Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2001
Biography Historical ArticleMy 50 years of interest in stereotactic and functional neurosurgery.
The author describes his personal reflections over the last 50 years. Special attention is drawn to Jean Talairach and Lars Leksell, who greatly influenced his work in stereotactic neurosurgery.
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With the improved utilisation and widespread availability of opiates, the oral treatment of pain due to malignancy has changed radically, so that the expected need for intrathecal (IT) delivery systems for this pain has largely failed to materialise. Instead, the lack of equal progress in the design and production of non-opiates for treating non-malignant pain, in the long term, has resulted in a greater interest in the development of these IT systems in this non-malignant area.
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Stereotact Funct Neurosurg · Jan 2001
Comparative StudyMotor cortex stimulation for phantom limb pain: comprehensive therapy with spinal cord and thalamic stimulation.
The effects of spinal cord stimulation (SCS), deep brain stimulation (DBS) of the thalamic nucleus ventralis caudalis (VC) and motor cortex stimulation (MCS) were analyzed in 19 patients with phantom limb pain. All of the patients underwent SCS and, if the SCS failed to reduce the pain, the patients were considered for DBS and/or MCS. Satisfactory pain control for the long-term was achieved in 6 of 19 (32%) by SCS, 6 of 10 (60%) by DBS and 1 (20%) of 5 by MCS. ⋯ The effects of both DBS of the VC and MCS were tested in four. One patient of them reported better pain control by MCS than by DBS, whereas two reported the opposite results. There is no evidence at present for an advantage of MCS over SCS and DBS of the VC in controlling phantom limb pain.
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Stereotact Funct Neurosurg · Jan 2001
Stereotactic radiosurgery for primary trigeminal neuralgia using the Leksell Gamma unit.
Previous papers have reported Gamma Knife radiosurgery to be a safe, effective method for primary trigeminal neuralgia. Since November 1996, we have treated primary trigeminal neuralgia using the Leksell Gamma Knife at the Tianjin Medical University. The present study reports clinical results of Gamma Knife radiosurgery in the treatment of trigeminal neuralgia in 80 cases. ⋯ Gamma Knife radiosurgery is a safe and effective method in the treatment of trigeminal neuralgia once diagnosis is established.
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Stereotact Funct Neurosurg · Jan 2001
Neurophysiological monitoring for epilepsy surgery: the Talairach SEEG method. StereoElectroEncephaloGraphy. Indications, results, complications and therapeutic applications in a series of 100 consecutive cases.
In some candidates for epilepsy surgery in whom the decision to operate is difficult to make, invasive presurgical investigations, namely depth electrode recordings, may be needed. The SEEG (StereoElectroEncephaloGraphy) method consists of stereotactic orthogonal implantation of depth electrodes (5 to 15, 11 on average). The object of this study is to clarify the indications for SEEG, to expose its complications, and to display its usefulness in terms of surgical strategy and results. ⋯ SEEG proved to be a relatively safe and a very useful method in 'difficult' candidates for epilepsy surgery. In addition, in some cases the implanted electrodes can be used to perform therapeutic RF thermocoagulation of epileptic foci or networks.