The Prevalence of Depression in Patients With Epilepsy in the Kingdom of Saudi Arabia.

Objective Among patients with epilepsy (PWE), the prevalence of depression ranges from 30% to 50%, with a 5-25% prevalence of suicide. Depression and epilepsy affect daily tasks such as driving, employment, and physical activity. Depression is the most common comorbidity among patients with epilepsy. Because both conditions involve pathophysiological changes, treating mood disorders helps treat epilepsy and vice versa. Studies about epilepsy and depression in Saudi Arabia are scarce, and no study has been conducted on this topic at King Fahad Medical City (KFMC); hence, we aimed to determine the prevalence of depression among PWE who were followed up at KFMC. Methods This retrospective hospital-based study was conducted at KFMC in Riyadh, Saudi Arabia. This investigation spanned a period of 10 years, from 2008 to 2018. The study included patients with PWE who were diagnosed with depression. Results According to a study of individuals aged 18 to 69, 73.7% of patients had been diagnosed with chronic depression (i.e., for more than a year); most of these patients had completed elementary school. Higher rates of depression were also observed among elementary school pupils, divorced women, and non-Riyadh residents. A correlation was observed between the severity of depression based on the Patient's Health Questionnaire( PHQ-9) score, which was used to screen for depression and diabetes mellitus (DM), the number of antidepressant medications (ADM) used, the duration of antidepressant use, suicidal ideation or attempts, and the duration of depression. Epilepsy was most prevalent in the temporal lobe, accounting for 22.6% of all cases, and it was managed in 78.2% of the patients. The duration of epilepsy was significantly associated with the severity of depression.

Weighing Successes and Challenges in the Establishment of Additional Epilepsy Monitoring Units at the Saudi Arabian Kingdom's Capital City.

Epilepsy has a prevalence rate of 6.54 per 1,000 people in Saudi Arabia, making it a prevalent chronic condition. Drug-resistant epilepsy (DRE) is thought to affect one-third of patients; in these circumstances, a complete presurgical examination in the epilepsy monitoring unit (EMU) is necessary. Unfortunately, to accommodate the growing number of referrals, the units' availability and number must be reviewed.

Sudden unexpected death in epilepsy: What Saudi people with epilepsy want to know-A cross-sectional study.

OBJECTIVE: Sudden unexpected death in epilepsy (SUDEP) is a significant cause of mortality in people with epilepsy (PWE), with an incidence of 1 per 1000 members of the population. In Saudi Arabia, no data are available that inform local clinical practitioners about the attitudes of PWE regarding SUDEP. The aim of this study was to investigate the perspectives of Saudi PWE toward SUDEP and to assess their knowledge of SUDEP. METHODS: A cross-sectional questionnaire-based study was conducted at the neurology clinics of King Abdul-Aziz Medical City, Riyadh and Prince Sultan Military Medical City, Riyadh. RESULTS: Of the 377 patients who met the inclusion criteria, 325 completed the questionnaire. The mean age of the respondents was 32.9 ± 12.6 years. Of the study subjects, 50.5% were male. Only 41 patients (12.6%) had heard about SUDEP. Most patients (94.5%) wanted to know about SUDEP, of whom 313 (96.3%) wanted to receive this information from a neurologist. A total of 148 patients (45.5%) thought that the appropriate time to receive information about SUDEP was after the second visit, whereas only 75 (23.1%) wanted to learn about SUDEP during the first visit. However, 69 patients (21.2%) thought that the appropriate time to be informed about SUDEP was when seizure control had become more difficult. Almost half (172, 52.9%) of the patients thought that SUDEP could be prevented. SIGNIFICANCE: Our findings suggest that most Saudi PWE do not know about SUDEP and want to be counseled about their risk of SUDEP by their physicians. Therefore, education of Saudi PWE about SUDEP must be improved.

Presentation of Dyke-Davidoff-Masson Syndrome in adult male.

