harmful spasticity. There are 2 major ablative surgeries for spasticity control. One is selective peripheral neurotomy that is indicated for focal spasticity such as equinus foot and inversion of the foot. ⋯ Recent reports on randomized-controlled studies indicate its long-term effectiveness. A less invasive technique and intraoperative neurophysiologic assessment is important in selective dorsal rhizotomy to maximize clinical benefits and minimize complications. Surgical management of harmful spasticity is a very important and rewarding clinical practice, and should be one of the standards employed in clinical neurosurgical practice.
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Spasticity is often observed in patients with brain or spinal cord injuries. Patients with severe spasticity experience considerable difficulty in performing the activities of daily living (ADLs). Baclofen is an agonisit at gamma-aminobutyric acid (GABA) receptors, and is, therefore, a neuroinhibitor, and decreases spasticity. ⋯ All patients implanted with the pump are satisfied with the reduction in spasticity which has improved the performance of activities among wheelchair users and facilitates locomotion. In 2 patients, the implants were removed; in 1, the reason for the removal infection, and in the other was disruption of catheter. Re-implantation surgery was performed on both patients and baclofen treatment was continued.
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Neuropsychiatric disturbances are common and burdensome symptoms of dementia. Assessment and measurement of neuropsychiatric disturbances are indispensable to the management of patients with dementia. Neuropsychiatric Inventory (NPI) is a comprehensive assessment tool that evaluates psychiatric symptoms in dementia. The Nursing Home Version (NPI-NH) of NPI was developed for use in extended care facilitate caring for residents with dementia. We translated the NPI-NH into Japanese and examined their validity and reliability. ⋯ The Japanese version of NPI-NH demonstrated sufficient validity and reliability as well as the original version of them. It is a useful tool for evaluating psychiatric symptoms in demented inpatients.