Any operation on the spinal cord. (Stedman, 26th ed)
Persistent pain that is refractory to some or all forms of treatment.
A bundle of NERVE FIBERS connecting each posterior horn of the spinal cord to the opposite side of the THALAMUS, carrying information about pain, temperature, and touch. It is one of two major routes by which afferent spinal NERVE FIBERS carrying sensations of somaesthesis are transmitted to the THALAMUS.
A condition caused by an apical lung tumor (Pancoast tumor) with involvement of the nearby vertebral column and the BRACHIAL PLEXUS. Symptoms include pain in the shoulder and the arm, and atrophy of the hand.
Difficulty and/or pain in PHONATION or speaking.
Congenital or acquired paralysis of one or both VOCAL CORDS. This condition is caused by defects in the CENTRAL NERVOUS SYSTEM, the VAGUS NERVE and branches of LARYNGEAL NERVES. Common symptoms are VOICE DISORDERS including HOARSENESS or APHONIA.
Procedures using an electrically heated wire or scalpel to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. It is different from ELECTROSURGERY which is used more for cutting tissue than destroying and in which the patient is part of the electric circuit.
A tumor derived from mesothelial tissue (peritoneum, pleura, pericardium). It appears as broad sheets of cells, with some regions containing spindle-shaped, sarcoma-like cells and other regions showing adenomatous patterns. Pleural mesotheliomas have been linked to exposure to asbestos. (Dorland, 27th ed)
An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of PHENYTOIN; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar.
A syndrome characterized by recurrent episodes of excruciating pain lasting several seconds or longer in the sensory distribution of the TRIGEMINAL NERVE. Pain may be initiated by stimulation of trigger points on the face, lips, or gums or by movement of facial muscles or chewing. Associated conditions include MULTIPLE SCLEROSIS, vascular anomalies, ANEURYSMS, and neoplasms. (Adams et al., Principles of Neurology, 6th ed, p187)
A generalized seizure disorder characterized by recurrent major motor seizures. The initial brief tonic phase is marked by trunk flexion followed by diffuse extension of the trunk and extremities. The clonic phase features rhythmic flexor contractions of the trunk and limbs, pupillary dilation, elevations of blood pressure and pulse, urinary incontinence, and tongue biting. This is followed by a profound state of depressed consciousness (post-ictal state) which gradually improves over minutes to hours. The disorder may be cryptogenic, familial, or symptomatic (caused by an identified disease process). (From Adams et al., Principles of Neurology, 6th ed, p329)
Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as EPILEPSY or "seizure disorder."
Drugs used to prevent SEIZURES or reduce their severity.
Recurrent conditions characterized by epileptic seizures which arise diffusely and simultaneously from both hemispheres of the brain. Classification is generally based upon motor manifestations of the seizure (e.g., convulsive, nonconvulsive, akinetic, atonic, etc.) or etiology (e.g., idiopathic, cryptogenic, and symptomatic). (From Mayo Clin Proc, 1996 Apr;71(4):405-14)
Conditions characterized by recurrent paroxysmal neuronal discharges which arise from a focal region of the brain. Partial seizures are divided into simple and complex, depending on whether consciousness is unaltered (simple partial seizure) or disturbed (complex partial seizure). Both types may feature a wide variety of motor, sensory, and autonomic symptoms. Partial seizures may be classified by associated clinical features or anatomic location of the seizure focus. A secondary generalized seizure refers to a partial seizure that spreads to involve the brain diffusely. (From Adams et al., Principles of Neurology, 6th ed, pp317)

Congenital kyphosis in myelomeningocele. The effect of cordotomy on bladder function. (1/105)

To determine the effect of cordotomy on the function of the bladder during surgical correction of congenital kyphosis in myelomeningocele, we reviewed 13 patients who had this procedure between 1981 and 1996. The mean age of the patients at operation was 8.9 years (3.7 to 16) and the mean follow-up was 4.8 years (1.3 to 10.8). Bladder function before and after operation was assessed clinically and quantitatively by urodynamics. The mean preoperative kyphosis was 117 degrees (52 to 175) and decreased to 49 degrees (1 to 89) immediately after surgery. At the latest follow-up, a mean correction of 52% had been achieved. Only one patient showed deterioration in bladder function after operation. Eight out of the nine patients who had urodynamic assessment had improvement in bladder capacity and compliance, and five showed an increase in urethral pressure. One patient developed a spastic bladder and required subsequent surgical intervention. Cordotomy, at or below the level of the kyphosis, allows excellent correction of the structural deformity.  (+info)

