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Frameless image-guided radiosurgery for initial treatment of typical trigeminal neuralgia.

https://arctichealth.org/en/permalink/ahliterature135280
Source
World Neurosurg. 2010 Oct-Nov;74(4-5):538-43
Publication Type
Article
Author
Joseph C T Chen
Javad Rahimian
Rombod Rahimian
Alonso Arellano
Michael J Miller
Michael R Girvigian
Author Affiliation
Department of Neurosurgery, Southern California Permanente Medical Group, Los Angeles, California, USA. joseph.c.chen@kp.org
Source
World Neurosurg. 2010 Oct-Nov;74(4-5):538-43
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Neuronavigation - methods
Radiation Dosage
Radiosurgery - methods
Retrospective Studies
Surgery, Computer-Assisted - methods
Trigeminal Neuralgia - physiopathology - surgery
Abstract
To review retrospectively initial experience at a single institution using frameless image-guided radiosurgery (IGRS) for trigeminal neuralgia employing the Novalis linear accelerator (LINAC) with ExacTrac robotic patient positioning device.
Over an 18-month period, 44 patients (27 women and 17 men; median age 65 years) were treated with frameless IGRS for typical trigeminal neuralgia (14 cases involved left-sided pain and 30 cases involved right-sided pain), responsive to anticonvulsant medications, with Barrow Neurological Institute Pain Scale (BNI-PS) scores of 4 or 5. All cases were initial radiosurgery treatments with an isocenter dose of 90 Gy delivered via a 4-mm circular collimator forming a spheroid dose envelope. Intrafraction positioning data were collected for all patients. The median follow-up was 15 months.
Overall intrafraction positioning error was 0.49 mm ± 0.44. After treatment, 40 patients achieved a BNI-PS score of IIIb or better; 19 patients achieved a BNI-PS score of I. The median time to pain relief was 4 weeks. Overall, new hypoesthesia was seen in five patients. No other complications were seen.
Use of frameless IGRS methods for treatment of trigeminal neuralgia showed results similar to the authors' prior experience with frame-based treatment methods. IGRS using frameless methods is a suitable treatment method for patients with trigeminal neuralgia and may be applicable to other functional indications.
Notes
Comment In: World Neurosurg. 2010 Oct-Nov;74(4-5):45121492593
Comment In: World Neurosurg. 2010 Oct-Nov;74(4-5):448-5021492592
PubMed ID
21492609 View in PubMed
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The influence of Chinook winds and other weather patterns upon neuropathic pain.

https://arctichealth.org/en/permalink/ahliterature131502
Source
Pain Med. 2011 Oct;12(10):1523-31
Publication Type
Article
Date
Oct-2011
Author
Sybil Ngan
Cory Toth
Author Affiliation
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Source
Pain Med. 2011 Oct;12(10):1523-31
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Alberta
Female
Humans
Humidity
Middle Aged
Neuralgia - physiopathology
Prospective Studies
Questionnaires
Seasons
Temperature
Weather
Wind
Abstract
Although Chinook winds are often viewed positively during a cold prairie winter, patients suffering with neuropathic pain (NeP) anecdotally report exacerbations of NeP during Chinooks and during other weather changes. Our objective was to identify if Chinook winds lead to acute exacerbations in pain severity in a NeP patient population.
Prospective diary-based assessments of patients with at least moderate NeP over 6-month periods during different seasons of the year were performed. Concurrent weather conditions were tracked hourly, with Chinook winds defined using accepted meteorological definition. We also examined other aspects of weather including precipitation, temperature, and humidity. Days with acute exacerbations were defined when a daily visual analog score pain score was =2 points above their average NeP score over the entire 6-month period.
Chinooks were not associated with individual acute exacerbations in NeP. Instead, Chinook days were found to be protective against acute exacerbations in NeP (odds ratio 0.52 [0.33-0.71]). Post hoc study associated Chinooks with NeP relief (odds ratio 1.83 [1.17-2.49]). We could not identify relationship between precipitation or humidity with acute NeP exacerbation. However, days with cold temperature = -14°C were associated with greater risk of NeP exacerbation.
Weather-mediated changes occur for patients with NeP, manifesting as relief from Chinook winds while cold temperature conditions can provoke exacerbations in NeP.
PubMed ID
21899716 View in PubMed
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Polyneuropathy, with and without neurogenic pain, and its impact on daily life activities--a descriptive study.

