Neurosciences最新文献

Objectives: To evaluate the prevalence of work-related burnout among neurosurgeons at multiple neurosurgical centers in Riyadh, Kingdom of Saudi Arabia.

Methods: A cross-sectional study was undertaken involving neurosurgeons in Saudi Arabia. From June 2023, to September 2023, a self-administered questionnaire was utilized to gather data from the neurosurgeons in Riyadh hospitals. This data pertained to their quality of life, exhaustion, frustration, and patient-doctor relationships.

Results: Out of 120 potential participants, 95 completed responses were collected, yielding a response rate of 79.2%. A significant positive correlation was revealed by correlation analyses between on-call hours and weekly working hours on one side, and burnout and poor quality of life on the other. Principle Component Analysis (PCA) revealed four components with eigenvalues greater than 1, accounting for 32.6%, 16.9%, 11.1%, and 7.8% of the total variance. The overall Kaiser-Meyer-Olkin (KMO) measure was 0.77, falling into the 'middling' category, with individual KMO measures ranging between 0.6 and 0.9.

Conclusion: The study revealed a job-related impairment of the work tolerance among neurosurgeons in Riyadh, which may be due to the limited number of neurosurgeons. Further measures are required to enhance the quality of life for neurosurgeons and, ultimately, patient care.

Brucellosis is a zoonotic infection that affects 500,000 individuals each year worldwide. Neurological complications occur in up to 5% of cases, and ocular involvement is rare. This report describes the case of a 26-year-old woman with progressive lower limb weakness and significant ambulatory impairment following two months of headache, nausea, vomiting, and visual disturbances. The patient had a history of urinary incontinence, lower back pain, and raw goat milk consumption. Clinical examination revealed bilateral papilledema and muscle weakness. Positive Brucella culture, abnormalities in the cerebrospinal fluid, and magnetic resonance imaging findings confirmed the presence of neurobrucellosis. Treatment with antibiotics led to minimal initial improvement. However, significant recovery was observed five months post treatment initiation. This case highlights the importance of considering neurobrucellosis in endemic regions and underscores its distinct clinical and radiological features. Early recognition and treatment are crucial for reducing morbidity.

Objectives: To evaluate the association between sarcopenic obesity and cognitive dysfunction. Changes in human body composition may be linked to the development of cognitive dysfunction. Sarcopenic obesity, characterized by excessive fat accumulation and reduced muscle mass, is implicated in various adverse health outcomes.

Methods: We conducted a systematic review and meta-analysis. PubMed, Cochrane Library, Web of Science, Embase, CINAHL, CNKI, Sinomed, Wanfang, and VIP databases were searched for studies examining the link between sarcopenic obesity and cognitive dysfunction. The process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Eight studies, comprising 87,520 participants (5 cohort and 3 cross-sectional studies) were included. Meta-analysis using a random effects model addressed high heterogeneity (p=0.020, I²=50.1%) and demonstrated a statistically significant association between sarcopenic obesity and cognitive dysfunction (odds ratio=1.77, 95% confidence interval 1.48-2.12, p<0.001). Sensitivity analysis confirmed the robustness of these findings, although funnel plots indicated some dispersion bias. Subgroup analyses based on varying diagnostic criteria for sarcopenic obesity and cognitive dysfunction revealed consistent associations.

Conclusion: Sarcopenic obesity is associated with cognitive dysfunction. However, further research utilizing standardized diagnostic criteria and methodologies is essential to corroborate these findings.

Objective: To establish expert consensus on the preventive treatment of migraine in Saudi Arabia, with a focus on the use of calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs), in light of the latest international guidelines and local clinical practice.

Method: A record-based study was performed retrospectively in Radiology department at our Hospital in Eastern region of Saudi Arabia, from Jan. 2019-2024. Adult patients for whom MRI brains were conducted for epilepsy work-up with added SWAN (susceptibility weighted angiography) sasequence were considered. Brain tumor, post-injury, and post-surgery cases were excluded. A venous angioma was documented when a tuft of veins drained to a larger vein (traversing through cortex or reaching under ependymal layer), appeared low signal curvilinear brnaching structure on SWAN image. The usefulness of the SWAN sequence in the detection of venous malformation determined if the visualized abnormality was found to be related to a focus resulting in abnormal waves on the brain electroencephalography. This observation was compared to the accidently found such malformations that were seen in epileptic patients with normal EEGs (control group). Fisher's Exact test was applied and a p-value of <0.05 was taken as statistically significant for an association.

