Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Nov 2013
ReviewPain in Parkinson's disease: analysis and literature review.
Pain is a common problem faced by Parkinson's disease (PD) patients. Despite its impact and disabling effects pain is still frequently overlooked. In this study we analyze a representative sample of peer reviewed literature for the prevalence and types of pain in PD, the impact and significance of pain in the quality of life of the PD patient and the challenges inherent in the diagnosis and management of pain in PD patients. ⋯ We conclude that pain in is an under-recognized and under treated symptom in PD patients. Effective management of pain in PD patients would significantly improve their quality of life. Our analysis is in line with current thinking that identifies PD is much more of a multisystem disease with non-motor symptoms than previously thought.
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Clin Neurol Neurosurg · Nov 2013
ReviewDeep brain stimulation of the subthalamic nucleus in Parkinson's disease: surgical technique, tips, tricks and complications.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become a frequently performed surgery in patients with advanced Parkinson's disease. The technique has been further refined throughout the years by improved imaging techniques, advanced neurophysiological recording possibilities, and advances in hardware and software technology. ⋯ Tips and tricks, complications and their management are the main elements of this article. In addition, we provide scientific information from our research and other groups in specific sections.
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Clin Neurol Neurosurg · May 2013
Review Meta AnalysisWhat is the best treatment of drug-resistant trigeminal neuralgia in patients affected by multiple sclerosis? A literature analysis of surgical procedures.
Drug-resistant trigeminal neuralgia (TN) can complicate the clinical course of patients affected by multiple sclerosis (MS). Various surgical procedures have been reported for the treatment of this condition, but there is no agreement on the best management of these patients. To our knowledge, there is no critical literature analysis focusing on this particular topic. The aim of this study was to evaluate the clinical outcome of different surgical procedures utilized for drug-resistant TN in MS patients. ⋯ Our study shows no differences in the short term results among different procedures for TN in MS patients. Each technique demonstrate advantages and limits in terms of long term pain, recurrence rate and complication rate. Each patient should be accurately informed on pros and cons of each procedure in order to be involved in the most appropriate choice.
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Clin Neurol Neurosurg · Feb 2013
Review Case Reports Meta AnalysisPannus regression after posterior decompression and occipito-cervical fixation in occipito-atlanto-axial instability due to rheumatoid arthritis: case report and literature review.
Several techniques have been proposed for treating cervical spine instability due to rheumatoid arthritis. The aim of this study was to screen the different treatment options used in this pathology to evaluate the best form of treatment when the progression of rheumatoid disease affected the cranio-vertebral junction (CVJ) stability. The most important purpose of this study was to achieve both the efficacy of occipito-cervical fusion (OCF) to stabilize the occipitocervical junction and stop pannus progression. The authors describe their case example and stress, in the light of a literature review, the hypothesis that a stable biomechanical system extended to all the spaces involved, has both direct and indirect effects on RA pannus progression and the condition responsible for its formation, such as inflammation and articular hypermobility. Hence, the aim of this study is to advance this thesis, which may be extended to a wider statistical sample, with the same characteristics. ⋯ Thirty-seven different studies were identified that reflected search criteria, five of which were literature reviews. The different surgical treatment options in cervical RA disease are described in relation to neurological outcome according to the Ranawat grading system, functional outcome or quality of life according to the Steinbrocker classification, and progression of cervical instability and radiographic index of cranial settling, focusing on the role of OCF.
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Clin Neurol Neurosurg · Nov 2012
Review Meta AnalysisGlioblastoma research 2006-2010: pattern of citation and systematic review of highly cited articles.
High and continuously increasing research activity related to different aspects of pathogenesis, epidemiology, diagnosis and treatment of glioblastoma has been performed between 2006 and 2010. Different measures of impact, visibility and quality of published research are available, each with its own pros and cons. For this review, article citation rate was chosen. ⋯ A large variety of preclinical and clinical topics achieved at least 25 citations. However, areas such as quality of life, side effects, and end-of-life care were underrepresented. Efforts to increase their visibility might be warranted.