Neuromodulation : journal of the International Neuromodulation Society
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To evaluate the economic effects of intrathecal baclofen (ITB) for patients with severe spasticity based on costs of care before and after implantation of an intrathecal drug delivery system. ⋯ The results suggest that spasticity patients receiving ITB would expect to experience a reduction in cumulative future medical costs relative to anticipated costs in the absence of a pump implant. This finding complements the existing literature on the cost-effectiveness of ITB.
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Lesch-Nyhan disease (LND) is a hereditary disorder characterized by hyperuricemia, self-mutilation, developmental retardation, and movement disorders such as spasticity and dystonia. The lack of a precise understanding of the neurological dysfunction has precluded the development of useful conservative therapies. We present our experience treating a LND patient by bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) with improvement in dystonia symptoms and disappearance of self-injurious behavior. ⋯ This case supports the hypothesis that automutilation in LND might be related to dysfunction of the basal ganglia circuits and the idea that bilateral GPi-DBS is a safe and effective treatment modality for this condition.
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To analyze sensory characteristics and small nerve fiber function in patients suffering from painful diabetic polyneuropathy (PDP) and compare outcomes in responders and nonresponders to SCS treatment. ⋯ From this small-scale clinical pilot study we conclude that forearm CHEP latencies are increased in PDP patients who respond to SCS therapy as compared with SCS nonresponders. Before the CHEP latency can be used as a predictor of SCS outcome in PDP patients, a large-scale study is needed.
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This study presents a multichannel patient-specific seizure detection method based on the empirical mode decomposition (EMD) and support vector machine (SVM) classifier. ⋯ Given its high sensitivity and low FDR, the proposed patient-specific seizure detection method can greatly assist clinical staff with automatically marking seizures in long-term EEG or detecting seizure onset online with high performance. Early and accurate seizure detection using this method may serve as a practical tool for planning epilepsy interventions.
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To examine the incidence of percutaneous spinal cord stimulator lead migration, given current hardware and surgical technique. ⋯ The rate of lead migration observed in our practice was considerably lower than previously published estimates of clinically significant lead migration or revision for lead migration (13%-22%). However, our study did not determine the reason for the decreased rate, which may be influenced by current hardware and implant techniques.