Prevalence of migraine and non-migraine headache among high school students at the National Guard Housing in Riyadh, Saudi Arabia

To determine the prevalence of headache and migraine, to identify symptoms that accompany headache attack, and to determine the possible effect of headache on school attendance, among high school students. A cross-sectional, questionnaire-based study of secondary school students of the National Guard Housing in Riyadh, Kingdom of Saudi Arabia, was executed during the academic year of 2002 and 2003. A sample of 1750 students was included from 4 schools by systemic random sampling for each school. The questionnaire included demographic data. The second part includes specific questions on headache, and whether there had been headache in the year preceding the survey, type of headache, and its diagnosis according to International Headache Society IHS criteria. Possible effect of headache on school attendance was recorded. Approximately one-third of the entire study sample had recurrent headache episodes not related to febrile illness in the year preceding the survey. Female students showed a significantly higher prevalence than males of migraine, as well as non-migraine headache, with the least prevalence among the younger students of ages 16-17 years. More than one-third of all students were absent from school due to headache. Recurrent headache is prevalent among the high school students, and more among female students. These prevalence rates are comparable with those reported elsewhere. Health education sessions at schools, primary care clinics, and the society in general are recommended to increase awareness for this common adolescent-s neurological problem

Novel presenilin 1 mutation associated with early-onset Alzheimer's disease in a Saudi patient

We report a 60-year-old Saudi patient with the clinical diagnosis of Alzheimer's disease [AD] and a novel mutation in the presenilin gene. We investigated mutations in the presenilin-1 gene in Saudi patients with AD using polymerase chain reaction and direct DNA sequencing methods. We extracted genomic DNA from the whole blood of both patients and normal control individuals. We sequenced and compared amplicons with the sequences of the respective exons of normal individuals as well as data available in GenBank. We detected a homozygous mutation [g c] in exon 12, resulting in the missense mutation [Arg377Thr], in the DNA of a 60-year-old patient. We located this mutation in the cytoplasmic loop near the transmembrane domain 7

Neuromuscular paralysis in the intensive care unit

To determine the features, causes, risk factors and outcome of acquired neuromuscular paralysis in critically ill patients. Retrospective review of all confirmed cases of acquired polyneuropathy and myopathy examined by our Neurology service in the Intensive Care Unit [ICU], at King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia over a period of 5 years. All patients had comprehensive electrophysiological studies and one third had muscle and nerve biopsies. Thirty cases were included, 8 cases of polyneuropathy, 15 cases of myopathy and 7 cases of mixed neuropathy and myopathy. Absent deep tendon reflexes and absent sensory potential on nerve conduction studies were significantly suggestive of neuropathy. The level of creatine phosphokinase was not of great diagnostic value. Most polyneuropathy and myopathy cases had passed through a stormy ICU course with sepsis and multiorgan failure. The use of high doses of steroids was more associated with myopathy. Seven patients died in ICU, the others were discharged to the wards after a mean ventilation period of 40 days. One patient became chronic ventilator dependent. From this series and available literature, it seems that symptomatic myopathy is more frequent than polyneuropathy and some risk factors are common for both [sepsis and multiorgan failure] while the use of steroids is more associated with ICU myopathy. Treating sepsis and stopping corticosteroids results in the improvement of most of the cases