Percutaneous cervical cordotomy for the control of pain in patients with pleural mesothelioma. (2/105)

BACKGROUND: Severe chest pain is common in mesothelioma. Percutaneous cervical cordotomy, which interrupts the spinothalamic tract at the C1/C2 level causing contralateral loss of pain sensation, is particularly appropriate in mesothelioma as the tumour is unilateral and systemic analgesia may be ineffective and is limited by harmful side effects. METHOD: A retrospective review was performed to determine the effectiveness and complication rate of this procedure. RESULTS: Fifty two patients were using opioids prior to cordotomy. The median daily dose of morphine before and after cordotomy was 100 mg (range 0-1000 mg) and 20 mg (range 0-520 mg), respectively (p < 0.001). Forty three patients (83%) had a reduction in pain such that their dose of opioid could be at least halved. Twenty patients (38%) were able to stop completely. Recurrence of pain requiring an increase in opioid medication was recorded in 18 patients at a median time of nine weeks (range 0.7-26 weeks). Four patients developed mild weakness, two had troublesome dysaesthesia. The median time from cordotomy to death was 13 weeks (range 0.3-52 weeks). Six early deaths within two weeks of cordotomy occurred early in the series and reflect postoperative chest infection and poor selection as the patients were in the terminal stages of mesothelioma. CONCLUSIONS: Percutaneous cervical cordotomy is successful in treating pain from mesothelioma. There was a low complication rate in this series. Referral to a unit experienced in cordotomy is recommended as soon as pain from chest wall invasion is suspected.  (+info)

Persistence of hybrid fibers in rat soleus after spinal cord transection. (3/105)

The effects of a chronic (up to 360 days) reduction in neuromuscular activity (defined as electrical activation and loading) on myosin heavy chain (MHC) isoform expression in the rat soleus muscle were studied. A complete mid-thoracic (T7-T8) spinal cord transection (ST) was used to induce a reduction in soleus muscle neuromuscular activity. Electrophoretic analyses revealed that MHC-I was progressively decreased after ST, accounting for approx. 90% of the total soleus MHC in controls and only approx. 12% 1 year after ST. The reductions in the proportion of MHC-I were countered by increases in MHC-IIa and MHC-IIx with the increase in MHC-IIx preceding the increase in MHC-IIa. Curiously, MHC-IIb was expressed only at very low levels. Thus, a complete transformation from predominantly MHC-I to MHC-IIb did not occur. Many fibers (up to approx. 80%) contained multiple MHCs (hybrid fibers) after ST. The proportion of hybrid fibers was maintained at a high level (approx. 50%) 1 year after ST. These data suggest that: 1) a prolonged reduction in neuromuscular activity was not sufficient to induce high level MHC-IIb expression by the soleus muscle; and 2) hybrid fibers were not simply transitional fibers. Thus, it appears that under appropriate conditions hybrid fibers may represent a "stable" fiber phenotype.  (+info)

The analgesic action of nitrous oxide is dependent on the release of norepinephrine in the dorsal horn of the spinal cord. (4/105)

BACKGROUND: The authors and others have demonstrated that supraspinal opiate receptors and spinal alpha2 adrenoceptors are involved in the analgesic mechanism for nitrous oxide (N2O). The authors hypothesize that activation of opiate receptors in the periaqueductal gray results in the activation of a descending noradrenergic pathway that releases norepinephrine onto alpha2 adrenoceptors in the dorsal horn of the spinal cord. METHODS: The spinal cord was transected at the level of T3-T4 in rats and the analgesic response to 70% N2O in oxygen was determined by the tail flick latency test. In a separate experiment in rats a dialysis fiber was positioned transversely in the dorsal horn of the spinal cord at the T12 level. The following day, the dialysis fiber was infused with artificial cerebrospinal fluid at a rate of 1.3 microl/min, and the effluent was sampled at 30-min intervals. After a 60-min equilibration period, the animals were exposed to 70% N2O in oxygen. The dialysis experiment was repeated in animals that were pretreated with naltrexone (10 mg/kg, intraperitoneally) before N2O. In a third series, spinal norepinephrine was depleted with n-(2-chloroethyl)-n-ethyl-2-bromobenzylamine (DSP-4), and the analgesic response to 70% N2O in oxygen was determined. RESULTS: The analgesic effect of N2O was prevented by spinal cord transection. After exposure to N2O, there was a fourfold increase in norepinephrine released in the first 30-min period, and norepinephrine was still significantly elevated after 1 h of exposure. The increased norepinephrine release was prevented by previous administration of naltrexone. Depletion of norepinephrine in the spinal cord blocked the analgesic response to N2O. CONCLUSIONS: A descending noradrenergic pathway in the spinal cord links N2O-induced activation of opiate receptors in the periaqueductal gray, with activation of alpha2 adrenoceptors in the spinal cord. N2O-induced release of norepinephrine in the dorsal horn of the spinal cord is blocked by naltrexone, as is the analgesic response. Spinal norepinephrine is necessary for the analgesic response to the N2O.  (+info)

