Long-term Experience with Occipital and Supraorbital Nerve Stimulation for the Various Headache Disorders – a Retrospective Institutional Case Series of 96 Patients

Abstract Background: The management of patients with fecal incontinence and an external anal sphincter (EAS) defect remains controversial.Methods: We present a retrospective series of overlapping anal sphincteroplasties performed between 1985-2013 by a single surgeon supplemented by selective puborectalis plication and internal anal sphincter repair. Patients were clinically followed along with anorectal manometry, continence scoring (Cleveland Clinic Incontinence Score - CCS) and patient satisfaction scales. Patients with a suboptimal outcome were managed with combinations of biofeedback therapy, (BFT) peripheral tibial nerve stimulation (PTNS), sacral nerve stimulation (SNS) or repeat sphincteroplasty.Results: There were 120 anterior sphincter repairs with 90 (75%) levatorplasties and 84 (70%) IAS repairs. Over a median follow-up of 120 months (range 60-173.7 months) there were significant improvements in the recorded CCIS values (90.8% with a preoperative CCIS > 15 vs. 2.5% postoperatively; P < 0.001). There were 42 patients who required ancillary treatment with 4 repeat sphincteroplasties, 35 patients undergoing biofeedback therapy, 10 patients treated with PTNS and 3 managed with SNS implants with an ultimate good functional outcome in 92.9% of cases. No difference was noted in ultimate functional outcome between those treated with sphincteroplasty alone compared with those who needed ancillary treatments (97.1% vs. 85.7%, respectively). Overall, 93.3% considered the outcome as either good or excellent.Conclusions: Long-term functional outcomes of an overlapping sphincteroplasty are good. If the initial outcome is suboptimal, response to ancillary treatments remains good and patients are not compromised by a first-up uncomplicated sphincter repair.

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Vagus Nerve Stimulation in Treatment-Resistant Depression: Long-term Clinical Outcomes

10.14293/s2199-1006.1.sor-.ppwjmqy.v1 ◽

2021 ◽

Author(s):

Stella Rosson ◽

Nicola Bresolin ◽

Domenico d’Avella ◽

Luca Denaro ◽

Alessandro Landi ◽

...

Keyword(s):

Vagus Nerve ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation ◽

Case Series ◽

University Hospital ◽

Psychiatric Disease ◽

Treatment Resistant Depression ◽

Treatment Resistant ◽

Resistant Depression

I ntroduction Vagus nerve stimulation (VNS) is a neuromodulation technique approved for Treatment-Resistant Depression (TRD).Evidence regarding its long-term efficacy and safety is still scarce. Objectives To descriptively report a case series of 3 patients undergoing adjunctive VNS for TRD with an over 10-year follow-up. Methods We investigated outcomes of clinical interest in patients with ongoing VNS for at least 10 years after the device implantation. They had participated in a larger single-arm interventional study conducted at the University Hospital of Padua. They were diagnosed with chronic unipolar (1), recurrent unipolar (1), and bipolar (1) TRD. Results Our 3 cases had an average 14-year history of psychiatric disease before surgery. Afterward, all subjects achieved clinical remission within two years. 2 patients experienced relapses within the first 4 years of treatment (respectively, 1 and 2 episodes). The other case showed a recurrent trend of brief relapses every two years. Only 1 individual needed to be admitted to the psychiatric unit once. None of them committed suicidal attempts. Prescription of antidepressants remained almost unchanged after the first two years. 2 individuals improved and 1 maintained their working position. Common adverse events were voice alteration (3/3), neck pain (2/3), and cough (2/3). Conclusions Very few cases of 10-year VNS for TRD have been reported so far. For our subjects, VNS was most likely to have a major impact on the clinical course of the disease. This treatment can be a safe and effective adjunctive intervention in a subgroup of patients with TRD.

