Search PubMed⌕ Search

Biomedical subjects

G Barolat

Publications and source records attributed to G Barolat.

27 records · Page 2Linked to original sources
PubMed1988

Effects of spinal cord stimulation on spasticity and spasms secondary to myelopathy.

16 subjects with severe spasms secondary to traumatic and nontraumatic myelopathy underwent epidural spinal cord stimulation. 4 patients had a complete motor and sensory spinal cord lesion. 6 of the subjects with an incomplete spinal cord lesion were ambulatory. All patients had previously undergone extensive trials with medications and physical therapy. All 14 subjects in whom a satisfactory placement of the electrode could be obtained had a reduction in the severity of the spasms. In 6 patients, the spasms were almost abolished. Extremity, trunkal and abdominal spasms were affected. Clonus in the upper extremities was consistently reduced. Marked improvement in bladder and bowel function was observed in each of 2 subjects. In over 1-year follow-up, 5 subjects show persistence of the results, with less stimulation required to maintain the therapeutic effects. No neurological deterioration occurred following the procedure or after long-term spinal stimulation. 1 patient showed after several months of continuous stimulation increased voluntary motor control present only when spinal cord stimulation was activated. Complications included 1 system infection, 1 electrode migration, 1 wire breakage and skin breakdown at a connector site, development of high impedance in 1 electrode and 1 skin breakdown over the lead.

Adult↗
PubMed1988

Trigeminal neuralgia in a patient with multiple sclerosis treated with high cervical spinal cord stimulation. Case report.

A 42-year-old male with advanced multiple sclerosis had severe left-sided trigeminal neuralgia in the maxillary and mandibular divisions that was extremely difficult to control with medications. Glycerol injection in the gasserian cystern provided only temporary results. Two electrodes were implanted epidurally at the C1-2 level, one in the midline and the other to the left of midline. Electrical stimulation produced complete relief from the painful paroxysms.

Adult↗
PubMed1986

Enhancement of voluntary motor function following spinal cord stimulation--case study.

One patient with an incomplete traumatic myelopathy underwent epidural spinal cord stimulation for the management of severe intractable spasms, which were abolished by the stimulation. After several months of stimulation, the patient regained some voluntary motor function in the lower extremities. Voluntary motor control of the left quadriceps was present only when spinal cord stimulation was activated and stopped immediately after it was turned off. The effects could be consistently reproduced. EMG polygraphic recordings confirmed the results.

Adult↗
PubMed1986

Management of bilateral locked facets of the cervical spine.

A total of 28 cases of cervical spine dislocation with bilateral locking of facets treated between 1976 and 1984 were analyzed to determine whether treatment modality had any effect on outcome based on cord or root function. Motor vehicle accidents were responsible for 19 cases; the most common levels of dislocation were C-5, C-6 and C-6, C-7, with 10 each. Twenty patients were admitted with complete myelopathies. Ten patients whose dislocations were successfully reduced with traction had no neurological changes, but 1 reduced elsewhere deteriorated from a C-5 to C-2 level. Eleven of these patients underwent posterior cervical fusions after delays of 1 to 17 days (mean = 6.3); 2 died, and 1 patient achieved slight root return. Seven underwent anterior decompression and fusion or combined anterior and posterior approaches after delays of 9 to 120 days. One patient died in the postoperative period, 1 had substantial recovery of cord function, and 5 had recovery of root function. There was no operation or improvement in 2 patients. Eight patients had incomplete myelopathies; 4 were initially reduced, with 2 improving slightly as a result. Three patients underwent posterior fusions with foraminotomies with minimal improvement. Five had anterior or combined approaches; these patients improved at least one neurological grade each, including 3 who became newly ambulatory. All 24 surviving patients achieved spinal stability, although it occurred slightly earlier in the anterior fusion groups. Surgical approaches designed to provide spinal stability and restore the normal anatomy of the spinal canal and neural foramina may be of functional benefit in the management of these dislocations.

Adolescent↗
PubMedDate not supplied

Spinal cord stimulation for chronic pain management.

This article outlines the role of spinal cord stimulation in contemporary chronic pain management. The anatomical and neurophysiological correlates of stimulation of the intraspinal structures are discussed. The most common indications are presented, including failed back syndrome, reflex sympathetic dystrophy, neurogenic thoracic outlet syndrome, and spinal cord injury, etc. The most common complications are presented, including paralysis, infection, electrode migration, cerebrospinal fluid leak, and pain. Spinal cord stimulation is one of the most effective techniques available in the management of severe chronic pain that has been refractory to other more conservative modalities.

Chronic Disease↗
PubMedDate not supplied

Spasms in spinal cord injury: a study of 72 subjects.

Seventy-two patients with spinal cord injury of at least two years duration were reviewed retrospectively to determine incidence and effects of spasms. The average time between the injury and the examination was ten years. Seventy patients experienced spasms. In 50 patients (72%) the spasms appeared within six months after the injury. Historically, the spasms reached their maximal severity within 12 months. No significant difference was found in intensity and frequency of spasms between patients with clinically complete or incomplete spinal cord injury. Extensor spasms were seen more frequently than flexor spasms in the long-term patients. Patients with incomplete myelopathies had more extensor spasms than those with complete SCI.

Adult↗
PubMedDate not supplied

Surgical management of spasticity and spasms in spinal cord injury: an overview.

Spasms and spasticity constitute a significant problem in spinal cord injured individuals. Surgical intervention may be indicated when spasms and spasticity cannot be satisfactorily controlled by medications and physical therapy. Surgical procedures carried out on the nervous system include neurotomy, rhizotomy, myelotomy, cordectomy and spinal cord stimulation. The various procedures and their indications will be discussed.

Baclofen↗
PubMedDate not supplied

Vagus nerve stimulation for treatment of partial seizures: 2. Safety, side effects, and tolerability. First International Vagus Nerve Stimulation Study Group.

Vagus nerve stimulation (VNS) significantly reduces the frequency of partial seizures in refractory epilepsy patients. We examined the serious adverse events, side effects, and tolerability as they relate to the surgical implant procedure and the stimulating device. We also reviewed potential drug interactions, device output complications, and impact of the therapy on overall health status. We analyzed the first 67 patients to exist the acute phase of the EO3 VNS trial comparing high (therapeutic) VNS to low (less or noneffective) VNS. Data were collected from case report forms used at each of the four visits during the 12-week baseline and at each of the four visits during the 14-week randomized phase of the trial. No significant complications were reported as a result of the implant procedure. Serious adverse events included 1 patient who experienced direct current to the vagus nerve owing to generator malfunction resulting in left vocal cord paralysis and withdrawal of the patient from the study. No clinically significant effects on vital signs, cardiac function, or gastric function were detected. Side effects associated with VNS in the high group were hoarseness (35.5%), coughing (13.9%), and throat pain (12.9%). In the low group, only hoarseness (13.9%) and throat pain (13.9%) were associated with VNS. These effects generally wrre not considered clinically significant and occurred primarily during the stimulation pulses. No patients discontinued VNS therapy during the acute phase because of side effects associated with normal stimulation. Except for the one instance of a short circuit in the system resulting in a direct current, stimulating system complications were minor, limited to programming, unscheduled stimulation, and high lead impedance. Patients, investigators, and patient companions rated patients receiving high stimulation as more "improved" than those receiving low stimulation in regards to overall health status. Antiepileptic drug (AED) plasma concentrations were not affected by VNS. The implant procedure, stimulating system, and therapy proved safe and tolerable during the study. The high percentage (67 of 68) of patients completing the study reflects patient acceptance and tolerability of this mode of therapy.

Adolescent↗