Dyk-Davidoff-Masson Syndrome (DDMS) is one of the rare neurological conditions attributed to the development of drug-resistant epilepsy (DRE). The DDMS condition is characterized by cerebral hemisphere asymmetry, where atrophy occurs on one side of the brain and clinically manifests as hemiparesis, seizure disorder, mental retardation, and facial asymmetry. In addition, the condition has various perinatal or postnatal etiologies. Herein, we report the case of a 29-year-old right-handed male with Dyke-Davidoff Masson syndrome and mild right-side weakness. The patient experiences attacks of seizures with stiffness in his right arm and right leg, sometimes experiencing agitation and abnormal movement of the body parts. The MRI of the brain showed asymmetry with atrophic changes involving the left hippocampus, consisting of mesial temporal sclerosis. Additionally, the results showed the presence of gyral hyperintensities over the left parietal region. Therefore, the patient's case is reported with a literature review to support it.

KCNMA1-related refractory status epilepticus responding to vagal nerve stimulation: Case report and literature review.

Epilepsy, one of the most prevalent chronic neurological diseases, can cause severe morbidity as well as mortality. A mutation of the KCNMA1 gene results in a rare genetic disease that causes epilepsy as its core presentation. Both neurological and non-neurological manifestations have been reported in patients with KCNMA1 gene mutation. We are reporting a KCNMA1 gene variant referred to as c.2369C>T (p. Pro790Leu), which encodes the subunit of alpha of calcium-sensitive potassium channels, which causes epilepsy but not dyskinesia in a young Saudi female who is the daughter of consanguineous parents. Our case shows that calcium-sensitive potassium channels can cause an isolated generalized epilepsy as reported previously in a single case. Moreover, this case aids in delineating the clinical and structural picture and the treatment of the KCNMA1 gene mutation in patients.

Efficacy and safety of corpus callosotomy versus vagus nerve stimulation as long-term adjunctive therapies in children with Lennox-Gastaut syndrome: Experience of a tertiary care center.

OBJECTIVES: To compare the efficacy and safety of corpus callosotomy versus vagus nerve stimulation (VNS) as long-term adjunctive therapies in children with Lennox-Gastaut syndrome. METHODS: This retrospective study was conducted in King Fahad Medical City between 2010 and 2019. The authors identified and followed 9 patients with Lennox-Gastaut syndrome (LGS) who underwent corpus callosotomy or VNS implantation for at least 12 months; seizure frequency and major complications were monitored. Five patients with a mean age of 10.8±1.3 years had corpus callosotomy, and 4 patients with a mean age of 13.8±3.9 years were implanted with VNS stimulators. RESULTS: Reduction in seizure frequency was achieved in all 5 patients who underwent corpus callosotomy, with greater than 75% seizure reduction in more than 50% in one, and greater than 25% in 2 respectively. However, in those implanted with VNS, 2 (50%) patients achieved a reduction in seizure frequency of greater than 75% and 2 (50%) greater than 25%, respectively. No significant difference was observed between the 2 treatment groups. One patient who underwent corpus callosotomy suffered cerebrospinal fluid leakage, and swallowing difficulties in one patient who underwent VNS. CONCLUSION: Both corpus callosotomy and VNS are safe and effective as adjunctive treatments for LGS patients.

Musicogenic reflex seizure with positive antiglutamic decarboxylase antibody: A case report.

The association of musicogenic epilepsy (ME) with antibodies against glutamic decarboxylase (GAD) supports autoimmune workups for these patients. No appropriate treatment has been established for ME; therefore, immunotherapy should be considered for patients who become drug-resistant. The connection between neurological manifestations and antibodies against GAD, a rate-limiting enzyme that helps create the inhibitory neurotransmitter gamma-aminobutyric acid, has been well established. Furthermore, a strong correlation has been found between ME and the temporal lobe. However, its connection with anti-GAD antibodies is still unclear. This paper reports on a 50-year-old right-handed female who has had ME symptoms for 14 years and been found to be anti-GAD antibody-positive. Therefore, we will elaborate on the relation between ME and anti-GAD antibodies.