This presentation will review briefly the current practice and state of the art in functional electrical stimulation (FES) as applied to stroke, head injured or brain tumour operated patients. A similar application is used in paretic patients following trauma or other aetiology. Over 20 years experience in the application of FES, as practised in Ljubljana, will be highlighted and the devices currently in use will be described. The statistics show the results obtained on 2,500 hemiplegic patients examined for FES application during the last 10 years. The statistics and results of the Slovenian population indicate 0.15-0.20% new cases annually or 1,500 new cases per million inhabitants. Up to 63% of annual cases are candidates for an FES based therapeutic locomotion rehabilitation programme. Experience indicates that 60% of hemiplegic patients received single-channel stimulation to correct equinovarus or foot drop, 30% obtained dual or even three channel stimulation treatment and only 10% of patients were involved in multichannel FES of four to six or even eight channels of stimulation. The benefits and outcome of rehabilitation will be presented and discussed in regard to current trends in the field of FES for hemiplegic and paretic patients. The partly inactive but very important field of FES application to the upper extremity in hemiplegic and paretic patients will be discussed and the relatively modest achievements presented. Future developments will be presented together with advances foreseen by steadily improving technology.

Spinal cord stimulation (SCS) is an advanced therapy and method of pain management for certain types of chronic pain. SCS has thus far been shown to be more effective for neuropathic forms of pain than for nociceptive forms of pain. The history of electrical stimulation for pain relief is reviewed as well as the basic anatomy of the spinal cord. Although its exact mechanisms are still unknown, SCS involves both neurophysiological mechanisms and pharmacological mechanisms to achieve paresthesia. The implantable pulse generator (IPG) and external radio frequency (RF) spinal cord stimulators, their parameters, and implantation procedures are described. Future success of SCS will depend on improving the model for SCS's mechanisms, improving the patient selection criteria, and optimizing the lead configuration for improved pain relief.