[Efficacy of acupuncture combined with computer-aided movable and measurable ankle-foot orthosis (CMM-AFO) on injury of nervus peroneus communis].

OBJECTIVE: To observe the efficacy difference among medication, medication plus rehabilitation training and medication plus rehabilitation training plus acupuncture on injury of nervus peroneus communis. METHODS: A total of 81 patients were randomly divided into a control group, an observation 1 group and an observation 2 group; three patients dropped out and 78 patients were included into statistical analysis, 26 patients in each group. The patients in the control group were treated with oral administration of mecobalamin, 500 µg per time, 3 times a day for 60 days. Based on the treatment of control group, the patients in the observation 1 group were treated with rehabilitation training by computer-aided movable and measurable ankle-foot orthosis (CMM-AFO). Based on the treatment of observation 1 group, the patients in the observation 2 group were treated with acupuncture at Jiexi (ST 41), Fenglong (ST 40), Yanglingquan (GB 34) and Zusanli (ST 36), etc, 30 min per treatment, once a day for 60 days. After 60-day treatment, the clinical efficacy was evaluated; the muscle strengths of foot dorsal stretch and digital flexion were evaluated; the motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) were recorded. RESULTS: After treatment, 20 patients were cured in the observation 2 group, which was significantly higher than 8 patients in the control group and 15 patients in the observation 1 group (both P<0.05). The muscle strengths, SCV and MCV in the observation 2 group were significantly higher than those in the control group and the observation 1 group (all P<0.05). CONCLUSION: Acupuncture combined with CMM-AFO have significant efficacy on injury of nervus peroneus communis, and improve muscle strengths, SCV and MCV, which are superior to medication alone and medication plus rehabilitation training.

Evaluation of the Efficacy and Robustness of a Second Generation Implantable Stimulator in a Patient With Hemiplegia During 20 Years of Functional Electrical Stimulation of the Common Peroneal Nerve.

We evaluated the efficacy and robustness of a second generation implantable stimulator for correcting drop foot (DF) in a patient with left-sided hemiplegia over 20 years of functional electrical stimulation (FES) of the common peroneal nerve (CPN). Dorsal flexion and eversion of the affected foot was partially restored by FES of the superficial region of the CPN innervating mostly the tibialis anterior (TA) and partly peroneus longus (PL) and peroneus brevis (PB) muscles. The reasons for implant failure during the long-term follow-up assessment were analyzed and resolving procedures were identified. The stimulator had an average failure rate of once every three years, due to repetitive mechanical load on the lead wires of its internal and/or external unit, and had to be serviced once per year to replace the heel switch integrated into the shoe sole. FES-associated mechanical trauma to the CPN elicited a thickening of the connective tissue around the CPN and a slightly compromised conduction velocity of the CPN. FES of the CPN, with the second generation implantable stimulator, improved gait parameters of the affected leg during the 20 years period. Long-term, daily FES enables a functional and reliable recruitment of nerve fibers, thus providing a sufficient dorsal flexion and optimal eversion of the affected foot to sustain unassisted, almost normal gait. Therefore, the presented implant is suitable for very long-term FES of the CPN.

Esguince de tobillo de primer grado como causa de paresia del nervio peroneo común. Caso clínico / / Entorse de tornozelo de primeiro grau como causa de paresia do nervo fibular comum. Relato de caso / Grade I inversion ankle sprain causing paresia of the common peroneal nerve. Case report

Los esguinces de tobillo, con mecanismo de inversión, son incidencias comunes en la población y constituyen las lesiones más frecuentes en el deporte. Eventualmente pueden ocasionar una neuropatía del nervio peroneo común, debido a un mecanismo de tracción indirecta, a través del nervio peroneo superficial. Se presenta el caso clínico de un varón de 37 años que, tras sufrir un esguince de tobillo de primer grado durante la práctica deportiva, presentó una paresia intensa del nervio peroneo común que se constató mediante estudio ecográfico y electroneuromiográfico. El cuadro se resolvió con tratamiento conservador y electroestimulación. Pese a su rareza, ha de conocerse la asociación entre el esguince de tobillo y la lesión del nervio peroneo común y debe evaluarse la función de dicho nervio en todos los pacientes con esguince de tobillo en sus diferentes grados, tanto en su exploración inicial como en el seguimiento posterior (AU)

