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1. Clock face model applied to tibial intraneural ganglia in the popliteal fossa

Author

Marie Noëlle Hébert-Blouin, Allen Maniker, Robert J. Spinner, and Kimberly K. Amrami

Subjects
musculoskeletal diseases, medicine.medical_specialty, Popliteal Vein, Popliteal fossa, Superior tibiofibular joint, Models, Biological, medicine, Humans, Radiology, Nuclear Medicine and imaging, Cyst, Tibia, Tibial nerve, Retrospective Studies, medicine.diagnostic_test, business.industry, Popliteus muscle, Magnetic resonance imaging, Anatomy, musculoskeletal system, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, Orthopedic surgery, Ganglia, Tibial Nerve, business
Abstract

Tibial intraneural ganglia occurring in the popliteal fossa are often misdiagnosed because of their relative rarity. Their joint connection is typically not recognized and therefore not treated, leading to recurrence. This is a retrospective clinical study. Magnetic resonance images (MRIs) of six patients with confirmed tibial intraneural ganglia arising from the superior tibiofibular joint were analyzed and were compared to ten individuals with normal tibial nerves who were imaged with MRI. All studies were interpreted as left-sided. A previously designed clock face model introduced for peroneal intraneural ganglia was used to describe the superior tibiofibular joint connection (tail sign). A single axial image was sought to determine the normal anatomic and pathologic relationships of the tibial nerve and tibial articular branch to the superior tibiofibular joint. In all patients with intraneural ganglia, a single conventional axial image at the mid-fibular head level could reliably demonstrate: (1) intraneural cyst within the articular branch at the superior tibiofibular joint connection (tail sign) between 8 and 9 o’clock and intraneural cyst within the tibial nerve, (2) the central location of the tibial nerve posterior to the tibia, and (3) popliteus muscle denervation changes and atrophy (popliteus sign). This technique can provide radiologists and surgeons with rapid and reproducible information for diagnosis and treatment planning of tibial intraneural ganglia. Similar to its use with the clock face model in peroneal intraneural ganglia, a standard axial image at the mid-fibular head level can be used to interpret key features of tibial intraneural ganglia and identify the joint connection. Improved identification of the presence of a joint connection will change the therapeutic approach of this pathology and reduce cyst recurrences.

Published
2009
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2. Contributors

