Headache pain pathways targeted by neurostimulation.

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1 Electronic Aspirin Group no.3. 2 Cluster Headache Severe pain Chronic condition Occurs periodically Unilateral pain, usually felt around eye.
Conduction speed.
The Nature & Symptoms of Pain
Headache and Facial Pain: Differential Diagnosis and Treatment
Various lower limb ankle orthoses used in the management of distal lower limb muscle weakness in patients with inherited neuropathies. Various lower limb.
Figure 3 Ascending pain pathways and the brain regions involved
OCT left eye (case 3). OCT showed bilateral foveal atrophy (white arrows), with an island of preserved retina in the left fovea (yellow arrow; only left.
Figure 4 Implantable neuromodulation treatments
Worldwide distribution of clinical cases of hepatitis E virus (HEV) infection. Worldwide distribution of clinical cases of hepatitis E virus (HEV) infection.
Lifecycle of the urinary catheter
Masashi Maeda et al. Heart Asia 2013;5:7-14
Typical imaging findings.
Neuropathic Pain: Principles of Diagnosis and Treatment
‘Poppers’ retinopathy.
Case one: (A and B) Right and left colour fundus photographs of the optic nerve head showing small crowded discs with anomalous branching of the blood.
Photograph of the legs of a patient with inherited erythromelalgia, showing erythema to the level of the mid-calf. Photograph of the legs of a patient.
(A) Moderately well differentiated adenocarcinoma in subarachnoid space (H&E). (A) Moderately well differentiated adenocarcinoma in subarachnoid space.
Schematic representation of hepatitis E virus (HEV) genotype 3 in developed countries. Schematic representation of hepatitis E virus (HEV) genotype 3 in.
Single colour fundus photographs of patients with disc swelling secondary to raised intracranial pressure (papilloedema). Single colour fundus photographs.
Case 2—Urgent CSF divergence surgery restored visual function.
Confocal images of skin biopsies taken from the legs of a control subject (A) and a patient with small fibre neuropathy secondary to HIV (B) showing PGP.
Single colour fundus photographs of pseudopapilloedema in patients initially thought to have IIH. (A) Elevated, lumpy disc with anomalous vascular pattern.
Photograph of the legs of a patient with inherited erythromelalgia, showing erythema to the level of the mid-calf. Photograph of the legs of a patient.
Indocyanine green angiography (ICG) and fluorescein angiography (FA) of the right eye (case 8). Indocyanine green angiography (ICG) and fluorescein angiography.
Confocal images of skin biopsies taken from the legs of a control subject (A) and a patient with small fibre neuropathy secondary to HIV (B) showing PGP.
Injection sites for greater occipital nerve (GON) block.
(A) Showing 10 untreated Parkinson patients; all positive for α-synuclein and 3-nitro-tyrosin (a marker for mitochondrial stress) on sigmoidoscopy and.
Page 1 of a fact sheet available at www. neurosymptoms. org
Schematic representation of the visual pathway and the location of lesion leading to the temporal crescent syndrome. Schematic representation of the visual.
Humphrey perimetry (SITA-Standard 24–2): (A) 1 month postquinine overdose, showing marked constriction of the visual field; (B) 6 months postquinine overdose,
Flow diagram of sample selection and reduction of subject numbers by application of exclusion criteria. ‡Data from Medical Record; ‡‡Records missing gender.
Suggested algorithm for genetic testing in Charcot–Marie–Tooth disease (CMT) and related disorders in the age of disease-specific gene panels. *Motor nerve.
Vitamin B12 (cobalamin) is a cofactor in conversion of methylmalonyl coenzyme A (CoA) to succinyl CoA and of homocysteine to methionine. Vitamin B12 (cobalamin)
Autofluorescence left eye (case 3)
(A) Axial CT scan of head at presentation, showing a right occipital hypodense lesion. (A) Axial CT scan of head at presentation, showing a right occipital.
Star cancellation task from the behavioural inattention test
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Diagram showing the normal progression of severe PPH
PRISMA flow diagram for selection of RCTs from leading sports medicine journals for the publication years 2005 and 2015. PRISMA, Preferred Reporting Items.