Inversion ankle sprains are common in population and the most usual injurie in the sports. Eventually ankle sprains can cause a common peroneal nerve neuropathy via traction mechanism over the superficial peroneal nerve. Case of a 37 year old man who suffered a minor ankle sprain during sport activity followed by common peroneal nerve paresia. This neuropathy was confirmed through ultrasonography and electrodiagnostic evaluation. Paresia solved with conservative treatment and electrostimulation. In spite of the uncommon presentation of common peroneal nerve injury after an inversion ankle sprain, it is important to know the association between both pathologies. Physician may evaluate the function of this nerve in all patients with minor severe ankle sprain in the first and later medical examination (AU)

Entorses de tornozelo por inversão são comuns na população e um dos problemas mais frequentes nos esportes. Eventualmente a entorse de tornozelo pode gerar uma neuropatia do nervo fibular comum devido ao mecanismo de tração indireta sobre a superfície do nervo peroneal. Caso de um homem de 37 anos que sofreu uma entorse de tornozelo de primeiro grau durante a atividade desportiva, seguida de paresia do nervo fibular, constatando-se através de análise por ultrassonografia e avaliação eletromiográfica uma intensa afecção desse nervo. A paresia foi solucionada com tratamento conservador e eletroestimulação. Apesar da apresentação incomum de lesão envolvendo o nervo fibular recorrente de uma entorse de tornozelo por inversão, é importante conhecer a associação dessas 2 patologias. Deve-se avaliar a função deste nervo em todos os pacientes com entorse de tornozelo em diferentes graus, tanto na exploração inicial como também em momentos posteriores (AU)

[Repairing the spinal cord with vitamin D: a promising strategy]. / La vitamine D au secours du traumatisme médullaire : un espoir à confirmer.

In 2014, a phase II randomised, double blind clinical trial assessing the efficacy of cholecalciferol (vitamin D3) in patients with a cervical trauma will be set up. This trial stems from previous studies showing that vitamin D supplementation improves functional recovery in rat models of peripheral or central nerve injury. In a first series of experiments, we used a rat model of peripheral nerve trauma to demonstrate the therapeutic efficiency of vitamin D. We first demonstrated that ergocalciferol (vitamin D2) increases the number and the diameter of newly formed axons and improves the response of metabosensitive fibers from tibialis muscle, in a model of transected peroneal nerve. Then, we compared vitamin D2 and vitamin D3 and observed that the latter is more efficient. At the dose of 500 IU/kg/day, vitamin D3 induces a dramatic functional recovery. We also demonstrated that vitamin D3 increases the number of preserved or newly formed axons in the proximal end, the mean axon diameter in the distal end, neurite myelination in both the distal and proximal ends as well as the expression of genes involved in axogenesis and myelination. In parallel, we assessed the therapeutic role of vitamin D on the central nervous system. In a first study, using a rat model of spinal cord compression at the T10 thoracic level, we delivered vitamin D3 (cholecalciferol) orally at the dose of 50 IU/kg/day or 200 IU/kg/day. When compared to control animals, vitamin D-treated rats displayed, three months after injury, a significant improvement of ventilatory frequency and a reduction of H reflex indicating functional improvements at three months post-injury. In a second study, we used a rat model of cervical hemisection (C2) with a higher dose of oral vitamin D3 (500 IU/kg/day) delivered weekly, during 12 weeks. We observed an improved locomotor recovery, a reduced spasticity and a significantly higher rate of axons crossing the lesion site in treated animals. However, it must be pointed out that the functional improvement is reduced when vitamin D is provided one week after the trauma.

In vitro and in vivo optimization of infrared laser treatment for injured peripheral nerves.

