Effect of new modalities of treatment on physicians management plan for patients with spinal muscular atrophy
  Fahad  A.  Bashiri,  Hiyam  A. Idris,  Fahad  M.  Al-Sohime,  Mohamad  H.  Temsah,  Khalid  A.  Alhasan

Objectives: To determine physicians` attitudes and stated practice in the management of patients with spinal muscular atrophy (SMA). We also aimed to explore their knowledge about consensus statement for standard of care in SMA and the role of new treatment modalities in changing the method of practice in the management of these cases.
Methods: This is a quantitative observational cross-sectional study, conducted from February to May 2017 among physicians who manage SMA patients in Kingdom of Saudi Arabia. The study cohort included pediatric neurologists, adult neurologists, and physicians of other sub-specialties who manage SMA patients. We used online and paper-based questionnaires.
Results: Half of the 169 participants were aware of the consensus guidelines for the care of SMA patients. With regard to the newly released Nursinersen treatment protocol for SMA-diagnosed patients, half of the participants were uncertain, and the other half were hesitant about its outcomes. Junior physicians tended to be significantly more inclined to reverse the do-not-resuscitate (DNR) status of an SMA-diagnosed child than more senior physicians.
Conclusions: Our results indicate the existence of wide differences in physician practice with children of SMA disease. Our data demonstrate a need for increased awareness of consensus guidelines and further awareness about the physician`s role in the variability of care for children with SMA.

Neurosciences 2019; Vol. 24 (1): 16-21 doi:10.17712/nsj.2019.1.20180321


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9 years old girl previously healthy, presented with progressive dystonia, dysarthria and spastic gait. Her MRI brain is consistent with which of the following?
[A] Pelizaeus Merzbacher disease
[B] Wilson disease
[C] Pantothenate Kinase-Associated Neurodegeneration
[D] Sjogern Larsson syndrome