Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Apr 1982
Nociceptors and warm receptors innervated by C fibres in human skin.
The properties of 125 C fibre units recorded from the peripheral nerves of conscious man were studied. On the basis of receptive field properties and responses to natural stimulation, 120 of the units were classified as polymodal C nociceptors. ⋯ Polymodal nociceptors responded readily to moderately intense and noxious mechanical stimuli whereas the warm receptors produced inconsistent responses to even intense mechanical skin stimulation. Thermal stimulation in the innocuous range, perceived as warmth, optimally excited the thermoreceptors whereas the polymodal C nociceptors fired most intensely to noxious painful heat.
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J. Neurol. Neurosurg. Psychiatr. · Dec 1981
Comparative StudyExtradural diamorphine in the control of pain following lumbar laminectomy.
Catheters were inserted into the extradural space under direct vision at the time of surgery for prolapsed intervertebral disc or lumbar canal stenosis. In the post-operative period, diamorphine (3 mg in 5 ml water) was injected through the catheter when patients requested analgesia. In only four of 49 patients was significant pain relief not achieved after extradural diamorphine injection. ⋯ As judged by the improved mobility and by grading on a linear analogue pain scale, the quality of analgesia achieved was better than after intramuscular papaveretum (10-20 mg) and extradural diamorphine was requested less frequently. There were no serious side-effects in the patients studied, although the technique was not used in patients over 55 years of age. Extradural diamorphine appeared to be less effective in two patients who had undergone re-explorations.
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J. Neurol. Neurosurg. Psychiatr. · Sep 1981
The pathogenesis of pneumatic tourniquet paralysis in man.
The relative importance of ischaemic and direct mechanical injury to nerves compressed by a tourniquet, in the pathogenesis of tourniquet paralysis in man has not been established. To investigate this question, conduction in ulnar or median nerve fibres has been measured in healthy subjects both at the level of the pneumatic tourniquet and distal to the tourniquet. ⋯ However, a proximal to distal progression in conduction abnormalities distal to the tourniquet suggested that the earlier conduction abnormalities at the level of the tourniquet were primarily ischaemic in origin. Mechanical compression, however, probably contributed to disproportionate conduction delays and blocks across the border zones of the tourniquet.
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J. Neurol. Neurosurg. Psychiatr. · Apr 1981
Disability after severe head injury: observations on the use of the Glasgow Outcome Scale.
The nature of the neurological and mental disabilities resulting from severe head injuries are analysed in 150 patients. Mental handicap contributed more significantly to overall social disability than did neurological deficits. This social handicap is readily described by the Glasgow Outcome Scale, an extended version of which is described and compared with alternatives. Comments are made about the quality of life in disabled survivors.
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J. Neurol. Neurosurg. Psychiatr. · Apr 1981
The effect of dantrolene sodium in relation to blood levels in spastic patients after prolonged administration.
In 25 patients with spasticity, pharmacokinetics and effects of dantrolene sodium were investigated after prolonged administration. A beneficial effect occurred in seven patients. ⋯ Many side effects were noted such as: anorexia, nausea, drowsiness, depression and muscle weakness. From this study we conclude that dantrolene sodium is a muscle relaxant with a weak to moderate effect in patients with spasticity; the effect at doses higher than 200 mg daily is probably poor.