Neuromodulation : journal of the International Neuromodulation Society
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Objective. To assess long-term efficacy, safety and functional benefit of intrathecal baclofen for severe spinal spasticity. Materials and Methods. ⋯ A very significant decrease in tone and spasms was observed in all cases (p < 0.001). Tolerance appeared during the first 12 months, increasing doses from a mean initial dose of 83.2 μg (range 25-200 μg) to a mean final dose of 270 μg (range 25-800 μg). Later on, efficacy remained stable, except in cases of mechanical problems of the infusion system.
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Spinal cord stimulation (SCS) for the treatment of painful peripheral neuropathy (PN) has been met with mixed results. It has been suggested that early-stage symptoms that are sympathetically maintained (SMP) are more likely to respond to SCS, while progressive sympathetically independent symptoms (SIP) will not. Peripheral nerve stimulation (PNS), however, has successfully treated certain SIP presentations. With the advent of new selective nerve root stimulation (SNRS) strategies, the possibility of utilizing epidural, peripheral neurostimulation was investigated in a patient with endstage, diabetic, "dying back" peripheral SIP.
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Objective. The application of a decision algorithm is described here for the inclusion of patients in a protocol of therapeutic intervention by the use of an implantable neuromodulation system. This algorithm is based on the assessment of the psychological profiles of the patients and their environment. ⋯ In a third sample, made up of implanted patients from sample 1 and sample 2, a discriminant analysis was performed using a pooled variable. Conclusion. The results of the application of the pooled analysis confirm the need for considering the psychological profile as a variable predicting an optimum result in the therapeutic treatment of chronic pain.