Neuromodulation : journal of the International Neuromodulation Society
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The study shows placement of spinal cord stimulators using an Epiducer for placement of multiple cylindrical leads or single S-8 paddle leads. It also gives tips for problem-solving Epiducer use. ⋯ Some problems with Epiducer placement may occur. But these problem-solving techniques may help in troubleshooting.
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Data regarding rehospitalization and emergency department (ED) visits following vagus nerve stimulation (VNS) present data analysis challenges. We present a method that uses California's multiple databases to more completely assay VNS efficacy. ⋯ VNS surgery has low rates of complications and reoperations and is associated with reduced incidence of seizure-related ED visits and hospital admissions in the first and second postoperative years.
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Clinical Trial
Optimizing the duration of assessment of stage-1 sacral neuromodulation in nonobstructive chronic urinary retention.
The duration of test stimulation using two-stage sacral neuromodulation (SNM) is not studied. This study will determine the restoration of normal bladder sensation and resultant voiding in chronic urinary retention (CUR) after stage-1 SNM. ⋯ Stage-1 SNM may be left in situ for up to four weeks to ensure the maximum chance of restoring normal bladder function in this complex group of patients.
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Postoperative programming in deep brain stimulation (DBS) therapy for movement disorders can be challenging and time consuming. Providing the neurologist with tools to visualize the electrode location relative to the patient's anatomy along with models of tissue activation and statistical data can therefore be very helpful. In this study, we evaluate the consistency between neurologists in interpreting and using such information provided by our DBS programming assistance software. ⋯ Our five neurologists demonstrated high consistency in interpreting information provided by the CRAVE interactive visualization software for DBS postoperative programming assistance. Three of our five neurologists had no prior experience with the software, which suggests that the software has a short learning curve and contact selection is not dependent on familiarity with the program tools.
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Spinal cord stimulators (SCS) function by transmission of electrical impulses to electrode contacts placed within the epidural space depending on the painful area to be treated. Because of the electrical nature of the SCS, there has been concern about the interaction between these devices and devices that monitor or augment the cardiac system. Implantable loop recorders help to identify the causes of syncope or palpitation by continuously evaluating and recording portions of an electrocardiograph in patients being evaluated for cardiac conduction arrhythmias. The purpose of the study is to simulate the possible effects of spinal cord stimulation on a Confirm cardiac monitor (St. Jude Medical, St. Paul, MN, USA). ⋯ Our study demonstrates that spinal cord stimulation is unlikely to interfere with the data collected by the Confirm loop recorder, and the presence of an SCS should not interfere with the ability to use a loop recorder for diagnostic purposes.