M Wager 1, P Rigoard 2, C Bouyer 3, V Baudiffier 3, V Stal 4, B Bataille 5, R Gil 6, F Du Boisgueheneuc 3
Introduction: The indication for awake brain surgery depends on a prerequisite, i.e. recognition that the brain area concerned is truly eloquent, and identification of one or more functions that must be preserved. These functions are determined preoperatively in collaboration with the patient, and neuropsychological tests considered to be the most relevant are performed in the operating room according to each team’s technical preferences.
Operating environment: The neurosurgeon must choose transfer equipment considered to be relevant. Although a minimal technological environment is an option, a surgical team with great human wealth is essential, composed of specialized personnel with complementary skills.
Choice and implementation of intraoperative tests: The choice of intraoperative tests, which can be relatively simple for certain primary functions, can be much more difficult for high-level cognitive functions. No consensus has been reached concerning these tests, which must therefore be selected on an individual basis. Intraoperative testing must be based on preoperative multidisciplinary decisions made jointly by the neurosurgeon, neurologist, speech therapist and neuropsychologist.
Conclusions: Numerous operating tools and technology transfers are available for neurosurgical teams performing awake brain surgery but none – or very few – of them constitutes a mandatory prerequisite. In contrast, the transition from the concept of eloquent brain area to that of brain functions that must be preserved requires highly skilled multidisciplinary human resources. This goal will be more likely achieved in centers highly specialized in functional oncological neurosurgery.
Keywords: Awake brain surgery; Functional brain surgery; Intraoperative testing; Operating room; Technology transfer.
Copyright © 2017. Published by Elsevier Masson SAS.
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Segue novo site da nossa colaboradora Natalie Argolo! Já está no ar!
Com suas áreas de expertise e mais informações sobre trajetória e locais de atuação!
Christian Giancarlo Bernal Rodriguez, DDS, MS, Isabella Berlingieri Polho,
Luciane Hiramatsu Azevedo, DDS, MS, PhD, and Carlos de Paula Eduardo, DDS, MS, PhD
Background: Paralysis of the facial muscles produces functional and aesthetic disturbance that has a negative impact for the patient’s quality of life.
Objective: To evaluate the effects of a photobiomodulation (PBM) with low-level laser (LLL) on the treatment of a patient with 8 years of facial paralysis.
Methods: PBM with two different wavelengths of LLL (660 and 808 nm), applied only on the affected side, three times a week for 8 consecutive weeks. Evaluations were performed before starting treatments, after the 12th session of treatment and after the 24th session, using the House–Brackmann scale and electroneuromyography.
Results: The House–Brackmann and electroneuromyography tests showed improvements in the movement of the facial muscles when tested in the middle and at the end of the treatment with LLL.
Conclusions: PBM with LLL at the wavelength of 660 and 808 nm with the parameters used in this case report was an effective and noninvasive treatment for facial paralysis in this long-standing, chronic case of 8 years.
Keywords: facial paralysis, photobiomodulation, House–Brackmann scale, electroneuromyography test
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Expert Rev Neurother. 2010 Jun;10(6):875-8. doi: 10.1586/ern.10.60.
Dysphagia in Parkinson’s disease: a therapeutic challenge?
Michou E1, Hamdy S.
This article focuses on the current status and research directions on swallowing disorders (dysphagia) in patients with Parkinson’s disease (PD). Although epidemiological data are scarce, increased incidence of dysphagia in patients with PD leads to increased risk of mortality, secondary to aspiration pneumonia. Although studies show that aspiration pneumonia is a common cause of death in this group of patients, clinical practice lacks an evidence base and there is an increased need for randomized clinical trials. Importantly, the underlying mechanisms accounting for the progression of dysphagia in PD are still unclear. Furthermore, evidence shows that dopaminergic medication does not affect swallowing performance. Future research in the field is urgently needed and may result in improved management of dysphagia in patients with PD.
Em comemoração aos 25 anos de uma das revistas mais importantes no campo da disfagia mundial, foi lançada uma edição comemorativa neste mês de fevereiro de 2017.
Esta edição conta com importantes textos de ponto de vista e revisões em áreas como avaliação por FEES (Langmore), reabilitação (Easterling), estratégias compensatórias (Lazarus) além de avaliação videofluoroscópica, biofeedback, estudos em modelos animais, dentre outros. Vale a pena dar uma olhada.
Segue o link abaixo e a maioria dos artigos podem ser baixados a partir de uma conexão universitária. Bom carnaval! 😉
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