Acta neurochirurgica. Supplement
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Neurally Augmented Sexual Function (NASF) is a technique utilizing epidural electrodes to restore and improve sexual function. Orgasmic dysfunction is common in adult women, affecting roughly one quarter of populations studied. ⋯ Our series of women treated by NASF is described. Our experience shows that the evaluation of potential candidates for both correctable causes and psychological screening are important considerations.
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Acta Neurochir. Suppl. · Jan 2007
ReviewOccipital neurostimulation for treatment of intractable headache syndromes.
Intractable migraine and other headache syndromes affect almost 40 million Americans and many more millions worldwide. Although many treatment protocols exist, mainly designed around medication regimens, there are estimated to be at least 3-5% of these headache sufferers that do not respond in a meaningful way to medications and whose lives can be severely restricted to darkened, quiet rooms, heavy doses of narcotics, failed personal relationships and an overwhelming sense of hopelessness. In this article, we describe current neuromodulation-based approach to the management of intractable headache.
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Acta Neurochir. Suppl. · Jan 2007
ReviewPeripheral nerve stimulation for the treatment of neuropathic craniofacial pain.
Treatment of neuropathic pain in the region of head and face presents a challenging problem for pain specialists. In particular, those patients who do not respond to conventional treatment modalities usually continue to suffer from pain due to lack of reliable medical and surgical approaches. Peripheral nerve stimulation (PNS) has been used for treatment of neuropathic pain for many decades, but only recently it has been systematically applied to the craniofacial region. Here we summarize published experience with PNS in treatment of craniofacial pain and discuss some technical details of the craniofacial PNS procedure.
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Acta Neurochir. Suppl. · Jan 2007
ReviewManagement of chronic back and leg pain by intrathecal drug delivery.
Intrathecal delivery of analgesic drugs by implantable pump systems has been recognized as a treatment option for patients with chronic pain of benign or malignant origin that is resistant to oral or parenteral medication. Patients with chronic back and leg pain (CBLP), a benign but severely disabling condition of the lumbar spine with multifactorial genesis, have been demonstrated in a number of retrospective and in some prospective clinical studies to benefit from intrathecal delivery of opioid and/or non-opioid substances, either as single drugs or in combinations. ⋯ It discusses important clinical issues such as drug selection, drug combinations, and side effects and complications of intrathecal infusion. It is concluded that further clinical research is needed in order to provide stronger evidence for the usefulness of a number of drugs currently used for intrathecal therapy on a mostly empirical basis.
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Spasticity is a clinical condition characterized by a velocity-dependent increase of muscle tone due to "parapyramidal" disturbance of the inhibitory afferents to the second motor neuron. Intrathecal baclofen (ITB) is at present the most effective treatment tor generalized spasticity provided that an accurate assessment of patients to be candidates for ITB is made. The most important patient ,election criterion is lack of positive response to any oral antispastic drug or appearance of undesired side effects of such oral treatment. ⋯ In each of these two groups treatment goals vary and require different protocols for the patients' evaluation. Assessment of patients is completed with the functional index measurement (FIM) scale in order evaluate changes in patients' quality of life caused by variations in the motor performance. Currently, treatment of spasticity with ITB is the most effective way of reducing spasticity regardless of its cause.