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Background: Chronic pain is a common non-motor symptom in patients with Parkinson's disease (PD)., Aim: To facilitate the diagnosis of pain in PD, we developed a new classification system the Parkinson's disease pain classification system (PD-PCS) and translated the corresponding validated questionnaire into German., Methods: A causal relationship of the respective pain syndrome with PD can be determined by four questions before assigning it hierarchically into one of three pain categories (neuropathic, nociceptive and nociplastic)., Results: In the initial validation study 77% of the patients (122/159) had PD-associated pain comprising 87 (55%) with nociceptive, 36 (22%) with nociplastic and 24 (16%) with neuropathic pain. The study revealed a high validity of the questionnaire and a moderate intrarater and interrater reliability. The questionnaire has been adapted into German and employed in 30 patients., Discussion: The PD-PCS questionnaire is a valid and reliable tool to determine the relationship of a pain syndrome with PD before classifying it according to the underlying category, facilitating further diagnostics and treatment., (© 2022. The Author(s).)

Background: The development of high-intensity magnetic resonance imaging (MRI)-guided focused ultrasound (MRIgFUS) ablation has widened the spectrum of interventional techniques for stereotactic functional neurosurgery of lesions. This has resulted in novel incisionless intervention approaches for the therapy of tremor disorders. The safety and efficacy is documented by recent study data., Objectives: This article encompasses a description of the technological basis and typical course of MRIgFUS interventions, a comparison to alternative open or incisionless surgical techniques as well as a review of the current evidence base for MRIgFUS ablation in the context of lesional interventions to treat tremor., Material and Methods: Narrative literature review and comparison., Results: Depending on the surgical target and tremor etiology published trials of MRIgFUS ablation report a reduction of tremor intensity of up to 80% after 6-12 months follow-up without the disadvantages of open brain surgery., Conclusion: The MRIgFUS functional neurosurgery is conducted only at a limited number of treatment sites. First data on lesions of the thalamic ventral intermediary nucleus (V.im.) as well as subthalamic fiber tracts have been published. These results indicate an effective and safe treatment of tremor disorders by MRIgFUS ablation. Incisionless lesional surgery using MRIgFUS is a significant addition to the interventional armamentarium for functional stereotactic neurosurgery and a potentially valuable alternative to established interventional therapy options for tremor disorders.

The establishment of stroke networks is an approach to forward guideline driven stroke care to hospitals without full-time neurological service. Tele- stroke networks are evidence based for remote neurological support of acute stroke patients, administration of thrombolysis safely as well as increasing thrombolysis rates. Since 2011 the district hospital in Grabs was linked to the stroke center at the cantonal hospital St. Gallen which provided teleconsultations with full-scale audiovisual communication and access to brain images 24 hours per day 7 days per week. Regarding quality and safety issues the experiences were promising including the selection of patients for appropriate treatment with allocation to systemic thrombolysis or en dovascular reperfusion therapy. As perspective it may definitely contribute to better supply of rural areas with acute stroke therapy but also other specializations and neurological indications may benefit from telemedical support