Author

Frank L. Acosta, P. David Adelson, John R. Adler, ., Kamran V. Aghayev, Manish K. Aghi, Basheal M. Agrawal, Manmeet S. Ahluwalia, Faiz Ahmad, Ellen Air, Pablo Ajler, Felipe C. Albuquerque, Arun P. Amar, Luca Amendola, Christopher Ames, Beejal Y. Amin, Sepideh Amin-Hanjani, Joshua M. Ammerman, William S. Anderson, Ronald I. Apfelbaum, Michael L.J. Apuzzo, Rocco Armonda, Paul M. Arnold, Harel Arzi, Ashok R. Asthagiri, Kurtis Auguste, Tariq E. Awad, Khaled M. Aziz, Tipu Aziz, Joachim M. Baehring, Mirza N. Baig, Roy Bakay, Perry A. Ball, Stefano Bandiera, Nicholas M. Barbaro, Frederick G. Barker, Daniel L. Barrow, Sachin Batra, Joshua Bederson, Kimon Bekelis, Carlo Bellabarba, Lorenzo Bello, Allan J. Belzberg, Bernard R. Bendok, Ludwig Benes, Edward C. Benzel, Helmut Bertalanffy, Chetan Bettegowda, Ravi Bhatia, Sanjay Bhatia, Allen T. Bishop, Keith L. Black, Lewis S. Blevins, George T. Blike, Ari Blitz, Göran C. Blomstedt, Benjamin Blondel, Kofi Boahene, Bernardo Boleaga, Markus Bookland, Stefano Boriani, Christopher M. Boxell, Henry Brem, Albino Bricolo, Jason A. Brodkey, Jacques Brotchi, Jeffrey N. Bruce, Michael Bruneau, Bradley R. Buchbinder, Kim J. Burchiel, Timothy G. Burke, Ali Bydon, Francesco Cacciola, Kevin Cahill, Paolo Cappabianca, Anthony J. Caputy, Francesco Cardinale, Ricardo L. Carrau, Benjamin S. Carson, Bob S. Carter, Giuseppe Casaceli, Laura Castana, Gabriel Castillo, Luigi M. Cavallo, C. Michael Cawley, Aabir Chakraborty, Edward F. Chang, Eric C. Chang, Steven D. Chang, Jens R. Chapman, E. Thomas Chappell, Neeraj Chaudhary, Douglas Chen, James Chen, Linda C. Chen, Boyle C. Cheng, Joshua J. Chern, John H. Chi, Wade W. Chien, E. Antonio Chiocca, Rohan Chitale, Bhupal Chitnavis, Lana D. Christiano, Ray M. Chu, Elisa F. Ciceri, Michelle J. Clarke, Alan Cohen, Annamaria Colao, Geoffrey P. Colby, Massimo Collice, Daniel Condit, Alexander L. Coon, Cassius Vinícius Corrêa Dos Reis, G. Rees Cosgrove, Massimo Cossu, William T. Couldwell, William T. Curry, Guilherme Dabus, Teodoro Forcht Dagi, Giuseppe D'Aliberti, Moise Danielpour, Mark J. Dannenbaum, Ronan M. Dardis, Hormuzdiyar H. Dasenbrock, Reza Dashti, Arthur L. Day, John Diaz Day, Vedran Deletis, Ramiro Del-Valle, Franco DeMonte, Francesco Dimeco, Robert Dodd, Francesco Doglietto, Lutz Dörner, Michael J. Dorsi, Gaby D. Doumit, James M. Drake, Doniel Drazin, Rose Du, Thomas B. Ducker, Hugues Duffau, Bradley S. Duhon, Paula Eboli, Mohamed Samy Elhammady, Pamela Ely, Nancy E. Epstein, Kadir Erkmen, Thomas Errico, Emad N. Eskandar, Clifford J. Eskey, Felice Esposito, Camilo E. Fadul, Gilbert J. Fanciullo, Kyle M. Fargen, Gidon Felsen, Dong Xia Feng, Richard G. Fessler, Aaron G. Filler, John C. Flickinger, John R. Floyd, Kevin T. Foley, Kostas N. Fountas, Howard Francis, James L. Frazier, Kai Frerichs, David M. Frim, Sebastien Froelich, Takanori Fukushima, Philippe Gailloud, Sergio Maria Gaini, Chirag D. Gandhi, Dheeraj Gandhi, Gale Gardner, Paul Gardner, Mark Garrett, Tomás Garzón-Muvdi, Alessandro Gasbarrini, Fred H. Geisler, Joseph J. Gemmete, Massimo Gerosa, Atul Goel, Ziya L. Gokaslan, L. Fernando Gonzalez, C. Rory Goodwin, Takeo Goto, Grahame C. Gould, M. Sean Grady, Andrew W. Grande, Ramesh Grandhi, Alexander L. Green, Jeffrey P. Greenfield, Bradley A. Gross, Rachel Grossman, Mari Groves, Gerardo Guinto, Richard Gullan, Gaurav Gupta, Nalin Gupta, Todd C. Hankinson, Ake Hansasuta, James S. Harrop, Griffith R. Harsh, Alia Hdeib, Stefan Heinze, John Heiss, Dieter Hellwig, Juha Hernesniemi, Roberto C. Heros, Todd Hillman, Jose Hinojosa, Girish K. Hiremath, Brian L. Hoh, L. Nelson Hopkins, Wesley Hsu, Yin C. Hu, Jason H. Huang, Judy Huang, Peter J. Hutchinson, Jonathan A. Hyam, Adriana G. Ioachimescu, Pascal M. Jabbour, Juan Jackson, George I. Jallo, Ivo P. Janecka, Mohsen Javadpour, Andrew Jea, Sunil Jeswani, David H. Jho, Diana H. Jho, Hae-Dong Jho, Bowen Jiang, Tae-Young Jung, M. Yashar S. Kalani, Hideyuki Kano, Silloo B. Kapadia, Michael G. Kaplitt, Christoph Kappus, Eftychia Z. Kapsalaki, Yuval Karmon, Amin B. Kassam, Sudhir Kathuria, Takeshi Kawase, Alexander A. Khalessi, Kathleen Khu, Daniel H. Kim, Matthias Kirsch ., Riku Kivisaari, Angelos G. Kolias, Douglas Kondziolka, Marcus C Korinth, Dietmar Krex, Mark D. Krieger, Kartik G. Krishnan, Ajit A. Krishnaney, Maureen Lacy, Santosh D. Lad, Jose Alberto Landeiro, Frederick F. Lang, Shih-Shan Lang, Françoise