Cervical Stimulation Research Articles

Brain Mapping – Neuromuscular correlations in long-term Postsurgical rehabilitation of Adult Brachial Plexus Palsies

Abstract: Background: Correlations of Transcranial magnetic stimulation (TMS) mapping of the cortical area and electromyography (EMG) + dynamometric testing may demonstrate active neuroplas-ticity events that are reliant on rehabilitation therapy (RT) compliance in adult postsurgical brachial plexus (BP) injuries. Material and Methods: On the right (dominant) arm of two patients with chronic operated BP lesions, we evaluated the progress of functional recovery. The trau-matic event was dated more than 10 years ago for both patients. The first patient (male, 50 years old) and the second one (female, 58 years old) had a history of several microsurgical neurotiza-tion and muscle transfer procedures, with less amelioration of the motor deficit, especially re-lated to elbow flexion (MRC 1/5 and 2/5, respectively). We followed up their evolution by EMG parameters, dynamometry, MRC scaling, and TMS. The motor region of the limb was mapped using TMS to assess the amplitudes of the motor evoked potentials (MEP), on a 4-axis protocol. The patients were assessed twice, with the second examination performed after RT had just fin-ished. TMS findings were compared with EMG and dynamometric results. Results: Higher MEP amplitudes were associated with improved MEP latency during stimulation of the left cerebral hemisphere's cortical area, as well as at the cervical level. EMG findings, both nerve conduction and needle EMG studies showed nonsignificant improvements, as well as muscle strength (as measured by the hydraulic dynamometer). The best results for the first patient showed an in-crease in MEP’s amplitude increase from 1.08 mV to 1.49 mV (in the hotspot), which correlated with measurable latencies, as compared to the first TMS (when no response was obtained at cer-vical stimulation). The second patient also had improvements in latencies: from 37.1 msec. to 36.3 msec. (cervical stimulation with recording at bicipital level) and from 39.2 msec. to 37.9 (cervical stimulation recording at the first interosseous), with a hotspot increase from 1.35 mV to 1.98 mV. The results demonstrate cortical region reactivity in regard to therapeutic techniques. Central modifications do not correlate with visible EMG and dynamometric improvements. Pa-tients with traumatic BP palsy may receive several microsurgical reconstructive procedures, nevertheless, the rehabilitation of the upper limb’s functionality may sometimes still be limited. This increases the risk of discontinuity of the neuromotor RT. We aim to prove that in spite of little correlations with clinical and EMG findings, mapping the cortical area using TMS provides proof of ongoing neuroplasticity phenomena, dependent on adherence to RT. Conclusion: The evidence of continued brain activity supports the requirement for long-term adherence to treatment guidelines and long-term study protocols.

(023) An Online Survey Study Investigating the Contribution of the Cervix to the Female Sexual Response and Patient-Reported Barriers to Sexual Counselling

Abstract Introduction The female sexual response is multifactorial and involves several anatomical locations which contribute to pleasurable sensations. Recently, the cervix has been discussed in terms of its role in the FSR, though there are still discrepancies regarding its contribution to these responses. Our pilot study showed that women are unfamiliar with the location of their cervix anatomically, but indicate feeling pleasure from deep penetration, and in the anatomical region of the cervix. If women experience pleasurable sensation from the cervix, then perhaps procedures that impact the cervix may impair overall pleasurable sexual responses in some women. In addition, there is some literature that describes barriers to sexual counselling for women, though these have not been thoroughly studied in the context of the FSR. Therefore, validation of the preliminary pilot data is needed, including confirmation of the importance of the cervix, in addition to defining barriers to sexual counselling. Objectives The objectives of this study were to determine whether women find cervical stimulation pleasurable and if it contributes to their sexual responses. This study also aimed to determine whether a medical history of gynecologic procedures is associated with negative impacts on sexual function, and what barriers women face when discussing sexual problems with their health care providers (HCPs). Methods A self-report survey was distributed via an online platform to over 500 participants. 308 responses were analyzed. IBM SPSS Statistics Version 26 was used for statistical analysis with CI (95%) and p-value (p≤ 0.05). Qualitative analysis was performed using Nvivo12. Results This study found that many women find cervical stimulation pleasurable, and that it is important to their overall sexual response. The responses also indicated that a subset of participants who underwent gynecologic procedures that impacted the cervix showed significant increases in levels of discomfort or pain during cervical stimulation (P<0.001) and difficulty becoming lubricated (p=0.016). Qualitative analysis of participants narrative responses when asking them to describe the location(s) of their sexual responses indicated that participants were better able to describe the location(s) using labelled diagrams rather than in words. Accordingly, a quarter of the participants indicated that they do not feel effective at communicating about their sexual sensations, nor do they feel capable of describing these sensations using words. Participants noted several barriers to sexual counselling with almost half of the participants indicating they feel uncomfortable talking to male physicians about their sexual responses, and that they feel stigma surrounding sexual sensations. Conclusions This study indicates that the cervix plays an important role in the FSR, and that procedures that impact the cervix may result in decreased sexual functioning. The results from this study also suggest that women have difficulty communicating their sexual responses using words and feel unable to discuss the concerns regarding their sexual responses with HCPs. Future studies should develop effective resources for physicians to communicate complex topics about sexual functioning to patients. They should also aim to investigate the experiences of women who experience FSD after procedures impacting the cervix, studies for which are ongoing. Disclosure No.