Central regulation of sympathetic neuron development. (5/105)

The sixth lumbar (L-6) ganglion has been used to study the central regulation of peripheral sympathetic neuron development. During post-natal ontogeny, tyrosine hydroxylase [tyrosine 3-monooxygenase, L-tyrosine, tetrahydropteridine: oxygen oxidoreductase (3-hydroxylating), EC] activity increased 60-fold, while total protein rose 10-fold in the ganglion. Transection of the spinal cord at the fifth thoracic (T-5) segment in neonatal rats prevented the normal developmental increase in tyrosine hydroxylase activity of the L-6 ganglion. However, spinal transection did not alter the ontogeny of tyrosine hydroxylase in the superior cervical ganglion, which derives its innervation from spinal segments rostral to the surgical lesion. Thus, spinal transection interfered with the maturation of sympathetic neurons distal to, but not proximal to, the lesion. The effect of transection on the L-6 ganglion persisted for at least one month, the longest time tested. Our observations suggest that trans-synaptic regulation of adrenergic maturation in the periphery is governed by suprasegmental mechanisms in the central nervous system.  (+info)

The effect of 2-deoxy-D-glucose and D-glucose on the efferent discharge rate of sympathetic nerves. (6/105)

Efferent discharges were recorded from nerve filaments dissected from the adrenal and renal nerves in the rabbit. 2. An increase in discharge rate was observed in the adrenal nerve filaments following I.V. administration of 2-deoxy-D-glucose (2-DG). No change in discharge rate after 2-DG infusion was observed in the renal nerve filaments. 3. A decrease in discharge rate of the adrenal nerve filaments was observed after I.V. injection of glucose, but there was no change in the activity of renal nerve filaments. 4. Transection of the spinal cord abolished the adrenal nerve response to the systemic administration of 2-DG and glucose. 5. It is suggested that there might be a pathway from the hypothalmic area to the adrenal nerve cells of the spinal cord, but not to the renal nerve cells, through which activity of the adrenal nerve might be changed in response to 2-DG and glucose infusion.  (+info)

High cervical commissural myelotomy in the treatment of pain. (7/105)

High cervical myelotomy was carried out on 10 patients. Commissurotomy was performed at the C1-3 level by a combined procedure of deep electrocogulation and sharp splitting of the posterior columns. The immediate results were excellent in all patients, but relapse of pain took place shortly in six of them; there was apparently no relation with the location of pain. No long-term favourable results were observed in this series. Only three patients exhibited a well-defined band of mild hypalgesia from C2 to T 10 dermatome, but it lasted for only three to four weeks. Transient lower or four limb ataxia was observed in seven patients. Different pain conducting systems seem to be affected by commissural myelotomy, but not to a sufficient extent to give permanent or long-lasting relief of pain. The indications for high cervical myelotomy are very limited: this procedure should be considered only in patients with unilateral or bilateral arm and/or upper chest pain, respiratory impairment, and short life expectancy.  (+info)

The crossing of the spinothalamic tract. (8/105)

