J Neurosurg Sci
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Occipital nerve stimulation may be effective for primary headache disorders. Four studies, including two double-blind show, stimulation-controlled studies that were performed for chronic migraine showed evidence of benefit. ⋯ In chronic cluster headache, several case series have shown improvement, which, combined with the safety of occipital nerve stimulation relative to deep brain stimulation, have led to published reports supporting this as the preferred surgical technique for chronic cluster headache. A few case reports suggest a possible benefit in short-lasting unilateral neuralgiform headache attacks with conjunctival injection tearing and short-lasting unilateral neuralgiform headache.
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As the population of many countries ages, disorders of cognition and memory-such as Alzheimer's Disease (AD) and dementia associated with Parkinson's Disease-will become a major societal burden. At present, few effective medical therapies against these conditions are available. ⋯ In this article, we review the scientific literature to address some of the mechanisms by which DBS may impact memory and cognition. We then summarize the results of recent clinical experience with DBS in AD and Parkinsonian dementia.
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Chronic pain is a common condition that confers a substantial burden--physical, psychological, and economic--to individuals and society. There are a wide variety of interventions available for this condition. ⋯ For drug therapy, this review will focus on three classes of medications: antidepressants, opiates and antiepileptic medications. For device therapy, the utility of electrical stimulation to neural structures (dorsal column, peripheral nerve and deep brain) and intrathecal therapy for chronic pain will be described.
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Electrical stimulation of peripheral nerves is an established modality in treatment of chronic pain. Although introduced half a century ago, it has enjoyed rapid growth in popularity and acceptance over the last decade or so. The spectrum of clinical situations where peripheral nerve stimulation (PNS) has been successfully used includes chronic pain in extremities, neck, lower back, chest and abdominal wall, and head and face regions. ⋯ Such administrative recognition of clinical value of PNS necessitates update on PNS status for interested readers. The goal of this article is to provide a comprehensive overview of the different types of peripheral neurostimulation that are used today and providing the most updated information on the current state of the modality. As clinical interest and experience with PNS continue to grow, we expected steady accrual of objective evidence in terms of safety, efficacy, best indications and optimal stimulation parameters, all of which will be necessary for worldwide regulatory approval of PNS and for the benefit of patients who are still suffering from chronic neuropathic pain.
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Review Case Reports
Thoracic spinal stenosis and myelopathy: report of two rare cases and review of the literature.
The authors report two cases of thoracic spinal canal stenosis (SCS) and myelopathy. One is extremely unusual because of degenerative changes occurred in the upper thoracic spine. The other because of its multiple etiology among which calcification and ossification of the ligamentum flavum (OLF) in a Caucasian man. ⋯ Both patients showed a rapid post-operative recovery and regained autonomous walking within 1 month of surgery. Thoracic spinal cord stenosis is a rare and complex disorder because of differential diagnosis, neuroimaging features and treatment options. Regardless of its cause, prompt surgical decompression plays a key role in improving the functional outcome of myelopathy.