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Journal of Internal Medicine Jul 2017The human nervous system is a vast network carrying not only sensory and movement information, but also information to and from our organs, intimately linking it to our... (Review)
Review
The human nervous system is a vast network carrying not only sensory and movement information, but also information to and from our organs, intimately linking it to our overall health. Scientists and engineers have been working for decades to tap into this network and 'crack the neural code' by decoding neural signals and learning how to 'speak' the language of the nervous system. Progress has been made in developing neural decoding methods to decipher brain activity and bioelectronic technologies to treat rheumatoid arthritis, paralysis, epilepsy and for diagnosing brain-related diseases such as Parkinson's and Alzheimer's disease. In a recent first-in-human study involving paralysis, a paralysed male study participant regained movement in his hand, years after his injury, through the use of a bioelectronic neural bypass. This work combined neural decoding and neurostimulation methods to translate and re-route signals around damaged neural pathways within the central nervous system. By extending these methods to decipher neural messages in the peripheral nervous system, status information from our bodily functions and specific organs could be gained. This, one day, could allow real-time diagnostics to be performed to give us a deeper insight into a patient's condition, or potentially even predict disease or allow early diagnosis. The future of bioelectronic medicine is extremely bright and is wide open as new diagnostic and treatment options are developed for patients around the world.
Topics: Biosensing Techniques; Biotechnology; Brain; Electric Stimulation Therapy; Electronics, Medical; Forecasting; Humans; Neurons; Paralysis; Synaptic Transmission
PubMed: 28419590
DOI: 10.1111/joim.12610 -
The British Journal of Oral &... Dec 2015Long-standing facial paralyses are those in which fibroadipose metaplasia of mimetic musculature has grown because of the time that has lapsed since the onset of the... (Review)
Review
Long-standing facial paralyses are those in which fibroadipose metaplasia of mimetic musculature has grown because of the time that has lapsed since the onset of the palsy: generally more than 18-24 months. Unlike the treatment of recent paralyses, to provide a neural input to reactivate the mimetic musculature is not enough. New healthy muscles must be transferred to the face. Operations may be subdivided into free-flap transplantations or masticatory muscle transpositions. The principles of treatment are correction of the asymmetry of the face by static means, and restoration of movements. Static correction of ptosis is achieved by deep-lifting, suspensions of fascia lata, and other procedures. Among movements, most efforts are concentrated on the restitution of smiling and closure of the eyelids. One of several techniques may be chosen after careful examination of the patient and paying close attention to their needs and expectations. Closure of the eyelids is generally achieved by a transposition of a double-belly temporalis flap or implantation of a gold/titanium lid plate. Other procedures are less used. Restoration of blinking remains impossible in most cases. The most popular techniques to restore smiling are rotation of a temporalis flap and transfer of a gracilis free flap with double innervation: both pros and cons must be considered. Surgery of the lower lip palsy is mainly based on limiting evident dragging upwards during smiling, because depressor function is difficult to achieve. Symmetry may also be reached by paralysing the lower lip on the other side. Movement of the forehead is a neglected area: reconstruction is possible, although the extent required seems disproportionate to the deficit. The need for ancillary surgery must be stressed. Only rarely are optimal results achieved without further fine-tuning of details.
Topics: Face; Facial Muscles; Facial Paralysis; Free Tissue Flaps; Humans; Plastic Surgery Procedures; Smiling
PubMed: 26194145
DOI: 10.1016/j.bjoms.2015.07.001 -
Annales de Chirurgie Plastique Et... Oct 2015
Topics: Clinical Decision-Making; Facial Paralysis; Humans; Plastic Surgery Procedures
PubMed: 26323206
DOI: 10.1016/j.anplas.2015.08.001 -
Anaesthesia, Critical Care & Pain... Aug 2016
Topics: Anesthesia, General; Cholinesterase Inhibitors; Humans; Neostigmine; Paralysis; Postoperative Complications
PubMed: 27475831
DOI: 10.1016/j.accpm.2016.06.004 -
Journal of Neuroengineering and... Nov 2023Individuals with a locked-in state live with severe whole-body paralysis that limits their ability to communicate with family and loved ones. Recent advances in... (Review)
Review
Individuals with a locked-in state live with severe whole-body paralysis that limits their ability to communicate with family and loved ones. Recent advances in brain-computer interface (BCI) technology have presented a potential alternative for these people to communicate by detecting neural activity associated with attempted hand or speech movements and translating the decoded intended movements to a control signal for a computer. A technique that could potentially enrich the communication capacity of BCIs is functional electrical stimulation (FES) of paralyzed limbs and face to restore body and facial movements of paralyzed individuals, allowing to add body language and facial expression to communication BCI utterances. Here, we review the current state of the art of existing BCI and FES work in people with paralysis of body and face and propose that a combined BCI-FES approach, which has already proved successful in several applications in stroke and spinal cord injury, can provide a novel promising mode of communication for locked-in individuals.