BACKGROUND AND OBJECTIVE: Repair of peripheral nerve injuries remains a major challenge in restorative medicine. Effective therapies that can be used in conjunction with surgical nerve repair to improve nerve regeneration and functional recovery are being actively investigated. It has been demonstrated by a number of peer reviewed publications that photobiomodulation (PBM) supports nerve regeneration, reinnervation of the denervated muscle, and functional recovery after peripheral nerve injury. However, a key issue in the use of PBM as a treatment for peripheral nerve injury is the lack of parameter optimization for any given wavelength. The objective of this study was to demonstrate that for a selected wavelength effective in vitro dosing parameters could be translated to effective in vivo parameters. MATERIALS AND METHODS: Comparison of infra-red (810 and 980 nm wavelengths) laser treatment parameters for injured peripheral nerves was done beginning with a series of in vitro experiments using primary human fibroblasts and primary rat cortical neurons. The primary rat cortical neurons were used for further optimization of energy density for 980 nm wavelength light using measurement of total neurite length as the bioassay. For these experiments, the parameters included a 1 W output power, power density of 10 mW/cm(2) , and energy densities of 0.01, 0.1, 0.5, 2, 10, 50, 200, 1,000, and 5,000 mJ/cm(2) . For translation of the in vitro data for use in vivo it was necessary to determine the transcutaneous penetration of 980 nm wavelength light to the level of the peroneal nerve. Two anesthetized, male White New Zealand rabbits were used for these experiments. The output power of the laser was set at 1.0 or 4.0 W. Power density measurements were taken at the surface of the skin, sub-dermally, and at the level of the nerve. Laser parameters used in the in vivo studies were calculated based on data from the in vitro studies and the light penetration measurements. For the in vivo experiments, a total of 22 White New Zealand rabbits (2.34-2.89 kg) were used. Translated dosing parameters were refined in a pilot study using a transection model of the peroneal nerve in rabbits. Output powers of 2 and 4 W were tested. For the final set of in vivo experiments, the same transection nerve injury model was used. An energy density of 10 mW/cm(2) at the level of the peroneal nerve was selected and the laser parameters were further refined. The dosing parameters used were: 1.5 W output power, 43 seconds exposure, 8 cm(2) area and a total energy of 65 J. RESULTS: In vitro, 980 nm wavelength light at 10 mW/cm(2) significantly improved neurite elongation at energy densities between 2 and 200 mJ/cm(2) . In vivo penetration of the infrared light measured in anesthetized rabbits showed that on average, 2.45% of the light applied to the skin reached the depth of the peroneal nerve. The in vivo pilot study data revealed that the 4 W parameters inhibited nerve regeneration while the 2 W parameters significantly improved axonal regrowth. For the final set of experiments, the irradiated group performed significantly better in the toe spread reflex test compared to the control group from week 7 post-injury, and the average length of motor endplates returned to uninjured levels. CONCLUSION: The results of this study demonstrate that treatment parameters can be determined initially using in vitro models and then translated to in vivo research and clinical practice. Furthermore, this study establishes that infrared light with optimized parameters promotes accelerated nerve regeneration and improved functional recovery in a surgically repaired peripheral nerve.

Neurotrophic and neuroprotective actions of Achyranthes bidentata polypeptides on cultured dorsal root ganglia of rats and on crushed common peroneal nerve of rabbits.

We have isolated Achyranthes bidentata Blume polypeptides (ABPP) from the aqueous extract of A. bidentata Blume, a traditional Chinese medicine with multiple therapeutic applications. In this study, we aimed to investigate neurotrophic effects of ABPP on cultured dorsal root ganglia (DRGs) of rats and neuroprotective effects on crushed common peroneal nerve of rabbits. Immunochemistry and Western blot analysis indicated that ABPP (0.01, 0.1, and 1.0 µg/ml) encouraged neurite outgrowth from cultured DRG explants/neurons in a concentration-dependent manner through activation of ERK1/2. After crush injury to rabbit common peroneal nerve, animals received daily administration of ABPP for 5 weeks. Electrophysiological assessments and histomorphological evaluation showed that 6.0mg/kg ABPP significantly enhanced nerve regeneration and function restoration. Our findings suggest that ABPP could be used as a neurotrophic and neuroprotective agent to treat peripheral nerve crush injury.

Enhancement of peripheral nerve regeneration due to treadmill training and electrical stimulation is dependent on androgen receptor signaling.

