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Neuromodulation in drug resistant epilepsy

Treatment of epilepsy can be considered generally as medical or surgical. Anti-epileptic drugs achieve a five-year seizure freedom in 54-70% patients. It is estimated that 50-90% of patients with drug-refractory epilepsy may not be candidates for resective surgery. For example,...

PPPD - the problem with the label

The recently described diagnostic entity of persistent postural perceptual dizziness (PPPD) has its merits regarding guiding intervention and treatment, but the label itself can be problematic for patients. This study was designed to determine the views of patients of the...

Transmastoid facial nerve decompression for persistent traumatic facial nerve paralysis

Facial nerve paralysis (FNP) can occur following trauma, with a small number of these patients requiring facial nerve decompression (FND) to aid recovery. The authors shared their experience in decompressing the facial nerve for persistent severe FNP via a transmastoid...

Does vestibular rehabilitation help patients with vestibular migraine? Is this also true if these patients have had a traumatic brain injury?

Vestibular migraine (VM) is a common diagnosis in ENT, and there is growing evidence that vestibular rehabilitation therapy (VRT) is an effective treatment, reducing self-perceived dizziness and improving gait. This is a retrospective review of the outcomes of 93 patients...

Unravelling the Meniere’s vs. migraine conundrum – what does the mastoid contribute?

This is an interesting observational study that attempts to classify subtypes of Meniere’s disease (MD) in relation to the coexistence of migraine. It is well known that the two conditions share common characteristics, making diagnosis and treatment challenging at times....

Is Gamma Knife Surgery effective for intracanalicular vestibular schwannomas?

Vestibular schwannomas (VSs) are rare, occurring in approximately five per 100,000 adults a year. In circa 8% of cases, the VS is contained within the internal auditory canal, i.e. intracanalicular (iVS). Although radiosurgery is a recognised treatment modality for VSs,...

Analysing videofluroscopy: does it matter how it’s done?

Videofluoroscopy, as a tool that assesses the process of swallowing, has transformed our understanding of dysphagia. Clinicians can observe the biomechanics of a bolus moving from the oral cavity through the pharynx and oesophagus and into the stomach. Over the...

Postoperative ultrasound surveillance in patients undergoing hemithyroidectomy

Hemithyroidectomy, as opposed to total thyroidectomy with radioiodine remnant ablation, is now increasingly undertaken for low-risk, differentiated thyroid cancer. If on histology, this proves ‘high risk’, completion thyroidectomy is done fairly soon. In this retrospective study, a total of 105...

How rare is vocal fold paralysis after spinal and epidural anaesthesia – should we be more concerned?

The authors present an unusual case of right vocal fold paralysis. Their patient was a 38-year-old woman who experienced new onset dysphonia following neuraxial anaesthesia (NA) for a caesarean section. Flexible nasendoscopy showed a right VFP with fixation in the...

In the context of the person with aphasia participating in life

Approaches to assessment and treatment for people with aphasia have traditionally taken a syndrome or deficit-based view. It’s only in the last few decades that a more functional approach to aphasia has been recognised, namely the need to couch both...