Neuromodulation : journal of the International Neuromodulation Society
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Controlled Clinical Trial
Effects of Neuromuscular Electrical Stimulation on the Frequency of Skeletal Muscle Cramps: A Prospective Controlled Clinical Trial.
We investigated if neuromuscular electrical stimulation (NMES) of calf muscles prevents spontaneous calf cramps. ⋯ The applied stimulation protocol seems to provide an effective prevention strategy in individuals affected by regular calf cramps.
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Cervical cord stimulation is used in the treatment of chronic (neuropathic) pain syndromes refractory to conservative treatments. Several authors describe different techniques for the placement of cervical electrodes. Electrodes can be placed retrogade [Correction added on 03 April 2018 after first online publication: the word "plased" has been changed to "placed".]. In this article, we describe a refinement on how to dissect the dorsal meningo-vertebral ligaments to decrease the risk of complications. ⋯ We describe an additional surgical detail for the known procedure for retrograde placement of high cervical plate electrodes. This surgical detail might result in a lower risk of complications. We present a case series of 28 patients to support this hypothesis.
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To investigate the relationship between motor cortical plasticity, intracortical inhibition, and clinical response to pallidal deep brain stimulation (DBS) in patients with cervical dystonia (CD). ⋯ Our findings indicate that a high degree of preOP plasticity is associated with higher symptom severity, underlining the role of abnormal plasticity in the pathophysiology of dystonia. At the same time individual degree of plasticity may drive reestablishment of normal motor programs, leading to better clinical outcome with DBS. The latter suggests that individual PAS-response may indicate the susceptibility for neuromodulatory processes as an important factor for clinical DBS effects. It might therefore serve as a neurophysiological marker to predict outcome and guide patient selection.
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To investigate the effectiveness of vagus nerve stimulation (VNS) in combination with pharmacological therapy in a longitudinal retrospective study at a single center. ⋯ VNS is a well-tolerated palliative neuromodulatory treatment for drug resistant epilepsy with a 43.8% seizure reduction after five years. Our data supports the idea that VNS effectiveness increases with time. Therefore we suggest that VNS should be evaluated for at least two years after implantation. AED changes should try to be kept to a minimum during evaluation in order to determine the effectiveness of VNS.
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"Dry eye" or "keratoconjunctivitis sicca" is a multifactorial disease estimated to have a worldwide prevalence of 5-33%. Conventional therapies targeting the ocular surface with artificial tears, anti-inflammatories, punctal closure, eyelid hygiene, and antibiotics do not provide relief in all patients, especially those with neuropathic-like ocular complaints (wind hyperalgesia and photophobia). We anticipated that ocular transcutaneous electrical nerve stimulation (TENS) would alleviate symptoms of ocular pain, photophobia, and dryness in these latter individuals. ⋯ Our data indicate that TENS may similarly provide analgesia in patients with dry eye symptoms as it does for many other chronic pain conditions. Furthermore, the noted effect on symptoms of photophobia and dryness suggest that all may be linked by similar trigeminal-thalamic-cortical pathways. Prospective studies with electrical stimulation of dry eye are needed to further elucidate its benefit and mechanism of action.