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Summary Objectives To describe the EEG characteristics of patients with Unverricht-Lundborg disease (ULD) and their changes during the long-term evolution of the disease. Methods A retrospective study including all patients with ULD confirmed by molecular biology and more than 15 years’ duration of disease progression at the time of inclusion. EEGs were recorded at inclusion, 2 years and 5 years of follow-up. Patients who discontinued treatment during follow-up had an EEG monitoring 1 year after reintroduction of therapy. Results Forty-seven EEGs were performed in 17 patients. The mean age at onset was 12.0 ± 5.5 years. The mean duration of follow-up was 26.5 ± 6.9 years. The average background rhythm was 8.2 c/s, and was normal in 30 EEGs (64%), slow in 17 (36%) and disorganized in 11 (23%). Epileptic abnormalities were found in 22 EEGs (47%). Myoclonic jerks were found in 13 EEGs (28%). After re-adaptation of antiepileptic medication in patients who had previously stopped treatment, control EEG showed a normal background rhythm with no epileptic abnormalities throughout the monitoring period. Conclusion This study shows that the progressive disappearance of EEG abnormalities is rather due to antiepileptic treatment than a gradual spontaneous tendency to decrease over time.

Background Few epidemiological data are available on multiple sclerosis (MS) patients in North Africa (NA). Studies of immigrants from NA showed a more aggressive course compared to European patients. Objective The aim of this study is to describe clinical and long term course characteristics of MS in Tunisia and to compare it to European cohorts. Method A total of 437 MS patients from three hospital based cohorts in Tunisia and having prospective follow up between 2010 and 2012 were analyzed. We considered as endpoints the time to reach EDSS scores of 3, 4 and 6 in the different clinical forms of MS and the beginning of a secondary progressive (SP) phase. Results Sex ratio was 2.34. Mean age of onset was 30.3 years. The course was relapsing–remitting (RR) in 91% of patients and primary progressive (PP) in 9%. The most frequent isolated onset symptoms were respectively motor (28%), optic neuritis (20%) and sensory (16%) dysfunction. Median time to SP onset was 19.1 years. Median times from onset of multiple sclerosis to assignment of a score of 3, 4 and 6 were 8, 10.7 and 15 years respectively. Benign form of MS represented 31.5%. Median interval from the onset of the disease to EDSS score of 3, 4 and 6 was shorter in PP-MS than in RR-MS. However, there was no difference between these two groups for the median time from the assignment of EDSS 4 to the assignment EDSS 6. Conclusions Our study shows that Tunisian MS patients have a quite similar clinical feature to European patients. Still, larger MS multicenter cohort studies in NA with longer follow-up duration could clearly respond to the issue.

Introduction Few epidemiological data on multiple sclerosis (MS) patients are available in North Africa (NA). Studies of immigrants from NA showed a more aggressive course of MS in NA than in European patients. Objective To describe clinical, long term course characteristics and prognostic factors of MS in a Tunisian population. Methods We performed a prospective multicentric study of 437 MS patients in Tunisia between 2010 and 2012. We considered as endpoints the time to reach non-reversible disability levels corresponding to EDSS scores of 3.0, 4.0 and 6.0, and the beginning of a secondary progressive phase. We used Kaplan–Meier analyses and Cox regression models to determine the influence of the clinical variables on the time to disability onset. Results Sex ratio was 2.34. Mean age of onset was 30.3±9.5 years and the duration of illness was 8.4±6.7 years. The course was relapsing-remitting (RR) in 77% of patients, secondary progressive (SP) in 15.5% and primary progressive (PP) in 8.5%. Median time to secondary progressive onset was 19.1 years. Median times from onset of multiple sclerosis to assignment of a score of 3, 4 and 6 were 8, 10.7 and 15 years respectively. A greater number of functional systems involved at onset, progressive from as well as late age, motor, cerebellar and sphincter symptoms at onset were factors predictive of a poor outcome. A longer first inter-attack interval was associated with a better prognosis. Once EDSS 4 was reached, the time course of progressive disability was similar in patients with progressive onset and those with RR MS. Conclusion This is the first multicentric study in our country. The present study showed a similar course of MS in a North African population compared to European cohorts. Similar long term prognosis factors were found.