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Biomedical subjects

R R Richardson

Publications and source records attributed to R R Richardson.

At least 37 records · Page 2Linked to original sources
PubMed1980

Transabdominal neurostimulation in treatment of neurogenic ileus.

Transabdominal neurostimulation (TANS) is an innovative concept used in the treatment of neurogenic ileus, which frequently follows chronic spinal cord or neurological lesions. It was used in the treatment of neurogenic ileus in 21 patients at Northwestern Memorial Hospital with rapid resolution of the ileus, elimination of nasogastric tubes, and institution of oral feedings soon after application. Major advantages in using TANS are effective resolution of ileus, ease of application, and lack of major gastrointestinal complications, especially those produced by nasogastric tubes.

Adult↗
PubMed1980

Cysticercosis cerebri occluding the foramen of Monro.

Cysticercosis cerebri is a rare neurological diagnosis, which is usually made at the time of operation or at autopsy. Few cases have been reported in North America, and these were usually found in immigrants and in domestic travelers who lived in infested countries. Cysticercosis cerebri is classically divided into four general types: 1) intraparenchymal, 2) basilar cisternal, 3) ventricular, and 4) diffuse cerebral. We are presenting a unique case of solitary ventricular cysticercosis occluding the foramen of Monro, and producing an asymmetrical obstructive hydrocephalus.

Brain Diseases↗
PubMed1979

Histological reaction to percutaneous epidural neurostimulation: initial and long-term results.

Percutaneously inserted spinal epidural neurostimulation has been derived as a simplified safe alternative to surgically implanted, dorsal column stimulation that is used in the effective treatment and control of spasticity and intractable pain. Twenty-seven tissue specimens from fifteen patients having had percutaneous epidural neurostimulation systems implanted were studied with the aid of light microscopy. The biopsies from tissues around the cables, around the receivers, and at the actual site of epidural stimulation (at the metallic contact), were studied at time intervals varying from one week to two years postimplantation. Long-term results, which only show dense fibrous encapsulation of the cables and the receiver, substantiate clinical belief regarding the "histological safety" of this electronic modality.

Electric Stimulation Therapy↗
PubMed1979

Percutaneous epidural neurostimulation in modulation of paraplegic spasticity. Six case reports.

Six cases of paraplegic, post-traumatic spasticity, alleviated by percutaneous epidural neurostimulation with temporary or permanent implanted neuroelectrodes from the L1 to L4 intervertebral levels are presented. Modulation of this spasticity and secondary beneficial physiological effects were achieved, including regulation of bowel regimens, production of sweating and piloerection below the level of the lesion, and morning erections. The main advantages of percutaneous epidural neurostimulation in modulating spasticity are the avoidance of destructive neurosurgical procedures, the regulation of secondary physiological and autonomic responses, the avoidance of antispasticity medications, and the reversibility of the neurostimulation procedure.

Adolescent↗
PubMed1979

Neurogenic tumors of the brachial plexus: report of two cases.

Two cases of solitary neurogenic tumors of the brachial plexus unassociated with von Recklinghausen's disease are presented. One patient had a malignant schwannoma. The lesion of the other patient was benign and was diagnosed pathologically as a plexiform neurofibroma. These uncommon neurogenic tumors of the brachial plexus unassociated with von Recklinghausen's disease pose diagnostic and surgical problems. The initial clinical presentation is usually that of a painless supraclavicular mass. At the time of surgical exploration, the exact site or nerve of origin cannot always be identified. If motor loss is caused by such a tumor of the brachial plexus, it usually indicates a malignant lesion and a poor prognosis. Although wide radical excision of a malignant neurogenic tumor is indicated surgically, one of our patients had an early malignant recurrence that necessitated immediate amputation.

Adult↗
PubMed1979

Autonomic hyper-reflexia modulated by percutaneous epidural neurostimulation: a preliminary report.

Our clinical experience in the management of five paraplegic or quadriplegic patients with subjective complaints and objective findings of autonomic hyper-reflexia is presented. These five patients had epidural neurostimulation systems implanted percutaneously to regulate intractable spasticity. During a follow-up period varying from 2 months to almost 2 years, four of the five patients experienced no episodes of autonomic dysfunction with the use of a low frequency, low voltage, square wave pulse output. From their responses and from recent neurophysiological evidence, the potential benefit of percutaneous epidural neurostimulation in the modulation of autonomic hyper-reflexia without antihypertensive medication is suggested. Further follow-up of these patients and additional clinical research should be performed to confirm our initial clinical impressions.

Adolescent↗
PubMed1979

Spinal epidural neurostimulation for treatment of acute and chronic intractable pain: initial and long term results.

Spinal epidural neurostimulation, which evolved from dorsal column stimulation, has been found to be effective in the treatment of acute and chronic intractable pain. Urban and Hashold have shown that it is a safe, simplified alternative to dorsal column stimulation, especially because laminectomy is not required if the electrodes are inserted percutaneously. Percutaneous epidural neurostimulation is also advantageous because there can be a diagnostic trial period before permanent internalization and implantation. This diagnostic and therapeutic modality has been used in 36 patients during the past 3 years at Northwestern Memorial Hospital. Eleven of these patients had acute intractable pain, which was defined as pain of less than 1 year in duration. Initial postimplantation results from the 36 patients indicate that spinal epidural neurostimulation is most effective in treating the intractable pain of diabetes, arachnoiditis, and post-traumatic and postamputation neuroma. Long term follow-up, varying from 1 year to 3 years postimplantation in the 20 initially responding patients, indicates that the neurostimulation continues to provide significant pain relief (50% or greater) in a majority of the patients who experienced initial significant pain relief.

