Search

Burkitt's lymphoma (BL) is a high-grade mature B cell neoplasm. Primary lymphoma of the central nervous system (CNS) is very rare. In contrast, BL can be localized in any part of the body and may spread to the CNS. Peripheral nervous system impairment caused by BL has been thoroughly described. However, Guillain–Barre syndrome (GBS) does not commonly appear as an initial manifestation of BL. We presented the case of a young child with sporadic BL with neuromeningeal involvement and spinal cord compression whose first clinical manifestation was the appearance of GBS. Lymphoma should be taken into account, especially in children presenting with the clinical features of acute polyradiculoneuropathy.

To record the experience of caregivers for neurologically impaired children during the lockdown periods. Data from 286 children's caregivers were collected through an administered questionnaire to record: access to care services during the lockdown periods, causes underlying loss of access to care, mitigations adopted by caregivers and patients’ outcomes. The mean age of children was 8.11 years-old and sex ratio (F/M) was 0.66. They were mainly followed-up for epilepsy or epileptic encephalopathy (53%) and cerebral palsy (21%). During the lockdown periods, caregivers reported that 45% of children had no access to healthcare majorly for neurorehabilitation (76.7%) and medicines (70.7%). Most caregivers (36%) related limitations in access to fear from catching the virus. The majority resorted to continuation of the same treatment via primary healthcare facilities (41%) and postponement of their appointments (24%). Our results show that access to healthcare for children with neurological disorders was deeply disrupted during the COVID-19 pandemic. The already precarious health systems’ infrastructures might have been the main causes for this and should be thus considered in the health policy and planing.

International audience; In this paper, a fractal antenna array for telecommunication applications is presented. The proposed antenna array is realized on a Plexiglas substrate, has 1×2 radiating elements, and dimensions of 170mm×105mm. The antenna array is composed of two Koch Snowflake patches and is fed by a Coplanar Waveguide (CPW) transmission line. Radiating elements and the ground plane are printed on the top side of the substrate. Defected Ground Structure (DGS) technique is employed to enhance the bandwidth and improve the impedance matching. The proposed antenna array operates at two frequency bands, 1.08-1.32GHz covering the GPS band and 1.7-3.7GHz covering the GSM 1800/1900, UTMS, Bluetooth, LTE, and WiMAX bands. In addition, the antenna has a good performance with efficiency and peak gain of 82% and 6.3dB respectively. These characteristics allow the antenna to be an attractive candidate for telecommunication systems. Design and analysis of different structures were carried out with Ansys HFSS.

Primary mucinous adenocarcinoma is an exceptionally rare neoplasm with a propensity for local recurrence and metastasis. We report the second case in the literature of a primary mucinous adenocarcinoma of the orbit in a 66-year-old male with its clinical, histological features, and management of this tumor.

Sanjad–Sakati syndrome (SSS), or hypoparathyroidism–mental retardation dysmorphism syndrome, is a rare autosomal recessive congenital disorder characterized by congenital hypoparathyroidism, growth and neurodevelopmental delay, acute symptomatic seizures due to hypocalcemia, and dysmorphic features. The syndrome is underdiagnosed, and neurological manifestations are not previously described. We report three Tunisian patients with SSS revealed by acute symptomatic hypocalcemic epileptic seizures. Despite the well-controlled seizures, patients tend to continue having poor growth and neurological outcome. The diagnosis of SSS allowed for proper treatment of the patients, prevented associated comorbidities, and provided genetic counseling to their families.

Parry–Romberg syndrome is a rare disorder characterized by unilateral facial atrophy affecting the skin, subcutaneous tissue, and muscles, and sometimes extending to the osteocartilaginous structures. Ophthalmological and neurological involvements are relatively rare. We present a case of an early onset of left hemifacial atrophy, a progressive severe left ocular impairment, and the presence of a neurological disorder in the left hemisphere of the brain. The neuro-ophthalmological manifestations on the left side include enophthalmos, mild pseudoptosis, moderate asymmetry of the eyebrows, diffuse chorioretinal atrophy, reduced visual acuity, reduced central retinal thickness (162 µm) with the interruption of the ellipsoid zone, and the alteration of the outer nuclear layer, with associated reduced responses in photopic and scotopic amplitudes. The patient reported high intensity left brain white matter and a brief clinical focal seizure. This case report adds to the repertoire spectrum of this rare syndrome. The presentation calls for a multidisciplinary care for patients like our case.

