Neurosurgery
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Nearly one-third of individuals with epilepsy have drug-resistant epilepsy, treated most effectively with surgery. This study aims to discuss the demographic profile, surgical access, and strategies used in drug-resistant epilepsy in Africa. ⋯ These findings demonstrate the efficacy and long-term benefits of epilepsy surgery in Africa, where epilepsy is a significant public health challenge. The high rates of seizure freedom and reduced seizure frequency from surgery highlight its potential to improve the quality of life for individuals with drug-resistant epilepsy in Africa.
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Patients undergoing thalamic ventral intermediate nucleus stimulation to treat essential tremor (ET) develop tolerance over time, requiring higher stimulation amplitudes that lead to more frequent battery changes and suboptimal tremor control. The study objective is to determine whether amplitude tolerance differs between patients with omnidirectional vs directional leads. ⋯ Both omnidirectional and directional deep brain stimulation reduces tremor severity in ET patients. However, directional leads offer more stable voltage requirements and less year-to-year voltage change, particularly in the first year. The increased likelihood of significant pulse width changes in omnidirectional leads suggests that directional leads may provide more sustainable therapeutic effects through other programming parameters. Ongoing research is needed to optimize deep brain stimulation technology and programming strategies to maximize patient benefit and device longevity.
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Physician rating websites (PRWs) are increasingly used by patients to find health care providers. This study explores spine neurosurgeon PRW ratings and their relationship with academic productivity. ⋯ Overall, spine neurosurgeon ratings on PRWs were favorable. Ratings were found to decrease with increasing surgeon age, and academic productivity was not correlated with better ratings.