Results: The expert panel reviewed updated clinical data and recent international guidelines recommending CGRP mAbs as first-line preventive treatment options. The panel reached consensus on key aspects of migraine management in Saudi Arabia, including treatment initiation criteria, patient selection, and the role of CGRP mAbs in clinical practice. The recommendations emphasize the need for earlier initiation of effective treatments to reduce disease burden and improve quality of life.

Conclusion: This expert consensus provides updated guidance on the preventive treatment of migraine in Saudi Arabia, supporting the integration of CGRP mAbs as a first-line option. These recommendations aim to enhance the standard of migraine care and address unmet needs in the local healthcare setting.

Objectives: To evaluate the effectiveness and safety of Stiripentol (STP) in individuals with Dravet syndrome resulting from SCN1A gene mutation METHODS: A retrospective study with a descriptive focus was carried out in 2023, involving 44 patients diagnosed with Dravet Syndrome, with data collected by chart review and interviews of caregivers based on a pre-structured data extraction sheet. Data included age of seizure onset, SCN1A gene variant, duration of seizures before STP initiation, age at the time of starting STP administration, change in seizure frequency or duration after STP initiation, and at 6 months following initiation, and concomitant anti-seizure medication.

Results: 25 patients experienced a significant reduction in the frequency of their seizures, while 12 showed a mild to moderate reduction. Almost all patients taking Stiripentol concomitant with Valproate and Clobazam had marked seizure reduction. Adverse reactions to Stiripentol were observed in 34 patients, but none were serious. Somnolence was the highest reported (20 patients), followed by behavioral changes, agitation, irritability, and hyperactivity (18 patients) CONCLUSION: Our study showed that over half of our patients with Dravet on Stiripentol had a marked reduction in seizure frequency and duration. The study revealed no serious adverse events. Minor adverse events included somnolence and behavioral changes.

Leprosy neuropathy can mimic chronic inflammatory demyelinating polyneuropathy (CIDP), especially in non-endemic areas. We report a 72-year-old Saudi woman initially misdiagnosed with CIDP based on nerve conduction studies. The patient presented with widespread pruritus, erythematous cutaneous lesions, and progressive sensorimotor symptoms. Despite treatment with intravenous immunoglobulin, her condition worsened. Subsequent sural nerve and skin biopsies revealed acid-fast bacilli, confirming leprosy. This case highlights the importance of considering leprosy in the differential diagnosis of neuropathies, even in regions where it is rare. Nerve ultrasound, a valuable diagnostic tool in differentiating leprosy from CIDP, should be incorporated into the diagnostic workup of atypical neuropathies.

Objectives: To explore the ability of physiotherapists in Saudi Arabia to identify cauda equina syndrome (CES) in a timely manner, and to identify the methods used by physiotherapists to manage patients with suspected CES.

Methods: This study utilized a cross-sectional research design and was conducted in the period May-October 2023. It included licensed physiotherapists working in Saudi Arabia. The data was collected using a survey that aimed to assess physiotherapists' ability to identify CES early, using 12 statements. Based on the participants response to these statements, all responders were categorized into the following groups based on their ability to identify and manage CES early: proficient (10-12 points); good ability (7-9); fair ability (5-6); and poor ability (<=4). Consensus to a statement was reached when more than 70% of participants agreed or disagreed with the statement.

Results: This study included 401 physiotherapists (mean age=29.51 (SD 5.54); 53.4% female). Most participants (63.6%) have a proficient-good ability to identify and manage CES early, while 36.4% were categorized as having fair-poor ability Consensus for the CES statements was achieved for 8 statements [1, 2, 3, 4, 5, 8, 9, 12] out of 12. Among these statements, most participants agreed that a patient should be suspected to have CES when they exhibited urinary difficulties of neurogenic origin (88.3%) and/or bilateral radiculopathy (85.5%); and 88.0% of them agreed that an MRI should be requested urgently when managing a patient with CES. Conversely, consensus was not achieved on statements, concerning communication with patients, patient instructions, and management decisions for suspected CES cases.

Conclusion: Most physiotherapists had a proficient-good ability to identify and manage CES early. The study's findings can aid in the creation or improvement of clinical standards and protocols pertaining to physiotherapists' roles in the early identification of CES.