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Clinical Neuroscience

NOVEMBER 30, 2018

[Effects of neural therapy on quality of live in patients with inoperable lower extremity artery disease ]

MOLNÁR István, DEÁK Botond Zsolt, HEGYI Gabriella, KOVÁCS Zoltán, KAPÓCS Gábor, SZŐKE Henrik

[Objectives - Our aim was to evaluate the effects of percutaneous neurolysis of lumbal sympathetic ganglions on pain and the resulting changes in quality of life with validated objective and subjective methods. To follow the adverse effects and complications of the procedure. Materials and methods - A prospective, non-randomized, interventional, clinical cohort study under real life conditons was conducted. The time of the observation was 6 months. Palliative neural therapy was performed to reduce the ischemic pain of the affected leg of the patients involved in the study. Prior to treatment and after 35 days, Visual Analogue Scale (VAS) was used to measure the intensity of lower limb pain. The related changes in the quality of life were followed by a general 36-Item Short-Form Health Survey (SF-36) questionnaire. We measured the changes of the patients’ skin temperature and ankle/arm index. The post-treatment results were compared to the pre-treatment results. We compared the results of objective and subjective measures. We followed the side effects and complications of the pain therapy. Each of the examined subjects had obliterative (Fontaine II/b stage) arterial disease of the lower limbs, in which no revascularization intervention was feasible and their ischemic pain was of VAS≥7. Results - Data of 124 patients (69 male, 55 female) could be evaluated. The decrease in intensity of limb pain in the post-treatment period was significant (p=0.001). Quality of life also indicated a significant improvement (p=0.004). Changes in skin temperature and ankle/arm index demonstrated significant improvement (p≤0.005): skin temperature increased from 27.6°C to 31.2°C, the ankle/arm index inceased from 0.67 to 0.83 on average. Changes in objective and subjective measures correlated with each other. No worthening of symptoms, serious adverse events or complications were observed. Conclusion - The chemical denervation of the lumbar sympathetic ganglions with percutaneous application is a minimally invasive intervention, useful in outpatient care, which can be well tolerated by the patient without any significant side effect or complication. Its hyperaemic effect and the pain reduction of the leg can improve the quality of life of the patients.]

Hungarian Radiology

MARCH 22, 2008

[Supracondylar process syndrome]

PÓTA Zsuzsanna, HUSZANYIK István, KAZAI Sándor, RÓDE László

[INTRODUCTION - Supracondylar process is a rare bone over-growth of atavistic origin. The entity shows several similarities with the tunnel syndromes. CASE REPORT - The case reports originate from the diagnosis and the treatment of two female patients. Both of them presented with elbow region pain, weakness in finger flexion and numbness. The clinical picture, the decrease in the speed of nerve conduction in the region of the supracondylar process and radiological evidence of the process over-growth made the proper diagnosis possible in both cases. Due to the failure of conservative therapy both patients underwent surgery. Careful surgical removal of the process and neurolysis resulted in cessation of symptoms. CONCLUSION - Use of atypical radiographic positioning and flouroscopy might be required to achieve a diagnosis. In patients who do not respond to physiotherapy and local steroid injections, surgical removal of the supracondylar process is indicated which prevents further arterial and nerve degeneration.]

Clinical Neuroscience

JULY 22, 2009

[The role of neurolytic obturator nerve block to relieve pain due to cancer and osteoarthritis (in English language)]

EMBEY-ISZTIN Dezső

[Neurolytic obturator nerve block have been performed successfully to relieve pain due to osteolytic metastases of pelvic bone since 1981 in our Pain Clinic. The analgesic effect of one block lasts from three to four months and can be repeated as required. Following the block the patient can go home one hour later. In 2008 we started to perform the neurolytic obturator nerve block to relieve pain due to degenerative osteoarthritis of hip joint. It is a good choice for those patients, who are not enough fit to be operated, or during the waiting time of hip replacement surgery.]