Egyptian Journal of Neurology, Psychiatry and Neurosurgery

Abstract Background Epileptic seizures arise from an excessively synchronous and sustained discharge of a group of neurons. The single feature of all epileptic syndromes is a persistent increase of neuronal excitability. Visual affection in epileptic children could be attributed to the disease itself or the use of anti-epileptic drugs, these changes may involve abnormal electro-physiological response. This biphasic study, conducted at the neuro-pediatric clinic at neurology department, aimed to investigate effect of idiopathic childhood epilepsy per se on (1) visual evoked potential and (2) optical coherence tomography and effect of selected two antiepileptic medications on them. All subjects were exposed to visual evoked potential and only cooperative subjects exposed to ocular coherence tomography before and after anti-epileptic drugs and were followed up over 2 years. Results The study included 50 newly diagnosed epileptic children and 50 healthy controls, the mean P100 latency in the right eyes of the control group was 110.4 ± 3.76ms, while in the patients group was 114.94 ± 12.81ms that showed significant difference between the two groups with p value (0.020). After 2 years of treatment by levetiracetam and valproate, the mean P100 latency of the right and left eyes in the valproate group was 112.34 ± 7.05 ms and 112.59 ± 5.2 ms, respectively, and it was 114.85 ± 10.39 ms and 116.14 ± 9.84 ms, respectively, in the valproate group, which showed insignificant difference between the two groups. The mean average of retinal nerve fiber layer thickness between patients and controls was significant in both right and left eyes with p value 0.002 and &lt; 0.001, respectively. After 1 year of treatment by levetiracetam in the first group and valproate in the second group, there was no significant difference between the two groups neither regarding retinal nerve fiber layer thickness nor ganglion cell complex in both eyes. Conclusions There was prolonged latency in the epileptic children before starting anti-epileptic drugs more than the control group; also there was thinning of the retinal nerve fiber layer thickness and average part of the ganglion cell complex thickness more in the epileptic children than in the healthy controls.

Amira Ahmed Moussa

Ayman Nassef

Maha A. Nada

Marwa A. Karim

Shaimaa S. Khater

Nahed Salah El deen

The Egyptian Journal of Neurology Psychiatry and Neurosurgery

Effect of childhood epilepsy and antiepileptic drugs on visual evoked potential response and optical coherence tomography

儿童癫痫及抗癫痫药物对视觉诱发电位反应和光学相干断层扫描的影响

Abstract Background Neurologic manifestations in the systemic autoimmune rheumatic diseases (SARDs) are protean. They add to the disease burden and could contribute to mortality. Increasing awareness about the neuro-rheumatologic syndromes might help with early diagnosis and effective therapy. Our aim is to survey the clinical and imaging patterns of neurological involvement in Egyptian patients with SARDs. Results Neurological involvement is common in Behçet’s disease (BD) (12.7%) and systemic lupus erythematosus (SLE) (6.4%) patients compared with other SARDs. Compared with SLE, neurological involvement in BD tends to develop at an older age (31 ± 7.1 versus 28.3 ± 9.6 years = 0.022) with a greater progression risk (13.8% versus 2.6%, P = 0.003). A higher proportion of SLE patients had abnormal neuroimaging without neurological symptoms (15.7% versus 4.3%, P = 0.026, OR = 4.9, 95%CI 1.1–22.4). SLE patients had a higher frequency of seizures (31.3% versus 6.4%, P &lt; 0.001, OR = 6.7, 95%CI 2.7–16.7) and benign intracranial hypertension (9.6% versus 1.1%, P = 0.009, OR = 9.8, 95%CI 1.2–77.7) but a lower prevalence of quadriplegia due to brain insult (1.7% versus 3.2%, P = 0.045, OR = 0.2, 95%CI 0.04–0.9), dural sinus thrombosis (13% versus 33%, P = 0.001, OR = 0.3, 95%CI 0.2–0.6), brainstem syndrome (0.9% versus 6.4%, P = 0.047, OR = 0.1, 95%CI 0–1.1) and cranial neuropathies (9.6% versus 31.9%, P &lt; 0.001, OR = 0.2, 95%CI 0.1–0.5). Concerning neuroimaging, brain atrophic changes were more common (27.4% versus 9.5%, P = 0.002, OR = 3.6, 95%CI 1.6–8.3) while thrombosis was less prevalent (36.3% versus 53.6%, P = 0.016, OR 0.5, 95%CI = 0.3–0.9) in lupus patients. The cerebral cortex was more commonly affected (20.4 versus 4.8%, P = 0.002, OR = 5.1, 95%CI 1.7–15.4) while dural sinuses (14.2% versus 40.5%, P &lt; 0.001, OR = 0.2, 95%CI 0.1–0.5), basal ganglia (1.8% versus 10.7%, P = 0.010, OR = 0.2, 95%CI 0–0.7), diencephalon (0% versus 13.1%, P &lt; 0.001) and brainstem (1.8% versus 22.6%, P &lt; 0.001, OR = 0.1, 95%CI 0–0.3) were less frequently involved in SLE patients. Concerning other SARDs, cranial neuropathies were the most common neurological presentations. Abnormalities in neuroimaging did not correlate with the patients’ clinical presentations. Conclusions Neurological presentations associated with SARDs are protean. Neuroimaging abnormalities should be interpreted within the context of the clinical picture and the results of other investigations.

