Neurosurgical treatment of multiple sclerosis.

Objectives: To describe the role of neurosurgical techniques in treatment of symptoms of multiple sclerosis (MS).

Methods: A review of the existing world literature searching (using PubMed, August 22, 2005) for key words 'multiple sclerosis' and multiple symptoms associated with MS including trigeminal neuralgia, pain (pump and rhizotomy), spasticity, intrathecal pump, hydrocephalus and stimulation (brain and spinal).

Results: In total, 1,404 articles met selection criteria.

Control of refractory status epilepticus precipitated by anticonvulsant withdrawal using left vagal nerve stimulation: a case report.

Objective: To describe a case of left vagal nerve stimulation (VNS) resulting in immediate cessation of status epilepticus (SE) with good neurological outcome.

Case Description: A 30-year-old man with medically intractable seizures including episodes of SE was successfully treated using left VNS. After requiring discontinuation of phenytoin, valproic acid, carbamazepine, and topiramate because of severe allergic reactions resembling Stevens-Johnson syndrome, the patient required pentobarbital coma along with phenobarbital, tiagabine, and levetiracetam for seizure frequency reduction.

Electroconvulsive therapy for seizure control: preliminary data in a new seizure generation and control model.

Electroconvulsive therapy (ECT) effect upon seizure cessation was studied in five male Wistar rats using a penicillin intracisternal injection model (which did not damage the cranial vault). Animals were observed both clinically and electrographically for seizure development. ECT was applied at varying times following onset of seizure, at varying parameters (frequency, pulsewidth, and duration).

Technical note: preliminary results in development of a novel intracisternal penicillin seizure model in the rat.

In order to develop an intracisternal penicillin rat model of epilepsy, eleven anesthetized male Wistar rats were studied. 5 underwent intracisternal injection of penicillin (doses 150,000-300,000 units) in the prone position, and another 5 underwent intraperitoneal penicillin injection; one died following intracisternal injection, prior to further study. Time between penicillin injection and seizure induction (determined by electroencephalography) was recorded.

Intracranial fungal granuloma: analysis of 40 patients and review of the literature.

Objective: To describe the characteristics of patients diagnosed with intracranial fungal granuloma (IFG) in the largest reported series to date (to our knowledge).

Methods: A 22-year retrospective, multi-institutional review of 40 patients, aged 16 to 62 years (mean, 40.2 years), was performed in patients with histopathologically confirmed IFG.

Implanted ventricular shunts in the United States: the billion-dollar-a-year cost of hydrocephalus treatment.

Objective: To characterize admissions related to ventricular shunts in the year 2000 in terms of diagnoses, procedures, socioeconomic status, and other related data.

Methods: The Nationwide Inpatient Sample database (year 2000) was analyzed retrospectively. We reviewed 7.

Metastatic lesions involving the sella: report of three cases and review of the literature.

Metastatic cancer must be considered as a possibility for intrasellar masses. Newer treatment modalities, such as gamma knife radiosurgery needs to be explored for these lesions. Three cases of intrasellar metastatic lesions were retrospectively reviewed.

Survival trends in elderly patients with glioblastoma multiforme: resective surgery, radiation, and chemotherapy.

Background: It is appropriate to investigate and to determine survival trends following glioblastoma multiforme treatment using resective surgery, radiation therapy, and/or chemotherapy in patients aged 59 years and higher.

Methods: We retrospectively reviewed 30 elderly patients (> or =59 years old) who were treated for histopathologically confirmed glioblastoma multiforme at our tertiary care institution from 1990 through 2002. All patients were treated with steroids.

Cortical representation of Hering's nerve: a possible anatomical pathway for seizure cessation following electrical stimulation.

Objective: We recently found that Hering's nerve stimulation (HNS) effectively blunts seizure activity. This study characterizes the cortical areas that are activated by HNS.

Methods: Hering's nerve (HN) was stimulated in 3 dogs and 6 pigs, and then the brains of the animals were removed.

The effectiveness of Hering's nerve stimulation in controlling penicillin-induced seizures in the rat is dependent on the amygdala.

Objective: This study tests the hypothesis that the ability of Hering's nerve stimulation (HNS) to blunt seizure activity is dependent on the availability of dopamine in the amygdala.

Methods: In 10 rats, Hering's nerve (HN) on the right side was isolated and placed on an electrode and penicillin was locally placed on each rat's left frontoparietal region to induce seizures. After the initiation of seizures, HN was stimulated.

Discernment of adipose versus nervous tissue: a novel adjunct solution in lipomyelomeningocele surgery.

Objective: To determine a solution capable of discerning adipose versus nervous tissue, to aid in surgical separation of the adipose tissue which appears to be visually indistinguishable from nervous tissue in lipomyelomeningoceles (LMMs).

Methods: The following solutes (in normal saline) were investigated, both at 25 and 37 degrees C: beta-carotene, vitamin D, vitamin E, lecithin, hydrogen peroxide, lipase, protease, hyaluronidase, partially purified collagenase, purified collagenase, trypsin, trypsin plus purified collagenase and non-solute-containing saline (control). Each solution was applied to a pediatric lipoma to determine gross effects over a period of approximately 30 min.

Ninth cranial nerve stimulation for epilepsy control. Part 2: surgical feasibility in humans.

Objective: To determine the anatomical and surgical feasibility of placement of a stimulator around the nerve of Hering (HN; a branch of cranial nerve nine). We previously determined the success of HN stimulation in controlling epileptiform activity in a canine model study. The present study assessed the ability to extrapolate the ease of surgical dissection and surrounding anatomy to humans.

Ninth cranial nerve stimulation for epilepsy control. Part 1: efficacy in an animal model.

Objective: To characterize the effects of stimulation of the nerve of Hering (HN; cranial nerve nine) in controlling seizure activity using a canine model.

Methods: Using penicillin applied topically to a region of the cerebral cortex, 16 seizure-type continuous epileptiform discharges were generated. Ten specimens of HN (five left-sided and five right-sided) were dissected from the cervical region in five dogs and stimulated at varying parameters to determine the effects in controlling epileptiform activity.