Beijing Institute of Functional Neurosurgery
Beijing Institute of Functional Neurosurgery
Zhang X.,Capital Medical University |
Zhang X.,Beijing Institute of Functional Neurosurgery |
Hu Y.,Capital Medical University |
Hu Y.,Beijing Institute of Functional Neurosurgery |
And 8 more authors.
Neuromodulation | Year: 2017
Objective: To investigate the effect of motor cortex stimulation (MCS) on central poststroke pain (CPSP) and the outcome predictors associated with medium- to long-term results. Materials and Methods: This is a retrospective review of 16 CPSP patients treated with MCS with a mean follow-up of 28.2 months. The pain intensity was assessed based on the visual analogue scale (VAS) before surgery and at various follow-up visits. An effective outcome was determined to be at least 40% pain relief. The type (hemorrhage or ischemia) and location (thalamus or non-thalamus) of the stroke, the location of the electrode (epidural or subdural), and preoperative repetitive transcranial magnetic stimulation (rTMS) results were analyzed to evaluate whether they are predictive of effective outcomes. Results: The mean VAS before surgery was 8.0 ± 0.7 compared with 3.8 ± 2.1 one month after surgery and 5.3 ± 2.4 at the last follow-up. There were no differences in the analgesic effects between the types of stroke (hemorrhage or ischemia), stroke location (thalamus or non-thalamus), or the location of the electrode (epidural or subdural). The association between preoperative rTMS and effective outcomes was significant with a positive predictive value of 0.8571 and a negative predictive value of 0.7778. Conclusions: Our results suggest that MCS significantly reduces the pain intensity of CPSP. The types of stroke (hemorrhage or ischemia), stroke location (thalamus or nonthalamus), and the location of the electrode (epidural or subdural) were not significant predictors of the analgesic effects of MCS. Preoperative rTMS might be helpful for screening candidates for MCS. © 2017 International Neuromodulation Society
Huang D.,Central South University |
Li Y.,Beijing Institute of Functional Neurosurgery |
Fan B.,China Japan Friendship Hospital
Pain Physician | Year: 2012
Background: Neuropathic pain is a relatively common outcome of Lyme disease. Pain management options for these patients have been limited to pharmaceutical treatments. Objective: We present a case of chronic pain following Lyme disease treated successfully using spinal cord stimulation (SCS). Study Design: Case report. Setting: Pain management clinic. Methods: A 62-year-old patient presented with a 5-year history of bilateral foot pain following Lyme disease that failed to respond to medication and physical therapy. The patient was treated by a trial of SCS at the clinic and then implanted with a spinal cord stimulator. The Visual Analog Scale (VAS) assessed pain before and after SCS. Results: The patient reported significant pain relief and improved foot function. The 10 point VAS score was reduced from 8-10 to 1-3. Limitations: Single case report. Conclusion: Spinal cord stimulation may be an effective option for relieving chronic pain originating from Lyme disease.
Wang S.,Tsinghua University |
Miao S.,Tsinghua University |
Zhuang P.,Beijing Institute of Functional Neurosurgery |
Chen Y.,Tsinghua University |
And 2 more authors.
Journal of Neuroscience Methods | Year: 2011
This study aimed to explore the role of surface electromyography (sEMG) on the changes of myoelectric activities of quadriceps femoris and the assessment of its clinical effect before and after selective femoral neurotomy on spastic cerebral palsy with stiff knee. Selective femoral neurotomy was carried out in 15 patients on 26 sides. The electromyography of quadriceps femoris was recorded before and after the operation. Passive and voluntary movements were performed during recording. The root mean square (RMS) and integrated electromyography (iEMG) was calculated by time domain analysis. Meanwhile, the range of the patients' knee joint motion (ROM) was measured by a joint goniometer. The RMS and iEMG of the quadriceps femoris during passive movement was significantly decreased post-operation when compared to those pre-operation (both P<. 0.05, n= 26). Meanwhile, the RMS and iEMG of the quadriceps femoris during voluntary movement post-operation was significantly reduced than those pre-operation (both P<. 0.05, n= 26). Additionally, total excursion on the sagittal plane and the peak knee flexion in the swing phase were significantly raised post-operation than those pre-operation (both P<. 0.05, n= 26). The spasms in the quadriceps femoris in spastic cerebral palsy patients with stiff knee was clearly improved, and the ROM of the knee was significantly enhanced after the selective femoral neurotomy. Importantly, surface EMG can objectively evaluate the clinical therapeutic effect of spastic cerebral palsy stiff knee as a noninvasive detection method. © 2011.
Duanyu N.,Capital Medical University |
Yongjie L.,Beijing Institute of Functional Neurosurgery |
Guojun Z.,Capital Medical University |
Lixin C.,Capital Medical University |
Liang Q.,Capital Medical University
Journal of Clinical Neuroscience | Year: 2010
We report a patient with medically intractable musicogenic epilepsy (ME) who was treated with surgery. Using the non-invasive methods of ictal and interictal electroencephalography (EEG), MRI, interictal single photon emission computed tomography and clinical manifestations, we first localized the musicogenic seizures (MS). The ictal onset zone was then further localized using intracranial EEG to the middle part of the left superior temporal gyrus. Surgical resection of the epileptogenic zone was then performed. The patient had two seizures within 2 weeks post-operatively, but has then had no seizures during the following year (Engel class II). The results suggest that patients who have medically intractable ME combined with unilateral ictal onset zones should be considered for the surgical treatment of epilepsy. © 2009 Elsevier Ltd. All rights reserved.
Li J.,Capital Medical University |
Zhang Y.,Capital Medical University |
Zhu H.,Capital Medical University |
Li Y.,Beijing Institute of Functional Neurosurgery
Journal of Clinical Neuroscience | Year: 2012
The reliability of intra-operative abnormal muscle response (AMR) monitoring as an indicator of post-operative outcome in patients with hemifacial spasm (HFS) is under debate. The primary aim of this study was to evaluate the correlation between intra-operative AMR changes and long-term post-operative outcome. We monitored intra-operative AMR during microvascular decompression (MVD) in consecutive patients with HFS (n = 104). Patients in this study were divided into two groups based on whether their AMR disappeared or persisted following MVD. Ninety patients were followed-up, and the mean duration from surgery to final follow-up examination was 3.7 years. Fourteen patients were lost to follow-up. AMR disappeared during surgery for 80 patients; of these, 74 achieved complete resolution of HFS, five had persistent HFS, and one patient developed a recurrence of HFS. Of the 10 patients with persistent AMR despite effective MVD, eight patients achieved complete resolution, one patient had persistent HFS, and one developed recurrent HFS. The long-term clinical outcome of HFS after MVD did not significantly correlate with intra-operative AMR changes (p = 0.791). Therefore, we suggest that intra-operative AMR monitoring may not be a reliable indicator of long-term post-operative outcome for HFS. © 2011 Elsevier Ltd. All rights reserved.