Central nervous system (CNS) BCGitis is a rare but a very severe complication of the Bacille Calmette–Guerin (BCG) vaccine. It could be a diagnostic challenge that may lead to a delay in treatment. A 5-month-old boy presented with infantile spasms, had posted natal BCG vaccination and developed brain tuberculomas as brain BCGitis. Laboratory findings were normal. He received 14 months of antitubercular regimen with good tolerance and both clinical and radiological improvement. The main difficulty in brain BCGitis is to make a diagnosis that requires histological or bacteriological examination. A good evolution without sequel could be seen if it is treated early.

Introduction The yearly incidence of Acute Demyelinating Syndromes (ADS) in a multiethnic cohort of children published by Langer-Gould and al in 2011 was estimated at about 1.66 per 100,000. Nevertheless, the real incidence for these disorders is still underestimated as the iterative revision for diagnosis criteria have failed to classify a significant number of children with ADS. Purpose This work was aimed to describe clinical and paraclinical characteristics of ADS in a pediatric population. Material and methods Demographic, clinical and paraclinical data of 42 children (24 females; 18 male; SR = 1.33), were collected from the medical records of patients admitted to the child neurology department of Sfax University Hospital between 2008 and 2021 for clinical events with presumed inflammatory origin. Next, patients were categorized as per M. N. Nouri and al. up dated classification for ADS. Finally, characteristics of different ADS categories were compared. Results The mean age onset was 6 years (± 3.5 years). For a mean follow-up period of 28 months, 69% of patients had a monophasic course. ADS in our pediatric population were Acute disseminated encephalomyelitis (ADEM) (36%), Clinically isolated syndrome (CIS) (24%), Multiple sclerosis (MS) (19%), Neuromyelitis optica spectrum disorder (NMOSD) (7%), Myelin oligodendrocyte glycoprotein antibodies-associated diseases (MOGAD) (2%) and Recurrent demyelinating disease not otherwise specified (RD-NOS) (10%). At presentation, patients showed different clinical picture according to ADS-subtype with more patients with epileptic seizure in ADEM-group (53.3%), optic neuritis in CIS-group (70%), motor deficit in MS-group (62.5%), area postrema syndrome in NMOSD-group (33.3%) and vesico-sphincter dysfunction in RD-NOS-group (75%). Among patients presenting with visual impairment (21.4%), Visual evoked potential (VEP) guided the diagnosis of NMOSD in 22.2% by objectifying axonal optic nerve damage. Different ADS subtypes were identified according to MRI results in 100% of ADEM-patients and 75% of MS-patients and on antibody testing in three patients. The ADS-subtype was recognized based on antibody testing in three patients. Two patients from CIS-group: the first with isolated optic neuritis (ON) was positive for antiaquaporin 4 antibodies (anti-AQP4) and the other with clinically polyfocal ADS was positive for antinuclear antibodies (ANA) type anti-RNP. The remaining patients who presented with ADEM-phenotype was positive for anti-myelin oligodendrocyte glycoprotein (anti-MOG). Significance Recognizing distinctive features of each ADS category may improve diagnosis accuracy as well as the indication of suitable treatment.

The Mediterranean region is increasingly recognized as a climate change hotspot but is highly underrepresented in hydrological climate change studies. This study aims to investigate the climate change effects on the hydrology of Lakhmass catchment in Tunisia. Lakhmass catchment is a part of the Medium Valley of Medjerda in northwestern Tunisia that drains an area of 126 km². First, the Hydrologiska Byråns Vattenbalansavdelning light (HBV-light) model was calibrated and validated successfully at a daily time step to simulate discharge during the 1981–1986 period. The Nash Sutcliffe Efficiency and Percent bias (NSE, PBIAS) were (0.80, +2.0%) and (0.53, −9.5%) for calibration (September 1982–August 1984) and validation (September 1984–August 1986) periods, respectively. Second, HBV-light model was considered as a predictive tool to simulate discharge in a baseline period (1981–2009) and future projections using data (precipitation and temperature) from thirteen combinations of General Circulation Models (GCMs) and Regional Climatic Models (RCMs). We used two trajectories of Representative Concentration Pathways, RCP4.5 and RCP8.5, suggested by the Intergovernmental Panel on Climate Change (IPCC). Each RCP is divided into three projection periods: near-term (2010–2039), mid-term (2040–2069) and long-term (2070–2099). For both scenarios, a decrease in precipitation and discharge will be expected with an increase in air temperature and a reduction in precipitation with almost 5% for every +1 °C of global warming. By long-term (2070–2099) projection period, results suggested an increase in temperature with about 2.7 °C and 4 °C, and a decrease in precipitation of approximately 7.5% and 15% under RCP4.5 and RCP8.5, respectively. This will likely result in a reduction of discharge of 12.5% and 36.6% under RCP4.5 and RCP8.5, respectively. This situation calls for early climate change adaptation measures under a participatory approach, including multiple stakeholders and water users.

