Knowledge of and attitudes toward epilepsy surgery among neurologists in Saudi Arabia.

OBJECTIVE: To investigate the levels of knowledge and attitudes toward epilepsy surgery among neurologists in Saudi Arabia and evaluate the factors that affect the physicians` knowledge and attitudes. METHODS: A quantitative observational cross-sectional study conducted at King Saud University Medical City, Riyadh. The data were collected using a newly developed, self-administered online questionnaire. The questionnaire contained 3 sections: demographic information, knowledge, and attitudes which then sent to neurologist in Saudi Arabia from December 2016 to March 2017. RESULTS: A total of 106 neurologists met our inclusion criteria. Eighty percent of the participants had at least one epilepsy center in their city, and 78% indicated that they had access to adequate expertise and resources to enable the appropriate selection of epilepsy surgical candidates. Only 57.5% of the neurologists had a sufficient level of knowledge regarding epilepsy surgery. Neurologists with higher level of knowledge referred more patients to EMU and discussed epilepsy surgery more often with their patients. Overall, more than half of the neurologists (52.8%) had a positive attitude toward epilepsy surgery. There was a significantly positive correlation between the scores of knowledge and attitude (p less than 0.001). CONCLUSION: Neurologists in Saudi Arabia appear to have moderate knowledge of and positive attitudes toward epilepsy surgery. The place of the last neurology certificate, type of practicing hospital, and access to expertise and resources, affected their knowledge. Adequate knowledge was positively correlated with attitude.

Immune-mediated comorbidities in Saudi patients with narcolepsy.

Background: Autoimmunity has been proposed as a cause of narcolepsy. A few studies have assessed comorbid autoimmune diseases in patients with narcolepsy, with conflicting results; however, no study has assessed autoimmune diseases in Arab narcolepsy patients. This study aimed to assess the coexistence of immune-mediated conditions such as allergies, autoimmune diseases, and autoinflammatory diseases in patients with narcolepsy type 1 (with cataplexy) (NT1) and narcolepsy type 2 (without cataplexy) (NT2). Methods: Personal and family history of autoimmune/autoinflammatory and allergic disorders was collected using a questionnaire in 80 consecutive Saudi patients with narcolepsy (46 NT1 and 24 NT2), who were diagnosed according to the International Classification of Sleep Disorders, Third Edition. The control group comprised 222 adults from the general population. Results: Comorbid autoimmune/autoinflammatory diseases were reported by 21.4% of the NT1 patients, and 12.2% of the controls, with no significant difference between cases and controls in a model adjusted for confounding covariates. However, allergic disorders were significantly more prevalent among NT1 patients. Both comorbid autoimmune/autoinflammatory and allergic disorders were significantly more prevalent among NT2 patients compared to controls. No differences in demographic and clinical characteristics were detected between narcolepsy patients with and without autoimmune/autoinflammatory diseases. Conclusion: NT1 is not associated with increased comorbid autoimmune diseases in the studied sample of Saudi patients. However, autoimmune diseases are associated with NT2, and allergic disorders are associated with both NT1 and NT2. These findings suggest the existence of dysregulation in the immune system of narcolepsy patients that requires further research.

Multiple sclerosis and myasthenia gravis following severe weight loss.

Weight loss has substantial health benefits, but it is not risk-free. Various neurological disorders have been reported following bariatric surgery-induced weight loss. Here, we report 3 patients who developed multiple sclerosis (MS), one of whom also developed myasthenia gravis (MG), shortly after significant weight loss. Two patients lost weight by following a diet plan and one underwent bariatric surgery. There may be an association between significant weight loss and the development of an autoimmune neurological disorder such as MS or MG; a high index of suspicion is required.

Knowledge of and Attitude Toward Repetitive Transcranial Magnetic Stimulation Among Psychiatrists in Saudi Arabia.

OBJECTIVES: The aims of this study were to assess psychiatrists' knowledge of and attitudes toward repetitive transcranial magnetic stimulation (rTMS) in Saudi Arabia and to determine the contributing factors. METHODS: A quantitative observational cross-sectional study was conducted using an online survey. The sample consisted of 96 psychiatrists in Saudi Arabia. A new valid and reliable questionnaire was developed. RESULTS: A total of 96 psychiatrists enrolled in the study, 81% of whom were men. Half of the participants were consultants. The sample mainly consisted of general psychiatrists (65%). The mean age of the participants was 37 years. The results showed that 80% of the psychiatrists had a sufficient level of knowledge about rTMS. Consultants had greater knowledge than residents. Training abroad was not significantly associated with the level of knowledge or the type of attitude. Most psychiatrists (79%) had a positive attitude toward rTMS. Only 53% of the psychiatrists said they would agree to receive rTMS if they experienced a psychotic depressive condition. A minority of psychiatrists (7%) said they would not refer their patients for rTMS. CONCLUSIONS: Most of the psychiatrists surveyed had good knowledge of and a positive attitude toward rTMS. Those who had a high level of training and experience showed higher levels of knowledge. Articles were reported to be a better source for improving physician knowledge than textbooks. Having a family member or relative who was treated with rTMS positively affected psychiatrists' attitudes toward rTMS.