C. SCIATlCÄ DUE TO INFLAMMATION OF MUSCULAR AND FASCIAL STRUCTURES - Rest, local

poesition with only one pillow for 3-6 weeks When pain is rallievead, plaster jacket to immobillise the lumbar spinecompletely for3-6 months After this the jaclket is removed, and a lumbar corset worn at all times during the day 2 Operative treatment - Indications - (i) Acute and incapacitating -sympiome not relieved by rest in bed or even immbilisation in plaster Jacket (ii) Quick recurrence öf symptoms. (iii) Evidence of large prolapse causing pressure on cauda equina, or clinical avidance öf severe root compressions shown by marked motor and sensory changes Operation consists of hemilaminectomy. remova of the protrusion, and curetting out nuclear material from the central part of the disc it is the most effective cure. C. SCIATlCÄ DUE TO INFLAMMATION OF MUSCULAR AND FASCIAL STRUCTURES - Rest, local applicalion. öf heat and massage. if tender nodules. injection with 2% procaine solution Treatment öf sepsis 1 Enhancement of GABA-mediated CNS Inhibition - Välproate, barbiturates, benzodiazepinas, baclofen 2 Membrane stabilizer action - Phenytion, carbamazepine Valproate may precipite phenytoln toxiclty (euan in absence of raised serum level) due to plasma protein displacement. Spinal cord compressaion - Mechänism of symptoms and signs -1 Direct pressure interfering with conduction in the roots and cord it self 2 Oedemaof cord balow site of compression from pressure on ascendig longitudinal spinal veirs 3 lschema from compression of spinal arteries Clinical manifestations of lesions in different parts of extrapyramdal system - Putamen - Athetosis Caudaie nucleus - Choteä Subthalamic nucleus - Hemlballsmus Globus pallindus and substantia nigra - Parkirsonian tremor and rigidity Chorea Hereditary neurological disorders Huntington's disease Benign familial chorea Päroxysmäl choraoathetosis Dentato-rubro-pällido-luysiän atrophy Wilseon's dsease Cerebellar degenerations Neuroacantrhocytsis 2 Other causes Sydenham's chorea Dopamine Pregnancy receptor-blocking drugs Oral contraceptives ldopathic