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Effects of Spinal Cord Stimulation in Patients with Small Fiber and Associated Comorbidities from Neuropathy After Multiple Etiologies.
J Clin Med
January 2025
Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain.
The aim of this study was to evaluate the effects of spinal cord stimulation (SCS) on pain, neuropathic symptoms, and other health-related metrics in patients with chronic painful peripheral neuropathy (PN) from multiple etiologies. A prospective single center observational longitudinal cohort study assessed SCS efficacy from April 2023 to May 2024, with follow-ups at 2, 4, 6, and 12 months in 19 patients suffering from the painful polyneuropathy of diverse etiologies: diabetic (DPN), idiopathic (CIAP), chemotherapy-induced (CIPN), and others. Patients were implanted with a neurostimulator (WaveWriter Alpha, Boston Scientific Corporation, Valencia, CA, USA) and percutaneous leads targeting the lower limbs (T10-T11) and, if necessary, the upper limbs (C4-C7).
View Article and Find Full Text PDFClinical Problem Solving: Two Patients With Gait Instability and Difficulty With Hand Coordination.
Neurohospitalist
January 2025
Instructor in Neurology, Harvard Medical School and Attending Physician, Stroke Division, Brigham & Women's Hospital, Boston, MA, USA.
Subacute-to-chronic gait instability has a broad differential diagnosis. The neurological exam can help elucidate the localization and suggest an underlying etiology of the symptomatology, which can lead to a more focused diagnostic approach. Two patients are described - 1 with a month of worsening difficulty with ambulation that evolved to bilateral hand discoordination and another with 18 months of progressive difficulty with ambulation that also then progressed to involve her bilateral hands.
View Article and Find Full Text PDFNeurophysiologic Innovations in ALS: Enhancing Diagnosis, Monitoring, and Treatment Evaluation.
Brain Sci
December 2024
Djavad Mowafaghian Centre for Brain Health, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Amyotrophic lateral sclerosis (ALS) is a progressive disease of both upper motor neurons (UMNs) and lower motor neurons (LMNs) leading invariably to decline in motor function. The clinical exam is foundational to the diagnosis of the disease, and ordinal severity scales are used to track its progression. However, the lack of objective biomarkers of disease classification and progression delay clinical trial enrollment, muddle inclusion criteria, and limit accurate assessment of drug efficacy.
View Article and Find Full Text PDFRelationship of Sex and Diagnosis With Symptoms and Illness Impact in Urologic Chronic Pelvic Pain; A Mapp Network Analysis.
Neurourol Urodyn
December 2024
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Objective: To assess differences in clinical presentation and illness impact in men and women presenting with urologic chronic pelvic pain syndrome (UCPPS) and between men diagnosed with interstitial cystitis/bladder pain syndrome (IC/BPS) or chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
Methods: 356 men and 605 women from six sites across the United States were assessed using a comprehensive set of demographic, symptom, and illness impact measures. Multivariable regression analyses examined differences between men and women and between men previously diagnosed with CP/CPPS or IC/BPS.
Combined Martin-Gruber and complete Riché-Cannieu anastomoses disclosed during the electrodiagnostic evaluation of carpal tunnel syndrome.
Clin Neurophysiol Pract
October 2024
Department of Neuromuscular Medicine, Hospital for Special Care, 2150 Corbin Avenue, New Britain, CT, 06053 USA.
Background: Electromyographers are frequently confronted by anomalous innervations and some may challenge the interpretation of nerve conduction studies (NCS). Reports of 2 or more anomalous innervations in the same patient are rare. I describe the NCS in a patient referred for an evaluation of carpal tunnel syndrome (CTS) who was found to harbor a combined Martin-Gruber anastomosis (MGA) and complete Riché-Cannieu anastomosis (RCA).
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