Moderate exercise in the form of treadmill training and brief electrical nerve stimulation both enhance axon regeneration after peripheral nerve injury. Different regimens of exercise are required to enhance axon regeneration in male and female mice (Wood et al.: Dev Neurobiol 72 (2012) 688-698), and androgens are suspected to be involved. We treated mice with the androgen receptor blocker, flutamide, during either exercise or electrical stimulation, to evaluate the role of androgen receptor signaling in these activity-based methods of enhancing axon regeneration. The common fibular (CF) and tibial (TIB) nerves of thy-1-YFP-H mice, in which axons in peripheral nerves are marked by yellow fluorescent protein (YFP), were transected and repaired using CF and TIB nerve grafts harvested from non-fluorescent donor mice. Silastic capsules filled with flutamide were implanted subcutaneously to release the drug continuously. Exercised mice were treadmill trained 5 days/week for 2 weeks, starting on the third day post-transection. For electrical stimulation, the sciatic nerve was stimulated continuously for 1 h prior to nerve transection. After 2 weeks, lengths of YFP+ profiles of regenerating axons were measured from harvested nerves. Both exercise and electrical stimulation enhanced axon regeneration, but this enhancement was blocked completely by flutamide treatments. Signaling through androgen receptors is necessary for the enhancing effects of treadmill exercise or electrical stimulation on axon regeneration in cut peripheral nerves.

Ineficácia da laserterapia aplicada no trajeto do nervo e nas raízes medulares correspondentes / Lack of effectiveness of laser therapy applied to the nerve course and the correspondent medullary roots

Objetivo: Verificar a influência da irradiação do laser de baixa intensidade na regeneração do nervo fibular comum de ratos após lesão por esmagamento. Métodos: Foram utilizados 25 ratos, divididos em três grupos: 1) nervo intacto, e não tratados; 2) nervo lesado, e não tratado; 3) nervo lesado, e laser irradiado sobre a região medular correspondente às raízes do nervo ciático e subsequentemente no trajeto do nervo lesado. A irradiação foi realizada por 14 dias consecutivos. Resultados: Foram avaliados por meio da análise funcional da marcha, através do índice funcional do peroneiro, e por análise morfométrica através do número total de fibras nervosas mielinizadas e sua densidade, número total de células de Schwann, número total de vasos sanguíneos e sua área, diâmetro mínimo da fibra e razão-G. Conclusão: De acordo com a análise estatística, não houve diferença significativa entre os grupos, e os autores concluem que a irradiação do laser de baixa intensidade possui pouca ou nenhuma influência na regeneração nervosa e recuperação funcional. Trabalho experimental.

Objective: To investigate the influence of low intensity laser irradiation on the regeneration of the fibular nerve of rats after crush injury. Methods: twenty-five rats were used, divided into three groups: 1) intact nerve, no treatment; 2) crushed nerve, no treatment; 3) crush injury, laser irradiation applied on the medullary region corresponding to the roots of the sciatic nerve and subsequently on the course of the damaged nerve. Laser irradiation was carried out for 14 consecutive days. Results: animals were evaluated by functional gait analysis with the peroneal functional index and by histomorphometric analysis using the total number of myelinated nerve fibers and their density, total number of schwann cells, total number of blood vessels and the occupied area, minimum diameter of the fiber diameter and G-quotient. Conclusion: according to the statistical analysis there was no significant difference among groups and the authors conclude that low intensity laser irradiation has little or no influence on nerve regeneration and functional recovery. Laboratory investigation.

Efeitos da laserterapia na regeneração nervosa periférica / Effects of laser therapy in peripheral nerve regeneration