PSpice modeling of cervical and site-focused vagus nerve ultrasonic stimulation for reduced tumor necrosis factor-α production

Clinical ultrasound is widely used as a diagnostic and therapeutic tool. Recently, it has been used to perform neuromodulation to treat diverse effects, including inflammation reduction through the vagus nerve. Although the mechanism by which ultrasound propagates through tissue for diagnostic purposes has been established, there is not a complete understanding of how it interacts with neurons to elicit excitation and inhibit inflammation. This work presents a novel technique based on a well-established electrical engineering tool, PSpice, to model cervical and site-focused vagus nerve ultrasonic stimulation to understand its capability in reducing tumor necrosis factor-α (TNF-α) production in the spleen. Transmission line theory is utilized as the basis for the different tissue layers. The models supported the hypothesis that site-focused stimulation has the advantage to decrease undesired efferent effects that would otherwise occur with cervical stimulation. Two different acoustic pressures, 0.25 and 0.83 MPa, were simulated for theoretical efficacy and safety based on previous experimental work conducted by others. The 0.25 MPa simulation was ideal for neurostimulation and reduction of TNF-α, while 0.83 MPa resulted in much higher intensity levels that will most likely induce additional inflammation.

Cervical vasovagal shock: A rare complication of incomplete abortion case report.

Introduction and importanceCervical vasovagal shock is termed as stimulation either by instruments or products of conception at cervical os results into bradycardia and hypotension. In primary care settings cervical vasovagal shock can occur during insertion of an intrauterine device (IUD) or any cervical stimulation during physical examination. This case we highlight an uncommon complication of incomplete abortion which is the rare cause of cervical vasovagal shock.Case presentationA 42-year-old Gravida 3 Para 2 Living 2 with Gestational age of 12 weeks presented with vaginal spotting for 2 days. Initial examination she was conscious with normal vital signs. However, after initiation of medical management of incomplete abortion, she had increased per vaginal bleeding with hypotension and bradycardia. Speculum examination was done; this revealed products of conceptus in cervical os and a diagnosis of cervical vasovagal shock was made. Patient was then counselled for evacuation and informed consent was sought. She was taken for evacuation; suction and gentle curettage was done. Post evacuation patients' vitals returned to normal ranges, and patient taken to the ward to continue with post procedure management.Clinical discussionBleeding in the first trimester is a common presentation in up to 30 % in early pregnancies and more than 50 % of those will go on to have a normal pregnancy. Most patients with incomplete abortion present at emergence department with shock, this will commonly be due to sepsis, hypovolemia, or haemorrhage. In this case report with discuss a rare cause of shock in women with incomplete abortion.ConclusionCervical vasovagal effect of the products of conception passing through the cervix causes a reflex bradycardia. It is crucial as physician attending women with incomplete abortion to make sure all the product of conception are passed out and in situation if there is remaining products of conception in the cervix should be removed using a sponge-holding forceps to prevent vasovagal stimulation in the cervix.

ID:16594 C1/C2 High Cervical Spinal Cord Stimulation in Refractory Facial Pain: A Retrospective, Single-Center Case Series

The prevalence of craniofacial pain has been estimated to be approximately 25%(1). Within this group, Trigeminal Neuralgia (TN) and Trigeminal Neuropathy (TNP) are challenging entities to treat(2). C1/C2 High Cervical (C1/C2-HC) stimulation has been used in the management of refractory chronic migraine(3). The purpose of this study was to evaluate the efficacy and safety of C1/C2-HC stimulation in the management of TN & TNP.

