Search

Background A high prevalence of obstructive sleep apnea (OSA) has been reported in medically refractory epilepsy patients, and there is increasing evidence that treatment of OSA in refractory epilepsy patients would reduce seizure frequency. Objective Studying the frequency of occurrence of OSA in a group of refractory epilepsy patients, compared to a matched group with medically controlled epilepsy. Methods Sixty patients with epilepsy, 30 patients with controlled epilepsy (group I), and 30 patients with refractory epilepsy (group II) were included. All patients underwent overnight polysomnogram and sleep EEG and completed Sleep Apnea Sleep Disorders Questionnaire (SASDQ). All patients had normal general and neurological examination. Results The frequency of OSA was found to be 10% in patients with controlled epilepsy, while its frequency in patients with refractory epilepsy was found to be 16.7%, yet this was statistically insignificant. In addition, O2 desaturation nadir was higher in group II, compared to group I with no statistical significance. In the controlled epilepsy group, we found that older patients tend to have higher Apnea–Hypopnea Index (AHI). Moreover, it was found that older subjects, with early onset of epilepsy, and longer duration of the illness tend to have higher AHI in group II. Conclusion There is an association between refractory epilepsy and OSA, especially regarding O2 desaturation during sleep. In addition, older age, early onset of epilepsy, and longer duration of illness are independent risk factors for the OSA in patients with refractory epilepsy.

Background Epilepsy is among the most common disabling neurological disorders among children. Altered serum levels of zinc and copper may facilitate seizure occurrence and repetition, and antiepileptic drugs may disturb their serum levels affecting disease control and outcome. Objective To investigate the association between serum levels of zinc and copper and epilepsy and antiepileptic treatment in a group of Egyptian epileptic children. Methods Case-control study on 100 epileptic patients, aged from 2 to 16 years, from neurology outpatient clinic and 50 apparently healthy children with matched age and sex. Venous samples were withdrawn from patients and controls then serum levels of zinc and copper were measured with graphite furnace atomic absorption spectrometer-A Analyst 800. Results Serum zinc level of patients’ group was significantly lower than that of controls with a mean of 59.1 μ/dL ± 22.7 and 85 μ/dL ± 22.2, respectively (P < 0.01). Serum zinc level of patients with history of febrile seizures was significantly decreased compared to patients without history of febrile seizures with a mean of 41.5 μ/dL ± 20.1 and 67.9 μ/dL ± 19.3, respectively (P < 0.01). Patient on carbamazepine intake showed significantly lower zinc serum level than patients without carbamazepine intake, with a mean of 49.0 μ/dL ± 17 and 61.8 μ/dL ± 23.4, respectively (P < 0.01). A significant negative correlation was noted between the duration of illness of epilepsy and the mean copper serum level (P < 0.05). Conclusion Zinc and copper altered homeostasis have mounting evidence about their role in the pathogenesis of epilepsy. Designing treatment plans that selectively restore zinc and copper normal levels may be a beneficial strategy in the future.

Objective: The prevalence of non-motor symptoms (NMSs) and their impact on health-related quality of life (HRQoL) in Parkinson's disease (PD) has been reported inconsistently among different populations. In this study, we aimed to investigate the NMSs and HRQoL profiles and their correlations in Egyptian PD patients, using a culturally adapted Arabic version of the 39-item Parkinson’s disease questionnaire (PDQ-39)). Methods: Ninety-seven PD patients were rated using the Unified Parkinson's Disease Rating Scale (UPDRS), the Non-Motor Symptoms Scales (NMSS), Beck Depression Inventory (BDI), and the Arabic version of PDQ-39. We used the Spearman’s rank correlation and multiple linear regression analyses to evaluate the relationship between NMSs domains and HRQoL dimensions. Results: Fatigue/sleep (91.3%) and mood/cognitive disturbances (87%) were the most frequently and severely affected NMSS domains. Other NMSs included urinary (75.9%), memory/attention (72.4%), gastrointestinal (67.8%), and cardiovascular problems (64.8%). The total NMSS scores were positively correlated with UPDRS I, II, and III scores. Depression assessed by BDI was prevalent in 76.7% of PD patients. Moreover, Aall enrolled PD patients reported impairment in different HRQoL dimensions, especially mobility (98.9%), activities of daily living (97.8%) and emotional well-being (95.5%). The summary index of PDQ-39 (PDQ-SI) was correlated to the total NMSS, UPDRS-I, UPDRS-II Off, UPDRS-III (Off and On states) and BDI scores. Conclusion: This study showeds the high prevalence of NMSs and the value of NMSS and BDI scores as predictors of HRQoL inof Egyptian PD patients. Therefore, Identifying characterizing the NMSsnon-motor profile is essential for tailoring management strategies offor PD patients.

Objective: To study the effect of cerebral ischemic vascular insult on the localization of language areas as regard to automatic speech, initiation, and mutism. Materials and Methods: Seventy ischemic stroke patients were selected within the first 48 h of the onset of stroke with left hemispheric stroke with aphasia. Inclusion criteria: any age above seven years, both sexes, first ever clinical stroke, admitted within the first 2 days of stroke insult. Patients underwent careful history taking, neurological examination, routine laboratory investigations, echo cardiography, and carotid duplex and language assessments. Results: Automatic speech disorders were mainly seen along left insular, left supramarginal and left frontal inferior orbital lesions. Initiation difficulty is seen mainly along as left insular, left temporal superior and left periventricular lesions. Mutism is seen along left external capsule, left internal capsule, left pallidum, left frontal inferior orbital and left inferior trigone lesions. Conclusions: Deep periventricular white matter and insular area in the dominant hemisphere play an important role in many language tasks. Thus aphasia is not a mere cortical function.