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Biomedical subjects

J M Tew

Publications and source records attributed to J M Tew.

143 records · Page 8Linked to original sources
PubMed1978

Application of stereotactic principles to the treatment of trigeminal neuralgia.

The application of neuroanatomical and neurophysiological principles to the functional surgery of the trigeminal nerve is discussed. Particular attention has been directed toward correlating the three-dimensional anatomical features of the trigeminal nerve and the surrounding structures to the two-dimensional radiograph of this same region. In this regard, 20 trigeminal nerves, including the surrounding neurovascular structures from 10 cadaver sphenoid blocks, were examined. Measurements of the third, fourth and sixth cranial nerves in relation to the profile of the clivus were made from lateral radiographs of the sphenoid blocks. The position of the internal carotid artery in relation to these structures was also noted. These neurovascular relationships are of clinical importance when using the percutaneous thermocoagulation technique for the treatment of trigeminal neuralgia.

Electrocoagulation↗
PubMed1975

Treatment of trigeminal neuralgia in the aged by a simplified surgical approach (percutaneous electrocoagulation).

Trigeminal neuralgia can be excruciatingly painful. For aged patients, among whom trigeminal neuralgia most commonly occurs, medical therapy may often afford relief of pain. However, since this disorder is likely to become worse with increasing age, medical therapy eventually may fail because of increasing drug requirements and intolerable side effects. Major forms of surgical treatment requiring craniotomy may afford longstanding relief but are associated with significant side effects in 3-5 per cent of cases. For these reasons the authors began to test a new surgical approach, i.e., stereotaxic percutaneous electrocoagulation of the trigeminal nerve. More than 300 patients have been treated by this technique in the past five years. Successive radiofrequency lesions allow the production of a graded sensory deficit sufficient to relieve pain while preserving touch and motor function in the face. Unnecessary suffering from the severe pain of trigeminal neuralgia need not occur because of age or a debilitated condition which might ordinarily preclude surgical treatment. More than 100 patients over 65 years of age (4 of them older than 90) have been treated. Of this group, 93 per cent reported good to excellent results. Seven per cent have had some recurrent pain during the follow-up period; however, recoagulation has been required in only 5 per cent of these patients. Recoagulation may be readily performed in any patient who shows evidence of fading of the sensory deficit. The electrocoagulation technique and the results in elderly patients are discussed.

Aged↗
PubMedDate not supplied

The origin of the scalp recorded P14 following electrical stimulation of the median nerve: intraoperative observations.

Direct and far-field recorded somatosensory evoked potentials (SEPs) obtained from 2 patients during neurosurgical procedures are presented. A previous report (Møller et al. 1986) has suggested that the P14 component of the SEP following median nerve stimulation is generated at the cuneate nucleus. The present data suggest that the scalp recorded P14 component (scalp-noncephalic electrode derivation) is generated rostral to the junction of the cervical cord and the medulla.

Electroencephalography↗