Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
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Comparative Study
Motor cortex dysfunction in complex regional pain syndrome.
Most patients with complex regional pain syndrome (CRPS) exhibit debilitating motor symptoms. The effect of continuous pain on motor system in CRPS, however, is not well known. We searched for signs of motor cortex dysfunction in chronic CRPS type 1 patients with motor impairment. ⋯ Abnormal motor cortex reactivity may be linked with motor dysfunction of the affected hand in CRPS.
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Randomized Controlled Trial Comparative Study Controlled Clinical Trial
Slow (1 Hz) repetitive transcranial magnetic stimulation (rTMS) induces a sustained change in cortical excitability in patients with Parkinson's disease.
Low-frequency (< or =1 Hz) rTMS (LF-rTMS) can reduce excitability in the underlying cortex and/or promote inhibition. In patients with Parkinson's disease (PD) several TMS elicited features of motor corticospinal physiology suggest presence of impaired inhibitory mechanisms. These include shortened silent period (SP) and slightly steeper input-output (I-O) curve of motor evoked potential (MEP) size than in normal controls. However, studies of LF-rTMS effects on inhibitory mechanisms in PD are scarce. In this companion paper to the clinical paper describing effects of four consecutive days of LF-rTMS on dyskinesia in PD (Filipović et al., 2009), we evaluate the delayed (24h) effects of the LF-rTMS treatment on physiological measures of excitability of the motor cortex in the same patients. There are very few studies of physiological follow up of daily rTMS treatments. ⋯ The results confirm the existence of a residual after-effect of consecutive daily applications of rTMS that might be relevant to the clinical effect that was observed in this group of patients and could be further exploited for potential therapeutic uses.
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Randomized Controlled Trial Comparative Study
A new clinical scale to grade the impairment of median nerve in carpal tunnel syndrome.
In carpal tunnel syndrome (CTS) distribution of paresthesias is related to the degree of the nerve impairment. To improve the clinical ability in detecting the damage severity, we have introduced the criteria "distribution of paresthesias" in a previous clinical scale: the historical-objective scale (Hi-Ob). ⋯ The new scale may be useful in routine examination and for scientific purposes.
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Propofol is an emulsion formulation of 2,6 diisopropylphenol developed in 1975. Widely recognized, it offers beneficial effects compared with other sedative drugs. ⋯ Since technological advances over recent years have allowed an ever-increasing number of patients undergoing propofol therapy to be monitored by using continuous digital EEG, it is important to have a complete understanding of the effects of propofol on EEG in diverse clinical scenarios. This paper presents a review of the effects of propofol in electroencephalograms and discusses proconvulsive, anticonvulsive proprieties and the EEG findings in different medical conditions.
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Comparative Study
A search for activation of C nociceptors by sympathetic fibers in complex regional pain syndrome.
Although the term 'reflex sympathetic dystrophy' has been replaced by 'complex regional pain syndrome' (CRPS) type I, there remains a widespread presumption that the sympathetic nervous system is actively involved in mediating chronic neuropathic pain ["sympathetically maintained pain" (SMP)], even in the absence of detectable neuropathophysiology. ⋯ This study shows that sympathetic-nociceptor interactions, if they exist in patients communicating chronic neuropathic pain, must be the exception.