Effect of Castor Oil on Cervical Ripening and Labor Induction: a systematic review and meta-analysis.

ObjectivesPost-term pregnancy is a condition associated with increased maternal and fetal complications. Administration of castor oil causes cervical stimulation by increasing the production of prostaglandins. We examined the effects of castor oil on cervical ripening and labor induction through a systematic review and meta-analysis.MethodsThe search process was performed to obtain relevant articles from databases including Pubmed, Cochrane library, Scopus, Science direct, SID, Iran Medex, and Google Scholar using the English keywords of cervical ripening, post-term, castor oil, labor induction, Bishop score, and pregnancy considering all possible combinations without time constraints and their Persian equivalents from national databases.ResultsA total of eight related articles from the 19 primary studies were extracted and systematically reviewed. According to a cumulative chart, the difference in the post-intervention Bishop score was statistically significant (standard mean difference [SMD] 1.64, 95% confidence interval [CI] 1.67-2.11, p = 0.001), indicating an effect of castor oil on increasing the Bishop score. In addition, the difference in labor induction was statistically significant after the intervention (odds ratio 11.67, 95% CI 3.34-40.81, p = 0.001), indicating an effect of castor oil on increasing the odds ratio of labor induction (experience of vaginal delivery).ConclusionThis meta-analysis showed that oral administration of castor oil is effective for cervical ripening and labor induction. Midwives should closely monitor pregnant women with prolonged labor and collaborate with obstetricians to employ castor oil as a safe intervention to induce cervical ripening and labor to prevent undue caesarean surgery.

Case Report: Godoy & Godoy method of cervical lymphatic therapy – indirect evaluation of the effect of the duration of stimulation on ocular edema

The aim of the present study is to report the indirect evaluation of cervical stimulation considering the effect of the duration of the stimulus on the control of intraocular pressure in a patient with bilateral glaucoma with important ocular edema. A 47-year-old woman reported the onset of pain and bilateral tearing in the eyes at 35 years of age and was diagnosed with glaucoma. The patient began clinical treatment, but intraocular pressure remained 35 to 40 mmHg even with the use of four eye medications in the form of drops. The patient reported that her vision was always blurred despite the use of the eyedrops. The patient was submitted to the Godoy & Godoy method of cervical lymphatic therapy to reduce the edema. The ophthalmologist measured her intraocular pressure every two and three days. We found that the pressure was maintained below 20 mmHg when lymphatic therapy was performed every two days, but intraocular pressure increased and the vision became blurred when therapy was performed every three days. The Godoy & Godoy method of cervical lymphatic therapy constitutes a novel lymphatic system stimulation strategy that maintains its effect on intraocular pressure for approximately 48 hours, as demonstrated through an indirect evaluation.

Effect of Cervical Transcutaneous Spinal Cord Stimulation on Sensorimotor Cortical Activity during Upper-Limb Movements in Healthy Individuals.

Transcutaneous spinal cord stimulation (tSCS) can improve upper-limb motor function after spinal cord injury. A number of studies have attempted to deduce the corticospinal mechanisms which are modulated following tSCS, with many relying on transcranial magnetic stimulation to provide measures of corticospinal excitability. Other metrics, such as cortical oscillations, may provide an alternative and complementary perspective on the physiological effect of tSCS. Hence, the present study recorded EEG from 30 healthy volunteers to investigate if and how cortical oscillatory dynamics are altered by 10 min of continuous cervical tSCS. Participants performed repetitive upper-limb movements and resting-state tasks while tSCS was delivered to the posterior side of the neck as EEG was recorded simultaneously. The intensity of tSCS was tailored to each participant based on their maximum tolerance (mean: 50 ± 20 mA). A control session was conducted without tSCS. Changes to sensorimotor cortical activity during movement were quantified in terms of event-related (de)synchronisation (ERD/ERS). Our analysis revealed that, on a group level, there was no consistency in terms of the direction of ERD modulation during tSCS, nor was there a dose-effect between tSCS and ERD/ERS. Resting-state oscillatory power was compared before and after tSCS but no statistically significant difference was found in terms of alpha peak frequency or alpha power. However, participants who received the highest stimulation intensities had significantly weakened ERD/ERS (10% ERS) compared to when tSCS was not applied (25% ERD; p = 0.016), suggestive of cortical inhibition. Overall, our results demonstrated that a single 10 min session of tSCS delivered to the cervical region of the spine was not sufficient to induce consistent changes in sensorimotor cortical activity among the entire cohort. However, under high intensities there may be an inhibitory effect at the cortical level. Future work should investigate, with a larger sample size, the effect of session duration and tSCS intensity on cortical oscillations.

