Epidemiological study and clinical profile of Parkinson's disease in the Assiut Governorate, Egypt: a community-based study.

BACKGROUND: Few comprehensive epidemiological studies of the prevalence of Parkinson's disease (PD) have been undertaken in Arab countries, and none has been carried out in Egypt. A community-based survey was conducted in the Assiut Governorate to estimate the prevalence and clinical profile of PD. METHODS: A community-based study was carried out, with random sampling of 7 districts, involving 6,498 inhabitants. Out of this sample, 578 subjects dropped out, leaving 3,066 males (51.8%) and 2,854 females (48.2%). There were 3,660 urban residents (61.8%) and 2,260 (38.2%) from the rural community. Patients were evaluated using a screening questionnaire, the Unified Parkinson Disease Rating Scale and the Non-Motor Symptoms Scale for PD. RESULTS: Thirty-nine subjects were found to have parkinsonism, giving a crude prevalence rate of 659/100,000 inhabitants. Of these subjects, 33 were diagnosed with PD (21 males), with a mean age of 66.9 ± 8.4 years, a crude prevalence rate of 557/100,000 and an age-specific prevalence rate (≥50 years old) of 2,748/100,000. There were more males than females (3,395 vs. 1,989/100,000), but the difference was not significant. The highest age-specific prevalence rate was recorded among subjects 70-79 years old (7,263/100,000). There was a significantly higher prevalence among rural than urban inhabitants (973 vs. 301/100,000) and among illiterate than literate persons (1,103 vs. 280/100,000). The clinical profile of our patients was similar to that of other populations but was characterized by a high prevalence of mood/cognition dysfunction and gastrointestinal symptoms; there were few reported perceptual problems. CONCLUSION: The overall prevalence of PD was high, especially in older adults.

Evaluation of patients with vertigo of vertebrobasilar insufficiency origin using auditory brainstem response, electronystagmography, and transcranial Doppler.

OBJECTIVES: Vertigo can be a manifestation of underlying vertebrobasilar stroke in older adults. The study objectives were to investigate the correlation, sensitivity, and specificity of the auditory brainstem response (ABR), electronystagmorgraphy (ENG), and transcranial Doppler (TCD) collectively to distinguish between vertigo due to vertebrobasilar insufficiency (VBI) and vertigo due to non-VBI. DESIGN: Prospective experimental study comparing ENG, ABR, and TCD battery findings between two groups of patients with vertigo and a control group. STUDY SAMPLE: Participants included 14 patients with vertigo of VBI origin, 14 patients with vertigo of non-VBI, and 11 matched controls. RESULTS: Participants with VBI had more abnormal findings in the ENG (86%), TCD (72%), and ABR (64%) compared to the non-VBI group (64%, 21%, and 7%, respectively) and the control group. The combined battery revealed positive correlations, 64% sensitivity, and 84% positive predictive value (PPV) in the VBI group, and 100% specificity with lack of correlations in the non-VBI group. CONCLUSIONS: The modest sensitivity and PPV helps with early detection of VBI, thus preventing risk of vertebrobasilar stroke in 84% to 64% of patients. The 100% specificity in the non-VBI group rules out VBI, thus reducing the referral rate for unnecessary, diagnostic evaluations and ineffective treatment.

Role of short-term out patient video electroencephalography in diagnosis of paroxysmal disorders.

BACKGROUND: To distinguish epileptic seizures from non-epileptic paroxysmal events, we often use video electroencephalography (EEG) recording. Long-term video electroencephalography recording for inpatients is of good value, but, it necessitates much resources (financial and manpower). There is some evidence suggesting that short-term video EEG (STVEEG) is useful, but its role in practice has yet to be evaluated. OBJECTIVE: To assess the usefulness of STVEEG in the diagnosis of different paroxysmal disorders and classifying epilepsy if present. METHODS: Thirty sex patients had STVEEG recordings (for 2h) during a 15 months period. RESULTS: A diagnostic event was recorded in 21 of 36 (58.3%) within the first 2h of monitoring: PNES (n=11), epilepsy (n=5), and other paroxysmal disorders e.g. syncope, hemifacial spasm, movement disorder (n=5). CONCLUSIONS: STVEEG is a useful diagnostic technique in diagnosis of different paroxysmal disorders and it can be used as a successful screening test for saving other resources like prolonged inpatient video EEG recording.

Epidemiological study of muscular disorders in Assiut, Egypt.

Few comprehensive epidemiological studies of the prevalence of muscle diseases have been undertaken, and none has been carried out in our locality. The present cross-sectional study was conducted in Assiut Governorate (Upper Egypt) to estimate the prevalence of different types of primary muscular disorder in 1997. The study involved 52,203 subjects, 15,617 (30%) from the rural community and 36,586 (70%) from the urban community. Patients were identified from a door-to-door survey, and all were subjected to a full clinical examination, with confirmation of the diagnosis through electrophysiological, and biochemical investigations. Histopathological studies were performed for the classification of muscular dystrophies. Forty patients with muscular disorders were identified, with a point prevalence of 76.6 per 100,000 in the total community with no significant differences between the rural and urban communities. The creatine kinase level was abnormally high (>225 IU/l) in 80% of the cases, increased in all patients with muscular dystrophy or myositis, in 88.8% of patients with systemic myopathy and 66.6% of patients with myotonia. None of the cases of myasthenia showed an increase in the creatine kinase level. The lifetime prevalence per 100,000 was 26.8 for muscular dystrophy, 11.49 for myotonia, 11.49 for myositis, 17.24 for systemic myopathy and 9.57 for myasthenia.