Neuromodulation : journal of the International Neuromodulation Society
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We compared the role of subthalamic nucleus deep brain stimulation (STN-DBS) in the management of medically refractory idiopathic Parkinson's disease in patients with relatively young onset (<40 years of age) Parkinson's disease (YOPD) and patients with relatively late onset Parkinson's disease (≥ 56 years of age, rLOPD). ⋯ Patients with YOPD and rLOPD exhibited comparable UPDRS motor scores and LEDD six months postoperatively. Levodopa could be prescribed at optimum doses following STN-DBS in patients with YOPD as abnormal movements are better controlled following STN-DBS implantation. Stimulation parameters were not different between the two groups. Our results suggest the age of onset does not influence response to STN-DBS Parkinson's disease patients.
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The use of spinal cord stimulation (SCS) is a form of neuromodulation used to treat chronic pain in those patients who are refractory to conventional medical management. Not uncommonly, SCS can dramatically improve a patient's quality of life, and those who are in the childbearing years may go on to become pregnant. The purpose of this case series is to describe: 1) implantation considerations in women of childbearing age; 2) use of rechargeable systems; 3) the obstetric and anesthetic concerns in patients with spinal cord stimulators; 4) risks of using SCS in the peripartum period. ⋯ Implantation of SCS devices in women of childbearing years should take into account the future needs of both obstetric and anesthetic care by avoiding the abdomen and lower lumbar spine whenever possible. There was no appreciable decline of battery capacity in present day constant current rechargeable generators when deactivated for the duration of pregnancy.
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We evaluated trends in inpatient spinal cord stimulation (SCS) for the 14-year period from 1993 to 2006. ⋯ Given the expense of these systems, it is important to assess not only the efficacy of novel neuromodulatory interventions, but also their cost. Future studies should be designed with these important outcome measures in mind.
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This paper examined the efficacy of an implantable electrical stimulator in rats for the functional regeneration of peripheral nerves. ⋯ The results suggest that the functional recovery of a severed peripheral nerve by the proposed implantable electrical stimulator was achieved through electrical current stimulation along the use of a collagen coating on the conduit surface.
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Chronic back and leg pain associated with lumbar spinal stenosis (LSS) is common in the elderly. Surgical decompression is usually performed when conservative treatments fail. We present an evaluation of the long-term outcome of patients suffering from symptomatic LSS treated with spinal cord stimulation (SCS). ⋯ Spinal cord stimulation seems to be effective in the treatment of patients suffering from chronic pain associated with LSS. Being less invasive and reversible, SCS should be considered before surgical decompression, particularly in patients with increased risks associated with back surgery.