Neuromodulation : journal of the International Neuromodulation Society
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This case study describes the therapeutic result of intrathecal administration of ziconotide, a new synthetic neurotoxin derived from the venom of the Philippine marine snail, Conus Magus, to a 48-year-old male with chronic, and previously untreatable, neuropathic pain of an undeterminable etiology. The patient suffered tactile allodynia and reported his baseline pain intensity to be 80 mm on the 100 mm Visual Analog Scale for Pain Intensity. ⋯ Currently, the patient rates his pain at 16 mm and enjoys an improved quality of life. This result suggests that treatment with ziconotide may provide outstanding relief to patients with chronic pain while sparing them the unpleasant side effects associated with other treatments.
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Objectives. To evaluate the long-term results of different therapies for failed back surgery syndrome (FBSS). Materials and Methods. ⋯ Conclusions. Medical therapy is effective for leg and back pain; nevertheless, several courses of therapy may be necessary. SCS is an effective treatment for leg pain, however, its effectiveness on back pain appears to be inadequate.
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Objective. Sensory feedback extracted from muscle afferents is an approach to achieve closed-loop control of paralyzed muscles using functional electrical stimulation (FES). The objective of the present study was to characterize the effect of agonist-antagonist electrical stimulation on nerve cuff recordings of muscle afferent activity. ⋯ It was suggested that the increased background activity could be attributed to the increased activity of the Golgi tendon organs. Conclusions. Sensory information about joint flexion and joint extension are preserved in muscle afferent recordings from electrically activated muscles at low and intermediate stimulation levels, but it still has to be shown whether muscle afferent information can be useful as sensory feedback in FES control.
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Objective. To evaluate changes in Minnesota Multiphasic Personality Inventory (MMPI) profiles pre- and post-treatment involving intrathecal opioid therapy. Patients and Methods. ⋯ Indeed, patients with the more normal profile pretreatment did not fare as well as those with the more elevated profile. A positive change in MMPI profile from pre- to post-treatment was associated with a higher level of pain reduction. Patient selection therefore should be based not on a single test such as the MMPI, but on consistency across multiple sources of information including physical examination, complaints of pain and disability, behavioral observations, and psychological testing.
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Objective. To present a novel treatment approach for intractable inguinal neuralgia utilizing percutaneous peripheral electrostimulation. Materials and Methods. ⋯ Both patients who were on disability due to inguinal pain have been able to return to full-time employment. Conclusion. These preliminary results suggest that the technique described is effective and safe, and may be cost-effective as well.