Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2015
Case ReportsPhantom Remodeling Effect of Dorsal Root Entry Zone Lesioning in Phantom Limb Pain Caused by Brachial Plexus Avulsion.
Dorsal root entry zone (DREZ) lesioning has been reported to be effective for phantom limb pain caused by brachial plexus avulsion pain. Most reports on DREZ lesioning for brachial plexus avulsion pain have focused on the results of pain relief without a detailed description of phantom sensations following DREZ lesioning. ⋯ The phantom arms and hands showed a prompt shortening and reduction in size, rather than a disappearance, following successful DREZ lesioning in patients with chronic phantom limb pain caused by brachial plexus avulsion.
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Stereotact Funct Neurosurg · Jan 2015
Treatment of postherpetic neuralgia using DREZotomy guided by spinal cord stimulation.
Postherpetic neuralgia (PHN) is the most common complication following an episode of acute herpes zoster. The curative effect of current treatments is limited. ⋯ Microsurgical DREZotomy assisted with SCS for target localization is an effective remedy for PHN.
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Stereotact Funct Neurosurg · Jan 2015
Comparative StudyAwake Neurophysiologically Guided versus Asleep MRI-Guided STN DBS for Parkinson Disease: A Comparison of Outcomes Using Levodopa Equivalents.
Deep brain stimulation (DBS) for Parkinson's disease (PD) has traditionally been performed in awake patients. Some patients are unable to tolerate awake surgery or extensive time off their medication to allow for neurophysiological testing during traditional DBS implantation, which has previously limited surgical options for these patients. Recently, asleep image-guided lead placement using intraoperative MRI or CT for verification has been proposed as an alternative for patients unable or unwilling to undergo awake DBS surgery. ⋯ Asleep MRI-guided DBS is a viable option for PD patients unable or unwilling to undergo awake placement, with similar results in terms of LEDD reduction and complications.
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Stereotact Funct Neurosurg · Jan 2015
Multimodal, Intraoperative Monitoring during Paddle Lead Placement for Cervicothoracic Spinal Cord Stimulation.
We investigated the efficacy of combined somatosensory evoked potentials (SSEP) and electromyography monitoring during paddle lead placement through cervicothoracic laminectomy under general anesthesia in a retrospective review of data from 25 patients. ⋯ Intraoperative neurophysiological guidance using SSEP and muscle MEP was useful for the safe and accurate placement of paddle leads for cervicothoracic SCS.
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Stereotact Funct Neurosurg · Jan 2015
Successful use of high-frequency spinal cord stimulation following traditional treatment failure.
High-frequency spinal cord stimulation (HFSCS) offers an alternative treatment for chronic refractory pain syndromes nonresponsive to traditional spinal cord stimulation (SCS). Following the conflicting findings of preliminary HFSCS clinical studies performed at 5-10 kHz, this study is the first to report successful clinical usage of 1-kHz frequency SCS with a standard generator. ⋯ HFSCS at the frequency of 1 kHz offers a new tool for treatment of chronic pain in patients with traditional stimulation settings. Furthermore, most standard SCS batteries are capable of delivering stimulation in this frequency range.