Doaa Hassan Sayed Attia

Alshaimaa Aboul Fotouh

Reem Hamdy Abdellatif Mohammed

Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort

埃及人群中系统性自身免疫性风湿病患者的中枢神经系统受累：一项描述性研究

Abstract Background Substance use disorders are often accompanied by irrational beliefs and unfavorable attitudes that contribute to their development and persistence. Metaphor therapy, utilizing stories and imagery, has emerged as a potential intervention to reshape thoughts. This study aimed to investigate the impact of metaphor therapy on irrational beliefs and attitudes among individuals with substance use disorders. A quasi-experimental study was conducted at Assiut University Hospital’s substance use inpatient unit from April to December 2023. A non-probability purposive sample of 115 individuals with substance use disorders was selected but only 100 were recruited and randomly assigned to study and control groups. The study group ( n = 50) received six 90-min group metaphor therapy sessions over 6 months, while the control group ( n = 50) received no intervention. Irrational beliefs and attitudes toward substance use were assessed using the Irrational Beliefs Scale and Attitude Toward Substance Abuse Questionnaire at pre-treatment, post-treatment, and follow-up. Results The metaphor therapy group demonstrated significant decreases in mean irrational belief subscale and total scores at post-treatment and follow-up compared to pre-treatment. Additionally, this group exhibited higher mean attitude scores, indicating more negative attitudes (rejection of substance use) during post-treatment and follow-up assessments. No significant changes were observed in the control group. Conclusions Metaphor therapy was effective in reducing irrational beliefs and fostering more favorable attitudes toward substance use among individuals with substance use disorders. The finding suggests metaphor therapy could be a valuable intervention for addressing cognitive and attitudinal factors contributing to substance use.

Hosnia Shehata Mohamed

Manal Abo Elial Abo elkiat Hamad

Gellan K. Ahmed

Shymaa Mohammed Sayed Hassan

Metaphoric interventions for challenging irrational thoughts and attitudes in substance use disorders

物质使用障碍中应对非理性思维和态度的隐喻干预

Abstract Background The risk of seizure aggravation following coronavirus disease 2019 (COVID-19) vaccines is a major cause behind vaccine hesitancy among patients with epilepsy (PWE), resulting in lower immunization rates. This work aimed to investigate the impact of COVID-19 different vaccines on seizure control in PWE. Results This study was conducted on 110 PWE who received at least the first dose of any COVID-19 vaccine. Sixty-one (55.5%) patients did not develop any side effects from vaccination. There was no statistically significant change in seizure frequency following receiving COVID-19 vaccines, either adenoviral vector vaccines, inactivated vaccines, or mRNA vaccines (P = 0.733, 0.778, respectively). Twelve patients (10.9%) experienced seizure exacerbation following COVID-19 vaccination; seizure occurrence in the first 24 h immediately after the vaccine was reported in only one patient. There were no statistically significant differences between patients who developed seizure exacerbation following COVID-19 vaccination and those who did not develop regarding age, age at onset, seizure etiology, type of vaccine, or seizure exacerbation following COVID-19 infection. Conclusions There is a low likelihood of COVID-19 vaccine-related seizure exacerbations in PWE. This data can be utilized to counsel PWE regarding the safety of COVID-19 vaccination.

