Neurosciences
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To study the safety and efficacy of an innovative device using distraction-based magnetically controlled growing rods (MCGR) for the treatment of pediatric scoliosis. ⋯ Level IV of medical evidence supports the use of MCGR as a safe and effective alternative for the treatment of severe pediatric scoliosis. Recommendation Grade C supports the role of MCGR with DR construct as an option to achieve a better correction of the scoliotic curve and to maximize the postoperative T1 - S1 spinal length.
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To study the safety and efficacy of an innovative device using distraction-based magnetically controlled growing rods (MCGR) for the treatment of pediatric scoliosis. ⋯ Level IV of medical evidence supports the use of MCGR as a safe and effective alternative for the treatment of severe pediatric scoliosis. Recommendation Grade C supports the role of MCGR with DR construct as an option to achieve a better correction of the scoliotic curve and to maximize the postoperative T1 - S1 spinal length.
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Trigeminal neuralgia is a syndrome of unilateral, paroxysmal, stabbing facial pain, originating from the trigeminal nerve. Careful history of typical symptoms is crucial for diagnosis. Most cases are caused by vascular compression of the trigeminal root adjacent to the pons leading to focal demyelination and ephaptic axonal transmission. ⋯ Surgical options are available if medications are no longer effective or tolerated. Microvascular decompression, gamma knife radiosurgery, and percutaneous rhizotomies are most promising surgical alternatives. This paper reviews the medical and surgical therapeutic options for the treatment of trigeminal neuralgia, based on available evidence and guidelines.
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Epilepsy is a common and serious chronic neurological disorder, affecting around 65 million people worldwide. Despite the advances in pharmacologic treatments for epilepsy, approximately 30% of the patients remain medically refractory and continue to have seizures on medications, in such cases, other treatment approaches are necessary. ⋯ Vagus nerve stimulation, deep brain stimulation of the anterior nucleus of thalamus, and responsive neurostimulation have class I evidence supporting their use in patients with intractable epilepsy. In this review, we discuss the evidence of these therapeutic modalities, their mechanism of action, efficacy, outcome, and their application in clinical use.
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Review Meta Analysis
Induced hypothermia to treat neonatal hypoxic-ischemic encephalopathy. Review of literature with meta-analysis and development of national protocol.
The efficacy of induced hypothermia to treat hypoxic-ischemic encephalopathy (HIE) in term infants has been evaluated in 6 multicenter randomized controlled trials. Meta-analysis of these trials shows that hypothermia in the first 6 hours after moderately severe HIE reduced the risk rate of death or neurological impairment at 18 months of age; risk ratio (RR): 0.81 (95% confidence interval [CI]: 0.71 to 0.93, p=0.002); risk difference -0.11 (95% CI: -0.18 to -0.04), with a number needed to treat of 9 (95% CI: 5-25). ⋯ We developed a national protocol using a simplified method of cooling. This protocol will hopefully lead to a widespread implementation of induced hypothermia in different settings within Saudi Arabia.