Effects of Vagus Nerve Stimulation on Progressive Myoclonus Epilepsy of Unverricht-Lundborg Type

Purpose : A 34-year-old woman with progressive myoclonus epilepsy of Unverricht-Lundborg type was considered for vagus nerve stimulation (VNS) therapy. Methods : After demonstration of intractability to multiple antiepileptic regimens and progressive deterioration in cerebellar function, the patient was implanted with a vagus nerve stimulator and followed for 1 year. Neurological status, seizure frequency, and parameter changes were analyzed. Results : VNS therapy resulted in reduction of seizures (more than 90%) and a significant improvement in cerebellar function demonstrated on neurological examination. The patient reported improved quality of life based in part on her ability to perform activities of daily living. Conclusions : VNS therapy may be considered a treatment option for progressive myoclonus epilepsy. The effects of VNS on seizure control and cerebellar dysfunction may provide clues to the underlying mechanism(s) of action.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65549/1/j.1528-1157.2000.tb00293.x.pd

European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

To develop a European guideline on pharmacologic treatment of Tourette syndrome (TS) the available literature was thoroughly screened and extensively discussed by a working group of the European Society for the Study of Tourette syndrome (ESSTS). Although there are many more studies on pharmacotherapy of TS than on behavioral treatment options, only a limited number of studies meets rigorous quality criteria. Therefore, we have devised a two-stage approach. First, we present the highest level of evidence by reporting the findings of existing Cochrane reviews in this field. Subsequently, we provide the first comprehensive overview of all reports on pharmacological treatment options for TS through a MEDLINE, PubMed, and EMBASE search for all studies that document the effect of pharmacological treatment of TS and other tic disorders between 1970 and November 2010. We present a summary of the current consensus on pharmacological treatment options for TS in Europe to guide the clinician in daily practice. This summary is, however, rather a status quo of a clinically helpful but merely low evidence guideline, mainly driven by expert experience and opinion, since rigorous experimental studies are scarce

Ultra-sonication treatment for saline groundwater: A new innovative approach for preventing emitter clogging in surface drip irrigation systems

Clogging is a serious problem in drip irrigation, especially when using saline groundwater; this may cause uneven water distribution. However, efficient and environmentally friendly methods are rarely available for mitigating clogging. In the present study, an innovative and environmentally friendly technology using ultrasonic waves within radio frequency without the use of chemicals to treat emitter clogging, is evaluated. The objectives of this study were to evaluate the chronological changes in the emitter flow rate and the effect of ultrasonic (US) water treatments on solving the problem of emitter clogging in the field. The performance of the drip irrigation system is tested by measuring emitter discharge and estimating the average emitter discharge (qav), the manufacturer coefficient of variation (CVm), the distribution uniformity of the lowest quarter (DUlq), the application efficiency (AE) and the Christiansen uniformity coefficient (CUC). The results showed that the qav for the emitters improved from 3.37 l/h before treatment to 4.1 l/h after 180 h of US irrigation water treatment. The DUlq and the AE of the drip irrigation system were respectively 76.7% and 69.1% before treatment, due to the presence of salts in the groundwater, which caused emitter clogging. After 180 hours of US water treatment, DUlq and AE improved to respectively 90.3% and 81.3%. This improvement led to saving about 15% of the daily irrigation water. This study showed that ultrasonic water treatment is highly effective as chemical-free treatment method with great potential for preventing emitters clogging in drip irrigation systems, and could be further promoted in drip irrigation with saline groundwater. Keywords: Clogging, drip, irrigation, emitter, saline groundwater, ultrasoni