The question whether the spinothalamic and spinoreticular fibres cross the cord transversely or diagonally was investigated in cases of anterolateral cordotomy and in a case of thrombosis of the anterior spinal artery. The pattern of sensory loss following transection of the anterolateral quadrant of the cord consists of a narrow area of decreased nociception and thermanalgesia at the level of the incision; it extends for 1-2 segments cranial and cordal to the incision. This area is immediately cranial to the area of total loss of these modalities. This pattern of sensory loss is explained as follows. The cordotomy incision transects two groups of fibres: those that are already within the anterior and anterolateral funiculi and those that are crossing the cord. The area of total thermanaesthesia and analgesia is due to transection of fibres that are already within this region. The area of partial sensory loss is due to transection of the fibres that are crossing the cord at that level. Owing to the craniocaudal extent of the branches of the dorsal roots, there is an overlap of their collaterals that results in every spinothalamic neurone receiving an input from several dorsal roots. The narrow cordotomy incision thus divides the few fibres crossing at that level, causing diminished noxious and thermal sensibility over a few segments above and below the incision. These facts can be accounted for only on the assumption that these spinothalamic fibres are crossing the cord transversely. This evidence of transverse crossing was found in the cervical, thoracic and lumbar segments. There were three of 63 cordotomies for which this explanation of the partial sensory loss could not be maintained. Although no explanation has been suggested, this is unlikely to be due to the fibres crossing the cord diagonally.  (+info)

Cordotomy is a surgical procedure that involves selectively cutting the spinothalamic tract, which carries pain and temperature signals from the body to the brain. This procedure is typically performed in the cervical (neck) region of the spinal cord and is used to treat chronic, severe pain that has not responded to other forms of treatment.

During a cordotomy, a neurosurgeon uses a specialized needle or electrode to locate and destroy the specific nerve fibers responsible for transmitting painful sensations from a particular part of the body. The procedure can be performed under local anesthesia with sedation or general anesthesia, depending on the patient's preferences and medical condition.

While cordotomy can provide significant pain relief in the short term, it is not a permanent solution, as the nerve fibers may eventually regenerate over time. Additionally, there are risks associated with the procedure, including weakness or numbness in the affected limbs, difficulty swallowing, and in rare cases, respiratory failure. Therefore, cordotomy is typically reserved for patients with severe pain who have exhausted other treatment options and have a limited life expectancy due to their underlying medical condition.

In medicine, "intractable pain" is a term used to describe pain that is difficult to manage, control or relieve with standard treatments. It's a type of chronic pain that continues for an extended period, often months or even years, and does not respond to conventional therapies such as medications, physical therapy, or surgery. Intractable pain can significantly affect a person's quality of life, causing emotional distress, sleep disturbances, and reduced mobility. It is essential to distinguish intractable pain from acute pain, which is typically sharp and short-lived, resulting from tissue damage or inflammation.

Intractable pain may be classified as:

1. Refractory pain: Pain that persists despite optimal treatment with various modalities, including medications, interventions, and multidisciplinary care.
2. Incurable pain: Pain caused by a progressive or incurable disease, such as cancer, for which no curative treatment is available.
3. Functional pain: Pain without an identifiable organic cause that does not respond to standard treatments.

Managing intractable pain often requires a multidisciplinary approach involving healthcare professionals from various fields, including pain specialists, neurologists, psychiatrists, psychologists, and physical therapists. Treatment options may include:

1. Adjuvant medications: Medications that are not primarily analgesics but have been found to help with pain relief, such as antidepressants, anticonvulsants, and muscle relaxants.
2. Interventional procedures: Minimally invasive techniques like nerve blocks, spinal cord stimulation, or intrathecal drug delivery systems that target specific nerves or areas of the body to reduce pain signals.
3. Psychological interventions: Techniques such as cognitive-behavioral therapy (CBT), mindfulness meditation, and relaxation training can help patients cope with chronic pain and improve their overall well-being.
4. Physical therapy and rehabilitation: Exercise programs, massage, acupuncture, and other physical therapies may provide relief for some types of intractable pain.
5. Complementary and alternative medicine (CAM): Techniques like yoga, tai chi, hypnosis, or biofeedback can be helpful in managing chronic pain.
6. Lifestyle modifications: Dietary changes, stress management, and quitting smoking may also contribute to improved pain management.

The spinothalamic tracts are a pair of white matter tracts in the spinal cord that carry sensory information from the body to the brain. They are responsible for transmitting pain, temperature, and crude touch sensation. The tracts consist of two components: the lateral spinothalamic tract, which carries information about pain and temperature, and the anterior spinothalamic tract, which carries information about touch and pressure. These tracts decussate (cross to the opposite side) at the level of the spinal cord where they enter, and then ascend to the thalamus, where the information is relayed to the sensory cortex for processing.

