scholarly journals Unilateral Dorsal Root Ganglion Stimulation Lead Placement With Resolution of Bilateral Lower Extremity Symptoms in Diabetic Peripheral Neuropathy

Cureus ◽  
2020 ◽  
Author(s):  
Kenneth B Chapman ◽  
Bert-Kristian W Van Roosendaal ◽  
Noud Van Helmond ◽  
Tariq A Yousef
Keyword(s):  
Peripheral Neuropathy ◽  
Dorsal Root Ganglion ◽  
Lower Extremity ◽  
Diabetic Peripheral Neuropathy ◽  
Dorsal Root ◽  
Bilateral Lower Extremity ◽  
Lead Placement

scholarly journals WenTong HuoXue Cream Can Inhibit the Reduction of the Pain-Related Molecule PLC-β3 in the Dorsal Root Ganglion of a Rat Model of Diabetic Peripheral Neuropathy

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Chengcheng Feng ◽  
Lijuan Xu ◽  
Shiyun Guo ◽  
Qian Chen ◽  
Yuguo Shen ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Sciatic Nerve ◽  
Dorsal Root Ganglion ◽  
Nerve Conduction ◽  
Diabetic Peripheral Neuropathy ◽  
Dorsal Root ◽  
Nerve Conduction Velocity ◽  
Model Group ◽  
Related Molecule ◽  
Metformin Group

WenTong HuoXue Cream (WTHX-Cream) has been shown to effectively alleviate clinical symptoms of diabetic peripheral neuropathy (DPN). This study investigated the gene and protein expression of the pain-related molecule PLC-β3 in the dorsal root ganglion (DRG) of DPN rats. 88 specific pathogen-free male Wistar rats were randomly divided into placebo (10 rats) and DPN model (78 rats) groups, and the 78 model rats were used to establish the DPN model by intraperitoneal injection of streptozotocin and were then fed a high-fat diet for 8 weeks. These rats were randomly divided into the model group, the high-, medium-, and low-dose WTHX-Cream + metformin groups, the metformin group, the capsaicin cream group, and the capsaicin cream + metformin group. After 4 weeks of continuous drug administration, the blood glucose, body weight, behavioral indexes, and sciatic nerve conduction velocity were measured. The pathological structure of the DRG and the sciatic nerve were observed. PLC-β3 mRNA and protein levels in the DRG of rats were measured. Compared with the model group, the high-dose WTHX-Cream group showed increased sciatic nerve conduction velocity, improved sciatic nerve morphological changes, and increased expression of PLC-β3 mRNA and protein in the DRG. This study showed that WTHX-Cream improves hyperalgesia symptoms of DPN by inhibiting the reduction of PLC-β3 mRNA and protein expression in the diabetic DRG of DPN rats.

A Prospective Analysis of Neuromonitoring for Confirmation of Lead Placement in Dorsal Root Ganglion Stimulation

2017 ◽  
Vol 14 (6) ◽  
pp. 654-660 ◽  
Author(s):  
Steven M Falowski ◽  
Andreas Dianna
Keyword(s):  
Neuropathic Pain ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Evoked Potential ◽  
Somatosensory Evoked Potential ◽  
Prospective Analysis ◽  
Awake Patient ◽  
Chronic Neuropathic Pain ◽  
Lead Placement

Abstract BACKGROUND Dorsal root ganglion stimulation is a neuromodulation therapy used for chronic neuropathic pain. Typically, patients are awakened intraoperatively to confirm adequate placement. OBJECTIVE To determine whether neuromonitoring can confirm placement in an asleep patient. METHODS This is a prospective analysis of 12 leads placed in 6 patients. Lead confirmation was confirmed by awake intraoperative testing, as well as asleep testing utilizing neuromonitoring. Patients were used as their own control. Sensory and motor thresholds for each patient with awake and asleep neuromonitoring testing were recorded. Intraoperative impedance and postoperative programming were also recorded. RESULTS In each patient, paresthesias were generated prior to motor contractions in the awake patient. For each patient, somatosensory evoked potential responses were present after lowering below the dropout threshold of electromyogram responses with neuromonitoring. There were varying degrees of separation in the thresholds that did not appear to be consistent across level or diagnosis. Smaller degrees of separation between thresholds during awake testing also held true in the asleep patient. This was further confirmed with postoperative programming. Impedances did not alter the separation in thresholds or amount of stimulation required for responses. One patient was combative during awake testing, and therefore motor thresholds were not obtained. This same patient was determined to have a ventral placement, confirmed with awake and asleep neuromonitoring testing. CONCLUSION This series demonstrates that the proposed neuromonitoring protocol can be used in an asleep patient to assure proper positioning of the dorsal root ganglion electrode in the dorsal foramen by generating somatosensory evoked potential responses in the absence of electromyogram responses.

Traumatic Digital Amputations of the Foot Inflicted by Pet Cat upon Individual with Diabetic Peripheral Neuropathy

2013 ◽  
Vol 103 (5) ◽  
pp. 441-444 ◽  
Author(s):  
William Hoffman ◽  
Kenneth Donovan
Keyword(s):  
Peripheral Neuropathy ◽  
Lower Extremity ◽  
Diabetic Peripheral Neuropathy ◽  
Relevant Literature ◽  
Pet Ownership ◽  
Common Cause ◽  
Potential Risks

Diabetic peripheral neuropathy (DPN) is a common cause of many lower-extremity complications. This case study illustrates the potential perils of pet ownership associated with diabetes and neuropathy. The case describes an incident resulting in traumatic digital amputations inflicted by a patient’s pet feline while she was sleeping. In presenting this case, the potential risks of pet ownership for patients with DPN are discussed along with a review of the relevant literature. (J Am Podiatr Med Assoc 103(5): 441–444, 2013)

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