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SummaryVagus nerve stimulation (VNS) is an established treatment for selected patients with medically refractory seizures. Recent studies suggest that VNS could be potentially useful in the treatment of resistant depressive disorder. Although a surgical procedure is required in order to implant the VNS device, the possibility of a long-term benefit largely free of severe side effects could give VNS a privileged place in the management of resistant depression. In addition, VNS appears to affect pain perception in depressed adults; a possible role of VNS in the treatment of severe refractory headache, intractable chronic migraine and cluster headache has also been suggested. VNS is currently investigated in clinical studies, as a potential treatment for essential tremor, cognitive deficits in Alzheimer's disease, anxiety disorders, and bulimia. Finally, other studies explore the potential use of VNS in the treatment of resistant obesity, addictions, sleep disorders, narcolepsy, coma and memory and learning deficits.

One hundred and forty patients with low cervical spinal cord injuries, who were admitted to the Riyadh Armed Forces Hospital over the past 10 years were reviewed. Motor vehicle accidents constituted 119 (85%) of the patients. Camel collisions were a major cause of vehicle accidents 39 (33%), after rollover accidents 70 (59%), and much more than head on collisions 9 (7.5%). Male to female ratio was 14 : 1 with a mean age of 32 years. Camel collision although a commonly observed cause of motor vehicle accidents in the Middle East has not been mentioned in the literature before. The mechanism of injury is not much dierent, but the exact description of the accident and sustaining injury is interesting because it leads to localised damage to the neck without major body trauma and mortality.

A large scale prevalence study for child disability of those under 15 years was conducted in a representative Saudi population with accurate demographic records. A 83% response rate in children of six to 15 years (1280 out of 1544 children registered) of age and a 100% response rate in children under five years (all the 1151 registered) was achieved. Thirty one children had severe impairment and 322 had minor impairment. This accounted for 3.76 per 1000 total population with major impairment and 42.8 per 1000 total for minor impairment.