Foix-chavany-marie syndrome [anterior opercular syndrome] case report

Foix-Chavany-Marie syndrome is a rare cortico-subcortical suprabulbar or pseudobulbar palsy of the lower cranial nerves 5, 7, 9, 10 and 12. This syndrome consists of anarthria, bilateralvolitional paresis of the facial, lingual, pharyngeal, and masticatory muscles bilaterally with preservation of the reflexive, emotional and autonomic innervations of the same muscles. We present the first case report in the Middle East of Foix-Chavany-Marie syndrome

Cerebral cavernoamas: radiological prevalence and clinical features in a 10 year retrospective study in a teaching hospital

Cerebral cavernous angiomas remain one of the most negotiable and controversial topics in neurological and neurosurgical practice. It can present with symptoms or can be found incidentally. The aim of this study is to evaluate the prevalence, clinical presentation, treatment options and outcome of patients with cerebral cavernoma.: Brain MRI for [14372] patients done in our university teaching hospital during 10 -year period from 2001 to 2011 were reviewed, 33 cases of cerebral cavernoma were found. The medical charts of these patients were reviewed and analyzed for their clinical presentation, treatment options and outcome. We identified 33 cases of cavernoma with a mean age of 33 +/- 16.8% years. There were 18 females and 15 males. Four cases were excluded from analysis [but included in prevalence calculation] due to unavailability of clinical data. In the 29 other cases there were 35 cavernomas. The radiologic prevalence of cavernomas in this population was 0.23%. Most cavernomas were found in the supratentorial regions mostly found in the frontal lobes. The most common presenting symptoms were seizures in males and headache in females. The radiologic prevalence of cerebral cavernomas was less than previous series, while clinical presentation was the same. Performing MRI at higher resolution and field strength with more sensitive sequences may lead to the detection of subtle or small brain abnormalities that would not have been detected previously

Mini-Mental state examination [MMSE] scores in healthy educated adult Jordanian population

The Mini-Mental Status Examination [MMSE] is a simple informative and validated screening test of cognitive functions. No data from MMSE scores in healthy populations has been published about educated Jordanians. To study the MMSE scores in the healthy educated Jordanian population. 150 healthy educated adult Jordanians were interviewed and tested for their MMSE score. Their scores were analyzed and the effect of age, sex and education on the score was studied. 150 adult subjects aged 35 +/- 12.5 years [range 18-71 years] with a mean level of education 14.2 +/- 2.6 years [range 7-20 years] scored 27.8 +/- 2.2 / 30 [range 21-30]. No correlation was found between age and MMSE score [Pearson correlation =-0.08, p=0.32], while there was direct correlation with education level [Pearson 0.53, p=0.000]. There were 77 [51.3%] males and 73 [48.7%] females who scored 27.7 +/- 2.4 and 27.8 +/- 2.1 respectively [p=0.942 ANOVA]. There was also no correlation with age at a cutoff of 45 years [p=0.203] while people with higher education [> 12 years, n=105] scored better than those with basic education [7-12 years, n=45], 28.4 +/- 1.8 and 26.3 +/- 2.5, respectively [p=0.000]. Local MMSE scores for healthy educated adult Jordanians are presented here that can be of help to the practicing physician assessing patients' cognitive functions. The local data confirmed previous associations with education but not with age as this series consists mostly of those from the young adult population. We suggest a lower normal score of 21 for those with basic education and a score of 24 for those with higher education

Clinical experience with Gullain Barre Syndrome over a 6-year period in one hospital in the Middle East

Gulain Barre Syndrome [GBS] is the most common cause of sporadic acute flaccid paralysis but is still relatively rare. No series describing the full clinical course of patients with GBS were reported form the Arab world. Here we report on our experience with GBS over a 6-years-old period in one large medical facility form January 1999 till December 2004. We encountered 12 patients with GBS. The median age was 47 years and all had generalized weakness and areflexi. One patient started as Miller Fisher Syndrome [MFS] and ended up with GBS. More than 80% of patients were admitted to Intensive Care Unit [ICU], and 75% were intubated. All patients received supportive care. Specific treatment included intravenous immunoglubin IVIG in all patients [100%], plasma exchange [PE] in 2 patients [17%], and intravenous methyl prednisolone [IVMP] in 1 patient [9%]. The median time to walk independently was 62 days. Transient complications occurred in the majority of patent but the overall outcome was good in the majority of patients; with one single [8%] and probably unrelated mortality. Compared to other series, no significant difference in clinical presentation or outcome was noted

Lipid profile in Jordanian patients with first ever ischemic stroke

To study the relationship between lipid profile, total cholesterol [TC], low density lipoprotein [LDL], high density lipoprotein [HDL], and triglycerides [TG] in Jordanian patients admitted with first ever ischemic stroke [IS] to a teaching hospital over a 3-year-period, and compared them to a control group. A retrospective case control study of all patients with diagnosis of IS who were admitted to the Jordan University Hospital, Amman, Jordan from January 2004 to December 2006 and had a documented fasting lipid profile within 48 hours of their admission. They were compared to controls without IS. Ninety-eight patients with IS were studied and compared to 98 control subjects. Both patients and control groups were similar regarding age, gender distribution, prevalence of hypertension, diabetes mellitus, ischemic heart disease [IHD], and smoking. The lipid profile showed a significantly lower HDL level in IS patients compared to the control group. There were no significant differences between the patients and control regarding TC, LDL, or TG levels. Control group used statins more frequently than patients [28% versus 10%, p=0.002]. Both groups had high prevalence of risk factors. Though this study is limited by its retrospective design, it suggests that IS patients have significantly lower levels of HDL

Neurologic involvement in wolfram syndrome

To study 10 patients with Wolfram syndrome sometimes referrd to as DIDMOAD [diabetes insipidus, mellitus, optic atrophy and deafness] from three Jordanian families to assess for neurologic involvement, all of them had diabetes mellitus, nine [90%] patients had optic atrophy [OA], and eight [80%] patients had sensorineural deafness. All patients had standard full clinical neurologic examination. Eight patients were seen by staff psychiatrist for one time interview. Standard non-contrast brain and pituitary magnetic resonance imaging was carried out for all the patients. five patients had full field pattern shift visual evoked response. Eight patients had nerve conduction study of one upper and one lower limb. Six patients had 18 channel electroencephalogram. Five patients had brainstem evoked response study. Apart from defining features of the syndrome [diabetes mellitus, optic atrophy, sensorineural deafness] 3 patients [30%] had abnormal neurologic examination [depressed deep tendon reflexes, stuttering and mild ataxia], two [20%] had mildly abnormal psychiatric findings [temper outburst and depression] three patients [30%] had abnormal brain magnetic resonance imaging, three patients [30%] had abnormal visual evoked response with demylinating pattern in early optic involvement and axonal pattern in late disease. Two patients [20%] had abnormal nerve conduction study [mild sensory motor polyneuropathy with axonal and demyelinating features]. One patient [10%] had abnormal electroencephalogram and all patients tested for brainstem evoked response [100%] had normal brainstem evoked response study. This study shows part of the spectrum of neurologic involvement in Wolfram syndrome. It is consistent with the degenerative nature of this clinical entity. Early demyelination followed by degeneration may be inferred from this study, and this is important to prove or disprove in the light of lacking enough neuropathologic data and understanding of its pathogenesis. Further pathologic and neurophysiologic studies are required