Pancoast syndrome is a constellation of symptoms resulting from the invasion and compression of various neurological and vascular structures at the apex (top) of the lung, most commonly caused by a specific type of lung cancer known as Pancoast tumor or superior sulcus tumor. The syndrome is characterized by shoulder pain, Horner's syndrome (meiosis, ptosis, and anhidrosis), and weakness or atrophy of the hand muscles due to involvement of the lower brachial plexus.

Dysphonia is a medical term that refers to difficulty or discomfort in producing sounds or speaking, often characterized by hoarseness, roughness, breathiness, strain, or weakness in the voice. It can be caused by various conditions such as vocal fold nodules, polyps, inflammation, neurological disorders, or injuries to the vocal cords. Dysphonia can affect people of all ages and may impact their ability to communicate effectively, causing social, professional, and emotional challenges. Treatment for dysphonia depends on the underlying cause and may include voice therapy, medication, surgery, or lifestyle modifications.

Vocal cord paralysis is a medical condition characterized by the inability of one or both vocal cords to move or function properly due to nerve damage or disruption. The vocal cords are two bands of muscle located in the larynx (voice box) that vibrate to produce sound during speech, singing, and breathing. When the nerves that control the vocal cord movements are damaged or not functioning correctly, the vocal cords may become paralyzed or weakened, leading to voice changes, breathing difficulties, and other symptoms.

The causes of vocal cord paralysis can vary, including neurological disorders, trauma, tumors, surgery, or infections. The diagnosis typically involves a physical examination, including a laryngoscopy, to assess the movement and function of the vocal cords. Treatment options may include voice therapy, surgical procedures, or other interventions to improve voice quality and breathing functions.

Electrocoagulation is a medical procedure that uses heat generated from an electrical current to cause coagulation (clotting) of tissue. This procedure is often used to treat a variety of medical conditions, such as:

* Gastrointestinal bleeding: Electrocoagulation can be used to control bleeding in the stomach or intestines by applying an electrical current to the affected blood vessels, causing them to shrink and clot.
* Skin lesions: Electrocoagulation can be used to remove benign or malignant skin lesions, such as warts, moles, or skin tags, by applying an electrical current to the growth, which causes it to dehydrate and eventually fall off.
* Vascular malformations: Electrocoagulation can be used to treat vascular malformations (abnormal blood vessels) by applying an electrical current to the affected area, causing the abnormal vessels to shrink and clot.

The procedure is typically performed using a specialized device that delivers an electrical current through a needle or probe. The intensity and duration of the electrical current can be adjusted to achieve the desired effect. Electrocoagulation may be used alone or in combination with other treatments, such as surgery or medication.

It's important to note that electrocoagulation is not without risks, including burns, infection, and scarring. It should only be performed by a qualified medical professional who has experience with the procedure.

Mesothelioma is a rare and aggressive form of cancer that develops in the mesothelial cells, which are the thin layers of tissue that cover many of the internal organs. The most common site for mesothelioma to occur is in the pleura, the membrane that surrounds the lungs. This type is called pleural mesothelioma. Other types include peritoneal mesothelioma (which occurs in the lining of the abdominal cavity) and pericardial mesothelioma (which occurs in the lining around the heart).

Mesothelioma is almost always caused by exposure to asbestos, a group of naturally occurring minerals that were widely used in construction, insulation, and other industries because of their heat resistance and insulating properties. When asbestos fibers are inhaled or ingested, they can become lodged in the mesothelium, leading to inflammation, scarring, and eventually cancerous changes in the cells.

The symptoms of mesothelioma can take many years to develop after exposure to asbestos, and they may include chest pain, coughing, shortness of breath, fatigue, and weight loss. Treatment options for mesothelioma depend on the stage and location of the cancer, but may include surgery, radiation therapy, chemotherapy, or a combination of these approaches. Unfortunately, the prognosis for mesothelioma is often poor, with a median survival time of around 12-18 months after diagnosis.

Carbamazepine is an anticonvulsant medication that is primarily used to treat seizure disorders (epilepsy) and neuropathic pain. It works by decreasing the abnormal electrical activity in the brain, which helps to reduce the frequency and severity of seizures. Carbamazepine may also be used off-label for other conditions such as bipolar disorder and trigeminal neuralgia.

The medication is available in various forms, including tablets, extended-release tablets, chewable tablets, and suspension. It is usually taken two to four times a day with food to reduce stomach upset. Common side effects of carbamazepine include dizziness, drowsiness, headache, nausea, vomiting, and unsteady gait.