Primary Congenital Lymphedema with More Than 10 Years of Treatment Using the Godoy Method Through to Adolescence.

Introduction: Lymphedema is a specific type of edema that affects regions of the body in a chronic, progressive manner. Aim: The aim of the present study was to describe the therapeutic evolution of more than ten years of treatment for primary congenital lymphedema using the Godoy and Godoy method. Method: Ten children with primary congenital lymphedema with more than ten years of treatment at the Godoy Clinic were evaluated. Children with a clinical diagnosis of primary congenital lymphedema in treatment for more than 10 years with the Godoy Method. Cervical stimulation is the first treatment option of the method and is performed as monotherapy. The patients were reevaluated with weekly, bi-weekly and monthly frequencies and then every three months or when the family was able to return to the clinic. Results: For cases in which cervical stimulation was not possible, grosgrain stockings as monotherapy was the second therapeutic option. Conclusion: The Godoy and Godoy Method is effective at reducing edema in cases of primary congenital lymphedema, with the maintenance of the results throughout the treatment period.

Sensory Stimulation of Oxytocin Release Is Associated With Stress Management and Maternal Care.

It has been shown that various types of stress initiate different physiological and neuroendocrine disorders. Oxytocin (OT) is mainly produced in the supraoptic nucleus (SON) and paraventricular nucleus (PVN) of the hypothalamus. Hypothalamic OT has antistress effects and attenuates the hypothalamic–pituitary–adrenal (HPA) axis. One mechanism behind the antistress effects of OT is mediated through the inhibition from GABAA receptors on corticotropin-releasing factor (CRF) expression at the PVN. Various manual therapies such as acupuncture, transcutaneous electrical nerve stimulation (TENS), and massage initiate the stimulation of somatosensory neurons of the body. It is well-known that TENS simulates OT expression, while it inhibits CRF expression at the PVN following chronic stress loading in rodents. Upregulation of OT expression at the hypothalamus is activated by the somatosensory stimulation, which is mediated via the spinothalamic pathway (the connection between the spinal cord and hypothalamus). Thus, somatosensory stimulation is beneficial in treating stress-associated symptoms. Hypothalamic OT is associated with the social behaviors, including maternal care and affiliation. Childhood neglect and/or child abuse are severely responsible for deleterious long-term effects on the cognitive/social activity and behavioral development. At parturition, a profound amount of OT is released into the systemic circulation in response to vaginal and cervical stimulation caused by the body of fetus, which induces the onset of maternal behavior. Peridural anesthesia effectively impairs the sensitivity to vaginal and cervical stimulation at parturition. OT levels in cerebrospinal fluid is significantly reduced following peridural anesthesia. The vaginal delivery mothers had significantly more OT pulses than the caesarian section (CS) mothers. Due to low levels of endogenous OT, maternal behavior could be interrupted by epidural anesthesia and CS at parturition because of the reduction of the usual sensory input from the genitalia.

Thyrohyoideus muscle innervation in the horse.

To describe the innervation of the thyrohyoideus (TH) muscle and to confirm our findings with stimulation of first cervical (C1) nerve branches. Ex vivo phase 1 and clinical phase 2. Fourteen head and neck specimens and 17 client-owned horses. In phase 1, the cranial nerve (CN) XII and the C1 nerve were dissected with their branches in 20 dissections were performed on 14 specimens (6 left and right side and 8 only left or right) Anatomy was noted. Samples of nerve bifurcations were collected for histological confirmation of anatomical findings. First cervical nerve branches were stimulated in horses undergoing cervical nerve graft to treat laryngeal hemiplegia. The nerve innervating the TH muscle arose directly from the C1 nerve in 17 of 20 dissections, from an anastomotic branch between CN XII and the C1 nerve in two of 20 dissections, and from the C1 nerve and the anastomotic branch in one of 20 dissections. No direct connection between the TH muscle and CN XII was found. Histological examination revealed that the anastomosis was composed of C1 nerve fibers passing over to CN XII. First cervical stimulation resulted in TH muscle contraction in 16 of 17 horses. The innervation of the TH muscle originated from the C1 nerve according to dissection, histological, and conduction studies, with variation in the branching pattern. Care should be taken to preserve the C1 nerve during prosthetic laryngoplasty. The surgical technique for C1 nerve grafts should be reconsidered in light of these findings, along with new options to treat dorsal displacement of the soft palate..

