Pediatric neurosurgery
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Pediatric neurosurgery · Jan 2020
Case ReportsA Case Report of Pediatric Geniculate Neuralgia Treated with Sectioning of the Nervus Intermedius and Microvascular Decompression of Cranial Nerves IX and X.
Classic geniculate neuralgia (GN) is a rare condition characterized by lancinating pain centered in the ear and not involving the throat. To the best of our knowledge, no case of pediatric GN has been reported in the English literature. ⋯ GN can affect the pediatric population. In carefully selected patients with consistent clinical and radiographic presentation, sectioning of the nervus intermedius and microvascular decompression of the lower cranial nerves can be an effective treatment.
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Pediatric neurosurgery · Jan 2020
Comparative StudyComparison of the Effects of Sufentanil and Fentanyl in Intravenous Patient-Controlled Analgesia after Pediatric Moyamoya Surgery: A Retrospective Study.
Intravenous patient-controlled analgesia (PCA) has been one of the most popular modalities for postoperative pain management in orthopedic surgery, plastic surgery, or neurosurgery in children. ⋯ Postoperatively, sufen-tanil in PCA provided more analgesia than fentanyl with less additional analgesics in moyamoya disease. However, PCA with sufentanil was more frequently discontinued due to nausea or vomiting compared to fentanyl-based PCA.
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Pediatric neurosurgery · Jan 2020
Case ReportsNusinersen Administration Via an Intrathecal Port in a 16-Year-Old Spinal Muscular Atrophy Patient with Profound Scoliosis.
Spinal muscular atrophy (SMA) is a genetic disease affecting the second motor neuron, causing progressive muscle atrophy and weakness due to decreased expression of the survival motor neuron. Different subtypes exist, type 2 being one of the most frequent ones. These patients show a high incidence of scoliosis requiring surgery. In 2016 and 2017, the Federal Drug Administration and European Medical Agency approved nusinersen for all types of SMA. It is a splicing modifier that enhances the expression of survival motor neuron and it has to be administered intrathecally. In patients with profound scoliosis, intrathecal administration can be challenging. Here, we present our experience with the implantation of an intrathecal port in a patient with SMA type 2. ⋯ We conclude that the implantation of an intrathecal port system in patients with SMA and profound scoliosis is a safe and feasible procedure and allows the administration of nusi-nersen while reducing the need for sedation and exposure to radiation.