Visual Snow: A Case Series from Israel.

Our aim was to examine the symptoms and clinical characteristics of visual snow in a group of 6 patients from a Department of Ophthalmology and a Department of Neurology. Visual snow is now recognized as a true physiological disorder. Previously, physicians unaware of this syndrome may have misinterpreted its symptoms as a persistent visual aura. By promoting awareness of this syndrome, greater quantitative and qualitative research may expand our understanding and treatment of this disorder.

[WHEN IT SNOWS ALL YEAR ROUND - VISUAL SNOW].

INTRODUCTION: Visual snow is a neurological condition manifested as a prolonged visual experience of small flickering dots encompassing the entire visual field with additional visual and sensory-neural symptoms. The pathogenesis of this disturbance is unknown, although much progress has been made in recent years. The disturbance has been better defined and characterized. Additional insight into the pathological processes that play a role in this phenomenon has been gained, and different treatment modalities have been tried, some with better results. The purpose of this review is to increase awareness of this syndrome.

Effect of a Complementary/Integrative Medicine Treatment Program on Taxane-Induced Peripheral Neuropathy: A Brief Report.

OBJECTIVE: Peripheral neuropathy is a common complication of cancer treatment impairing quality of life and function. This study explored the impact of a complementary and integrative medicine (CIM) program on taxane-induced peripheral neuropathy (TIPN). MATERIALS AND METHODS: Taxane-treated female patients with breast and gynecological cancer reporting TIPN-related symptoms were referred to an integrative physician, followed by patient-tailored CIM treatments (acupuncture with/without other modalities). Assessment of study outcomes at 6 to 12 weeks was conducted using the Measure Yourself Concerns and Wellbeing, which documented free-text narratives about patients' experience during the CIM treatment process. Content was analyzed using ATLAS.Ti software. RESULTS: Of the 125 patients treated with taxanes, 69 had been referred for CIM treatment of TIPN-associated symptoms. Multidisciplinary narrative analysis identified 2 groups of CIM-treated patients: those with an apparently moderate improvement in symptoms (n = 35) and those with either only an apparent mild or no improvement at all. For 10 patients, assessment of their response to treatment was unclear. The 2 identified groups had similar demographic, cancer-related, and quality of life-related parameters at baseline. Content analysis of patients with an apparent moderate improvement suggested a short-term (24-48 hours) effect with acupuncture treatment, either alone or combined with manual, mind-body, and anthroposophic music therapies. Symptoms showing improvement included paresthesia and numbness. CONCLUSIONS: Acupuncture and other CIM therapies may result in a short-term and transitory reduction in TIPN-related symptoms.

Susac's Syndrome: A Case with Unusual Cardiac Vestibular and Imaging Manifestations.

Susac's syndrome (SS) is a disease of the microvasculature of the retina, brain, and inner ear. We describe a patient with unusual manifestations of SS with possible involvement of the brainstem, cardiac arrhythmia, and MRI findings lacking the characteristic lesions found in Susac's syndrome.

Three-dimensional computerized mobilization of the cervical spine for the treatment of chronic neck pain: a pilot study.

BACKGROUND: Manual therapies for chronic neck pain are imprecise, inconsistent, and brief due to therapist fatigue. A previous study showed that computerized mobilization of the cervical spine in the sagittal plane is a safe and potentially effective treatment of chronic neck pain. OBJECTIVE: To investigate the safety and efficacy of computerized mobilization of the cervical spine in a three-dimensional space for the treatment of chronic neck pain. DESIGN: Pilot, open trial. SETTING: Physical therapy outpatient department. PARTICIPANTS: Nine patients with chronic neck pain. INTERVENTIONS: A computerized cradle capable of three-dimensional neck mobilizations was used. Treatment sessions lasted 20 minutes, biweekly, for six weeks. MAIN OUTCOME MEASURES: Visual analog scale (VAS) for pain, cervical range of motion (CROM), neck disability index (NDI), joint position error (JPE), and muscle algometry. RESULTS: Comparing baseline at week one with week six (end of treatment), the VAS scores dropped by 2.9 points (P < 0.01). The six directions of movement studied by the CROM showed a combined increase of 11% (P = 0.01). The NDI decreased significantly from 16 to 10 (P = 0.03), and the JPE decreased significantly from 3.7° to 1.9° (P = 0.047). There was no change in the pressure pain threshold in any muscle tested. There were no significant adverse effects. CONCLUSIONS: These preliminary results demonstrate that this novel, computerized, three-dimensional cervical mobilization device is probably safe. The data also suggest that this method is effective in alleviating neck pain and associated headache, and in increasing the CROM, although the sample size was small in this open trial.

