A Case Report of Neuro-Behçet Syndrome: Frequent Neurological Manifestations Concurrent With Life-Threatening Illnesses.

​​​​Behçet disease (BD) is a recurrent, multisystemic autoimmune vasculitis that affects both small and large vessels. A combination of neurological signs and symptoms in BD is called neuro-Behçet syndrome (NBS). We present the case of a 31-year-old male diagnosed with chronic progressive NBS who presented with multiple relapsing episodes concurrent with infective endocarditis due to intravenous drug abuse, drug-induced hepatitis, acute kidney injury, and septic shock that is not related to BD. Neurological relapsing episodes were treated with steroids azathioprine and colchicine. At the same time, concurrent illnesses were managed appropriately. Infective endocarditis needed valve replacement surgery, and sepsis was treated with selected antibiotics. Fortunately, the patient's brain images and laboratory investigation improved accordingly. On average, patients with parenchymal neuro-Behçet syndrome (P-NBS) have a poor prognosis; within 10 years of diagnosis, 50% of those patients are severely disabled as our patient who became aphasic and quadriplegic.

Tuberculous Otitis Media With Cerebral Venous Thrombosis: A Rare and Challenging Diagnostic Case.

Tuberculous otitis media is an uncommon cause of chronic suppurative infection affecting the middle ear and mastoid. Unfortunately, the signs and symptoms of tuberculous otitis media are very similar to those of non-tuberculous otitis media, which can make early diagnosis challenging. It is crucial to diagnose and treat the condition early to prevent damage to the ear and potential complications involving the central nervous system. We present a case of a 13-year-old Saudi girl who presented with a two-week history of headaches associated with photophobia. She had been complaining of ophthalmalgia, otalgia, and decreased hearing for one year. Physical examination revealed bilateral optic disc swelling with grade 3-4 papilledema, middle ear effusion, and bilateral hearing loss. CT scan showed sinusitis with right otomastoiditis and right petro-mastoiditis. MRI with magnetic resonance venography (MRV) revealed cerebral venous thrombosis. Tuberculosis screening by polymerase chain reaction (PCR) of a sputum sample and right ear effusion sample taken by tympanocentesis was done and it came back positive three weeks later. She was started on anti-tuberculous treatment, with clinical improvement observed over six months. Multiple factors contributing to the delay in diagnosis possibly included the lack of awareness about this ailment among doctors, leading to a low suspicion rate, variable clinical presentation, and diagnostic pitfalls.

Awareness of Stroke Risk Factors and Warning Signs Among Diabetic Patients in the Aseer Region, Saudi Arabia: A Cross-Sectional Study.

Objective This study aimed to determine the awareness of stroke risk factors and warning signs among diabetic patients in the Aseer Region, Saudi Arabia. Methods We adopted a cross-sectional study involving 314 participants in the Aseer Region, Saudi Arabia between February 27, 2023, and April 20, 2023. The target population was diabetic patients whose database was obtained from various health institutions. The questionnaire was then distributed to the respondents after obtaining informed consent. The data were analyzed using SPSS Statistics version 27.0.1.0 (IBM Corp., Armonk, NY, USA) to obtain important insights. Results The majority of the respondents (69.11%) demonstrated a good level of knowledge, while 30.89% had poor knowledge. A good proportion of the respondents (68.47%) knew about stroke, while 73.89% knew it primarily affects the brain. Most respondents claimed that elderly people were at higher risk of attack (52.55%) and that the younger population was also prone to stroke (64.97%). The respondents identified hypertension (74.52%), smoking (72.61%), diabetes (71.66%), and high blood cholesterol (68.47%) as the main risk factors for stroke. The participants also demonstrated a very good understanding of the warning signs, with difficulty speaking (80.57%) and the weakness or inability to move one-half of the body (85.35%) being the most common signs. Conclusion The findings in this study indicated a good level of understanding and awareness of stroke, its risk factors, and warning signs (69.11%). The older respondents and people with a higher level of education demonstrated more knowledge. The two variables, age and education, had a statistically significant relationship with the knowledge of stroke. The common risk factors associated with stroke were identified as hypertension, smoking, diabetes, and high blood cholesterol. The respondents demonstrated good knowledge of the warning signs, with the vast majority asserting that difficulty in speaking, decreased sensation, and weakness or inability to move one-half of the body are common warning signs.