Cortical Reorganization Allows for Motor Recovery after Crossed Cerebrocerebellar Atrophy

The authors report the case of a 33-year-old woman who exhibited, at the age of 17, a left-sided hemiplegia, which was followed by good motor recovery, though with a permanent deficit in fine finger movements. She had a widespread loss of neural tissue in the right hemisphere (crossed cerebrocerebellar atrophy), including (1) marked atrophy and thinning of the precentral and postcentral gyri; (2) widespread deep white matter destruction, including the corticospinal tract; and (3) crossed cerebellar atrophy. Except over the supplementary motor area (SMA), transcranial magnetic stimulation did not elicit motor evoked potentials in the affected hand. Nevertheless, during opening and closing of the affected hand, functional magnetic resonance imaging showed an activation of the lesioned primary sensorimotor cortex (SMC), as well as of the intact SMA and the parietal areas, but not of the ipsilateral motor areas. The authors speculate that recovery was achieved by a motor command generated in the SMC and the parietal cortex, passing through corticospinal axons originating in the SMA.     

Long-term treatment outcomes of coretherm microwave feedback thermotherapy

The gold standard for definitive management of symptomatic benign prostatic hypertrophy is transurethral resection of the prostate (TURP). Despite its efficacy, TURP has significant morbidity/mortality concerns such as hemorrhage and transurethral resection syndrome. This is especially worrisome for the medically high-risk patient, but the high rates of retrograde ejaculation found with TURP also pose a problem for young patients. A minimally invasive, outpatient alternative to TURP that has long-term efficacy, low morbidity/mortality, and provides a cost-effective advantage is in high demand. This review article discusses microwave thermotherapy as such an option and reports the long-term experience with the CoreTherm (CoreTherm Operations AB, Sweden) device.     

Contact diode laser myringotomy and mitomycin C in children

OBJECTIVE: To investigate the use of contact diode laser myringotomy (C-LAM), combined with topical mitomycin C, as an alternative method for prolonged middle ear ventilation in children with otitis media with effusion. STUDY DESIGN AND SETTING: Prospective study at a tertiary care pediatric institution. METHODS: Fifteen children enrolled in the study. Mitomycin C was applied to the intact tympanic membrane in the right ears, whereas saline on the left side was used for controls. C-LAM was then performed in all ears. Outcome measures included healing rate and scarring, ear infection, and long-term audiometric follow-up. RESULTS: There was no significant difference in median healing rate. In each group, the median was between the third and fourth month. Normal hearing thresholds were obtained in all children at 2-year follow-up. CONCLUSION: C-LAM proved to be an effective method for medium-term ventilation, but topical mitomycin C before C-LAM did not prolong patency rate in our patients. No significant complication was encountered at 2-year follow-up.