Intensive Treatment of Lower-Limb Lymphedema and Variations in Volume Before and After: A Follow-Up.

Background and objectiveLymphedema is a clinical condition resulting from a failure in the drainage of the lymphatic system and the consequent formation of edema. The aim of the present study was to report the results of five days of intensive treatment for lymphedema and the maintenance of such results at the first follow-up evaluation.MethodA clinical trial was conducted involving 409 patients with primary or secondary unilateral, lower-limb lymphedema who underwent intensive treatment with the Godoy method. The treatment consisted of eight hours per day of mechanical lymphatic drainage, 15 minutes per day of cervical stimulation, and compression mechanics involving the use of laced grosgrain (non-elastic) stockings alternated with bandages. Volumetric evaluations were performed at baseline, after five days of intensive treatment, and at the first follow-up evaluation performed one to three months after intensive treatment.ResultsThe mean volume was 2,083.43 ml at baseline and 937.55 ml after five days of intensive treatment, corresponding to a 55% reduction. The mean was 800.83 ml at the follow-up evaluation, corresponding to a reduction of 137 ml [17.12 non-significant difference (p = 0.1)].ConclusionThe intensive treatment of lymphedema leads to considerable reductions in edema within a short period of time, facilitating the continuity of treatment and demonstrating the credibility of the method.

A Computational Model of Functionally-distinct Cervical Vagus Nerve Fibers.

Cervical vagus nerve stimulation (VNS) is a neuromodulation therapy used in the treatment of several chronic disorders. In order to maximize the therapeutic effectiveness of VNS, it has become increasingly important to deliver fiber-specific neurostimulation, so that undesired effects can be minimized. Assessing the activation of different vagal fiber types through electrical stimulation is therefore essential for developing fiber-selective VNS therapies. Towards this goal, we conducted in silico investigations using a generic model of functionally distinct nerve fibers and clinically relevant cuff electrodes using COMSOL. Our model is constrained by histological observations from rat cervical vagus nerves and its outputs are validated against averaged compound nerve action potentials (CNAPs) obtained from rat vagus nerve recordings. We propose this model as an effective tool to design fiber-specific stimulation protocols before testing them in experimental animals.

P26 Inter-ictal molecular phenotyping of the neuro-immune axis in migraine patients under non-invasive cervical vagus nerve stimulation

P26 Inter-ictal molecular phenotyping of the neuro-immune axis in migraine patients under non-invasive cervical vagus nerve stimulation

P65 Difference between transcutaneous auricular and cervical vagus nerve stimulation on heart rate variability

P65 Difference between transcutaneous auricular and cervical vagus nerve stimulation on heart rate variability

Immediate effects of cervical stimulation and diaphragmatic release on vocal production

Abstract Introduction: The voice is heavily influenced by breathing and abdominal muscles. Objective: To verify the immediate effects of cervical stimulation and diaphragmatic release on the respiratory and phonatory function of adult women with no vocal complaints. Method: Relaxation maneuvers and eccentric work of the diaphragm were performed together with articulatory maneuver of the third cervical vertebra. Twenty-four women without vocal complaints, aged between 18 and 35 years were part of the intervention. All volunteers were submitted to an evaluation of respiratory muscle strength, maximum phonation time of the vowel /a/, sound pressure level and acoustic vocal analysis, before and after physiotherapeutic intervention. Statistical analysis consisted of the Student's t-test for independent samples and Spearman's correlation. Significance level was set at 5%. Results: There was a significant increase in the maximum phonation time of the vowel /a/ and in the modal sound pressure level. Regarding the acoustic analysis, there was a reduction in the standard deviation values of the fundamental frequency; in the smoothed pitch disturbance quotient; and in the fundamental frequency and amplitude variations. Conclusion: Cervical stimulation and diaphragmatic release improved vocal quality regarding duration of emission, sound pressure, and stability and noise of the glottic signal.

