Neuromodulation : journal of the International Neuromodulation Society
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The administration of intrathecal drugs has been shown to be efficacious in the treatment of both cancer pain and noncancer pain in patients who do not respond well to conventional treatment, in those who are unable to tolerate side-effects of opioids, and in those who constantly require significant increases in drug dosing. Although morphine represents the "drug of choice" for intrathecal administration, the use of alternative drugs (e.g., bupivacaine, clonidine, and hydromorphone) appears promising for intrathecal therapy of pain in patients who are unresponsive to morphine, those who cannot tolerate its side-effects, and those patients with neuropathic pain. This study analyzes results of studies published from 1990 to 2005 in order to evaluate the efficacy of intraspinal therapy.
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Objective. To assess the orthotic effect of a functional electrical stimulation device (Akita Heel Sensor System; AHSS) in the treatment of hemiplegic gait with foot drop. Materials and Methods. In the AHSS, a heel sensor is attached to a small plastic heel brace, and the peroneal nerve is stimulated via percutaneous intramuscular electrodes. During the swing phase of the hemiplegic gait, the common peroneal nerve is stimulated by the AHSS. ⋯ Mean step cadence was 31 ± 7 steps/10 m without stimulation and 27 ± 7 steps/10 m with stimulation. By correcting foot drop, the AHSS significantly increased walking speed and decreased cadence (p < 0.05). Conclusion. The AHSS can significantly improve walking in hemiplegic patients with foot drop.
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Objective. The objective of this study was to report our observations on the external electromagnetic field influences on deep brain stimulation (DBS) in our patient population and how these influences affected our patients' lives and other healthcare-related conditions. Materials and Methods. We have retrospectively analyzed data concerning the effects of external electromagnetic fields on 172 of our patients implanted with DBS. Results. Identifiable electromagnetic sources turned the implantable pulse generator (IPG) off in 20 patients. ⋯ Conclusions. External electromagnetic interference may, in rare cases, constitute a severe threat to the well-being of the patient implanted with a DBS system. Also, malfunction of a DBS system may constitute a medical emergency. Nevertheless, in spite of these external electromagnetic influences, we consider DBS to be a safe method, provided safety protocols are followed, and provided that provider awareness about potential hazards is present.