Neuromodulation : journal of the International Neuromodulation Society
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The objective of this study was to investigate and test a real time system implemented for Functional Electrical Stimulation (FES) assisted foot drop correction, deriving control timing from signals recorded from a peripheral sensory nerve. A hemiplegic participant was attached with a cuff electrode on the sural nerve connected to a telemetry controlled implanted neural amplifier, and a stimulation cuff electrode on the peroneal nerve connected to an implanted stimulator. ⋯ The detection system's ability to detect heel strike and foot lift without errors and to detect the difference between walking and standing proved to be stable for the duration of the study. We conclude that using ALNs and natural sensors provide a stable and accurate control signal for FES foot drop correction.
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Postherpetic neuralgia (PHN) is a common cause of chronic pain in the elderly. Opioids and adjunctive analgesics such as antidepressants and anticonvulsants effectively reduce discomfort in many patients, while others have pain that remains resistant to all forms of therapy. ⋯ Peripheral nerve stimulation has been described for such problems as chronic regional pain syndrome, but to date has not been reported for cranial nerve syndromes. This article describes the cases in which an 86-year-old man and a 76-year-old woman with intractable PHN of greater than 6 and 4 years, respectively, were effectively treated with peripheral nerve stimulation of the ophthalmic division of the trigeminal nerve.
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Percutaneous retrograde lead insertion for sacral nerve root stimulation is a newly described technique being applied to a variety of pain disorders. The success of the procedure rests in a defined epidural space such that there is unimpeded progression of the lead into the desired location. It is hypothesized that any condition that results in anatomic compromise of the epidural space would prevent the success of the procedure. ⋯ In another patient, repeated attempts at passing the epidural lead distal to the congenital defect were unsuccessful, and the percutaneous procedure was aborted. In conclusion, we have found that the diagnosis of spina bifida occulta, or any other condition in which the epidural space is anatomically disrupted, is a relative contraindication for this procedure. Preoperative roentograms of the lumbar spine may be helpful in avoiding technical difficulties due to this diagnosis.