Osteoarthritis (OA) of a hip joint, with subsequent total hip joint replacement surgery, is portrayed in the literature in terms of quantitative research studies, where the person living with the hip disappears in objective statistical analyses, or in qualitative studies where one person's story is fragmented within thematic findings. This ...

The qualities of chronic neuropathic pain (NeP) may be informative about the different mechanisms of pain. We previously developed a 2-factor model of NeP that described an underlying structure among sensory descriptors on the Short-Form McGill Pain Questionnaire. The goal of this study was to confirm the correlated 2-factor model ...

Complex regional pain syndrome is a neuropathic pain syndrome that is characterized by: severe pain beyond the area of injury; autonomic dysregulation; neurogenic edema; movement disorder; and atrophy and dystrophy. Ketamine is an open-channel NMDA blocker that only acts on those receptors whose Mg(2+) block has been lifted. It is ...

To report a rare case of congenital insensitivity to pain with anhidrosis. A 3-year-old girl presented with watering in the right eye for 3 days. Slit-lamp examination showed an epithelial defect and hypopyon in the right eye and a corneal scar with thinning and vascularization in the left eye. There ...

To determine common features of posterior ankle impingement in fast bowlers in the West Indies and to compare modes of treatment with respect to return to play without pain. Retrospective analysis of ankle impingement injuries treated in fast bowlers in the West Indies. Six fast bowlers had evidence of os ...

As part of an ongoing prospective study of referrals from surgical clinics to general neurology outpatient clinics, I audited direct referrals from oral and maxillofacial surgery clinics to neurology outpatient clinics to identify the number, sources, and any common indications for referral that might suggest specific training needs, or indicate ...

Botulinum neurotoxin (BoNT) is an effective treatment for conditions associated with overactivity of glandular, smooth or skeletal muscle, and this toxin can also ameliorate certain painful conditions. Electromyography, endoscopy and imaging techniques such as ultrasonography and fluoroscopy have been used to increase the accuracy of BoNT injections. This Review assesses ...

Spontaneous spinal epidural hematoma (SSEH) is a rare condition requiring urgent diagnosis and treatment. Patients with SSEH typically present with acute onset of severe back pain and rapidly develop signs of compression of the spinal cord. The authors present a case with spontaneous resolution of SSEH which is extremely rare. ...

Mounting evidence from animal studies has implicated that all commonly used anaesthetics and sedatives may induce widespread neuronal cell death and result in long-term neurological abnormalities. These findings have led to serious questions regarding the safe use of these drugs in young children. In humans, recent findings from retrospective, epidemiological ...

HISTORY AND ADMISSION FINDINGS: An 83-year old woman was admitted with pain in the left arm and on the left hemithorax. Subsequently, herpes zoster developed on the left arm. The next day, the patient got confused and was agitated. Furthermore, paresis of both legs and the left arm occurred. INVESTIGATIONS: ...

Our objective was to determine patterns, reasons for, and correlates of complementary and alternative medicine (CAM) use in US adults with common neurological conditions. We compared CAM use between adults with and without common neurological conditions (regular headaches, migraines, back pain with sciatica, strokes, dementia, seizures, or memory loss) using ...

Children with Guillain-Barré Syndrome (GBS) often do not present like adults with an ascending paralysis and sensory abnormalities, but typically have pain and gait difficulties as predominant symptoms. We present a case of paediatric GBS that was not diagnosed until late in the course because of limited neurological examination, erroneous ...

A healthy man developed cauda equina syndrome after uneventful combined spinal and epidural anesthesia. No pre-existing neurologic disorder was recorded. There was no pain or paresthesia during needle placement, drug injection or catheter insertion. The sensory levels were improved within a few days following the deficit but little improvement on ...

Ocular pain and related symptoms are frequent manifestations of primary and secondary headache disorders. Neurologists are often the first physician to evaluate patients affected by these clinical features. The cause of eye pain may be attributed both to pathological disorders with abnormal neurologic and neuro-ophthalmologic findings and to diseases with ...

The discipline of neurological surgery was considered primarily "hopeless" and, at best, experimental in the late 19th century. Harvey Cushing's efforts during his initial uncharted voyage through the surgery of the human cranium were rudimentary and exploratory. A direct review of his available patient records from early in his career ...

BACKGROUND: Diastematomyelia is a type of dysraphism with a double or bifid spinal cord divided by an osseous septum. This defect often co-occurs with other developmental disorders of the skull or the atlanto-occipital junction. The course may be benign or aggressive. 2. CASE REPORTS: We describe two female patients treated ...

The specialty of surgical neurology developed out of general surgery in the second half of the 19th century. It was aided by the development of general anesthetics, the advent of aseptic methods, and the emerging theory of cortical localization of function. This chapter examines the history of "modern" brain surgery, ...

