Dorsal cord stimulation (D.C.S.) in treatment of chronic non-neoplastic pain.
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Biomedical subjects
Publications and source records attributed to G Broggi.
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We report a case of Lennox-Gastaut-type epilepsy that was followed for 3 years. The patient showed typical EEG findings and later a parietotemporal astrocytoma (type II) on the left. Removal of the tumor was followed by recovery of the child and disappearance of EEG epileptic elements.
CT has been used in controlling stereotaxic thalamotomies in patients with movement disorders. The results obtained in 12 such patients, with early and delayed scans, are presented.
Since 1971, we have surgically treated spasticity in 109 cases of cerebral palsy with posterior rhizotomy. The best results have been obtained with functional posterior rhizotomy, an original modification of Foerster's technique, in which the selection of the roots/rootlets to be sectioned is based on functional exploration of the spinal circuits involved in the maintenance of spasticity, using intraoperative electrostimulation on dorsal roots. This method makes selective sections possible, thereby saving a larger number of normal proprioceptive afferents, with consequent reduction in negative side effects. No recurrencies have been observed in our 3-year follow-up. The main indication is Little's disease.
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Clinical electrophysiological and neuroradiological examination of a case of unilateral intention and action myoclonus is reported. Brachial arteriography revealed an angioma located mainly in the lateral portion of the right posterior thalamus. Clinical and electrophysiological findings suggesting involvement of nonthalamic structures were absent. Our case, together with some cases previously described, raises the possibility that volitional myoclonus may be related to a relatively circumscribed damage of some diencephalic and/or mesencephalic structures. The rare occurrence of a hyperkinetic syndrome as principal symptom of a cerebral vascular malformation should be borne in mind in view of the potential risk of a stereotactic surgical procedure designated to alleviate the involuntary movements.
The trigemino-facial reflex was studied in 7 patients affected by Huntington's chorea and in 10 patients affected by Parkinson's disease. The results show a different behavior of the habituation phenomenon in the two groups of patients: it is enhanced in the choreic and abolished in the parkinsonian patients. The main changes concern the time course of the second phase (the first inhibitory phase) of the reflex excitability cycle, in fact, the inhibitory phase appears very pronounced and prolonged in huntingtonian patients and reduced or abolished in parkinsonian patients. Some pathophysiological mechanisms involved in the control of the trigeminofacial reflex excitability are discussed with particular regard to the role of the hemispheric structures.
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