Neuromodulation : journal of the International Neuromodulation Society
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Case Reports
Lead Angle Matters: Side Effects of Deep Brain Stimulation Improved With Adjustment of Lead Angle.
Targeting the subthalamic nucleus (STN) for deep brain stimulation (DBS) using standard stereotactic coordinates in conjunction with high-resolution magnetic resonance imaging (MRI) generally results in effective symptomatic relief for the cardinal motor features of Parkinson's disease (PD). The angle of approach, however, influences the resultant field of stimulation and can lead to undesired side effects. ⋯ Lead angle can impact DBS outcome and should be taken into consideration.
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The aim of this study was to report on four patients with craniocervical dystonia (CCD) treated with deep brain stimulation (DBS). In addition, we investigated the treatment efficacy and surgical outcome predictors by the review and analysis of previously published studies. ⋯ GPi/STN-DBS is an effective treatment for patients with medically refractory CCD, including those with severe preoperative symptoms. The age at CCD onset and the disease duration do not predict improvement in movement scores.
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Review Case Reports
Spinal Cord Stimulation for Intractable Testicular Pain: Case Report and Review of the Literature.
Treating chronic testicular pain is often challenging, and few treatment options have been reported. We report a case of intractable testicular pain successfully treated with spinal cord stimulation (SCS). ⋯ This is the third reported case of intractable chronic testicular pain successfully treated with SCS. Although evidence is scarce, SCS appears to be a potential treatment for patients with testicular pain presenting with a clear distribution of pain.
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Neuromodulation, including cavernous nerve stimulation, gastric electrical stimulation, deep brain stimulation, and vagus nerve stimulation, has been used with success in treating several functional disease conditions. The FDA has approved the use of neuromodulation for a few indications. We discuss in our review article the evidence of using neuromodulation for treating some important disorders involving the autonomic nervous system that are not currently FDA approved. ⋯ This review article shows preliminary support based on clinical studies that neuromodulation can be of benefit for patients with important autonomic nervous system disease conditions that are not currently approved by the FDA. All of these investigational uses are encouraging; further studies are necessary and warranted for all indications discussed in this review before achieving FDA approval.
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Multicenter Study
Spinal Cord Stimulation (SCS)-The Implantable Systems Performance Registry (ISPR).
The Implantable Systems Performance Registry (ISPR) was created to monitor the product performance of Medtronic Spinal Cord Stimulation (SCS) and implanted intrathecal drug infusion systems available in the United States. ⋯ The ISPR is designed to serve as an ongoing source of system and device-related information with a focus on "real-world" safety and product performance. ISPR data continue to be used to guide future product development efforts aimed at improving product reliability and quality.