It is important to note that carbamazepine can interact with other medications, including some antidepressants, antipsychotics, and birth control pills, so it is essential to inform your healthcare provider of all the medications you are taking before starting carbamazepine. Additionally, carbamazepine levels in the blood may need to be monitored regularly to ensure that the medication is working effectively and not causing toxicity.

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which is one of the largest nerves in the head. It carries sensations from the face to the brain.

Medically, trigeminal neuralgia is defined as a neuropathic disorder characterized by episodes of intense, stabbing, electric shock-like pain in the areas of the face supplied by the trigeminal nerve (the ophthalmic, maxillary, and mandibular divisions). The pain can be triggered by simple activities such as talking, eating, brushing teeth, or even touching the face lightly.

The condition is more common in women over 50, but it can occur at any age and in either gender. While the exact cause of trigeminal neuralgia is not always known, it can sometimes be related to pressure on the trigeminal nerve from a nearby blood vessel or other causes such as multiple sclerosis. Treatment typically involves medications, surgery, or a combination of both.

Tonic-clonic epilepsy, also known as grand mal epilepsy, is a type of generalized seizure that affects the entire brain. This type of epilepsy is characterized by two distinct phases: the tonic phase and the clonic phase.

During the tonic phase, which usually lasts for about 10-20 seconds, the person loses consciousness and their muscles stiffen, causing them to fall to the ground. This can result in injuries if the person falls unexpectedly or hits an object on the way down.

The clonic phase follows immediately after the tonic phase and is characterized by rhythmic jerking movements of the limbs, face, and neck. These movements are caused by alternating contractions and relaxations of the muscles and can last for several minutes. The person may also lose bladder or bowel control during this phase.

After the seizure, the person may feel tired, confused, and disoriented. They may also have a headache, sore muscles, and difficulty remembering what happened during the seizure.

Tonic-clonic epilepsy can be caused by a variety of factors, including genetics, brain injury, infection, or stroke. It is typically diagnosed through a combination of medical history, physical examination, and diagnostic tests such as an electroencephalogram (EEG) or imaging studies. Treatment may include medication, surgery, or dietary changes, depending on the underlying cause and severity of the seizures.

A seizure is an uncontrolled, abnormal firing of neurons (brain cells) that can cause various symptoms such as convulsions, loss of consciousness, altered awareness, or changes in behavior. Seizures can be caused by a variety of factors including epilepsy, brain injury, infection, toxic substances, or genetic disorders. They can also occur without any identifiable cause, known as idiopathic seizures. Seizures are a medical emergency and require immediate attention.

Anticonvulsants are a class of drugs used primarily to treat seizure disorders, also known as epilepsy. These medications work by reducing the abnormal electrical activity in the brain that leads to seizures. In addition to their use in treating epilepsy, anticonvulsants are sometimes also prescribed for other conditions, such as neuropathic pain, bipolar disorder, and migraine headaches.

Anticonvulsants can work in different ways to reduce seizure activity. Some medications, such as phenytoin and carbamazepine, work by blocking sodium channels in the brain, which helps to stabilize nerve cell membranes and prevent excessive electrical activity. Other medications, such as valproic acid and gabapentin, increase the levels of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which has a calming effect on nerve cells and helps to reduce seizure activity.

While anticonvulsants are generally effective at reducing seizure frequency and severity, they can also have side effects, such as dizziness, drowsiness, and gastrointestinal symptoms. In some cases, these side effects may be managed by adjusting the dosage or switching to a different medication. It is important for individuals taking anticonvulsants to work closely with their healthcare provider to monitor their response to the medication and make any necessary adjustments.

Generalized epilepsy is a type of epilepsy characterized by seizures that involve both halves of the brain (generalized onset) from the beginning of the seizure. These types of seizures include tonic-clonic (grand mal) seizures, absence (petit mal) seizures, and myoclonic seizures. Generalized epilepsy can be caused by genetic factors or brain abnormalities, and it is typically treated with medication. People with generalized epilepsy may experience difficulties with learning, memory, and behavior, and they may have a higher risk of injury during a seizure. It's important for individuals with generalized epilepsy to work closely with their healthcare team to manage their condition and reduce the frequency and severity of seizures.