Acute Disease↗
PubMed1979

Spinal epidural cavernous hemangioma.

A case of spinal extradural venous hemangioma is presented. Its initial manifestation simulated a herniated intervertebral cervical disc. The probable precipitating mechanism of its presentation in producing radicular pain and its successful surgical extirpation are discussed.

Adult↗
PubMed1978

Intraneural hematoma of the sciatic nerve. Case report.

A case of an encapsulated organizing hematoma of the sciatic nerve is reported. Hemorrhage-induced neuropathy as a complication of anticoagulant therapy, leukemia, hemophilia, and other bleeding diatheses has been frequently reported. While trauma is the most common etiology of a hemorrhagic neuropathy, actual hematoma formation beneath the epineurium is very rare.

Hematoma↗
PubMed1978

Percutaneous epidural neurostimulation for paraplegic spasticity.

A case of post-paraplegic, post-traumatic spasticity, alleviated by percutaneous epidural neurostimulation from implanted electrodes at the L1 and L3 intervertebral levels, is presented. Secondary beneficial physiological effects and controls of involuntary activity that were achieved were regulation of a bowel regime, production of sweating below the level of the lesion, increased piloerections, and morning penile erections. Electrical modulation of the involuntary motor and autonomic activities below a complete spinal cord injury is discussed. The main advantages of such treatment in modulating spasticity are the avoidance of all other destructive neurosurgical procedures and the regulation of secondary physiological, autonomic responses. Long-term follow-up and additional therapeutic proofs are necessary to substantiate this preliminary report.

Adult↗
PubMedDate not supplied

Transabdominal neurostimulation in acute spinal cord injuries.

Transabdominal neurostimulation (TANS) is a new term and concept used in the prevention and treatment of adynamic or paralytic ileus. Though it may occur for other reasons, ileus is a frequent and common complication of acute spinal cord injuries. The calculated incidence of ileus in this study of 43 control acute spinal-injured patients at Northwestern University was 15%. Of 44 patients on whom the TANS procedure was used, none developed paralytic ileus. The primary advantages observed from the use of TANS were the following: the ease of application, the lack of major complications, and the prevention of ileus.

Electric Stimulation Therapy↗
PubMedDate not supplied

Transcutaneous electrical neurostimulation in musculoskeletal pain of acute spinal cord injuries.

Cervical, thoracic, thoracolumbar, and lumbar fractures associated with physiologic complete or incomplete spinal cord injuries frequently have severe soft-tissue injury as well as severe pain associated with the site or area of injury. Transcutaneous electrical neurostimulation has proved effective in the treatment of various causes of severe acute and chronic intractable pains. We applied this modality to a group of 20 patients who had acute spinal cord injuries and pain associated with severe, extensive soft-tissue injury. Its advantages include ease of application, lack of major complications, increased intestinal peristalsis, and avoidance of narcotic analgesic medications. It also produced significant (greater than 50%) pain relief in 75% of patients treated by transcutaneous electrical neurostimulation.

Electric Stimulation Therapy↗
PubMedDate not supplied

Transcutaneous electrical neurostimulation in postlaminectomy pain.

Transcutaneous electrical neurostimulation (TENS) has been shown to be very effective in providing acute postoperative and delivery pain relief. We specifically applied this modality ot Northwestern Memorial Hospital using constant postoperative neurostimulation to patients who had had cervical or lumbar laminectomies for a variety of reasons, but mainly for herniated intervertebral discs and osteoarthritic spurs. The results in both groups were compatible with earlier findings by Hymes and co-workers, who reported decreased narcotic intake, decreased pain behavior or subjective complaints, and increased physical recovery. Patients who responded to TENS showed an average 50% decrease in dosage of narcotic analgesics, expressed fewer complaints of pain, and appeared to show more rapid postoperative physical recovery than the patients who were not treated with TENS. Seventy-nine percent of the lumbar laminectomy group and 87.5% of the cervical laminectomy group showed 50% or greater relief of acute, severe postlaminectomy pain. Other advantages of using TENS included ease of application and lack of major complaints.

Electric Stimulation Therapy↗
PubMedDate not supplied

Transcutaneous electrical neurostimulation in functional pain.

Transcutaneous electrical neurostimulation (TENS) has recently emerged as a distinct therapeutic modality in the alleviation of acute and chronic pain. We applied this modality to 15 nonsurgical low-back pain patients having diagnoses of functional pain, with 40% initially having significant pain relief (50% of greater). However, this pain-alleviating effect of TENS did not last longer than two months. After initiation of neurostimulation, increased pain and/or bizarre and inappropriate sensations and behavior frequently developed. We also applied this modality in the diagnostic evaluation and treatment of 24 patients having diagnoses of postsurgical chronic intractable low-back pain of psychosomatic origin and achieved similar results. In both groups, we utilized a simplified poststimulation "normal-saline-sterile-water intramuscular injection test" to confirm the findings from transcutaneous electrical neurostimulation and to verify the functional basis of the present low-back pain.

Adult↗