Post-traumatic Stress Disorder (PTSD), depression and anxiety are the most common psychiatric consequences among parents of children with epilepsy.We aimed to investigate the prevalence and predictors of PTSD, depression and anxiety in a sample of parents of children with epilepsy.A survey of 135 parents of children with epilepsy, treated in the pediatric neurology department at the Sfax Teaching Hospital in Tunisia, was conducted in the last quarter of 2019. The PTSD Checklist for DSM-5 and the Hospital Anxiety and Depression Scale (HADS) were used to assess, respectively, PTSD, depression and anxiety in parents. Associations with clinical and demographic variables with PTSD, depression and anxiety were evaluated in a logistic regression model.Results revealed PTSD rates of 20.7%, depression rates of 28.9% and anxiety rates of 55.6%. The main factors associated with PTSD on multivariable analysis were female gender (P=0.026, ORa=13.1), insufficient involvement of partner in disease management (P10These findings suggest that clinicians should pay more attention to psychological health of parents of children with epilepsy and help healthcare providers to develop preventive and intervention strategies for parents of such children.

Seizures occur frequently in inflammatory diseases. Primary Intestinal Lymphangiectasia (PIL) is a systemic disorder but epilepsy was not reported before. In this paper, we presented the case of 17 years old boy, diagnosed for PIL, who developed by the age of 16 recurrent epileptic seizures. The epilepsy was confirmed, the patient was treated with carbamazepine with good outcomes. Epilepsy may occur in patients with PIL, and doctors should be aware and treat seizures when the diagnosis of symptomatic acute seizures is excluded.

International audience; This paper presents the design and analysis of Koch fractal antenna with transparent substrate for telecommunication systems. This wide band antenna is capable to cover GSM900 (890-960 MHz), GSM1800 (1710- 1880 MHz), GSM1900 (1850-1990 MHz), UMTS (1920-2170 MHz), WLAN (2400-2480 MHz) and LTE (2.6-2.7 GHz) bands with VSWR < 2 over the entire frequency range. The antenna consists of a Koch fractal antenna developed according to the second iteration of the Koch snowflake fractal structure with slot inside. The antenna is fed by coplanar wave guide (CPW) using the concept of modified ground structure. The proposed antenna is designed on a transparent substrate with a dielectricconstant of 4.6 and a size of 60 x 70 x 3 mm3. The radiating element and ground plane are both designed using AgHT-4, while the substrate is made of glass. The gain of the proposed antenna is 1.69dB, 2.92dB at 1.9 GHz and 2.4 GHz respectively, which correspond to the needs of our application. The analysis of antenna is performed using HFSS software.

Objective and importance While bone invasion and hyperostosis are frequent phenomena in meningiomas, primary intraosseous meningiomas are rare and their occurrence in the skull base is an extraordinary exception. Moreover, radiation-induced meningiomas represent a unique clinical dilemma given the fact that patients with these tumors had often received a prior full course of radiotherapy. Clinical presentation A 42-year-old man presented with a 3-month history of progressively worsening facial asymmetry. His medical history was consistent for a posterior cranial fossa irradiation at the age of 6 years for a non-confirmed brain stem tumor. On admission his Karnofsky performance status was graded as 50% and his neurological examination showed a complete right facial nerve paralysis and hearing impairment. Computed tomography and magnetic resonance imaging demonstrated an osteolytic tumor invading the whole right petrous bone without intracranial involvement. Intervention As the tumor reached the external auditory canal, a tissue sample was obtained locally. Pathological examination of the lesion identified a grade II clear cell meningioma and the patient was consequently addressed for an intensity modulated radiation therapy. His condition remained unchanged till the most recent follow-up examination, 8 months later. Conclusions To the best of our knowledge, a radiation induced osteolytic clear cell meningioma of the petrous bone has not been previously reported. As little literature exists regarding the use of adjuvant therapies for these tumors, intensity modulated radiation therapy remains an attractive treatment option in case of pervious irradiation and general status alteration.