S E Emmonds | PubMed Health

PubMed1992

Spinal cord stimulation for multiple sclerosis: quantifiable benefits.

From 1984 to 1991, a quantitative study of 5 multiple sclerosis (MS) patients has been determining benefits from epidural (C7-T1 level) spinal cord stimulation (SCS). The 5 patients (4 male, 1 female; 4 tetraparetics, 1 hemiparetic) were 36-45 years of age having had symptoms for 12-22 years. Five quantitative tests were given prior to and during SCS on 4-8 occasions; 'off' periods were planned and also did occur when the electrode(s) broke (3 patients). With SCS, hand dynamometry showed a 2- to 4-fold increase in the 3 patients with weak hand function. Jebson Hand Time Testing showed a rapidity improvement to 1/2-1/7 of time in the same 3 patients. Minnesota Manipulation Testing with SCS was improved to 1/3-1/2 of time in 2 of these 3 patients tested. Manual muscle strength increased in all patients by 20-50% in 'normal range'. Ambulation in the parallel bars increased with SCS in 2 of the 4 wheelchair patients, while the hemiparetic patient could walk without his cane. All patients showed varying quantifiable improvements with SCS, but over the duration of testing the patients slowly deteriorated. SCS is a rehabilitation option for the weakened MS patient, to be used earlier rather than later in the deterioration of MS patients.

Adult↗

PubMed1992

Cerebellar stimulation for seizure control: 17-year study.

Since 1974, 32 seizure patients have undergone chronic cerebellar stimulation (CCS); 27 have been contacted with 9 (7 spastic, 2 epileptic) continuing to use CCS for an average of 14.3 years (10-17 years). 6 (67%) are seizure-free and 3 (33%) have a reduction of seizure frequency. In the last 2 years, 2 other patients with spastic seizures, who were using CCS for 13 years, died of respiratory illness; 1 had been seizure-free and the other had a reduction. Of the remaining 16 patients (12 spastic, 4 epileptic) who did use CCS for an average of 8.3 years (2-14 years) and now have nonfunctioning stimulators, 5 (31%) continue to be seizure-free, 7 (44%) have a reduction and 4 (25%) have no change or a slight increase. Overall, 23 (85%) patients have benefitted from CCS. Stimulation charge densities were 0.9-2.5 microC/cm2/phase delivered at 10-180 pulses/sec to bilateral electrode pads on the superomedial cerebellar cortex. CCS is relatively safe and nonablative, and could be offered for patients with intractable seizures originating from bilateral or extratemporal foci.

Cerebellar Cortex↗