OBJETIVO: Analisar o efeito do laser nas doses de 5, 10 e 20J/cm2 na reparação do nervo fibular de ratos após esmagamento. Os resultados foram avaliados por meio da análise funcional da marcha e de parâmetros morfométricos.MÉTODOS: Lesão por esmagamento controlado do nervo fibular comum direito e submetidos a intensidades crescentes (G1: sem irradiação; G2: sham; G3: 5J/cm2; G4: 10J/cm2; G5: 20J/cm2) de irradiação do laser diretamente sobre o local da lesão por 21 dias consecutivos. A análise funcional da marcha foi realizada a intervalos semanais, tendo sido medido o índice funcional do fibular (IFF). Os animais foram sacrificados nos 21º dia pós-operatório para remoção do nervo fibular, que foi preparado para a análise morfométrica.RESULTADOS: Não houve diferença significativa (p>0,05) dos valores da análise de marcha (IFF) entre os grupos em qualquer momento de avaliação para o parâmetro. A área total da secção transversal do nervo foi significantemente maior no grupo 2 do que nos grupos 3 e 4, enquanto a densidade de fibras foi significantemente maior no grupo 4 do que no demais grupos.CONCLUSÃO: A irradiação com o laser AsGaAl de baixa potência não acelerou a regeneração do nervo fibular com nenhuma das doses utilizadas. Nível de Evidência I, Estudos terapêuticos - Investigação dos Resultados do Tratamento.

OBJECTIVE: The influence of dose of low power lasertherapy (AsGaAl, 830 nm) on the regeneration of the fibular nerve of rats after a crush injury was evaluated by means of the functional gait analysis and histomorphometric parameters.METHODS: Controlled crush injury of the right common fibular nerve, immediately followed by increasing doses (G1: no irradiation; G2: simulated; G3: 5 J/cm2; G4: 10 J/cm2; G5: 20 J/cm2) laser irradiation directly on the lesion site for 21 consecutive days. Functional gait analysis was carried out at weekly intervals by measuring the peroneal/fibular functional index (PFI). The animals were killed on the 21st postoperative day for removal of the fibular nerve, which was prepared for the histomorphometric analysis.RESULTS: The PFI progressively increased during the observation period in all groups, without significant differences between them (p>0.05). The transverse nerve area was significantly wider in group 2 than in groups 3 and 4, while fiber density was significantly greater in group 4 than in all remaining groups.CONCLUSION: The low power AsGaAl laser irradiation did not accelerate nerve recovery with any of the doses used. Level of Evidence I, Therapeutic Studies Investigating the Results of Treatment.

[Experimental study on Buyang Huanwu decoction ([Chinese characters: see text]) for promoting functional recovery of crushed common peroneal nerve in rats].

OBJECTIVE: To study the effects of Buyang Huanwu Decoction ([Chinese characters: see text]) on promoting functional recovery of crushed common peroneal nerve in rats. METHODS: Thirty Sprague-Dawley rats were subjected to produce common peroneal nerve injuries model,and the length of injury was 5 mm. All the rats were divided into 3 groups: BYHWD group, mecobalamin group and model group. The drugs were given by gavage daily for 18 days. Footprint test was performed at the 18th day after surgery to evaluate toe spread function (TSF). Electrophysiology was performed at the 18th day after operation to determine the nerve conduct velocity (NCV). The wet weight ratio and section area of tibial muscle were also measured. RESULTS: (TSF:At the 18th day after operation, the TSF in BYHWD group (-0.15 +/- 0.07) increased significantly compared with that of model group (-0.25 +/- 0.07) (P < 0.01); the TSF in mecobalamin group (-0.17 +/- 0.08) also increased notably compared with that of model group (P < 0.01).(2) NCV: the NCV in BYHWD group [(18.36 +/- 2.74) m/s] (P < 0.01l) and in mecobalamin group [(16.32 +/- 3.54) m/s] (P < 0.05) also increased significantly compared with that of model group [(9.08 +/- 2.56) m/s]; there was striking variation between model group and mecobalamin group (P < 0.05). (3) Wet weight ratio: the wet weight ratio in BYHWD group [(64.21 +/- 2.92)%] (P < 0.01)and in mecobalamin group [(62.43 +/- 3.21)%] (P < 0.01) all increased significantly compared with that of model group [(54.27 +/- 2.05)%]. (4) The section area of tibial muscle: the section area of tibial muscle in BYHWD group [(654.21 +/- 42.92) cm2] (P < 0.01) and in mecobalamin group [(638.43 +/- 93.21) cm2] (P < 0.01) all increased significantly compared with that of model group [(574.27 +/- 52.05) cm2]; there was also striking variation between model group and mecobalamin group (P < 0.05). CONCLUSION: BYHWD can promotes functional recovery of crushed nerve as a result of accelerating recovery of TSF, raising NCV and delaying the decrease of tibial muscle section area and wet weight ratio.

