Neurology
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To prospectively evaluate the effect of pump-infused intrathecal baclofen infusion (ITB) in therapeutic doses on sleep quality and on daytime and nighttime respiratory function in patients with severe spasticity. ⋯ Compared with oral baclofen, intrathecal baclofen infusion did not affect respiratory function and improved sleep continuity. Intrathecal baclofen infusion in therapeutic doses may act at the spinal level rather than at the supraspinal level.
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We performed sonographic examination of the common peroneal nerve in 41 consecutive patients with a footdrop to determine whether there was a structural lesion of the peroneal nerve. Five of the 28 patients (18%) with an isolated peroneal mononeuropathy had an intraneural ganglion of the peroneal nerve confirmed by histology. High-resolution sonography should be considered in patients with nontraumatic peroneal palsy.
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Randomized Controlled Trial
Pilot clinical trial of gabapentin to decrease postoperative delirium in older patients.
In this randomized pilot clinical trial, the authors tested the hypothesis that using gabapentin as an add-on agent in the treatment of postoperative pain reduces the occurrence of postoperative delirium. Postoperative delirium occurred in 5/12 patients (42%) who received placebo vs 0/9 patients who received gabapentin, p = 0.045. The reduction in delirium appears to be secondary to the opioid-sparing effect of gabapentin.