Haidy Elshebawy

Nirmeen A. Kishk

Nouran Alaa

Mona Hussein

Mohamed Abdelghaffar

Rehab Magdy

Impact of COVID-19 vaccination in patients with epilepsy

COVID-19疫苗在癫痫患者中的影响

Abstract Background A subdural hematoma is a type of traumatic brain injury that results from the rupture of the bridging veins. It often presents with various neurological deficits. The Kernohan–Woltman notch phenomenon (KWNP) is a rare complication associated with subdural hematomas, characterized by ipsilateral hemiparesis due to compression of the contralateral cerebral peduncle. Case presentation We present a case of a 30-year-old female with a left subdural hematoma who exhibited paradoxical ipsilateral hemiparesis and discuss the appearance of KWNP in the context of alcohol withdrawal. We also report on the appearance of delirium tremens 6 days after evacuation. Conclusion In our report, we effectively rule out other causes of ipsilateral hemiparesis such as cerebrovascular accident or mass effect, and demonstrate a rare presentation of KWNP in an uncommon demographic. Our report also demonstrates an incidental finding of delirium tremens that may have been delayed in presentation due to intubation. The findings contribute to further research on these uncommon neurological and psychiatric manifestations.

Kapil Chauhan

Jabari-Ture Brooks

Mosunmola Oyawusi

Roger Weir

Possible presentation of Kernohan–Woltman notch phenomenon in a young female with heavy drinking: a case report

年轻女性重度饮酒者可能出现Kernohan-Woltman切迹现象：一例报告

Abstract Background Idiopathic inflammatory myopathies are a group of autoimmune conditions primarily affecting the proximal muscles and can involve other organs, such as the skin, joints, and lungs. Many diagnostic and classification criteria have been suggested for myositis depending on the clinical picture, laboratory investigations, electromyography, muscle biopsy and, recently, myositis-specific antibodies, in our cross-sectional observational study we analyzed data of a cohort of 77 patients all of whom presented with clinical manifestations indicative of myositis. The investigations involved the detection of 17 myositis autoantibodies, aiming to detect the presence of those autoantibodies in a sample of adult and juvenile-onset myositis Egyptian patients. Additionally, whole-body muscle magnetic resonance imaging (MRI), encompassing T1, T2 and STIR (short-tau inversion recovery) sequences, was performed. Results A total of 34 (44%) patients, comprising 23 adults and 11 juvenile-onset patients, exhibited positive results for myositis autoantibodies. In the adult group, dermatomyositis emerged as the predominant subtype, with a notable female sex predominance. In the juvenile group, overlap myositis was the most common antibody subtype, with a predominance of males. Detailed presentations of the clinical features, laboratory results, and MRI findings were obtained for both the adult and juvenile age groups. Conclusion Autoantibodies and MRI of muscles are important tools for the diagnosis of myositis subtypes in all patients with inflammatory myopathy, which paves the way for accurate diagnoses and therapies.

Yosra Fahmy Eid

Abeer Elsayed Shehab

Dahlia Abdel Mohsen Hussein

Nagia Aly Fahmy

Adult and juvenile-onset inflammatory myopathy: autoantibodies and muscle MRI in a cohort of Egyptian patients

成人及青少年起病的炎性肌病：埃及患者队列中的自身抗体及肌肉磁共振成像

Abbreviation	Egypt J Neurol Psychiatry Neurosurg
Journal Impact	1.14
Quartiles(Global)	NEUROSCIENCES(Q4)

ISSN	1110-1083, 1687-8329
h-index	18

Publication Information	Publisher: Springer Nature，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2018，Proportion of original research papers: 80.98%，Self Citation Rate:0.00%， Gold OA Rate: 99.80%
Average review cycle	网友分享经验：23 Weeks

Egyptian Journal of Neurology, Psychiatry and Neurosurgery

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Effect of childhood epilepsy and antiepileptic drugs on visual evoked potential response and optical coherence tomography

Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort

Metaphoric interventions for challenging irrational thoughts and attitudes in substance use disorders

Impact of COVID-19 vaccination in patients with epilepsy

Possible presentation of Kernohan–Woltman notch phenomenon in a young female with heavy drinking: a case report

Effect of childhood epilepsy and antiepileptic drugs on visual evoked potential response and optical coherence tomography

Impact of COVID-19 vaccination in patients with epilepsy

Neurological involvement in patients with systemic autoimmune rheumatic diseases: a descriptive study in an Egyptian cohort

Metaphoric interventions for challenging irrational thoughts and attitudes in substance use disorders

Adult and juvenile-onset inflammatory myopathy: autoantibodies and muscle MRI in a cohort of Egyptian patients