P105 Chronic vagal nerve stimulation suppress thirst through decreasing vasopressin secretion in the rats with chronic heart failure

Abstract Introduction Chronic right cervical vagal nerve electric stimulation (VS) exerted prognostic benefits in heart failure rats. Exploring the mechanism is significant for clinical application. This study examined the effect of VS on arginine vasopressin (AVP) secretion and drinking behavior in the rats with chronic heart failure. Methods After a week recovery of myocardial infarction (MI), surviving rats after were randomly instrumented to VS group and sham stimulation (SS) group. A drop sensor was used to record real-time fluid consumption. Blood samples were collected weekly from the 3rd week during the 6 weeks treatment. Results Vagal stimulation did not change the daily fluid consumption (Mean ± SE, 76.2 ± 1.1 vs. 77.8 ± 2.1 ml/kg/day, n = 6, P < 0.05). Thirst, which is defined as per drinking volume (PDV), significantly increased during the early weeks after MI (Fig A), while VS significantly suppressed PDV (Fig B is the data of 6th week) by increasing the drinking intervals. The level of plasma AVP was increased to about 2 fold during 6 weeks observation in the SS group, however, VS suppressed this upregulation (Fig C). Conclusion These results suggest that VS may activate vagal afferent components which related to inhibition of AVP secretion and then suppressed the augmentation of thirst. Frequent drinking small volume may benefit for homeostasis in CHF. Abstract P105 Figure. Drinking behavior and AVP

P2625Pathophysiology of diaphragm involvement in systolic heart failure: insights from diaphragm ultrasound and phrenic nerve stimulation studies

Abstract Background Diaphragm ultrasound allows for assessment of both diaphragm excursion and thickness. Cervical and cortical magnetic stimulation (CEMS and COMS) with recording of the diaphragmatic compound motor action potential (CMAP) is diagnostically useful to evaluate the conductive properties of the inspiratory pathway. Systolic heart failure (HF) is characterized by a loss of systolic pump function. Diaphragm weakness in HF has been reported to potentially contribute to exercise intolerance Methods 14 patients with systolic HF (11 men, 3 women; 64±12 years, NYHA 2±0.9, LVEF 36.1±5.6%) and 12 healthy controls matched for age and gender (4 men, 8 women; 56±8 years) underwent spirometric lung function testing and assessment of diaphragm excursion (during tidal breathing, TB, voluntary sniff, VS and deep breathing, DB) and thickness of the right hemidiaphragm by ultrasound. COMS and CEMS of the phrenic nerves with simultaneous bilateral recording of the diaphragm CMAP using surface electrodes was performed in 9 patients. Results Compared to controls, HF patients showed reduced forced vital capacity (75.46±18.05% vs. 107.62±17.13%, p<0.05). Diaphragm excursion amplitude was significantly reduced in HF patients (4.29±1.35 cm vs. 7.34±2.10 cm, p<0.05). Diaphragm contractility was impaired too, as reflected by the diaphragm thickening ratio (DTR; 2.01±0.46 vs. 2.53±0.74, p<0.05). Diaphragm CMAP following COMS and CEMS of the phrenic nerves revealed normal latencies in HF patients compared to controls (COMS Latency; 19.05±2.37 msec vs. 18.97±3.59 msec, p= n. s.). Conclusions Diaphragm involvement in systolic HF is reflected by reduced FVC and impaired ultrasound parameters of diaphragm function. Diaphragmatic pathology is likely to be myopathic because magnetic phrenic nerve conduction studies show no abnormalities. Diaphragm ultrasound may be useful as a diagnostic tool for assessment of diaphragm function in systolic HF. Acknowledgement/Funding This study was supported by Sanofi-Genzyme, Neu-Isenburg, Germany. The funders had no role in study design, data collection and analysis, preparation.

Primary Congenital Lymphedema in the Upper Limbs of Children: Case Series

The aim of the present study was to report a case series involving the treatment of primary congenital lymphedema using the Godoy method. Eight children (seven girls and one boy) with primary congenital lymphedema of the upper limbs treated at the Godoy Clinic. A retrospective clinical trial was conducted to evaluate treatment for primary congenital lymphedema of the upper limbs in children using the Godoy & Godoy lymphatic therapy method. The first treatment option for all children was cervical lymphatic therapy. The mothers were trained in the technique under the supervision of the team and, after demonstrating the ability to perform the therapy, were then free to continue cervical stimulation on their children at home. A reduction in edema was found in all children throughout treatment, ranging from two months to two years.

Proceedings #60: Non-Invasive Cervical Root Stimulation to Facilitate Corticospinal Transmission

Proceedings #60: Non-Invasive Cervical Root Stimulation to Facilitate Corticospinal Transmission