LaPierre, Paul S. Larson, Michael T. Lawton, Marco Lee, Martin Lehecka, Allan Levi, Elad I. Levy, Robert E. Lieberson, Michael Lim, Ning Lin, Göran Lind, Bengt Linderoth, Timothy Lindley, Antoine Listrat, Charles Y. Liu, James K. Liu, John C. Liu, Giorgio Lo Russo, Christopher M. Loftus, Russell R. Lonser, Daniel C. Lu, Yi Lu, L. Dade Lunsford, M. Mason Macenski, Jaroslaw Maciaczyk, Joseph R. Madsen, Subu N. Magge, Giulio Maira, Martijn J.A. Malessy, David G. Malone, Allen Maniker, Geoffrey T. Manley, Jotham Manwaring, Mitchell Martineau, Robert L. Martuza, Marlon S. Mathews, Nestoras Mathioudakis, Paul McCormick, Michael W. McDermott, Cameron G. McDougall, H. Maximilian Mehdorn, Vivek A. Mehta, Arnold Menezes, Patrick Mertens, Frederic B. Meyer, Matthew K. Mian, Rajiv Midha, Diego San Millán Ruíz, Jonathan Miller, Neil R. Miller, Zaman Mirzadeh, Ganpati Prasad Mishra, Symeon Missios, James B. Mitchell, Alim Mitha, J. Mocco, Abhay Moghekar, Jacques J. Morcos, Chad J. Morgan, John F. Morrison, Henry Moyle, Carrie R. Muh, Debraj Mukherjee, Arya Nabavi, Michael J. Nanaszko, Dipankar Nandi, Raj Narayan, Sabareesh K. Natarajan, Edgar Nathal, Vikram V. Nayar, Audumbar Shantaram Netalkar, C. Benjamin Newman, Trang Nguyen, Laura B. Ngwenya, Antonio Nicolato, Mika Niemelä, Guido Nikkhah, Anitha Nimmagadda, John K. Niparko, Ajay Niranjan, Richard B. North, José María Núñez, W. Jerry Oakes, Christopher S. Ogilvy, Kenji Ohata, Jeffrey G. Ojemann, Steven Ojemann, David O. Okonkwo, Edward H. Oldfield, Brent O'Neill, Nelson M. Oyesiku, Roberto Pallini, Aditya S. Pandey, Dachling Pang, Kyriakos Papadimitriou, José María Pascual, Aman Patel, Anoop P. Patel, Toral R. Patel, Vincenzo Paterno, Rana Patir, Alexandra R. Paul, Sanjay J. Pawar, Richard Penn, Erlick A.C. Pereira, Mick J. Perez-Cruet, Eric C. Peterson, Mark A. Pichelmann, Joseph M. Piepmeier, Marcus O. Pinsker, Lawrence H. Pitts, Rick J. Placide, Willem Pondaag, Kalmon Post, Matthew B. Potts, Lars Poulsgaard, Gustavo Pradilla, Charles J. Prestigiacomo, Daniel M. Prevedello, Ruth Prieto, Alfredo Quiñones-Hinojosa, Leonidas M. Quintana, Scott Y. Rahimi, Rudy J. Rahme, Rodrigo Ramos-Zúñiga, Nathan J. Ranalli, Shaan M. Raza, Pablo F. Recinos, Violette Renard Recinos, Shrikant Rege, Thomas Reithmeier, Katherine Relyea, Daniel Resnick, Daniele Rigamonti, Philippe Rigoard, Jaakko Rinne, Jon H. Robertson, Shimon Rochkind, Jack P. Rock, Rossana Romani, Guy Rosenthal, Robert H. Rosenwasser, Nathan C. Rowland, James T. Rutka, Samuel Ryu, Francesco Sala, Roberto Salvatori, Kari Sammalkorpi, Nader Sanai, Thomas Santarius, Amar Saxena, Gabriele Schackert, Uta Schick, Thomas A. Schildhauer, Alexandra Schmidek, Henry H. Schmidek, Meic H. Schmidt, Paul Schmitt, Johannes Schramm, Joseph Schwab, Theodore H. Schwartz, Patrick Schweder, Daniel M. Sciubba, R. Michael Scott, Raymond F. Sekula, Patrick Senatus, Amjad Shad, Ali Shaibani, Manish S. Sharma, Rewati Raman Sharma, Sameer A. Sheth, Alexander Y. Shin, Ali Shirzadi, Adnan H. Siddiqui, Roberto Leal Silveira, Nathan E. Simmons, Marc Sindou, Marco Sinisi, Timothy Siu, Edward Smith, Joseph R. Smith, Patricia Smith, Matthew Smyth, Domenico Solari, David Solomon, Adam M. Sonabend, Mark M. Souweidane, Edgardo Spagnuolo, Robert F. Spetzler, Robert J. Spinner, Andreas M. Stark, Philip A. Starr, Ladislau Steiner, Michael P. Steinmetz, Shirley I. Stiver, Prem Subramanian, Michael E. Sughrue, Ian Suk, Daniel Q. Sun, Ulrich Sure, Oszkar Szentirmai, Alexander Taghva, Giuseppe Talamonti, Rafael J. Tamargo, Richard J. Teff, John M. Tew, Nicholas Theodore, Philip V. Theodosopoulos, B. Gregory Thompson, Wuttipong Tirakotai, Stavropoula I. Tjoumakaris, James H. Tonsgard, David Trejo, Michael Trippel, R. Shane Tubbs, Luis M. Tumialan, Andreas Unterberg, Michael S. Vaphiades, T. Brooks Vaughan, Anand Veeravagu, Ana Luisa Velasco, Francisco Velasco, Gregory J. Velat, Angela Verlicchi, Frank D. Vrionis, Michel Wager, M. Christopher Wallace, Gary S. Wand, Benjamin C. Warf, Michael F. Waters, Joseph Watson, Martin H. Weiss, Nirit Weiss, William Welch, J. Kent Werner, Louis A. Whitworth, Christopher Winfree, Timothy F. Witham, Jean-Paul Wolinsky, Judith M. Wong, Shaun Xavier, Bakhtiar Yamini, Claudio Yampolsky, Michael J. Yaremchuk, Reza Yassari, Chun-Po Yen, John Yianni, Alexander K. Yu, Eric L. Zager, Bruno Zanotti, Marco Zenteno, Mehmet Zileli, and Alexandros D. Zouzias

