Validation of an Arabic version of Fatigue Severity Scale.

OBJECTIVES: To develop and test the psychometric properties of an Arabic version of Fatigue Severity Scale (FSS-Ar) that can be used to measure fatigue in Arabic patients with disorders where fatigue is a major symptom.  METHODS: Forward and backward translations of FSS were undertaken to develop an Arabic version. The validity and reliability of the FSS-Ar was then tested on 28 patients with systemic lupus erythematosus (SLE), 24 patients with multiple sclerosis (MS), and 31 healthy subjects. Exploratory factor analysis and hypothesis testing methods were used to examine construct validity. The correlation between FSS-Ar and the vitality domain of the RAND 36-Item Health was examined to test construct validity. The study was conducted at the King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between February and June 2012. RESULTS: Using a score of ≥4.05 to define fatigue, 39 of 52 (75%) participants were fatigued compared with 10 out of 31 (32%) healthy participants. The correlation between the FSS-Ar and the vitality domain of the RAND-36 was acceptable (r = -0.46). Factor analysis showed that items of the FSS-Ar measured one underlying construct, namely, fatigue. Test-retest reliability and internal consistency of the FSS-Ar was acceptable (intraclass correlation coefficient model 2,1 = 0.80; Cronbach's alpha = 0.84). CONCLUSION: The Arabic version of the FSS demonstrated acceptable psychometric properties and was able to differentiate between patients with SLE or MS, and healthy subjects.

Multiple sclerosis. Recent modalities of treatment.

Multiple sclerosis (MS) has devastating physical, psychological, and economic consequences. The disease commences in most patients with a relapsing-remitting course, and it is likely that treatment is most effective during this phase before permanent axon damage has occurred. Despite the absence of a cure for MS, the 4 available drug therapies (Interferon (IFN) beta-1a, IFN beta-1b, glatiramer acetate, and mitoxantrone) play a role in the management of MS based on their demonstrated efficacy. In particular, the use of disease-modifying drugs has been shown to reduce the frequency and severity of debilitating relapses and to delay disease progression. Efforts to develop alternative therapies with increased efficacy and patient acceptability are in progress.

Imaging findings of neuro-Behcet disease.

OBJECTIVE: To study the neuroimaging findings of neuro-Behcet`s disease (NBD) in Saudi patients and to discuss the radiological differential diagnosis. METHODS: The clinical data and radiological findings on CT, MRI and cerebral angiography of 16 patients with NBD attending King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, from January 1990 to February 2003 were reviewed. RESULTS: Out of 16 patients with NBD, 11 patients (68.75%) had cerebral venous thrombosis predominantly involving superior sagittal sinus causing intracranial hypertension, while 5 patients (31.25%) had symptoms and signs related to brain parenchymal involvement predominantly affecting brainstem. CONCLUSION: Pattern of distribution of brain parenchymal lesions in NBD might help to differentiate it from other vasculitides as well as from demyelinating disease such as multiple sclerosis. Cerebral venous thrombosis is a common manifestation of NBD.

Non paraneoplastic opsoclonus - myoclonus syndrome.

We analyzed the features of opsoclonus syndrome as a manifestation of post viral encephalopathy in 3 patients (one child and 2 adults). This is the first report of opsoclonus-myoclonus syndrome in the Arabian Peninsula. Symptoms appeared a few days after a viral-like illness in all patients. We excluded the possibility of paraneoplastic syndrome as investigations were carried out and follow-up did not reveal malignancy. One patient received a relatively long duration steroid treatment, another one received steroids in pulsed therapy, the third did not receive any specific treatment. The outcome was very good with improvement except in one who had severe sequelae.