Background: Visual perception is the ability to interpret and use what is seen. Interpretation is a mental process involving cognition, which gives meaning to the visual stimulus. Any dysfunction in different components of visual perception may lead to problems in activities of daily living, academics etc. It has been proven that visual perceptual and visual motor skills are different abilities and that test of visual perception and visual-motor integration, measure different skills. Motor free visual perception test-revised (MVPT–R) has been established as a valid and reliable tool for measuring visual perception. Activities like meditation training, mental imagery, visual and tactile cues amongst others can help in improving visual perceptual skills.

Objectives: To find the prevalence of visual perceptual deficits in typically developing children between 5-12 years of age and to compare the effects of motor and motor-free intervention for visual perceptual deficits.

Methods: The study was done in two phases. Phase 1: Survey- The purpose of phase 1 of the study was to find the prevalence of visual perceptual disorders in typically developing children. On a sample of 173 children, MVPT–R was applied and recorded results were analyzed with PASW (version 18.0). The phase 2 of the study (i.e. pre-test post-test experimental study) was done to compare the effects of motor and motor-free visual perceptual training. 30 children who had low scores in MVPT-R assessment were selected for phase 2 of the study. They were divided in 2 groups of 15 children each and received motor and motor-free visual perceptual training respectively for 30 minutes per session, thrice a week for 4 weeks.

Results: The point prevalence was found to be 62.42%. All children showed improvement in visual perceptual skills, but no significant difference was found in motor and motor-free intervention groups even though the means showed a slightly better improvement in motor group. The right handed children performed significantly better than the left-handed children. Also, there was no significant difference in improvement between both the genders. Significant correlation was not found between any variable except ‘Perceptual quotient pre-test’ and ‘Perceptual quotient post-test’ in all groups.

Conclusion: Prevalence of visual perceptual deficits is significant in typically developing children. Also, motor and motor-free visual perceptual trainings bring about similar improvements in visual perceptual skills.

In recent years, two outstandingly effective drugs for the treatment of multiple sclerosis (MS) have appeared on the market: Tysabri® (Biogen Idec/Elan, 2008) and Gilenya® (Novartis, 2010). Tysabri (Natalizumab) is a humanized monoclonal antibody that binds to the cellular adhesion molecule alpha-4 integrin, which is used by lymphocytes to cross vascular walls and penetrate the blood-brain barrier. Tysabri thus reduces the flux of infected or autoimmune lymphocytes into the CNS. Gilenya (Fingolimod) is an immunomodulatory drug that acts on the sphingosine-1-phosphate receptor to sequester lymphocytes in peripheral lymph nodes, thus also indirectly reducing the flux of infected or autoimmune lymphocytes into the CNS. Both drugs have great clinical promise for treating MS, but both have revealed a critical shortcoming: their use increases the risk of Progressive Multifocal Leucoencephalopathy (PML), a demyelinating disease worse than MS and quickly fatal if not controlled. PML arises in individuals whose immune function is compromised, such as patients undergoing chemotherapy for various kinds of cancer. During the early years of the AIDS epidemic (approximately from 1986-1999), the incidence of PML rose in parallel with increasing numbers of immunocompromised AIDS patients, then fell after effective combined aggressive retrovirus treatment (cART) for HIV-1/AIDS became widely available (after 2000-2001). Unfortunately, the incidence of PML is now rising again in conjunction with the increased use of Tysabri and Gilenya in treating MS. It is therefore important to identify effective treatment modalities for PML.

Pelizaeus-Merzbacher disease is a rare X-linked recessive disorder regarding the defective myelin sheath formation in the CNS neurons due to mutations of the proteolipid protein 1 gene (PLP1). Even though it is predominant in males, affected females have been found to represent a small proportion in the medical literature 1. A wide variety of PLP1 mutations have been reported as a cause. Herein, we describe the case of a 9-month-old female with (bearing) the typical features of the disease who was found to have a rare mutation.

A major gap exists between fusion oriented surgeons and Pain Management leaders, bridged by transforaminal endoscopic surgeons represented by the International Intradiscal and Transforaminal Therapy Society (formerly IITS). Current surgical philosophy by key opinion leaders (KOL’s) focus on attaining fusion of the painful spinal segment by emphasizing femoral-pelvic and overall spine sagittal alignment, representing another phase in the evolution of fusion techniques. For pain management, Neuro Modulation of the Spinal Cord and more recently, the Dorsal Root Ganglion is the area of focus as represented by the key opinion leaders, Gabor Racz and the World Institute of Pain (WIP). Endoscopic surgeons support “full endoscopic” decompression procedures as the least invasive of the trend toward minimally invasiveness in spine surgery. Notably, transforaminal decompression is still under-valued and under-utilized because formal training in academic centers is lacking, and since advancements have been made in private practice settings.