Biomedical subjects
Publications and source records attributed to G Dieckmann.
The authors describe a compact computed calculator system which allows a fast and secure destination of the target point during stereotaxic operations.
In 7 patients with medial thalamic electrodes implanted for relief of chronic pain, clinical observations and electrophysiological recordings showed: (1) Clinically, paresthesia in the pain area and contralateral half of the body was reported as well as some unpleasant side effects. The EEG was not changed during medial thalamic stimulation. (2) Threshold for non-painful and painful perception of electrical stimuli were not significantly raised by contralateral medial thalamic stimulation. (3) After electrical median nerve stimulation, evoked thalamic potentials started after 17 msec. With ipsilateral stimulation the early components (up to 40 msec) showed longer latencies and the late components slightly shorter latencies as compared to the contralateral stimulation. (4) Median nerve evoked cortical SSEPs are not significantly changed either by a 500 msec lasting conditioning stimulation of the dorsal columns or by such stimulation of the medial thalamic structures. A facilitation at about 90 msec was found in the cortical SSEP after medial thalamic conditioning in only one of three patients tested. (5) Visual and auditory evoked potentials can be recorded in the medial thalamus as well.
2 or 3 years follow-up of 13 hypothalamotomy patients with alcohol and drug addiction reveals that the addicted patients regained their self-control, the severe preoperative social deterioration was removed, and the tendency to social stabilisation was clearly in evidence.
The indications for central stereotactic procedures in chronic painful states are essential neuralgia, postherpetic neuralgia, anaesthesia dolorosa, causalgia, phantom-limb pain, the thalamic syndrome and pain neoplastic diseases. Stereotactic surgery applied for these conditions consists of nucleotomy of the tractus spinalis nervi trigemini, mesencephalotomy, thalamotomy, hypophysectomy, psychosurgical interventions, and chronic stimulation with implanted electrodes. The techniques and results of the interventions are reported.
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In 13 patients with torticollis, the electromyographic (EMG) activity in the neck muscles at rest was investigated before, during and after stimulation of the H1 bundle (in horizontal torticollis) and inner part of oral ventral nucleus (in the rotatory form), as well as after coagulation. Three EMG types of torticollis-spasmodic, myoclonic and mixed - could be differentiated. During the 8-, 25- and 50-Hz stimulations, a diminution in the amplitude and frequency of muscle potentials, followed by electric silence, was most often obtained; in general, the electric silence was preceded by a rhythmic activity of grouped potentials. Following coagulation, no spontaneous EMG activity was any longer recorded in the neck muscles, in the majority of the cases.
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