A irradiação local com o laser de baixa potência acelera a regeneração do nervo fibular de ratos / Local low power laser irradiation accelerates the regeneration of the fibular nerve in rats

OBJETIVO: Estudar a influência da irradiação com o laser AsGaAL de baixa potência na regeneração de um nervo periférico, após lesão por esmagamento controlado. MATERIAL E MÉTODOS: O nervo fibular comum direito de 30 ratos Wistar foi submetido a uma lesão por esmagamento com uma pinça de carga regulável (5.000 g, 10 minutos de aplicação), os animais sendo divididos em três grupos (n=10), de acordo com o procedimento pós-operatório (sem irradiação; irradiação simulada; irradiação efetiva). A irradiação com o laser (comprimento de onda: 830 nm; potência do emissor: 100 mW; modo contínuo; dose: 140 J/cm²) era iniciada no primeiro dia pós-operatório e realizada por 21 dias consecutivos. Foram analisados a massa corporal dos animais, o tempo de percurso na passarela de marcha e o índice funcional do fibular (PFI), pela análise das impressões das pegadas, no período pré-operatório e no 21º dia pós-operatório. RESULTADOS: O tempo de marcha e o PFI melhoraram significativamente mais no grupo de irradiação efetiva com o laser, apesar do ganho significante de massa corporal entre os períodos pré e pós-operatório. CONCLUSÃO: A irradiação com o laser AsGaAL de baixa potência com os parâmetros aqui empregados acelerou e melhorou a regeneração do nervo fibular do rato.

OBJECTIVE: To study the influence of low power GaAs-Al laser irradiation on the regeneration of a peripheral nerve, following a controlled crush injury. MATERIAL AND METHODS: The right common fibular nerve of 30 Wistar rats was submitted to a crush injury with an adjustable load forceps (5 000 g, 10 minutes of application). The animals were divided into three groups (n=10), according to the postoperative procedure (no irradiation; sham irradiation; effective irradiation). Laser irradiation (830 nm wave-length; 100 mW emission power; continuous mode; 140 J/cm²) was started on the first postoperative day and continued over 21 consecutive days. Body mass, time spent on the walking track and functional peroneal index (FPI) were analyzed based the hind footprints, both preoperatively and on the 21st postoperative day. RESULTS: Walking time and PFI significantly improved in the group that received effective laser irradiation, despite the significant gain in body mass between the pre- and post-operative periods. CONCLUSION: Low Power GaAs-Al laser irradiation, with the parameters used in our study, accelerated and improved fibular nerve regeneration in rats.

Musculoskeletal dysfunction and drop foot: diagnosis and management using osteopathic manipulative medicine.

Drop foot arises from dysfunction within the anatomic, muscular, or neurologic aspects of the lower extremity. The authors describe a patient with drop foot who had a compressed common peroneal nerve caused by posterior fibular head dysfunction. One 15-minute session of osteopathic manipulative treatment resolved the patient's symptoms. It is important for physicians to use osteopathic manipulative medicine to diagnosis and manage this condition, particularly when it results from fibular head dysfunction.

Functional electrical stimulation of denervated muscles: an experimental evaluation.

For many years there has been a dearth of effective treatment options for the severe wasting and secondary consequences of motor nerve injury. In recent years, however, an intensive regime of electrical stimulation has been shown to have considerable therapeutic benefits. This article reviews the results of an extensive study designed to address the clinically relevant issues in an appropriate animal model. The study reveals both the benefits and the limitations of the technique, but strongly endorses the therapeutic advantages of introducing a program of stimulation during the initial, nondegenerative phase of the muscle response to nerve or root injury.

Profound reduction of somatic and visceral pain in mice by intrathecal administration of the anti-migraine drug, sumatriptan.