Epilepsy, partial is a type of epilepsy characterized by recurrent, unprovoked seizures that originate in a specific, localized area of the brain. These seizures are also known as focal seizures and can vary in severity and symptoms depending on the location of the abnormal electrical activity in the brain.

Partial epilepsies can be further classified into two main categories: simple partial seizures and complex partial seizures. Simple partial seizures do not involve a loss of consciousness, while complex partial seizures are associated with impaired awareness or responsiveness during the seizure.

The causes of partial epilepsies can include brain injury, infection, stroke, tumors, genetic factors, or an unknown cause. Treatment typically involves anti-seizure medications, and in some cases, surgery may be recommended to remove the specific area of the brain responsible for the seizures.

  • These include dysesthesia (abnormal sensation), urinary retention and (for bilateral cervical cordotomy) apnea during sleep (acquired central hypoventilation syndrome) caused by inadvertent division of the reticulospinal tracts. (
  • Tranmer B, Tucker W, Bilbao J. Sleep apnea following percutaneous cervical cordotomy. (
  • However, it is still sometimes used where percutaneous cordotomy is unfeasible, especially in children or other patients who are unable to co-operate. (
  • These procedures include cordotomy, ganglionotomy, rhizotomy and neurotomy. (
  • In extreme cases, surgeons may have to sever pain pathways by altering areas of the brain associated with pain perception -- or performing a rhizotomy (which destroys portions of peripheral nerves) or a chordotomy (destroys ascending tracts in the spinal cord). (
  • Anterolateral cordotomy is effective for relieving unilateral, somatic pain while bilateral cordotomies may be required for visceral or bilateral pain. (
  • Anterolateral cordotomy]. (
  • Cordotomy is performed as for patients with severe intractable pain, usually but not always due to cancer. (
  • The authors present a review of 146 patients who underwent 181 percutaneous cervical cordotomies for intractable pain. (
  • Cordotomy (or chordotomy) is a surgical procedure that disables selected pain-conducting tracts in the spinal cord, in order to achieve loss of pain and temperature perception. (
  • In open cordotomy, a thoracic approach is normally used so that the spinal cord tracts controlling the breathing muscles are not put at risk. (
  • A number of studies in the 1970s and 1980s reported that neurosurgical procedures, such as cordotomy and selective posterior radiculotomy, provided good to excellent relief from Pancoast tumor pain. (
  • Cordotomy is especially indicated for pain due to asbestos-related cancers such as pleural and peritoneal mesothelioma. (
  • Being irreversible and relatively invasive, cordotomy is used exclusively for pain where treatment to level 3 of the World Health Organization pain ladder (i.e., use of major opiates such as morphine) has proved inadequate. (
  • Cordotomy can be highly effective in relieving pain, but there are significant side effects. (
  • Whereas some cordotomies, both in the current series and as reported in the literature, may affect these functions differentially, optimum pain relief seems to be obtained only when pinprick sensation is also abolished in the affected segments. (
  • Evoked pain sensation is not abolished by cordotomy, but its threshold is greatly raised. (
  • Endoscopic laser posterior cordotomy is performed in patients with bilateral vocal fold paralysis in adduction. (
  • Laser posterior cordotomy is a minimal invasive procedure done for the bilateral vocal fold paralysis in midline position. (
  • Some authors recommend endoscopic carbon dioxide laser posterior cordotomy without tracheotomy, believing that the minimal postoperative edema does not compromise respiration. (
  • 33. [Therapeutic effects of endoscopic posterior cordotomy for bilateral vocal cord paralysis]. (
  • 38. Voice Outcomes Following Posterior Cordotomy With Medial Arytenoidectomy in Patients With Bilateral Vocal Fold Immobility. (
  • Comprehensive solutions for voice problems, thyroplasty and microlaryngeal surgeries airway reconstruction procedures includes Kashima's laser cordotomy, arytenoidectomy, anterior cricoid split and tracheal reconstruction and anastomoses, and endoscopic removal of benign tumours of larynx and trachea. (
  • Cordotomy (or chordotomy) is a surgical procedure that disables selected pain-conducting tracts in the spinal cord, in order to achieve loss of pain and temperature perception. (
  • [ 7 ] Several techniques exist for performing cordotomy, including open surgical exposure and mechanical lesioning of the spinothalamic tract, and percutaneous radiofrequency techniques with use of fluoroscopy or CT. (