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LONG TERM EXPERIENCE WITH BOSENTAN IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION (PAH) ASSOCIATED WITH ADVANCED IDIOPATHIC PULMONARY FIBROSIS (IPF) AND INTERSTITIAL LUNG DISEASE (ILD): A RETROSPECTIVE CASE SERIES

CHEST Journal ◽

10.1378/chest.128.4_meetingabstracts.218s-b ◽

2005 ◽

Vol 128 (4) ◽

pp. 218S ◽

Cited By ~ 1

Author(s):

Ganesh Raghu ◽

Jennifer Hayes ◽

Carolyn Spada ◽

Jeffrey Moniz ◽

Steve Yang

Keyword(s):

Pulmonary Arterial Hypertension ◽

Interstitial Lung Disease ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Arterial Hypertension ◽

Case Series ◽

Retrospective Case ◽

Pulmonary Arterial ◽

Long Term Experience

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Nociception specific supraorbital nerve stimulation may prevent cluster headache attacks: Serendipity in a blink reflex study

Cephalalgia ◽

10.1177/0333102414526055 ◽

2014 ◽

Vol 34 (11) ◽

pp. 920-926 ◽

Cited By ~ 5

Author(s):

Danielle YP Haane ◽

Peter J Koehler

Keyword(s):

Cluster Headache ◽

Nerve Stimulation ◽

Case Series ◽

Blink Reflex ◽

Chronic Cluster Headache ◽

Prophylactic Effect ◽

Supraorbital Nerve ◽

Non Invasive ◽

Transcutaneous Stimulation ◽

Stimulation Of

Background In cluster headache, neuromodulation is offered when patients are refractory to pharmacological prophylaxis. Non-invasive peripheral neuromodulatory approaches are of interest. We will focus on these and particularly on nociception specific, transcutaneous supraorbital nerve stimulation. Methods In a study using the nociception specific blink reflex, we made a serendipitous discovery, notably the potential prophylactic effect of bilateral, time contingent, nociception specific, transcutaneous stimulation of the supraorbital nerve. Results We report on a case series of seven cluster headache patients, in whom attacks seemed to disappear during repeated stimulation of the supraorbital nerves. Three patients stopped experiencing attacks since study participation. Conclusions Bilateral, time contingent, nociception specific, transcutaneous supraorbital nerve stimulation may have a prophylactic effect in episodic and chronic cluster headache. Given its limited side effects and its non-invasive nature, further studies to investigate this potential peripheral neuromodulatory approach for both episodic and chronic cluster headache are warranted.

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Peripheral Nerve Stimulator for the Treatment of Supraorbital Neuralgia: A Retrospective Case Series

Cephalalgia ◽

10.1111/j.1468-2982.2008.01535.x ◽

2008 ◽

Vol 28 (4) ◽

pp. 355-359 ◽

Cited By ~ 51

Author(s):

S Amin ◽

A Buvanendran ◽

K-S Park ◽

JS Kroin ◽

M Moric

Keyword(s):

Peripheral Nerve ◽

Nerve Stimulation ◽

Case Series ◽

Opioid Consumption ◽

Pain Clinic ◽

Retrospective Case ◽

Nerve Blocks ◽

Peripheral Nerve Stimulator ◽

Supraorbital Nerve ◽

Supraorbital Neuralgia

Peripheral nerve blocks of the supraorbital, supratrochlear or occipital nerve have been utilized for the relief of headaches, although relief may be short-lasting. The purpose of this study was to evaluate the efficacy of supraorbital nerve stimulation for treatment of intractable supraorbital neuralgia. Patients presenting to the pain clinic with refractory frontal headaches who responded to a diagnostic supraorbital nerve block were selected for this case series. Patients underwent a trial of supraorbital nerve stimulation, and efficacy was assessed after 5-7 days ( n = 16). From the trial, 10 patients consented to undergo permanent implantation of the stimulator. Opioid consumption and headache scores were monitored preoperatively and at timed intervals for 30 weeks. Headache scores decreased, and opioid consumption was reduced in half, and these beneficial accomplishments were maintained up to 30 weeks after implantation. In selected patients, supraorbital nerve stimulation for the treatment of chronic frontal headaches appears to be efficacious.

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