Osteoid osteoma is a benign tumor commonly found in young patients. The most interesting feature of the tumor is its peculiar obvious pain. The intensity of pain produced by osteoid osteoma is unproportionate to its nature and size. Much has been written about the mechanism of this symptom of the ...

Isthmic spondylolisthesis is present in a small subset of the adult population. Although the incidence of low back pain in these persons is similar to that of the general population, both pars interarticularis defect and forward slip can serve as unique pain generators. Neurologic symptoms may result from nerve root ...

Hemophilia A is an X-linked bleeding disorder, caused by deficient or defective blood coagulation factor VIII. The most characteristic symptoms of the severe forms of hemophilia A are joint and muscle bleeds. Intracranial hemorrhage occurs only in 3-10% of the patients. Spinal epidural hematomas are rarely seen. We describe a ...

OBJECTIVES: To describe the clinical and epidemiological aspects of post-polio syndrome (PPS) and identify predictors of its severity. MATERIALS AND METHODS: 132 patients with PPS were selected at the Neuromuscular Disease Outpatient Clinic of the Federal University of São Paulo. Descriptive analysis was carried out and predictors of PPS severe ...

The purpose of this study was to examine factors affecting the severity of neurological deficits and intractable back pain in patients with insufficient bone union following osteoporotic vertebral fracture (OVF). Reports of insufficient union following OVF have recently increased. Patients with this lesion have various degrees of neurological deficits and ...

The first half of the 20th century witnessed the rapid emergence of neurological surgery as a surgical subspecialty. Only few surgeons made a name for themselves equally in general surgery and neurological surgery. One of them was the Swiss surgeon Theodor Kocher (1841-1917). He was honored with the Nobel Prize ...

OBJECTIVE: Acrodysostosis is a rare syndrome characterized by peripheral dysostosis, nasal hypoplasia and frequently mental retardation. Only one adult case of acrodysostosis has been reported to have neurologic symptoms. We report one further adult case of acrodysostosis with severe neurologic findings including myelopathy and spastic paraparesis due to diffuse spinal ...

Spine infections are infrequent but important sources of back pain, posing significant risk of neurological sequelae. Risk factors include diabetes, recent trauma or instrumentation, and infection. Pathogens include Staphylococcus aureus and beta-hemolytic Streptococcus. A 67-yr-old man presented with lower back and hip pain of 2-mo duration without fever. Initial treatment ...

While it is well established that the principal ascending pathways for pain originate in the dorsal horn of the spinal cord and in the medulla, the control and sensitivity to pain may reside in additional neurological loci, especially in the mesolimbic system of the brain (i.e., a reward center), and ...

A 49-year-old man presented with a brainstem cavernous angioma associated with hemophilia manifesting as gradual progression of neurological deficits over a period of 2 weeks. Computed tomography revealed a hematoma and perifocal edema on the left side of the pons, and T(2)-weighted magnetic resonance imaging revealed a hemosiderin rim around ...

Only 6 cases of pyogenic spondylitis following vertebroplasty or kyphoplasty have been reported, and their causes remained unclear. The authors report on 4 cases of delayed pyogenic spondylitis (DPS) following vertebroplasty or kyphoplasty for osteoporotic compression fractures and metastatic disease. Four patients presented with DPS after vertebroplasty or kyphoplasty and ...

Several issues regarding diagnosis, pharmacological treatment, and surgical treatment of trigeminal neuralgia (TN) are still unsettled. The American Academy of Neurology and the European Federation of Neurological Societies launched a joint Task Force to prepare general guidelines for the management of this condition. After systematic review of the literature the ...

OBJECTIVE: The optimal management of spinal column metastatic disease is controversial. Furthermore, the literature lacks an accurate animal model to study the efficacy of surgical treatment options for spinal column metastases. We compared the efficacy of surgery, radiotherapy, or surgery plus adjuvant radiotherapy in a rat model of metastatic epidural ...

Polyarteritis nodosa (PAN) is a necrotising vasculitis of medium-sized vessels of unknown origin. This type of vasculitis is usually systemic, but restriction to a single organ, for example the testis, the appendix or the gall bladder, can occur. Testicular pain or tenderness are frequent clinical features. In this report, we ...

We report a patient with bisphosphonate-associated osteonecrosis of the jaws who developed pathological fractures of the upper and lower extremities after the suspension of treatment with bisphosphonates. Temporary discontinuation of the drugs does not alter the clinical course of the disease, and could result in the recurrence of bone pain ...

BACKGROUND: Solid plastic replicas of anatomical structures obtained by stereolithography from computed tomographic images and magnetic resonance imaging are being used as complementary tools for diagnostic purposes and therapy planning for diverse pathologies. CASE DESCRIPTIONS: Case 1--The spine mold of a 62-year-old man with neurologic compromise secondary to degenerative cervical ...

