No shinkei geka. Neurological surgery
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In a study of 44 patients with different types of chronic pain, mostly associated with deafferentation, chronic percutaneous epidural spinal stimulation has proved useful treatment achieving an initial 52% incidence of pain amelioration overall. Long-term result showed at six months in 86%, at 1 year in 90%, although technical problems, which included electrode displacement and required minor operative readjustment, affected 48% of those permanently implanted. No other complications were seen. ⋯ When stimulation was applied the late component was suppressed in most of those who enjoyed a good result. The early component was not changed in those patients even during stimulation. These results suggest that spinal cord stimulation would suppress the denervative hypersensitivity of dorsal horn in the patients with deafferentation pain.(ABSTRACT TRUNCATED AT 250 WORDS)
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The author reported a case of central alveolar hypoventilation (Ondine's curse) which was treated by diaphragm pacing. A 59-year-old man was admitted because of sudden deep coma and tetraparesis. Neurological examination on admission showed miotic pupils with absent light reaction, no oculocephalic reflex, no corneal reflex and tetraparesis. ⋯ A cuff electrode was put around the right phrenic nerve in the right thorax, and the receiver installed subcutaneously in the right anterior chest. Postoperative respiratory study showed ventilation on pacing with satisfactory blood gas and he became able to move around using a wheel chair. In 1966 Glenn demonstrated a new technique to move the diaphragm paced by a receiver through the phrenic nerve, triggered by radio wave from external device.(ABSTRACT TRUNCATED AT 250 WORDS)