Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Oct 1983
Dorsal root entry zone lesions (Nashold's procedure) for pain relief following brachial plexus avulsion.
Brachial plexus avulsion is an important cause of severe intractable pain, particularly in young motor cyclists. The pain usually develops soon after the injury. In a minority of cases severe pain persists and is refractory to management. ⋯ Early post-operative motor or sensory disturbance in the ipsilateral leg have been temporary side effects, with mild persisting deficits in a minority. Sixteen cases have had significant persisting pain relief. The maximum follow-up period is 2 1/2 years.
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J. Neurol. Neurosurg. Psychiatr. · Sep 1983
Case ReportsIndomethacin-responsive episodic cluster headache.
The case of a man with a 34 year history of episodic cluster headaches is described. At the peak of a cluster the headaches occurred up to twenty times a day. The headaches were unresponsive to conventional therapy but were dramatically abolished by indomethacin. This effect of indomethacin was confirmed in a double-blind placebo-controlled trial.
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J. Neurol. Neurosurg. Psychiatr. · Jul 1983
The incidence of Wernicke's encephalopathy in Australia--a neuropathological study of 131 cases.
In a nine year necropsy study in Western Australia, the incidence of Wernicke's encephalopathy was 2.8%. The incidence appears to be increasing. Although Wernicke's encephalopathy is a nutritional disorder, the majority of cases occur in the alcoholic population. ⋯ This large discrepancy between numbers of cases diagnosed clinically and pathologically suggests that chronic Wernicke's encephalopathy, which comprised 83% of the cases, may be the end result of repeated subclinical episodes of Wernicke's encephalopathy. Thus, Wernicke's encephalopathy could be considered a "progressive" disorder and as patients respond well to thiamine replacement therapy, early diagnosis is important. Alternatively, prevention by vitamin enrichment of alcoholic beverages may have to be considered in an attempt to minimise the social and economic impact of Wernicke's encephalopathy on Western society.
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All the medical, surgical and engineering personnel in the UK who have used spinal cord stimulation (SCS) in patients, attended a workshop to discuss their results. The major use of SCS has been for multiple sclerosis and intractable pain. ⋯ Further information on long term benefit is needed and the use of SCS in other conditions, such as spinal injury and peripheral vascular disease, is not yet established. SCS cannot be recommended for use outside large centres as x-ray screening, urodynamic and neurophysiological assessment facilities are required as well as biological engineering assistance.
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J. Neurol. Neurosurg. Psychiatr. · Dec 1982
Ataxia and other data reviewed in Charcot-Marie-Tooth and Refsum's disease.
The author reports his experience on Refsum's disease and that gained after personally examining in detail 64 patients with Charcot-Marie-Tooth disease over the past ten years. The "cerebellar" inco-ordination in Charcot-Marie-Tooth disease (with or without distal wasting) and in Refsum's disease is analysed. Some variations in the motor and sensory neuropathy of Charcot-Marie-Tooth disease and Refsum's disease are discussed. ⋯ The possibility of extensor plantar responses in patients with Charcot-Marie-Tooth and Refsum's disease without structural lesion of the pyramidal tract is pointed out. The existence of the association between Friedreich's ataxia and Charcot-Marie-Tooth disease is criticised. It is emphasised that spinocerebellar degeneration (other than Friedreich's ataxia) presenting with distal limb weakness and wasting and sensory impairment may mimic Charcot-Marie-Tooth disease.