We report the displacement of a tunnelled intrathecal catheter causing significant cerebrospinal fluid (CSF) leak, resulting in partial coning and a sixth nerve palsy. The patient had advanced malignant mesothelioma and all other methods of pain control had been unsuccessful. As far as we are aware, there are no published ...

Historical observations and interpretations regarding the treatment of components of the nervous system can be found in the writings of the Bible and Talmud. A review of topics germane to modern neuroanatomy, neurology, and neurosurgery from these early, rich writings is presented herein. These historic writings provide a glimpse into ...

OBJECTIVE: Half of the adults in the United States use complementary and alternative medicine with mind-body therapy being the most commonly used form. Neurology patients often turn to their physicians for insight into the effectiveness of the therapies and resources to integrate them into their care. The objective of this ...

OBJECTIVES: The authors sought to determine the prevalence of pain among neurological inpatients and the impact of pain on psychological and social variables depending on severity and chronicity of pain. PATIENTS AND METHODS: 400 consecutive newly referred inpatients to a neurological department who were 18 years and older and able ...

BACKGROUND: We present the case of a 14-year-old with a 3-month history of back pain, who on presentation, was demonstrated to have neurological signs. METHOD: Investigation with radiographs and subsequent magnetic resonance imaging was performed, which demonstrated an expansile lesion in the tenth thoracic vertebra with posterior extension causing spinal ...

The indications for lumbar discectomy are pain and neurological dysfunction. This paper considers the extent and timing of neurological recovery following spinal decompression.

The authors report on a 14 years old female with intracranial hypotension who had a history of spinal instrumentation surgery for scoliosis 3 months prior to her admission. She had been diagnosed with migraine in a neurology clinic and was under medical therapy when presented. During the investigation process, a ...

As a trainee of Dr. Harvey Cushing, cofounder and first president of the American Association of Neurological Surgeons, and founder of a prestigious international academic fellowship, Dr. William P. van Wagenen is an important figure in the history of neurological surgery. Perhaps less well known or appreciated is his seminal ...

Spondylodiscitis is an unusual diagnosis among children and consequent abscess formation is even rarer. A 6-year-old girl with fever, hip pain, and refusal to walk was evaluated. The neurologic examination was normal. Recurrent joint pain with cold weather, iron for anemia without improvement, and decreased intervertebral spaces raised the use ...

The objective of this article is to provide an overview of the natural history and treatment of herpes zoster, with a focus on pain management. Herpes zoster has the highest incidence of all neurological diseases, occurring annually in approximately 1 million people in the United States. A basic feature of ...

In order to analyze aspects of pain patient care in neurology, we conducted a survey among German neurology departments that aimed to determine different structural aspects of neurological pain medicine. A 5-page questionnaire was sent to 391 neurological departments, and a return rate of 59.8% was achieved. Some 70% of ...

There is a paucity of studies assessing changes in measures of human neurotransmission during stressful events, such as surgery. Thirty-five patients without any neurological disorders undergoing knee replacements with spinal bupivacaine anaesthesia and propofol sedation had cerebrospinal fluid (CSF) drawn from a spinal catheter before, three hours after and the ...

Conservative surgical strategies are appropriate for most symptomatic hemangiomas causing cord compression without instability or deformity. Even so, complete intralesional spondylectomy following embolization of aggressive vertebral hemangiomas with circumferential vertebral involvement can be safely accomplished. Such a spondylectomy can also prevent recurrence of hemangiomas. Transarterial embolization without decompression is an ...

This article reviews the current and most neurologic uses of botulinum neurotoxin type A (BoNT-A), beginning with relevant historical data, neurochemical mechanism at the neuromuscular junction. Current commercial preparations of BoNT-A are reviewed, as are immunologic issues relating to secondary failure of BoNT-A therapy. Clinical uses are summarized with an ...

Although pituitary tumors were well recognized by the end of the 20th century, very few surgeons had attempted to remove such tumors. In 1906, Hermann Schloffer at the Innsbruck University Clinic of Surgery reviewed the subject of pituitary surgery. Very little was known about the function of the pituitary, and ...

BACKGROUND: Serefeddin Sabuncuoğlu (A.D. 1385-1468) was the author of the first illustrated surgery atlas Cerrahiyyetü'l Haniyye (Imperial Surgery), which was written in Turkish in 1465. The purpose of this report is to present his unique contribution to modern neurological surgery. METHODS: Cerrahiyyetü'l Haniyye consists of 412 pages in three chapters, ...

Cervical radiculopathy is a disorder involving dysfunction of cervical nerve roots that commonly manifests as pain radiating from the neck into the distribution of the affected root. Acute cervical radiculopathy generally has a self-limited clinical course, with up to a 75% rate of spontaneous improvement. Thus, nonsurgical treatment is the ...