Evaluation of clinical outcome and safety profile of edaravone in treatment of amyotrophic lateral sclerosis: a 72-week single-center experience.

Edaravone is a free radical scavenger that has been recently approved for treatment of Amyotrophic lateral sclerosis (ALS) to delay functional decline. We aim to evaluate edaravone efficacy and safety in ALS patients in the main neurology tertiary center in Kuwait over 72-week period. We conducted a prospective observational cohort study in the main tertiary hospital over 72-week period from July 2018 until January 2020. Patients were assessed at baseline, 24, 48 and 72 weeks of therapy using ALSFRS-R score, MRC sum score, FVC value, among other parameters. Seventeen consecutive patients were evaluated. All patients were assessed at baseline, 24 and 48 weeks, while 9 patients (52.9%) were further assessed at 72 weeks. There was a statistically significant decline of ALSFRS-R at 72 weeks, MRC sum score at 48 and 72 weeks, while the decline in FVC was not statistically significant. Glycosuria was found in only one patient. Our study showed significant functional decline after 1 year of edaravone therapy with preserved respiratory function. The drug had a high level of dissatisfaction among our cohort despite having a high safety profile.

Demographics, Clinical Characteristics, and Management of Idiopathic Intracranial Hypertension in Kuwait: A Single-Center Experience.

Background: Idiopathic intracranial hypertension (IIH) affects predominantly obese females during their reproductive age period. The demographics of this condition has not been studied in Kuwait before. Objectives: To determine the demographics, clinical features, risk factors, and treatment modalities of IIH in the main neurology tertiary referral hospital in Kuwait and to compare our data with literature. Methods: A retrospective study was conducted to identify cases of IIH seen between January 1, 2018, and December 31, 2018. Patients were diagnosed in and referred from the neurology and neuro-ophthalmology clinics. Results: Our cohort consisted of 139 patients. We estimated a crude annual incidence rate of IIH of 3.28 per 100,000 population. Female-to-male ratio was 9.6:1. Mean age was 32.1 ± 10.8 years. Mean age of males was 31.46 ± 12.63 and that of females was 32.11 ± 10.67. The median of the duration from the first symptoms till diagnosis was 6 weeks (2-10 weeks). Headache was the most common symptom in 134 (96.4%) patients, followed by visual disturbances in 85 (61.2%) patients, transient visual obscurations (TVOs) in 84 (60.4%) patients, pulsatile tinnitus in 72 (51.8%) patients, diplopia in 22 (15.8%) patients, other symptoms (e.g., nausea, vomiting, radicular neck, and back pain) in 19 (13.7%) patients, and 1 (0.7%) patient had facial weakness. High body mass index (BMI) was seen in 89.9% of patients, either overweight or obese, and it was the most common risk factors in both males (46.2%) and females (61.1%). Anemia was found in 38.1%; 21.6% of patients used OCPs and 7.9% used vitamin A. Bilateral transverse sinus stenosis (BTSS) was detected in 47 (33.8%) patients. Only 2 (1.4%) patients developed "fulminant IIH" characterized by rapidly progressive disease. All the patients received medical treatment and only 12 (8.6%) needed surgical management. Conclusion: Incidence of IIH in Kuwait is similar to other regional studies but higher than Western studies. Demographics and clinical features of IIH in our study are comparable to international and regional figures. Most of our patients had a benign course. IIH is more prevalent in females and strongly associated with obesity.