Neuromodulation : journal of the International Neuromodulation Society
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Spinal cord stimulation (SCS) is not typically recommended for the treatment of central poststroke pain (CPSP). We examined whether the pharmacological evaluation of CPSP is useful for selecting the candidates for SCS. ⋯ We speculate that the pharmacological evaluation of CPSP patients can be a useful tool for selecting candidates for SCS.
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Intrathecal baclofen (ITB) screening assesses response to a test dose of ITB on spasticity and function and identifies adverse reactions. ⋯ Screening helps identify appropriate candidates for ITB.
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When spasticity interferes with comfort, function, activities of daily living, mobility, positioning, or caregiver assistance, patients should be considered for intrathecal baclofen (ITB) therapy. ⋯ ITB should be considered when spasticity interferes with comfort or function.
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Peripheral nerve field stimulation (PNFS) is a potential treatment for chronic low-back pain. Pain relief using PNFS is dependent on activation of non-nociceptive Aβ-fibers. However, PNFS may also activate muscles, causing twitches and discomfort. In this study, we developed a mathematical model, to investigate the activation of sensory and motor nerves, as well as direct muscle fiber activation. ⋯ The results suggest that direct muscle activation does not occur during PNFS, and concomitant motor and sensory nerve fiber activation are only likely to occur when using between-lead configuration. Thus, it may be relevant to investigate the location of the innervation zone of the low-back muscles prior to electrode implantation to avoid muscle activation.
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Intrathecal baclofen (ITB) therapy aims to reduce spasticity and provide functional control. ⋯ ITB dosing is multistep and individualized.