Diagram of a transverse section of the cervical spinal cord, showing the somatotopic organisation of the spinothalamic tracts (schematically enlarged),
After 4 s of raw magnetoencephalography data (two channels contain obvious artefacts), the door to the magnetically shielded room is opened during recording.
Optical coherence tomography showing thinning of the retinal nerve fibre layer (RNFL) 1 month postquinine overdose.  OU, oculus uterque (both eyes); OD,
Headache frequency after medication withdrawal in medication-overuse headache. Headache frequency after medication withdrawal in medication-overuse headache.
Tunnel vision: functional (ie, tubular field) versus physiological.
(A) Frontalis test: unilateral injection of the frontalis muscle with botulinum toxin (BoNT). (A) Frontalis test: unilateral injection of the frontalis.
Suggested algorithm of addressing non-motor symptoms in clinic (modified from Chaudhuri et al).48 HCP, healthcare professional; QoL, quality of life; PDSS,
Sagittal T2-weighted MR scan of spine of case 1 (A) and case 2 (C), showing intramedullary signal hyperintensity at T11/12 in case 2 (C). Sagittal T2-weighted.
Functional tremor. (A) The tremor affects both hands but there is variation in amplitude and frequency between the right and left spirals. Functional tremor. (A)
(A) Pupillary responses by age (from Meisami et al)
The organisation of cortical microcolumns within the sulcal bank, tangentially orientated to the skull, allows their detection with magnetoencephalography.
. . MR scan of brain (1.5 Tesla), patient aged 30 years. (A) Axial T2-weighted sequences at midbrain level show disproportionate volume loss and signal.
The organisation of cortical microcolumns within the sulcal bank, tangentially orientated to the skull, allows their detection with magnetoencephalography.
MRI in autosomal recessive hereditary spastic paraplegia: high T2 signal intensity in periventricular white matter and corona radiata with thin corpus.
The superior quality of MRI over CT is demonstrated in this figure.
(A) MR scan of brain from an 82-year-old woman who presented with recurrent episodes of sudden onset needles affecting the face, gum and hand, with facial.
Proportions of subjects with ≥50% reductions in all qualifying regions of residual limb pain and phantom limb pain. Proportions of subjects with ≥50% reductions.
 Anatomical illustration of the greater superficial petrosal nerve (GSPN) (black arrowheads).  Anatomical illustration of the greater superficial petrosal.
General Medical Council’s (GMC) National Training Survey results for average clinic attendance per week at 33 sites across the UK in General Medical.
 Left side: normal short latency somatosensory evoked potentials (SSEPSs) after stimulation of the median nerve (top picture) and posterior tibial nerve.
(A) High intensity lesions in the left dorsolateral midbrain on T2 weighted magnetic resonance imaging in case 1. (A) High intensity lesions in the left.
Kaplan-Meier table analysis of patients with corticobasal degeneration after onset of symptoms; the y axis refers to proportion of patients who are alive.
Axial T1-weighted MRI of the thigh (A) and lower leg (B) for case 1 shows fatty infiltration of the quadriceps and adductor muscles (L2, 3 and 4 myotomes;
Determinants of moderate Cardiovascular Health Index Score (achieving three or more risk factor targets), stratified by region conventions as in figure.
(A) Clinical selection of scapular muscles depending on the side of the elevation of the shoulder in a patient with dystonic head rotation. (A) Clinical.
Flow of recruitment: the screening and enrolment process for a 6-week randomised double-blind placebo-controlled feasibility trial in people with multiple.
Figure MRI T1 coronal images show homogenous hyperintense lesion involving the right trigeminal nerve root (white arrows) in A and B and Meckel's cave.
Unloader knee brace patient pathway
Presentation transcript:

Headache pain pathways targeted by neurostimulation. Headache pain pathways targeted by neurostimulation. A simplified diagram of the various peripheral and central pain pathways targeted by current neurostimulation devices. LC, locus coeruleus; NRM, nucleus raphe magnus; PAG, periaqueductal grey; SPG, sphenopalatine ganglion; SSN, superior salivary nucleus; TNC, trigeminal nucleus caudalis; V1, first division of the trigeminal nerve. Sarah Miller et al. Pract Neurol 2016;16:362-375 ©2016 by BMJ Publishing Group Ltd