https://arctichealth.org/en/permalink/ahliterature150692
Source
Disabil Rehabil. 2009;31(17):1402-8
Publication Type
Article
Date
2009
Author
Gunilla M Liedberg
Magnus Vrethem
Author Affiliation
Faculty of Health Sciences, Department of Social and Welfare Studies, Linkiping University, Norrkiping, Sweden. gunilla.liedberg@isv.liu.se
Source
Disabil Rehabil. 2009;31(17):1402-8
Date
2009
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Disability Evaluation
Employment
Female
Humans
Leisure Activities
Male
Middle Aged
Neuralgia - physiopathology - psychology
Pain Measurement
Polyneuropathies - physiopathology - psychology
Quality of Life
Questionnaires
Sweden
Abstract
Few studies on disabilities relate to neurogenic chronic pain conditions and how pain influences the patient's ability to maintain life roles. Polyneuropathy is a condition with muscle weakness, sensory impairment and sometimes additional pain of neurogenic origin. The aim was to investigate disability reported in daily activities and quality of life in patients with polyneuropathy, with and without neurogenic pain.
A mail questionnaire designed to collect data on the state of health and impact on daily activities, including the Quality of Life-scale, Swedish version (QOLS-S), were sent to 60 patients with polyneuropathy. Forty-two (72.4%) responded.
Twenty-three patients were old-age pensioners (>65 years), ten had disability pension and nine were employed. Twenty-seven patients reported pain in addition to polyneuropathy. The neuropathy symptoms influenced occupational performance at work and leisure and in housework for 72% of the patients. Patients with additional neurogenic pain reported significantly greater performance problems in 55% of the daily activities compared with patients without pain. Quality of life was significantly lower for patients with pain concerning health and participation in active recreation.
Symptoms in polyneuropathy, especially when accompanied by pain, give rise to disability that affects daily activities and ought to be considered in planning a successful intervention programme.
PubMed ID
19479570 View in PubMed
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The retrogasserian zone versus dorsal root entry zone: comparison of two targeting techniques of gamma knife radiosurgery for trigeminal neuralgia.

https://arctichealth.org/en/permalink/ahliterature145059
Source
Acta Neurochir (Wien). 2010 Jul;152(7):1165-70
Publication Type
Article
Date
Jul-2010
Author
Seong-Hyun Park
Sung-Kyoo Hwang
Dong-Hun Kang
Jaechan Park
Jeong-Hyun Hwang
Joo-Kyung Sung
Author Affiliation
Department of Neurosurgery, Kyungpook National University Hospital 50, Samduk-2-ga, Jung-gu, Daegu, 700-721, South Korea. nsdoctor@naver.com
Source
Acta Neurochir (Wien). 2010 Jul;152(7):1165-70
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Postoperative Complications - etiology - physiopathology - prevention & control
Radiosurgery - methods
Retrospective Studies
Stereotaxic Techniques
Trigeminal Ganglion - anatomy & histology - surgery
Trigeminal Nerve - anatomy & histology - surgery
Trigeminal Neuralgia - physiopathology - surgery
Abstract
We performed a comparative study of the retrogasserian zone (RGZ) with the dorsal root entry zone (DREZ) target to determine effective gamma knife radiosurgery (GKRS) technique in patients with medically refractory trigeminal neuralgia (TN).
We retrospectively reviewed the records of 39 patients with refractory TN undergoing GKRS between April 2005 and October 2008. Until October 2007, DREZ was used as the primary target point. Since November 2007, RGZ has been targeted, located anterior to DREZ. The pain outcome of patient, pain recurrence, and treatment-related complications were evaluated.
Using the Barrow Neurologic Index (BNI) pain score, 15 (93.8%) RGZ and 20 (87.0%) DREZ cases achieved treatment success (BNI pain score I-IIIb) (p = 0.631). Seven (43.8%) RGZ and four (17.4%) DREZ patients reported complete pain relief without medications (BNI pain score I). The time to a response after the GKRS was significantly shorter in the RGZ group (mean 4.1 weeks) than in the DREZ group (mean 6.4 weeks) (p = 0.044). The total complication rate (25.0%) in the RGZ group was similar to the DREZ group (26.1%); however, frequency of bothersome facial numbness and dry eye syndrome was lower in the RGZ group (0%, 0%) compared to the DREZ group (13.1%, 8.7%) (p = 0.255 and 0.503).
The RGZ targeting technique in the GKRS for TN had a better treatment success, with fewer bothersome complications compared to the DREZ target.
PubMed ID
20204664 View in PubMed
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[Sanatorium-based treatment of lumbar quadrate myofascial pain syndrome].

https://arctichealth.org/en/permalink/ahliterature148917
Source
Vopr Kurortol Fizioter Lech Fiz Kult. 2009 Jul-Aug;(4):44-5
Publication Type
Article
Author
V A Avershin
B V Oleinikov
R P Pil'kevich
S A Sofel'
A N Kniazhishche
S S Grebenkin
Source
Vopr Kurortol Fizioter Lech Fiz Kult. 2009 Jul-Aug;(4):44-5
Language
Russian
Publication Type
Article
Keywords
Acupuncture Points
Acupuncture Therapy
Facial Neuralgia - physiopathology - therapy
Health Resorts
Humans
Lumbosacral Region
Muscle, Skeletal - innervation - physiopathology
Pain Measurement
Physical Therapy Modalities
Russia
Treatment Outcome
Abstract
This paper summarizes experience gained in the Central Military Sanatorium, Sochi, in the field of diagnosis, treatment, and rehabilitation of patients with myofascial pain syndrome affecting the quadratum lumborum muscle. Conditions facilitating development of triggering myofascial structures in these muscles are analysed and methods of their diagnosis are discussed. The proposed compression test allows active trigger structures to be identified in the quadratum lumborum muscle. Detailed description of the method of myofascial meridional reflexotherapy is presented (ischemic compression of condensed trigger structures or points with dry needling, taking account of the breathing act). The authors emphasize the importance of correction of structural disproportions responsible for the formation of myofascial trigger structures.
PubMed ID
19708564 View in PubMed
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