Said S. Dahbour

MRI documented acute myelitis in a patient with Vogt-Koyanagi-Harada syndrome: First report

MRI findings in transverse myelitis complicating Vogt-Koyanagi-Harada (VKH) syndrome have not been documented before. Here, we present a case with acute myelitis complicating VKH syndrome and show the MRI findings.

The promoter SNP, but not the alternative splicing SNP, is linked to multiple sclerosis among Jordanian patients.

Multiple sclerosis is a chronic inflammatory autoimmune disease of the human central nervous system. A number of studies with compelling evidence have provided correlation between single nucleotide polymorphisms in interleukin-7 receptor alpha and multiple sclerosis (MS) in several populations. One such variation, rs6897932, is located within the coding region and results in the generation of a soluble receptor, whereas another one, rs11567685, is located in the promoter region and affects gene expression. In this study, we investigated the frequencies of these two SNPs and their association to MS in 200 healthy controls and 200 MS patients based on a simple PCR-RFLP strategy not reported previously. The frequencies of the high risk alleles for both SNPs were in a high range among healthy and MS subjects relative to previous studies. In addition, whereas no association was found between the alternative splicing SNP, rs6897932, and MS, a significant link was found between the promoter SNP, rs11567685, and MS. These results are in contrast to other studies and may have important implications as to the molecular contribution of IL-7Rα in multiple sclerosis.

Mesenchymal stem cells and conditioned media in the treatment of multiple sclerosis patients: Clinical, ophthalmological and radiological assessments of safety and efficacy

This open‐label prospective phase I/IIa clinical study used autologous bone marrow‐derived mesenchymal stromal cells (BM‐MSCs) followed by mesenchymal stromal cells conditioned media (MSC‐CM) for the first time to treat multiple sclerosis (MS) patients. The primary goal was to assess the safety and feasibility and the secondary was efficacy. The correlation between the MSC‐CM content and treatment outcome was investigated.

Nonconvulsive status epilepticus: high incidence in dialysis-dependent patients.

Nonconvulsive status epilepticus is defined as a mental status change from baseline of at least a 30‐min duration associated with constant or near‐continuous ictal discharges on an electroencephalogram (EEG). Nonconvulsive status epilepticus is an often‐overlooked diagnosis as a cause of acute confusional state. There are few case reports in dialysis patients. We are reporting 5 patients on chronic dialysis treatment who presented with an acute confusional state. Nonconvulsive status epilepticus was diagnosed by EEG and response to intravenous benzodiazepines. We recommend early EEG to be considered in the evaluation of dialysis patients with an acute confusional state.

Stem Cell Therapies in Neurological Disorders

The self-renewal, differential capacity of stem cells and technical advancement in large-scale clinical grade expansion make stem cells a potential tool for regeneration, restoration, or replacement therapies for a variety of neurological disease conditions.

Towards establishing a multiple sclerosis biobank in Jordan

Genome-wide association studies (GWAS) have been a promising approach in unraveling genetic associations to multiple sclerosis (MS), a complex, multifactorial disease. Biobanks are repositories of patient biospecimens and information that can promote GWAS research. However, the success of GWAS and biobanking is dependent on the level of participation of MS patients in genetic research. In order to initiate MS-based biobanking and GWAS research in Jordan, the willingness of MS patients to participate in long-term, genetic research in Jordan and their preferred type of a consent form were investigated. MS patients (289) were recruited for genetic studies. Personal and clinical information were collected from those who enrolled in the study. Approximately 96% of MS patients agreed to participate in genetic studies. The female:male ratio among patients was 2:1 with most patients being diagnosed with relapsing-remitting MS (88%). The mean age of onset was 28.3 years, the mean duration of illness was 6 years, and the mean Expanded Disability Status Scale was 2.8. Relatedness of parents was significantly associated with having secondary-progressive MS. Approximately 85% of the patients preferred open consent with 37% of them preferring to renew their consent. All the patients approved to be recontacted and update their information via accessing their medical files or physicians. These observations support the establishment of a specialized MS biobank in Jordan and pave the way to participate in international large-scale genetic initiatives.

Cerebral Cavernoamas : Radiological Prevalence and Clinical Features in a 10 Year Retrospective Study in a Teaching Hospital = الأورام الوعائية الكهفية الدماغية : دراسة انتشار شعاعية مع المظاهر السريرية : دراسة استعادية لفترة عشر سنوات في مستشفى تعليمي

Objectives: Cerebral cavernous angiomas remain one of the most negotiable and controversial topics in neurological and neurosurgical practice. It can present with symptoms or can be found incidentally. The aim of this study is to evaluate the prevalence, clinical presentation, treatment options and outcome of patients with cerebral cavernoma. Materials and Methods: Brain MRI for (14372) patients done in our university teaching hospital during 10 -year period from 2001 to 2011 were reviewed, 33 cases of cerebral cavernoma were found. The medical charts of these patients were reviewed and analyzed for their clinical presentation, treatment options and outcome. Results: We identified 33 cases of cavernoma with a mean age of 33.3±16.8 years. There were18 females and 15 males. Four cases were excluded from analysis (but included in prevalence calculation) due to unavailability of clinical data. In the 29 other cases there were 35 cavernomas. The radiologic prevalence of cavernomas in this population was 0.23%. Most cavernomas were found in the supratentorial regions mostly found in the frontal lobes. The most common presenting symptoms were seizures in males and headache in females. Conclusion: The radiologic prevalence of cerebral cavernomas was less than previous series, while clinical presentation was the same. Performing MRI at higher resolution and field strength with more sensitive sequences may lead to the detection of subtle or small brain abnormalities that would not have been detected previously.