Articles: spinal-nerves.
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Curr Pain Headache Rep · Jun 2007
ReviewGreater occipital nerve block for migraine and other headaches: is it useful?
Peripheral nerve blocks have long been used in headache treatment. The most widely used procedure for this purpose has been greater occipital nerve (GON) block. The rationale for using GON block in headache treatment comes from evidence for convergence of sensory input to trigeminal nucleus caudalis neurons from both cervical and trigeminal fibers. ⋯ However, few were controlled and blinded. Despite a favorable clinical experience, little evidence exists for the efficacy of GON block in migraine treatment. Controlled studies are needed to better assess the role of GON block in the treatment of migraine and other headaches.
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Croatian medical journal · Feb 2007
ReviewRole of decreased sensory neuron membrane calcium currents in the genesis of neuropathic pain.
The pathogenesis of neuropathic pain is incompletely understood and treatments are often inadequate. Cytoplasmic Ca(2+) regulates numerous cellular processes in neurons. This review therefore examines the pathogenic contribution of altered inward Ca(2+) flux (I(Ca)) through voltage-gated Ca(2+) channels in sensory neurons after peripheral nerve injury. ⋯ Concurrently, cytoplasmic Ca(2+) transients are diminished. In conclusions, axotomized neurons, especially pain-conducting ones, develop instability and elevated excitability after peripheral injury. Treatment of neuronal I(Ca) loss at the level of injury of the dorsal root ganglion may provide a novel therapeutic pathway.
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Acta Neurochir. Suppl. · Jan 2007
ReviewSacral neuromodulation as a functional treatment of bladder overactivity.
Sacral neuromodulation, namely the electrical stimulation of the sacral nerves has become an alternative treatment for cases of idiopathic bladder overactivity. The mechanism of action in this type of spinal cord modulation is only partially understood but it seems to involve stimulation of inhibitory interneurons. Temporary sacral nerve stimulation is the first step. ⋯ In experienced hands, this is a safe procedure. When the patients are selected on the basis of sound criteria, more than three-quarters of them show a clinically significant improvement with a reduction in the frequency of incontinence episodes by more than 50%; however, the results vary according to each author's method of evaluation. The application of this technique should be combined with careful follow-up and attentive adjustments of the stimulation parameters in order to optimize the coordination of activity between the neurological systems involved.
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Minerva anestesiologica · Jun 2006
ReviewUsing the nerve stimulator for peripheral or plexus nerve blocks.
Conventional methodology for nerve location utilizes anatomical landmarks followed by invasive exploration with a needle to a suitable endpoint. An appropriate endpoint can be either anatomical in nature (e.g. transaterial technique) or functional (paresthesia or motor response to electrical stimulation). Ability to electrically stimulate a peripheral nerve or plexus depends upon many variables, including; 1) conductive area at the electrode, 2) electrical impedance, 3) electrode-to-nerve distance, 4) current flow (amperage), and 5) pulse duration. ⋯ The above parameters can be varied optimally to enhance successful nerve location and subsequent blockade. Unlike imaging modalities such as ultrasonography, electrical nerve stimulation depends upon nerve conduction. Similarly, percutaneous electrode guidance (PEG) makes use of the above variables to allow prelocation of the nerve by transcutaneous stimulation.
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Retrospective chart review. ⋯ Repeated radiofrequency neurotomies are an effective long-term palliative management of lumbar facet pain. Each radiofrequency neurotomy had a mean duration of relief of 10.5 months and was successful more than 85% of the time.