Ideggyogy Szemle
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Vertebroplasty is a image-guided therapeutic procedure, consisting of an injection of acrylic cement through a bone biopsy needle into a vertebral body. Main indication for vertebroplasty is painful vertebral body compression fracture due to osteoporosis. The procedure is an efficient mean with high success in pain release and prevention of further collapse of the treated vertebrae; however, the technique does not allow to realign the spine. ⋯ All three modalities mentioned above have been applied in the treatment of our patient suffered from multiple osteoporotic vertebral body compression fractures. Using kyphoplasty an almost total VB height restoration could be achieved. The pain relief was more than 50% after both operation.
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To evaluate the efficacy and tolerability of levetiracetam in children with drug resistant epilepsy from a retrospective study. ⋯ Levetiracetam is a well tolerated new antiepileptic drug that may effectively improve seizures control as an add-on drug in resistant epilepsy in childhood with good tolerability.
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Traditional concept holds that the pain unit consists of three neurons. The first of these, the primary nociceptive neuron, starts with the nociceptors and terminates in the dorsal spinal cord. The second one, called spinothalamic neuron, crosses over in front of the central canal and connects the dorsal horn with the thalamus. ⋯ The localisation of cortical centres involved in the generation of pain are presented based on the results of studies using imaging techniques, and the structural basis of corticospinal modulation is also outlined. Seven levels of nociception and pain are highlighted where pharmacological intervention may be successful, 1. the peripheral nociceptor, 2. the spinal ganglion, 3. the multisynaptic system of the dorsal horn, 4. the modulatory system of the brain stem, 5. the antinociceptive system, 6. the multisynaptic system of the thalamus, and 7. the cortical evaluating and localisation system that is also responsible for descending (inhibiting) control. The many levels of nociception and pain opens new ways both for pharmacological research and the general practitioner aiming to alleviate pain.