Sumatriptan and the other triptan drugs target the serotonin receptor subtypes1B, 1D, and 1F (5-HT(1B/D/F)), and are prescribed widely in the treatment of migraine. An anti-migraine action of triptans has been postulated at multiple targets, within the brain and at both the central and peripheral terminals of trigeminal "pain-sensory" fibers. However, as triptan receptors are also located on "pain-sensory" afferents throughout the body, it is surprising that triptans only reduce migraine pain in humans, and experimental cranial pain in animals. Here we tested the hypothesis that sumatriptan can indeed reduce non-cranial, somatic and visceral pain in behavioral models in mice. Because sumatriptan must cross the blood brain barrier to reach somatic afferent terminals in the spinal cord, we compared systemic to direct spinal (intrathecal) sumatriptan. Acute nociceptive thresholds were not altered by sumatriptan pre-treatment, regardless of route. However, in behavioral models of persistent inflammatory pain, we found a profound anti-hyperalgesic action of intrathecal, but not systemic, sumatriptan. By contrast, sumatriptan was completely ineffective in an experimental model of neuropathic pain. The pronounced activity of intrathecal sumatriptan against inflammatory pain in mice raises the possibility that there is a wider spectrum of therapeutic indications for triptans beyond headache.

The repair effects of Achyranthes bidentata extract on the crushed common peroneal nerve of rabbits.

In this study the effect of the Achyranthes bidentata root aqueous extract on regeneration of the crushed common peroneal nerve in rabbits by using a combination of electrophysiological assessment and histological aspect were investigated. The examined functional and morphological parameters suggest that A. bidentata extract could accelerate peripheral nerve regeneration in a dose-dependent manner (10-20 microg/kg, i.v.).

Retrospective analysis of neurapraxia and axonotmesis injuries of select peripheral nerves of the foot and ankle and their conservative and surgical treatment (external neurolysis and neurectomy).

There is a paucity of scientific literature that has reviewed the conservative and surgical treatment efficacy for the management of injuries causing neurapraxia and axonotmesis. This retrospective study evaluates the clinical outcomes of certain treatments for these injuries. Twenty-seven patients fulfilled the inclusion/exclusion criteria for the study, and represented both genders and a wide variety of ages, weights, levels of education, and backgrounds. Surgical intervention resulted in a slightly better clinical outcome when compared to conservative therapies. Patients undergoing surgery for a single nerve problem improved more than those who underwent surgery when three or more nerves were involved. Failure was most often associated with: 1) multiple nerve injuries, 2) a previous history of psychopathology, and 3) application of conservative therapy without surgical intervention for single nerve injury.

Drop foot as a complication of acupuncture injury and intragluteal injection.

Two cases of peroneal nerve palsy resulting in drop foot are reported. One case involves direct injury to the common peroneal nerve by an acupuncture needle. A second case describes sciatic nerve injury caused by an intragluteal injection. Although acupuncture injury at the spinal cord level and the peripheral nerves of the upper extremity has been documented, peroneal nerve palsy resulting from acupuncture therapy has not been previously reported.

Hyperbaric oxygen treatment after rat peroneal nerve transection and entubulation.

Rat peroneal nerves were transected and entubulated with a Silastic channel. The experimental group was treated with hyperbaric oxygen to evaluate changes in acute edema, functional recovery, and histology. Hyperbaric oxygen was administered with 100% O2 at 2.5 atmospheres absolute for 90 minutes twice a day for 1 week and then four times a day for 1 week. Acute edema changes based on nerve water weight and transfascicular area measurements were greater in injured than in uninjured nerves but demonstrated no differences between hyperbaric oxygen-treated and -untreated groups 2, 8 and 16 days after surgery. Functional evaluation with gait analysis demonstrated significant changes between injured and uninjured group 1, 3, 7, and 13 weeks after injury but no differences between hyperbaric oxygen-treated and -untreated groups. Thirteen weeks after the initial injury, elicited muscle force measurements demonstrated no significant improvement from hyperbaric oxygen treatment of injured nerves. Histologic evaluation of nerve area, myelinated axon number, myelinated axon area, myelin thickness, and blood vessel number and area revealed no significant differences between hyperbaric oxygen-treated and -untreated groups. Hyperbaric oxygen was not associated with improvement of nerve regeneration with any of the outcome variables in this model.