Old remedies for epilepsy: Avicenna's medicine

The history of epilepsy and its treatments dates back to at least 4 millennia. Avicenna, c. 980 AD in Bukhara, Khorasan - 1037 in Hamedan was a Persian-speaking Iranian physician, who has many recommendations and suggested various therapies for epilepsy in his book, The Canon of Medicine. We first reviewed the most important ancient treatments for epilepsy mentioned by Avicenna and considered those as the key words for our next step. Then, we made a literature search [medline and scopus] with those key words to find out new scientific findings in modern medicine about the Avicenna's suggestions. Among the Avicenna's recommended therapies for epilepsy, only Rue has been tested for anticonvulsant activities in modern medicine. Interestingly, it had a dose dependent anticonvulsant effect. It is worthwhile to consider the Avicenna's recommended therapies for epilepsy and to design future scientific studies based on his suggestions

[Correlation between working memory and quality of life in multiple sclerosis patients]

Working memory impairment is one of the most important cognitive deficits in multiple sclerosis [MS] patients that affect the quality of life even in the early stages of the disease. The purpose of this study was to evaluate the correlation between the working memory and the quality of life in MS patients. This case-control study was performed on 35 [case] and 28 healthy [control] participants. Working memory and quality of life were assessed using Wechsler adult intelligence scale and the MS quality of life 54 [MSQOL-54] inventory, respectively. Results showed a significant difference between the two groups in the means of working memory in both auditory [P<0.001] and visual span [P<0.0001] as well as physical quality of life [P<0.04]. Moreover, logistic regression analysis showed that MS disease had an impact on both physical [OR= 0.679 and CI= 0.889-0.519] and mental [OR= 0.929 and CI= 0.857-0.998] components of the quality of life. Findings of the study indicate that cognition is an effective factor to engage in activities of daily living. Moreover, the relation between the working memory impairment and the quality of life in MS patients highlights the importance of the early recognition of cognitive deficit

Amyotrophic lateral sclerosis in a patient with Behcet's disease

Behcet's disease is a multisystem vasculitis. Its neurological involvement mostly includes parenchymal and nonparenchymal central nervous system manifestations. Peripheral nervous system presentations are rare. A 32-yr-old male patient who fulfilled the international study group criteria for Behcet's disease, referred to our center with walking difficulty and repeated falling downs. Neurological examination revealed weakness, wasting and fasciculation of distal muscles associated with corticospinal signs. Neuroimaging data were insignificant but electrodiagnostic studies were in favor of motor neuron disease. To best of our knowledge, this is the first report of association of amyotrophic lateral sclerosis [ALS] and Behcet's disease

Primary antiphospholipid syndrome; differentiation from multiple sclerosis: a study of 22 cases

Anti-phospholipid syndrome [APS] is a well-known cause of thrombosis and can mimic multiple sclerosis [MS]. We analyzed the neurologic manifestation, laboratory and MRI findings of our patients with primary APS [PAPS] in an attempt to identify parameters that might differentiate the two entities. Of 180 cases with the diagnosis of probable or definite MS, we studied 29 patients who had symptoms suggesting an underlying systemic disease, unusual laboratory findings or atypical evolution for MS. Of these, 22 patients [15 female and 7 male, mean age 30 year] proved to have PAPS with antiphospholipid antibody [aPL] positivity [titer 10 GPL units] and were followed-up for at least 8 months. Brain MRI was performed in all of the patients. The most frequent initial manifestations were paresis [10 cases] and cerebellar signs [4 cases]. During the established stage, 15 cases had paresis; and cerebellar signs, depression and sensory disturbance were seen in 10, 9 and 8 patients respectively. High ESR, thrombocytopenia and prolonged partial thromboplastin time [PTT] were detected in 8, 4 and 3 patients respectively. MRI of the brain showed multiple lesions in 15 and a single lesion in 7 cases. Also 4 of the female patients had a history of unexplained fetal loss. We believe that all cases with the initial impression of MS who present with systemic or laboratory features of APS or a history of unexplained fetal loss should be screened for the presence of aPL, and APS should be considered as an alternative diagnosis to MS