Seminars in neurology
-
High-voltage electrical injuries may be devastating, with extensive burns, cardiac arrest, amputations, and long, complicated hospitalizations. Low-voltage injuries, after other pathologic and high-voltage sources are ruled out, tend to be rather benign acutely although they may have significant long-term morbidity, including chronic pain syndromes. Lightning injuries affect 800 to 1000 persons per year. ⋯ Although high-voltage injuries may require the services of trauma surgeons, in general, therapy for low-voltage and lightning injury is supportive and involves cardiac resuscitation for the more seriously injured and supportive care for the less severely injured. Long-term problems from sleep disturbances, anxiety attacks, pain syndromes, peripheral nerve damage, fear of storms (for lightning patients), and diffuse neurologic and neuropsychologic damage may occur in both electrical and lightning patients. Other sequelae--such as seizures or severe brain damage from hypoxia during cardiac arrest and spinal artery syndrome from vascular spasm--are indirect results of electrical and lightning injury.
-
Seminars in neurology · Dec 1988
Review Comparative StudyPercutaneous methods for the treatment of trigeminal neuralgia and other faciocephalic pain; comparison with microvascular decompression.
The treatment of trigeminal neuralgia by the minor percutaneous invasive procedures of selective thermal rhizotomy, glycerol injection, and balloon compression in the middle cranial fossa are compared with the open operations of compression in the middle fossa and MVD in the posterior fossa. A conservative end point for any one of the three percutaneous methods is recommended as the first invasive procedure in this disorder. The management of the facial pains in multiple sclerosis, cancer, posttraumatic and postherpetic pain, migrainous neuralgia (cluster headache), and vagoglossopharyngeal neuralgia is also discussed.