Chemotherapy-related cognitive impairment: does integrating complementary medicine have something to add? Review of the literature.

Chemotherapy-related cognitive impairment is a phenomenon of cognitive decline that some patients experience during and after chemotherapy. The prevalence of chemotherapy-related cognitive impairment in cancer survivors ranges from 14 to 85 %. Memory loss and lack of concentration are the most frequent symptoms, often resulting in deterioration of daily functioning and a decreased quality of life. Despite ongoing research on chemotherapy-related cognitive impairment, a clear understanding of the underlying mechanisms of the neurotoxicity induced by chemotherapy and the factors that determine a patient's vulnerability are still lacking. We review current knowledge regarding the etiology of chemotherapy-related cognitive impairment, risk factors, conventional therapy, coping strategies, and potential complementary and integrative medicine treatments. Complementary and integrative medicine modalities that may improve chemotherapy-related cognitive impairment include mind-body techniques and acupuncture, as well as nutrition and herbal therapies. Studies on these modalities have not directly tested the hypothesis of modifying chemotherapy-related cognitive impairment and were done on different disorders of memory loss and lack of concentration. We recommend conducting further research on the potential role of complementary and integrative medicine modalities in the treatment and prevention of chemotherapy-related cognitive impairment.

Computerized mobilization of the cervical spine for the treatment of chronic neck pain.

BACKGROUND: Manual therapies for chronic neck pain (NP) are imprecise, inconsistent, and brief because of therapist fatigue. OBJECTIVE: Investigate the safety and efficacy of computerized mobilization of the cervical spine in the sagittal plane for the treatment of chronic NP. DESIGN: Pilot open trial. SETTING: : Physical therapy outpatient department. PARTICIPANTS: Ten patients with chronic NP. INTERVENTIONS: A computerized cradle capable of 3-dimensional neck mobilization was utilized. However, in the present trial the cradle was only utilized in the sagittal plane. Treatment sessions lasted 20 minutes, biweekly, for 6 weeks. MAIN OUTCOME MEASURES: : Numerical rating scale for pain, Neck Disability Index questionnaire, muscle algometry, cervical range of motion (CROM), surface electromyography, and 36-item Short Form Health Survey questionnaire. RESULTS: Treatment was not associated with any significant adverse effects. Pain scores reduced by 2 ± 0.5 numerical rating scale points. CROM showed significant improvement at the end of the study (P<0.05). Neck Disability Index showed marked improvement by the fourth week, end of study, and 2 weeks after treatment (P<0.05); headache subscale showed marked reduction. CONCLUSIONS: These preliminary results demonstrate the safety of a novel computerized mobilization of the cervical spine. In addition, the data suggest that this method is effective in increasing CROM and in alleviating NP and associated headache.

Antiepileptic drugs in the treatment of neuropathic pain.

Antiepileptic drugs are an effective treatment for various forms of neuropathic pain of peripheral origin, although they rarely provide complete pain relief. Multiple multicentre randomised controlled trials have shown clear efficacy of gabapentin and pregabalin for postherpetic neuralgia and painful diabetic neuropathy. Theses drugs can be rapidly titrated and are well tolerated. Topiramate, lamotrigine, carbamazepine and oxcarbazepine are alternatives for the treatment of painful diabetic neuropathy, but should be titrated slowly. Carbamazepine remains the drug of choice for trigeminal neuralgia; however, oxcarbazepine and lamotrigine are potential alternatives. There is an apparent need for large-scale randomised controlled trials on the efficacy of antiepileptic drugs in neuropathic pain in general, and in cancer-related neuropathic pain and neuropathic pain of central origin in particular. Trials with long-term follow-up are required to establish the long-term efficacy of antiepileptic drugs in neuropathic pain. There is only limited scientific evidence to support the idea that drug combinations are likely to be more efficacious and safer than each drug alone; further studies are warranted in this area.

Acupuncture therapy for persistent hiccups.

Persistent hiccups (singultus) is a rare but severely disabling disorder. The causes of persistent hiccups are numerous, as are the treatment options. However, none of the treatment modalities has proven to be effective by evidence-based criteria, and no treatment has been shown to be superior to another. Traditional acupuncture has not been previously reported as a modality for the treatment of persistent hiccups in the English medical literature. We describe 2 patients with persistent hiccups refractory to conventional treatments that were treated successfully using acupuncture.