Glycerol rhizotomy via a retrosigmoid approach as an alternative treatment for trigeminal neuralgia.

Objectives: Trigeminal neuralgia is a sensory nerve disorder characterized by lancinating pain and treated most commonly with carbamazepine, rhizotomy treatment, or open surgical management with microvascular decompression. We describe a novel technique to complement surgical treatment for trigeminal neuralgia via direct injection of the trigeminal nerve with glycerin in the cisternal portion of the nerve.

Patients And Methods: We performed a retrospective analysis of patients who received standard microvascular decompression and injection of glycerin to the inferior third of the cisternal portion of the nerve anterior to the root entry zone with lack of a compressive vessel on MRI as the primary indication.

Glycerol rhizotomy and radiofrequency thermocoagulation for trigeminal neuralgia in multiple sclerosis.

Object: Patients with trigeminal neuralgia due to multiple sclerosis (TN-MS) and idiopathic TN (ITN) who underwent glycerol rhizotomy (GR) and radiofrequency thermocoagulation with glycerol rhizotomy (RFTC-GR) were compared to investigate the effectiveness of these percutaneous ablative procedures in the TN-MS population.

Methods: Between 1998 and 2010, 822 patients with typical TN were evaluated; 63 (8%) had TN-MS and 759 (92%) had ITN. Pain relief comparisons were made between 22 GR procedures in patients with TN-MS and 470 GR procedures in patients with ITN; 50 RFTC-GR procedures in patients with TN-MS and 287 RFTC-GR procedures in patients with ITN were compared.

Effectiveness of repeat glycerol rhizotomy in treating recurrent trigeminal neuralgia.

Background: Percutaneous glycerol rhizotomy (GR) is used to treat trigeminal neuralgia (TN), with satisfactory pain relief lasting 2 to 3 years in most patients after the first intervention. The efficacy of subsequent GRs, however, has not been studied.

Objective: To compare the pain relief and durability achieved by the first GR with those obtained after subsequent GRs in a retrospective cohort of TN patients.

Surgical treatment of pediatric trigeminal neuralgia: case series and review of the literature.

Purpose: Pediatric trigeminal neuralgia (TN) is a rare entity. The purpose of this study was to retrospectively analyze a small series of pediatric patients diagnosed with TN and surgically treated with microvascular decompression (MVD) at a single center.

Methods: Nine patients were identified who presented with TN symptoms that began before the age of 18.

Feasibility study of home care wound management using telemedicine.

Objective: Evaluate the effectiveness of telemedicine (TM) with digital cameras in treating wounds in a home care setting.

Design: Randomized controlled study.

Participants And Setting: One hundred three subjects with 160 pressure ulcers (PrUs) or nonhealing surgical wounds referred to a metropolitan Visiting Nurse Agency.

Use of sterile maggots in an unusual trauma injury.

Sterile larvae of the common green bottle, Lucilia sericata, have been shown to be a highly cost-effective alternative to conventional treatments for the debridement and cleansing of all types of chronic wounds. (Thomas, 2006). One or two treatment cycles each lasting approximately 3 days are often sufficient to achieve complete debridement of such wounds, provided sufficient numbers of maggots are applied on each application.

Chronic inflammatory demyelinating polyradiculoneuropathy in two children with type 1 diabetes mellitus.

An association between chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and type 1 diabetes has been described in adults, but not previously in children. Two adolescents with both CIDP and type 1 diabetes are reported here. In order to raise the awareness of CIDP among pediatricians, a description of the clinical and laboratory features, treatment, and prognosis of the condition is provided.

Distal ventriculoperitoneal shunt failure caused by silicone allergy. Case report.

The placement of a ventriculoperitoneal (VP) shunt is the most common form of treatment for hydrocephalus. Although allergic reactions to the silicone in shunt hardware are very rare, the authors describe a case of silicone allergy causing multiple ventricular shunt revisions. A 24-year-old man, who had undergone multiple VP shunt revisions, presented with shunt malfunction caused by allergic reaction of the tissues surrounding the shunt tubing.