Topics: Humans; Brain-Computer Interfaces; User-Computer Interface; Locked-In Syndrome; Paralysis; Electric Stimulation; Brain
PubMed: 37980536
DOI: 10.1186/s12984-023-01272-y -
Nature Mar 2018
Topics: Aging; Anti-Bacterial Agents; Autoimmune Diseases; Drug Discovery; Gastrointestinal Microbiome; Gene Editing; Humans; Infant, Newborn; Infections; Medicine; Paralysis
PubMed: 29517043
DOI: 10.1038/d41586-018-02472-6 -
The Journal of Hand Surgery Oct 2017The posterior interosseous nerve (PIN) is susceptible to a number of traumatic and atraumatic pathologies. In this article, we aim to review our current understanding of... (Review)
Review
The posterior interosseous nerve (PIN) is susceptible to a number of traumatic and atraumatic pathologies. In this article, we aim to review our current understanding of the etiology, pathology, diagnosis, treatment options, and published outcomes of atraumatic PIN palsy. In general, the etiology of atraumatic PIN palsy can be divided into mechanical, which is caused by an extrinsic compressive force on the nerve, and nonmechanical, which is caused by an intrinsic inflammatory reaction within the nerve. As per this discussion, there are 3 causes for atraumatic PIN palsy. These are entrapment neuropathy, Parsonage-Turner syndrome, and spontaneous "hourglass" constriction. The typical presentation of atraumatic PIN palsy is a patient with spontaneous onset of weakness of fingers/thumb metacarpophalangeal joints extension. However, the wrist extension is preserved with radial deviation due to preservation of extensor carpi radialis longus/brevis function. Magnetic resonance imaging is the imaging of choice and neurophysiology is indicated in all patients. If there is an obvious structural cause of the nerve palsy, prompt decompression and removal of the causative lesion are recommended to avoid irreversible damage to the nerve/muscles. Otherwise, in general, we would recommend consideration for exploration should there be no sign of recovery after 6 weeks of observation.
Topics: Hand; Humans; Nerve Compression Syndromes; Paralysis
PubMed: 28969808
DOI: 10.1016/j.jhsa.2017.07.026 -
Science (New York, N.Y.) Apr 2023Neuroprosthetic technologies can control blood pressure and restore walking.
Neuroprosthetic technologies can control blood pressure and restore walking.
Topics: Humans; Paralysis; Walking; Blood Pressure; Neural Prostheses; Spinal Cord Injuries
PubMed: 37023195
DOI: 10.1126/science.adg7669 -
Practical Neurology Nov 2023Classic Raymond syndrome is a rare neurological presentation comprising ipsilateral abducens palsy, contralateral facial paresis and contralateral hemiparesis. We...
Classic Raymond syndrome is a rare neurological presentation comprising ipsilateral abducens palsy, contralateral facial paresis and contralateral hemiparesis. We present a man in his late 60s who presented with diplopia, dysarthria and right-sided limb weakness. This syndrome is one of a group of 'crossed paralyses' of the caudal pons.
Topics: Male; Humans; Brain Ischemia; Stroke; Pons; Facial Paralysis; Paresis; Ischemic Stroke
PubMed: 37524438
DOI: 10.1136/pn-2023-003782 -
Journal of the Neurological Sciences May 2020
Topics: Genetic Predisposition to Disease; Humans; Hypokalemic Periodic Paralysis; Paralyses, Familial Periodic; Paralysis; Thyrotoxicosis
PubMed: 32229026
DOI: 10.1016/j.jns.2020.116794