  • In this study the authors investigated the surgical outcomes of cordotomy in patients with thoracic malignant astrocytomas to determine the effectiveness of this procedure. (
  • [ 5 , 8 ] We present 2 cases that highlight the continuing challenges of patient selection and timing of the cordotomy procedure. (
  • Cordotomy is considered as a minimal invasive procedure because functional results as swallowing and voice quality are good. (
  • 32. Outcomes Following Cordotomy by Coblation for Bilateral Vocal Fold Immobility. (
  • Diagram showing cordotomy incision (blue dotted line) on the posterior part of right vocal cord. (
  • In open cordotomy, a thoracic approach is normally used so that the spinal cord tracts controlling the breathing muscles are not put at risk. (
  • One-stage cordotomy should be indicated for patients with thoracic GBM or AA presenting with complete paraplegia preoperatively. (
  • In patients with thoracic GBM, even if paralysis is incomplete, cordotomy should be performed before the tumor disseminates through the CSF. (
  • Anterolateral cordotomy is effective for relieving unilateral, somatic pain while bilateral cordotomies may be required for visceral or bilateral pain. (
  • Two patients underwent percutaneous CT-guided cordotomy for refractory cancer-related pain: one patient had melanoma and the other had ovarian carcinoma. (
  • [ 5 ] In 1999, Friedman et al described the application of the cordotomy in children from 14 months to 13 years old. (
  • Being irreversible and relatively invasive, cordotomy is used exclusively for pain where treatment to level 3 of the World Health Organization pain ladder (i.e., use of major opiates such as morphine) has proved inadequate. (
  • This review forms part of the Invasive Neurodestructive Procedures in Cancer Pain pilot study: The role of cordotomy in mesothelioma-related pain in the UK. (
  • In an attempt to consolidate all available evidence, the Invasive Neurodestructive Procedures in Cancer Pain (INPiC) pilot study was designed to focus on the use of cordotomy in mesothelioma-related pain (Makin, unpublished data, 2012). (
  • There is a clear need for prospective controlled studies to evaluate the effectiveness of cordotomy for patients receiving optimal medical treatment. (
  • Aim/design We report on the results of the first comprehensive systematic review of the use of cordotomy in mesothelioma-related pain, with specific reference to effectiveness in relieving pain and safety. (
  • This article reports on the results of the first comprehensive systematic literature review, with specific reference to safety and effectiveness of cordotomy in mesothelioma-related pain. (
  • Cordotomy involves creating a lesion of the lateral spinothalamic tract, which is located in the anterolateral quadrant of the spinal cord. (
  • In the 2 patients with AA, the initial treatment consisted of partial tumor resection and subtotal resection combined with radiotherapy, and rostral tumor growth and progressive paralysis necessitated cordotomy 2 and 28 months later. (
  • Most cordotomies are now performed percutaneously with fluoroscopic or CT guidance while the patient is awake under local anesthesia. (
  • Open cordotomy, which requires a laminectomy (removal of part of one or more vertebrae), takes place under general anaesthetic and has a longer recovery time and a higher risk of side-effects including permanent weakness. (
  • The goal of cordotomy is to achieve diminished pinprick sensation in the painful region of the body. (
  • Cordotomy was performed in 5 patients with glioblastoma multiforme (GBM) and 2 with anaplastic astrocytoma (AA). (
  • Cordotomy was performed in a single stage in 2 patients with GBM and in 2 stages in 3 patients with GBM and 2 patients with AA. (
  • In the 2 patients with GBM, cordotomy was performed 2 and 3 weeks after a partial tumor resection. (
  • Cordotomy is quite easy to perform, and the technique is quickly acquired. (
  • A national registry for cordotomy would be a valuable first step in this process. (
  • There seems to be little published evidence to support continued provision and commissioning of cordotomy, a fact that is supported by the findings of Raslan et al 5 who concluded that 'evidence needs to meet the current evidence-based standards through clinical trials. (
  • After almost 6 years of wait, Chordotomy are back to crush with their new, highly anticipated album, Subjugated Into Obedience. (
  • noun surgery Alternative spelling of cordotomy . (
  • Although it seems to suggest that cordotomy might be safe and effective in this setting, more reliable evidence is needed to aid decision making on continued provision. (
  • Percutaneous CT-guided cordotomy at C1-2 is currently the standard technique used. (
  • Help support Wordnik (and make this page ad-free) by adopting the word chordotomy . (

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