Published
2012
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4. Safety and efficacy of vagus nerve stimulation in Fibromyalgia: A Phase I/II proof of concept trial

Author

Jennifer FitzGibbons, Gudrun Lange, Dane B. Cook, Malvin N. Janal, Benjamin H. Natelson, Malusha Fobler, and Allen Maniker

Subjects
Adult, medicine.medical_specialty, Neurology, Fibromyalgia, Vagus Nerve Stimulation, medicine.medical_treatment, Pilot Projects, Article, Epilepsy, Postoperative Complications, Quality of life, medicine, Humans, Depression (differential diagnoses), business.industry, Chronic pain, General Medicine, Middle Aged, medicine.disease, Anesthesiology and Pain Medicine, Tolerability, Physical therapy, Female, Neurology (clinical), Analgesia, business, Vagus nerve stimulation, Follow-Up Studies
Abstract

We performed an open-label Phase I/II trial to evaluate the safety and tolerability of vagus nerve stimulation (VNS) in patients with treatment-resistant fibromyalgia (FM) as well as to determine preliminary measures of efficacy in these patients.Of 14 patients implanted with the VNS stimulator, 12 patients completed the initial 3-month study of VNS; 11 patients returned for follow-up visits 5, 8, and 11 months after start of stimulation. Therapeutic efficacy was assessed with a composite measure requiring improvement in pain, overall wellness, and physical function. Loss of both pain and tenderness criteria for the diagnosis of FM was added as a secondary outcome measure because of results found at the end of 3 months of stimulation.Side effects were similar to those reported in patients treated with VNS for epilepsy or depression and, in addition, dry mouth and fatigue were reported. Two patients did not tolerate stimulation. At 3 months, five patients had attained efficacy criteria; of these, two patients no longer met widespread pain or tenderness criteria for the diagnosis of FM. The therapeutic effect seemed to increase over time in that additional participants attained both criteria at 11 months.Side effects and tolerability were similar to those found in disorders currently treated with VNS. Preliminary outcome measures suggested that VNS may be a useful adjunct treatment for FM patients resistant to conventional therapeutic management, but further research is required to better understand its actual role in the treatment of FM.

