Neuromodulation : journal of the International Neuromodulation Society
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Case Reports
Treatment of severe tetanus with intrathecal baclofen via implantable infusion device: a case report.
Severe tetanus remains a serious issue in less developed countries, leading to prolonged hospitalization due to prolonged neuromuscular contraction of muscles. We present a case of severe tetanus in the United States that was successfully managed with intrathecal baclofen. ⋯ Due to prolonged muscle weakness associated with long-term use of paralytic agents and sedation, early ITB trial and pump placement should be considered as an alternative in the treatment of severe tetanus to shorten length of stay and improve the functional outcome of the patient.
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The study aims to describe a novel cosmetic implantation technique of internal pulse generators (IPGs) for deep brain stimulation (DBS) electrodes. ⋯ Although this procedure is a little more time consuming compared with the conventional procedure, it is safe and leads to very good cosmetic results in DBS patients, which has significant benefits from the standpoint of social and work activities.
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Spinal cord stimulation and dorsal column stimulation have been used successfully in the management of visceral pain for many years. A novel technique of ventral column stimulation has been used in our institute with good outcomes since 2007. We describe a retrospective series of 26 patients with visceral neuropathic pain who were treated with neuromodulation. ⋯ There is a need to further investigate the use of ventral stimulation for visceral pain syndromes. This would need multicenter trials to collect adequate numbers of patients to allow hypothesis testing to underpin recommendations for future evidence-based therapies.
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Spinal cord stimulation can be effectively used in the treatment of low back pain and extremity pain in failed back surgery syndrome. Ideal targets for stimulation corresponding to paresthesia overlap in the low back versus the extremities may differ in cranial-caudal location. ⋯ Dual paddle placement through a single laminotomy may be a reasonable option for select patients where coverage of anatomically-separated pain regions is necessary. This technique can be performed in most patients without significantly increased morbidity.
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The objective of this study is to develop a fully implanted, intramuscular, bipolar, myoelectric signal (IM-MES) recording electrode for functional electrical stimulation (FES), prosthetic myoelectric control, and other permanently implantable systems. ⋯ A fully implanted, bipolar intramuscular recording electrode (IM-MES) was developed. Implantation of the IM-MES is straightforward, and almost any muscle can be targeted. Testing has been performed to demonstrate the suitability of the IM-MES electrode for clinical use. Initial clinical applications were successful.