Central neuropsychiatric complications of hepatitis C virus infection in Egyptian patients

Central neuropsychiatric hepatitis C virus [HCV]-associated disorders have been described with increasing frequency in the literature. Anticardiolipin antibodies [aCL] associated with HCV may be an important marker for the central neurological complications. furthermore, cryoglobulinemia could be an important genic factor for such complications. To study various central neuro-psychiatric complications of chronic hepatitis C infection and their possible pathogenetic mechanisms. This study was conducted upon 160 Egyptian patients with chronic hepatitis C infection. They were subdivided into 2 subgroups: Group I which included 80 chronic hepatitis C patients with clinically apparent neuropsychiatric complication [s] and group II which included 80 chronic hepatitis C patients neuropsychiatric asymptomatic. The control group included 30 healthy volunteers as a control group for the neuropsychological evaluation. Patients were subjected to clinical neuropsychological evaluation, estimation of hepatitis markers, cryoglobulins, anticardiolipin antibodies, antinuclear antibodies, EEG, MRI brain. In neuropsychiatric manifested HCV patients, the most commonly encountered disorders were memory impairment and mood disorders each affected 11.7% of patients red by fatigue which affected 10% of patients then cerebrovascular complications and tension-type headache each.affected 8.3% of patients and in less frequency, late onset idiopathic intracranial hypertension and CNS infections There was highly statistical significant difference between both groups regarding the presence of cryoglobulin, anticardiolipin antibody, antinuclear antibody, EEG changes and MRL lesions being more common in group I. Cognitive impairment, mood disorders, fatigue, cerebrovascular complications are common with HCV infection especially when associated with+ve cryoglobulins, ACL and antinuclear antibodies

electro-physiologic study of trigeminal brainstem circuits in migraine

The study aimed at investigating functional changes in the trigeminal and optic nerves brainstem connections in migraine patients. Trigeminal somatosensory evoked potentials [TSER's], electric blink reflex [EBR] and light stimulus evoked blink reflex [LBR] were carried out interictally on 18 patients suffering from migraine without aura and 12 healthy controls. TSER's latencies [N1, P1, N2, and P2], EBR latencies [R1, ipsilateral and contralateral R2] as well as LBR latencies [direct and indirect responses] and their amplitudes were recorded and compared to healthy controls. The ipsilateral and the contralateral R2 components of the EBR [R2i, R2c] showed a highly significant delay as compared to the control group [p<0.000]. N1, P1 and N2 latencies in patients were significantly longer than the control group bilaterally. P1 latencies showed the most significant prolongation of latency [p<0.0000]. The latencies of the LBR direct and indirect responses were significantly prolonged in the patient group [p<0.000] and had a double fold amplitude compared to those of the control group. Migraine patients show a disruption in the central circuits not only at the level of the brainstem but possibly within the higher cerebral regions as well