[Pott's disease of the upper cervical spine [three cases and literature review]]

Sub-occipital Pott's disease is rare, but dangerous. To recall diagnostic aspects and spatially the neuroradiological ones of sub-occipital Pott's disease. We describe three patients with sub-occipital Pott's disease followed in our department from 2002 to 2007. there were two women and one man [mean age at onset: 48 years]. The early clinical picture was non specific. Exploration, in addition to standard radiographies included a computerized Tomography [CT] [n=2] and MRI [n=1 and n=3]. The diagnosis was confirmed histologically on a biopsy of the abscess [n=1], a bacteriological evidence [n=2] and retained thanks to argument presumption [n=3]. The treatment was based on quadruple antituberculous chemotherapy with external traction [n=2 and n=3] associated with urgent surgery [n=1] because of the worsening of the neurological complications. The evolution was fatal [n=1] and positive [n=2 and n=3]. Tuberculosis should be suspected in patients with chronic torticollis and residing in an area when tuberculosis is endemic. Medical treatment is based on a quadruple antituberculosis chemotherapy with fraction in the presence of atlanto-axial instability. Surgery is reserved in case of neurological worsening or persistent instability

[Mesial temporal lobe epilepsies: A report of 9 cases]

Introduction: Mesiotemporal epilepsy [MTLE] is a clinical syndrome caracterised by the association of a history of febrile seizures, a homogenous clinical presentation of seizures, temporal interictal and ictal EEG recordings and an underlying pathology that is mesial sclerosis. MTLE is the most common type of medically intractable partial epilepsy with a drug-resistance in 90% of cases

Objective: The aim of this study is to describe the clinical, EEG and MRI findings of 9 patients with MTLE attending the outpatient clinic of Charles Nicolle Hospital

Results: The median age of our study population was 30 years. A history of febrile seizures was found in 5 patients. Hippocampal atrophy was found in all the cases right in 4 cases and left in 5 cases. Drug-resistance was observed in 7 patients. No patient underwent surgery

Conclusion: It is important in front of medically intractable partial epilepy to evoke MTLE, to confirm the diagnosis with neuro-imaging and to propose an interdisciplinary therapeutic approach including neurologists, epileptologists and neurosurgeons