Abdul Kader Daif

Photosensitive Epilepsies and Photoconvulsive Responses in Arabs

SUMMARY: The occurrence of photosensitivity (PS) was examined in 327 Arabs ≥15 years of age with epilepsy by intermittent photic stimulation (IPS). A control group of 192 nonepileptic Arabs ≥15 years of age were also examined by IPS. Of the epileptic patients, 24 (7.3%) were photosensitive, an incidence comparable to that in whites in contradistinction to the reported rarity among African blacks. This finding indicates that environmental factors, particularly excessive sunshine, does not appear to influence the occurrence of PS among epileptic patients. The occurrence of PS among epileptic patients may depend more strongly on the presence of an epileptic syndrome known to have association with PS.

Bickerstaff brainstem encephalitis: A grave non-demyelinating disease with benign prognosis

We describe 6 patients with ophthalmoplegia, ataxia and normal or exaggerated deep tendon reflexes. All had been preceded by a febrile illness and had a full recovery without sequelae. The brainstem auditory evoked potentials showed a localised lesion in the upper brainstem while the pattern shift visual evoked potentials were normal and did not show any additional silent lesions. CSF IgG oligoclonal bands were not detected in any of the patients. MRI in 2 patients showed a confluent high intensity lesion in the upper mesencephalon and thalamus involving white and gray matter. Follow-up ranged from 6 to 24 months and showed no relapse.

Pancerebellar syndrome in heat stroke: clinical course and CT scan findings

SummaryWe present the clinical course and computerized tomography (CT) findings in a case of pancerebellar syndrome due to heat stroke at the Mekkah Pilgrimage. CT scan was initially normal, but five months later, a considerable generalized cerebellar atrophy was seen despite remarkable clinical improvement.

Unusual presentation of tuberculous meningitis.

We present 4 cases of tuberculous meningitis with atypical clinical features and CSF findings. Two patients had initially normal CSF examination, one developed internuclear ophthalmoplegia, while the other had deterioration of consciousness. The third patient presented with paranoid psychosis, and the fourth had a picture mimicking acute bacterial meningitis and he developed right hemianopia due to a tuberculoma detected by MRI. All recovered completely with anti-tuberculous treatment.

Can cytotoxic drugs cure subacute sclerosing panencephalitis

SIR—Subacute sclerosing panencephalitis (SSPE) is a slow viral infection with poor prognosis. It is associated with previous measles infection’ but rarely with acute lymphoblastic leukaemia (ALL). Although there is no specific therapy for the disorder, there is evidence that the use of inosine pranobex or interferon could be beneficial, but the efficacy of antiviral enzymes of immunomodulator agents is controversial.2 We have managed a case of SSPE associated with acute lymphoblastic leukaemia successfully with cytotoxic drugs. A 12-year-old girl had a 3-month history of fever, vomiting, generalised bone pains, and inability to walk. Her gait problems had started 4 years previously when she noticed unsteadiness and weakness of her extremities which

Deep cerebral venous thrombosis presenting as acute amnestic syndrome

A 45 year‐old man presented with a rapid onset of memory impairment Brain computed tomography showed multiple abnormal low density areas in the deep cerebral white matter. Magnetic resonance imaging revealed bilateral thalamic infarcts and extensive thrombosis of the vein of Galen and the straight sinus, which was confirmed by cerebral angiography. The only potential cause was protein S deficiency. Heparin therapy was started only after the occurrence of a pulmonary embolism. The outcome was excellent Deep cerebral venous thrombosis must be considered as a possible cause of amnestic syndrome. Clinical awareness and early use of anticoagulation may alter the usual fatal outcome.

The value of oligoclonal bands in neurobrucellosis.

We performed polyacrylamide gel isolectric focusing on diluted sera and non-concentrated CSF from ten patients with neurobrucellosis, ten patients with definite multiple sclerosis, seven patients with neuro-Behcets syndrome, five patients with tuberculous meningitis, and eight patients with other neurological disorders. Our data support the proposed theory of the intrathecal synthesis of immunoglobulins in the presence of neurobrucellosis, and showed that evidence of oligoclonal IgG bands in cerebrospinal fluid and serum provides rapid and helpful confirmation of diagnosis of neurobrucellosis.

Papilledema without Lateralizing Signs

The cases of 40 patients (aged, 18-40 y) who presented with papilledema without lateralizing signs (PWLS) were analyzed retrospectively, with particular reference to the underlying causes. Benign i...