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Makkawi S, Aljafari D, Alsharif R, Maaddawi H, Alwagdani A, Aljumah T, Alghweinem Z, Alshehri S, Khojah O, Halawani A, Ahmed Adas R, Abulaban A, Al Malik Y. The clinical and radiological features and prevalence of Neuro-Behçet's Disease: A retrospective cohort multicenter study in Saudi Arabia. Mult Scler Relat Disord 2024; 85:105558. [PMID: 38569381 DOI: 10.1016/j.msard.2024.105558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/22/2024] [Accepted: 03/16/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Neuro-Behçet's disease (NBD) is defined as primary neurological involvement in patients with systemic symptoms of BD. The variety of clinical presentations seen in NBD and the long list of similar conditions make diagnosis challenging. This retrospective study aimed to estimate the prevalence and describe neurological involvement in patients with Behçet's disease who presented to King Abdulaziz Medical Cities in Jeddah and Riyadh, Saudi Arabia. METHODS This was a retrospective, cohort study which utilized a non-probability consecutive sampling technique to include all patients diagnosed with NBD patients. All patients with BD (215) were screened for neurological symptoms. Thirty-five patients were found to be diagnosed with NBD. Outcomes were estimated using the modified Rankin scale (mRS). RESULTS In our cohort, one in six patients with BD was diagnosed with NBD. A total of 35 patients were diagnosed with NBD (mean age 27.56 ± 10.36 years; [2.88:1; Male: Female]). The main clinical features of NBD were headaches, weakness, unsteadiness, and dysarthria. The most commonly involved sites on imaging were the brainstem, diencephalon, cerebellum and basal ganglia. Oligocolonal bands were negative in all patients. Maintenance therapy most commonly included oral corticosteroids, azathioprine, and/or infliximab. Most patients received pulse corticosteroids alone when presenting with acute relapse. Half of our cohort was asymptomatic and three in four had favorable outcomes. CONCLUSION NBD is common among patients with BD in our population with most patients having favorable outcomes. Patients might have a wide array of symptoms which might make the diagnosis challenging.
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Affiliation(s)
- Seraj Makkawi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Neurosciences, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Danya Aljafari
- Neuroscience Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Rawaf Alsharif
- Neurology Division, Department of Medicine, Ministry of The National Guard-Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hadeel Maaddawi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Alhanouf Alwagdani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Talal Aljumah
- Neurology Division, Department of Medicine, Ministry of The National Guard-Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ziyad Alghweinem
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sultan Alshehri
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Osama Khojah
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Neurosciences, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Aisha Halawani
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Medical Imaging, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Reem Ahmed Adas
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Medical Imaging, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Ahmad Abulaban
- Neurology Division, Department of Medicine, Ministry of The National Guard-Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Yaser Al Malik
- Neurology Division, Department of Medicine, Ministry of The National Guard-Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Tohyama S, Oh J, Timm M, Cheng JC, Halawani A, Mikulis DJ, Solomon AJ, Hodaie M. Should trigeminal neuralgia be considered a clinically isolated syndrome? Mult Scler 2023; 29:637-641. [PMID: 36703283 PMCID: PMC10152555 DOI: 10.1177/13524585221149886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The association between trigeminal neuralgia (TN) and multiple sclerosis (MS) is well established. Many MS patients with TN have magnetic resonance imaging (MRI) evidence of a symptomatic demyelinating lesion. Although infratentorial presentations are included in the diagnostic criteria for MS, there remains confusion in clinical practice as to whether TN should be considered a clinically isolated syndrome for the application of McDonald criteria. In this case series, we discuss this diagnostic quandary in patients presenting with TN and additional MRI findings suggestive of MS and highlight the unmet need for data in such patients to optimally guide their care.
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Affiliation(s)
- Sarasa Tohyama
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA/Division of Brain, Imaging and Behaviour—Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada/Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jiwon Oh
- Division of Neurology, Department of Medicine, St. Michael’s Hospital, Toronto, ON, Canada
| | - Makenna Timm
- Division of Brain, Imaging and Behaviour—Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Joshua C Cheng
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Aisha Halawani
- Division of Brain, Imaging and Behaviour—Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada/Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - David J Mikulis
- Division of Brain, Imaging and Behaviour—Systems Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada/Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | | | - Mojgan Hodaie
- M Hodaie Division of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, 399 Bathurst Street, 4W W-443, Toronto, ON M5T 2S8, Canada.
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Bin Lajdam G, Alaryani K, Ghaddaf AA, Aljabri A, Halawani A, Alshareef M, Algarni M, Al-Hakami H. Septoplasty versus septoplasty with turbinate reduction for nasal obstruction due to deviated nasal septum: a systematic review and meta-analysis. Rhinology 2022; 60:411-420. [PMID: 36150153 DOI: 10.4193/rhin22.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Compensatory inferior turbinate hypertrophy is a common accompanying manifestation in patients with nasal obstruction due to deviated nasal septum (DNS). The grounds for inferior turbinate reduction (ITR) in this population are still not well established. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of septoplasty with ITR versus septoplasty alone. METHODS Computerised search in Medline, Embase, and CENTRAL was performed. Eligible for inclusion were randomised controlled trials (RCTs) comparing septoplasty to septoplasty with unilateral, contralateral, ITR in adults with DNS. Primary outcomes were health-related quality of life and nasal patency. The secondary outcome was the occurrence of adverse events. Standardised mean differences (SMD) and odds ratios (OR) with 95% confidence intervals were calculated. RESULTS Twelve RCTs that enrolled 775 participants were found eligible. Data were reported at follow-up periods ranging from 1 month to 48 months. The pooled effect estimate showed a statistically significant improvement with unilateral, contralateral, ITR in Nasal Obstruction Symptom Evaluation scale (NOSE) scores. The rate of adverse events was significantly higher with ITR. CONCLUSIONS Unilateral reduction of the hypertrophied contralateral inferior turbinate during septoplasty resulted in better subjective relief of nasal obstruction in adults with DNS than septoplasty alone. However, caution is warranted since only few well-designed RCTs were identified.
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Affiliation(s)
- G Bin Lajdam
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - K Alaryani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - A A Ghaddaf
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - A Aljabri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - A Halawani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - M Alshareef
- Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - M Algarni
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.,Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - H Al-Hakami
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.,Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Halawani A. Experimental Study on the Resistance ofEntamoeba Histolyticato Emetine Hydrochloridein Vitro. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1930.11684640] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Halawani A, Baquir H. Etrenol (hycanthone) in the treatment of Schistosoma haematobium infections in Iraq. Bull Endem Dis (Baghdad) 1970; 12:7-20. [PMID: 5525831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Halawani A, al-Waidh M, Said SM. Serology in the study of the relationship between S. haematobium infestation and cancer of the urinary bladder. Br J Urol 1970; 42:580-5. [PMID: 5475806 DOI: 10.1111/j.1464-410x.1970.tb04507.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Halawani A, al-Barrak N, Hamid K. The effect of bilharziasis--chemotherapy by ambilhar on the ova and susceptibility of B. truncatus to miracidia. Bull Endem Dis (Baghdad) 1969; 11:134-40. [PMID: 5408712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Biggam A, Halawani A, Ragab A. The treatment of amœbic dysentery by oral yatren. Trans R Soc Trop Med Hyg 1931. [DOI: 10.1016/s0035-9203(31)90060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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