Published
2011

7. Myokymia in obstetrically related brachial plexopathy

Author

Gary, Sclar, Allen, Maniker, and Joseph, Danto

Abstract

Myokymic discharges are spontaneous bursts of semirhythmic potentials that are sometimes correlated with rippling movements of skin and muscle. They have been reported in limb muscles in patients with Guillain-Barré syndrome, spinal stenosis, nerve root and nerve compression, and envenomations. They commonly occur with radiation induced plexopathies (approximately 60% of patients), but have not been reported in obstetrically related brachial plexopathies. We report 2 instances of myokymia in children with obstetric brachial plexus palsies. Each child was studied twice, and it was only at the later study, when the child was 10 or 11 months of age, that these potentials were noted. This could represent ongoing recovery from lesions incurred at birth or developmental changes. The final common pathway of all causes of myokymia could be to generate axonal membrane hyperexcitability.

Published
2008

8. Malignant peripheral nerve sheath tumors

Author

Gaurav Gupta, Antonios Mammis, and Allen Maniker

Subjects
Pathology, medicine.medical_specialty, Cell of origin, Schwann cell, Antineoplastic Agents, Nerve sheath, Nerve Sheath Neoplasms, Pathogenesis, Peripheral nerve, Peripheral Nervous System Neoplasms, Risk Factors, Peripheral Nerve Sheath Tumors, medicine, Humans, business.industry, Soft tissue sarcoma, Neural crest, General Medicine, medicine.disease, Combined Modality Therapy, Magnetic Resonance Imaging, medicine.anatomical_structure, Positron-Emission Tomography, Surgery, Neurology (clinical), business
Abstract

Malignant peripheral nerve sheath tumors (MPNSTs) are a rare variety of soft tissue sarcoma of ectomesenchymal origin. MPNSTs arise from major or minor peripheral nerve branches or sheaths of peripheral nerve fibers and are derived from Schwann cells or pluripotent cells of neural crest origin. Arthur Purdy Stout played a pivotal role in the development of our current understanding of the pathogenesis of peripheral nerve sheath tumors by identifying the Schwann cell as the major contributor to the formation of benign and malignant neoplasms of the nerve sheath. Although this fact remains essentially true, the cell of origin of the MPNST remains elusive and has not yet conclusively been identified. Some have suggested these tumors may have multiple cell line origins. In the present review, MPNSTs and their epidemiology, diagnosis, management, and treatment are discussed.

Published
2008

9. Malignant peripheral nerve sheath tumors

Author

Gaurav Gupta and Allen Maniker

Subjects
Pathology, medicine.medical_specialty, Neurofibroma, business.industry, Cell of origin, Neural crest, Schwann cell, General Medicine, Schwannoma, medicine.disease, Nerve Sheath Neoplasms, medicine.anatomical_structure, Peripheral Nervous System Neoplasms, Neurofibrosarcoma, medicine, Humans, Surgery, Neurology (clinical), Sarcoma, Neurofibromatosis, business, Peripheral Nerve Sheath
Abstract

Malignant peripheral nerve sheath tumors (MPNSTs) are rare soft tissue sarcomas of ectomesenchymal origin. The World Health Organization coined the term MPNST to replace previous heterogeneous and often confusing terminology, such as "malignant schwannoma," "malignant neurilemmoma," "neuro- genic sarcoma," and "neurofibrosarcoma." Malignant peripheral nerve sheath tumors arise from major or minor peripheral nerve branches or sheaths of peripheral nerve fibers, and are derived from Schwann cells or pluripotent cells of neural crest origin. The Schwann cell is thought to be the major contributor to the formation of benign as well as malig- nant neoplasms of the nerve sheath. While this fact remains essentially true, the identity of cell of origin of the MPNST remains elusive, and has not yet been conclusively identified. It has been suggested that these tumors may have multiple cell line origins. In this review, the authors discuss the epidemiology, diagnosis, management, and treatment of MPNSTs. KEY WORDSmalignant tumorneurofibromatosisperipheral nerve sheath

Published
2007

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