Neuromodulation : journal of the International Neuromodulation Society
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Spinal cord compression from catheter tip granulomatous masses following intrathecal drug administration may produce devastating permanent neurologic deficits. Some authors have advocated intrathecal catheter placement below the conus medullaris to avoid the possibility of spinal cord involvement. Multiple cases of catheter tip granulomas in the thoracolumbar region have been reported. ⋯ Histologic examination of the mass confirmed a sterile inflammatory mass. It has been suggested that intrathecal catheters be placed below the conus medullaris to avoid the possibility of spinal cord involvement. We present an unusual case documenting devastating permanent neurologic deficits from a catheter tip granuloma in the sacral region.
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The aim of this study was to investigate the causation of an insufficient clinical response to acute external stimulation after implantation of brain stimulating electrodes in patients with idiopathic Parkinson's disease (IPD). This study represents to our knowledge the first consecutive postoperative monitoring of the electrical properties of electrodes and tissue in this patient cohort. We hypothesized that changes in brain tissue resistance would be etiologic for this clinically observed phenomenon. ⋯ The changes of the voltage drop on the electrodes and the tissue were insignificant over the time course. We conclude that the decline of the clinical benefit is not due to an alteration of tissue resistivity. As an explanation, we postulate that the reactive formation/resolution of edema around the electrode has the same resistivity as the target and is therefore not detectable by our measurements or modulated by a still unknown mechanism.
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Objective. The outcomes of different modes of TENS (transcutaneous electrical nerve stimulation) in relieving experimental heat and cold pain were studied. Materials and methods. Three modes of stimulation, conventional, burst, and high rate frequency modulation (HRFM) including placebo, were trancutaneously applied to 20 right handed healthy volunteers (10 males and 10 females). Stimulation was carried out using two pad electrodes placed over the median nerve for 120 s in each case. ⋯ Conclusions. All modes of stimulation statistically decreased both heat and cold pain when compared to placebo. HRFM was the most effective mode of TENS. It might be worthwhile to test the patterns of stimulation in chronic pain patients.
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The paper describes an original method of endoluminal electrical stimulation of the stomach developed by authors. The aim of the study was to compare two types of electrical stimulation: low frequency (LF) and high frequency (HF) in human patients. Twenty-three patients with postoperative gastroparesis (after abdominal surgery) were involved in the study and randomized into two groups. ⋯ Symptoms score decreased on the consecutive days of pacing from 8.3 to 3.8, 1.3, to 0.9 in the LF group and from 8.2 to 3.1, 1.0, to 0 in the HF group. We conclude that HF is more effective than LF in the treatment of postoperative gastroparetic human patients. No adverse effects of HF and LF were observed in this study.