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Epilepsy Behav ; 116: 107712, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33460988


OBJECTIVE: To examine the lateralizing value of unilateral peri-ictal and interictal headaches in patients with drug-resistant focal epilepsy (DRFE). METHODS: Four-hundred consecutive patients undergoing presurgical evaluation for DRFE were interviewed. Patients with headache were broadly divided into two groups: peri-ictal and interictal headache. The lateralizing value of unilateral headache was compared in each group between three diagnoses: temporal lobe epilepsy (TLE), extratemporal lobe epilepsy (ETLE), and temporal-plus epilepsy (TEMP+ epilepsy). RESULTS: Out of 400 patients, 169 (42.25%) had headaches. Peri-ictal headaches were experienced in 106 patients (26.5%) and interictal headaches were experienced in 63 (15.75%). In the peri-ictal group, unilateral headaches were present in 48 out of 60 patients (80%) with TLE; they were ipsilateral to the seizure focus in 45 out of 48 patients (93.75%). Unilateral headaches in patients with ETLE were present in 20 out of 31 patients (64.5%) and were ipsilateral to the seizure focus in 14 out of 20 patients (70%). In patients with TEMP + epilepsy, unilateral peri-ictal headaches were present in 9 out of 15 patients (60%); they were ipsilateral to the seizure focus in all 9 patients (100%). In the interictal headache group, unilateral headaches were ipsilateral the seizure focus in 9 out of 10 patients (90%) with TLE and 5 out of 6 patients (83.3%) with ETLE. None of the TEMP + epilepsy patients had a unilateral interictal headache. CONCLUSION: Headache is a frequently encountered symptom in patients with DRFE. When occurring in a unilateral fashion, it has a high lateralizing value in temporal and extratemporal lobe epilepsies. This has been demonstrated to be true for both peri-ictal and interictal headaches. In the vast majority of patients with DRFE, unilateral headache occurs ipsilateral to the seizure focus.

Saudi Med J ; 40(4): 372-378, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30957131


OBJECTIVES: To determine if there is a relationship between acute stress and either the onset or relapse of multiple sclerosis (MS) and to discover how different types of acute stressors may be involved. Methods:  This study was carried out in Saudi Arabia between September 2017 and June 2018 and involved King Fahad University Hospital in Eastern province, Arfa Multiple Sclerosis Society in the Central and Western province of Saudi Arabia. A cross-sectional descriptive study was performed using an Arabic self-constructed questionnaire consisted of 4 sections: 1) demographic data and time of diagnosis; 2) emotional/psychological stressors; 3) environmental/physical stressors; and 4) 4 specific stressors measuring their effect on the severity and recurrence of attacks. Results: A total of 370 patients participated in the study. Almost half of patients reported no effect of family problems on their disease, whereas the other reported that family problems have an impact on the onset or relapse of the disease. Majority of patients reported that work and social life stressors affect the recurrence of attacks. Cold weather showed no effect on MS; however, hot weather and physical activity increased the number of attacks. Continuous thinking about social stress and problems, mood swings, and sleep deprivation showed an impact on the severity and recurrence of attacks. Financial problems showed no effect.  Conclusion: Study indicates that an association exists between acute stress and relapse in MS but not the disease onset.

Esclerosis Múltiple/epidemiología , Esclerosis Múltiple/etiología , Estrés Fisiológico/fisiología , Estrés Psicológico/complicaciones , Enfermedad Aguda , Adolescente , Adulto , Estudios Transversales , Humanos , Persona de Mediana Edad , Prevalencia , Recurrencia , Factores de Riesgo , Arabia Saudita/epidemiología , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Factores de Tiempo , Adulto Joven
Mult Scler Relat Disord ; 25: 334-336, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30195202


Increasing evidence has emerged lately regarding the use of autologous hematopoietic stem cell transplantation (HSCT) in the treatment of aggressive multiple sclerosis (MS). However, data is scarce regarding the use of allogenic HSCT in treating MS. We present a 42 years old male with aplastic anemia who underwent allogenic HSCT for severe aplastic anemia. This patient was diagnosed with primary progressive multiple sclerosis (PPMS) one-year post transplant and had to undergo a second HSCT due to his hematological disorder. His second HSCT was conditioned with an alemtuzumab containing regimen, after which his MRI and expanded disability status scale (EDSS) remained to be stable for 18 months.

Alemtuzumab/uso terapéutico , Antineoplásicos Inmunológicos/uso terapéutico , Trasplante de Células Madre Hematopoyéticas/métodos , Esclerosis Múltiple Crónica Progresiva/tratamiento farmacológico , Esclerosis Múltiple Crónica Progresiva/cirugía , Acondicionamiento Pretrasplante/métodos , Adulto , Encéfalo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Esclerosis Múltiple Crónica Progresiva/diagnóstico por imagen , Médula Espinal/diagnóstico por imagen
Epilepsy Behav Case Rep ; 9: 26-28, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29692966


Numerous autoantibodies are implicated in the pathogenesis of autoimmune epilepsy. In the past decade, many case series reported the association of glutamic acid decarboxylase 65 (GAD 65) antibodies with epilepsy. Conjoint presence of GAD 65 antibodies with antinuclear, anti-thyroid, and anti-parietal cell antibodies has often been demonstrated. However, concomitant elevated levels of GAD 65 and P/Q voltage gated calcium channel (VGCC) antibodies is rare. We report a case of autoimmune epilepsy with conjoint GAD 65 and P/Q VGCC antibodies in the absence of malignancy. This report highlights a possible role of P/Q VGCC antibodies in the pathogenesis of autoimmune epilepsy.