Neurology
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We performed sonographic examination of the common peroneal nerve in 41 consecutive patients with a footdrop to determine whether there was a structural lesion of the peroneal nerve. Five of the 28 patients (18%) with an isolated peroneal mononeuropathy had an intraneural ganglion of the peroneal nerve confirmed by histology. High-resolution sonography should be considered in patients with nontraumatic peroneal palsy.
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Dose stabilization of intrathecal baclofen (ITB) is usually achieved within 6 to 18 months. In some patients, an increase in ITB dose may result in paradoxical unresponsiveness to baclofen. We present two cases demonstrating increased tone and functional decline with increasing ITB doses after a period of clinical stability. In both cases, reduction of ITB dose was associated with marked clinical improvement.
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Randomized Controlled Trial
Pilot clinical trial of gabapentin to decrease postoperative delirium in older patients.
In this randomized pilot clinical trial, the authors tested the hypothesis that using gabapentin as an add-on agent in the treatment of postoperative pain reduces the occurrence of postoperative delirium. Postoperative delirium occurred in 5/12 patients (42%) who received placebo vs 0/9 patients who received gabapentin, p = 0.045. The reduction in delirium appears to be secondary to the opioid-sparing effect of gabapentin.