Neurosurgery
-
Forty-eight cases of causalgia are described. The syndrome was caused by missile injury in 33 patients. ⋯ Causalgia was cured by correcting the lesion of the nerve and of the adjacent axial artery in the subsequent 32 patients. The concept of complex regional pain syndrome Type 1 and Type 2 is challenged.
-
The purpose of this review is to summarize the basic science literature related to chronic nerve injuries, and to then use this as the background to provide emerging insights into the promising role of cellular therapy for nerve injury repair. ⋯ There are several avenues of stem cell-based approaches to peripheral nerve repair. One of these, skin-derived precursor cells, are easily accessible, autologous adult stem cells that can survive and myelinate in the peripheral nerve environment and become SC-like in their apparent differentiation.
-
Parsonage-Turner syndrome (PTS) is a rare syndrome of unknown cause, affecting mainly the lower motor neurons of the brachial plexus. The brachial plexus is a group of nerves that conduct signals from the spine to the shoulder, arm, and hand. PTS is usually characterized by the sudden onset of severe 1-sided shoulder pain, followed by paralysis of the shoulder and lack of muscle control in the arm, wrist, or hand several days later. ⋯ Individuals with the condition first experience severe pain across the shoulder and upper arm. Within a few hours or days, weakness, wasting (atrophy), and paralysis may affect the muscles of the shoulder. Although individuals with the condition may experience paralysis of the affected areas for months or, in some cases, years, recovery is usually eventually complete.
-
Herein, we provide an unbiased review of piriformis syndrome (PS), a highly controversial syndrome for which no consensus exists regarding diagnostic criteria or pathophysiology. ⋯ PS remains a controversial diagnosis for sciatic pain. The debate regarding the clinical significance of PS remains active. Nonetheless, there may be a subset of patients in whom the piriformis muscle is a source of pain. The syndrome should be considered in the differential diagnosis of patients with unilateral lower extremity pain.
-
Review
Intraoperative nerve action potential recordings: technical considerations, problems, and pitfalls.
The purpose of this article is to provide our experience with intraoperative nerve action potential (NAP) recordings. In particular, we focus on a discussion of the technical considerations of intraoperative NAP with emphasis on identifying and remedying problems and pitfalls. ⋯ Visual inspection of a nerve lesion in continuity can be misleading. Although there is no "head-to-head" comparison of our data with data obtained without the use of intraoperative NAP recordings, we feel strongly that with experience and knowledge of the problems and pitfalls regarding intraoperative recording techniques, one may take advantage of the great benefits of this very useful and informative surgical tool.