Study of the neurologic soft signs in a sample of obsessive compulsive patients and its correlation with the severity of obsessive compulsive symptoms and the degree of insight

Is to detect the presence of Neurologic Soft Signs [NSS] in a group of patients having Obsessive Compulsive Disorder [OCD] and its correlation to the clinical presentation of OC symptoms and the degree of insight. 50 patients with OCD and 50 healthy subjects were assessed for the presence of NSSs by using physical and neurological examination of soft signs scale [PANESS]. In the patients group, Yale-Brown OC scale [Y-BOCS], and scale to Assess Unawareness of Mental Disorder will be used to evaluate the severity of OC symptoms and the degree of insight. The total mean NSS score was significantly higher in patient group compared to control group [P=0.000] as regard the following items of PANESS [balance, motor movement, and graphesthesia]. The total NSS score was positively correlated with total OC symptoms score and duration of illness. Also, patients with poor insight had a significantly higher soft sign mean score than patients with good insight. Neurological soft signs are likely to relate to both structural and functional brain abnormalities that the affected regions of the brain for NSS probably resemble those in OCD, and that NSSs may be followed by the symptoms of OCD

Cognitive effects of antiepileptic drug therapy on children born to epileptic mothers

Is to evaluate the long term effect of antiepileptic drugs [AEDs] on some cognitive functions in prenatally exposed children of mothers with epilepsy. Thirty children aged between 5 and 12 years, born to mothers with epilepsy were recruited from epilepsy clinic of neuropsychiatric Department of Alexandria Main University Hospital. Fifteen of them were exposed to AED in-utero and fifteen were unexposed. We compared them with control group of 15 children matched for age, education, and socio-economic level. Structured interviews, electroencephalogram and psychometric tests, Wechsler Intelligence Scale for Children III [WISC III] were applied to each child. Children of mothers with epilepsy have lower scores in the mean verbal, performance, as well as full scale IQS. Children exposed to valproate monotherapy and those exposed to polytherapy have reduced verbal IQ compared with other study group and control children. This study highlight the potential harmful effects of in-utero exposure to AEDs on neuropsychological development. The pattern of cognitive changes depends on two factors, one of them is exposure to seizures, the other is whether the mothers' were on monotherapy versus polytherapy

Role of diffusion weighted MRI in early detection of ischemic cerebrovascular stroke

Is to evaluate the role of diffusion-weighted [DWI] MRI in early diagnosis of ischemic stroke. This study was carried out on one hundred and fifty patients presented with acute focal neurological deficits suggestive of ischemic vascular origin. Brain MRI and diffused weighted images were done to all patients. Brain MRI showed negative results in forty two patients, diffused weighted images were positive in all cases and differentiate multiple age indeterminate ischemic lesions. Also, lesions appeared larger and more conspicuous on DW MRI sequences. Diffusion weighted MRI is superior to the conventional MRI imaging in early detection of ischemic cerebrovascular stroke

Cognitive dysfunctions in patients with carotid artery stenosis and ipsilateral transient ischemic attacks

Patients with carotid artery stenosis [CAS] and ipsilateral transient ischemic attacks [TIAs] can have lasting cognitive impairment, despite the recovery of focal neurological deficits. Is to assess the frequency, nature and severity of cognitive impairment in patients with carotid artery disease who have suffered from TIAs and correlates these findings with the localization of ischemic brain lesions. 30 patients with TIAs attributed to an stenosis of carotid artery and 17 healthy controls underwent thorough neuropsychological assessment. MRI of the brain, carotid doppler ultrasound were carried out to all patients in addition to aboard clinical assessment. Patients with CAS and ipsilateral TIAs were cognitively impaired compared to controls. Cognitive impairment was not related to the presence of ischemic brain lesions in MRI. Impairment occurred also in patients with isolated retinal symptoms. Patients with carotid artery stenosis and ipsilateral TIAs were cognitively impaired. The impairment are non-specific in nature. The presence of cognitive impairment in patients with normal MRI raise the possibility that a compromised blood flow may play an important role in causing cognitive impairment in addition to microinfracts invisible on MRI