1
|
Nasri A, Sghaier I, Neji A, Gharbi A, Abida Y, Mrabet S, Gargouri A, Djebara MB, Kacem I, Gouider R. Phenotypic Spectrum of Progressive Supranuclear Palsy: Clinical Study and Apolipoprotein E Effect. J Mov Disord 2024; 17:158-170. [PMID: 38290492 PMCID: PMC11082606 DOI: 10.14802/jmd.23178] [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: 09/09/2023] [Revised: 12/08/2023] [Accepted: 01/30/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE Progressive supranuclear palsy (PSP) is a rare neurodegenerative disorder encompassing several phenotypes with various motor and cognitive deficits. We aimed to study motor and cognitive characteristics across PSP phenotypes and to assess the influence of apolipoprotein E (APOE) gene variants on PSP phenotypic expression. METHODS In this 20-year cross-sectional study, we retrospectively reviewed the charts of all patients classified as PSP patients and recategorized them according to phenotype using the Movement Disorder Society criteria (2017). Phenotypes were divided into three subgroups, Richardson's syndrome (PSP-RS), PSP-cortical (PSP with predominant frontal presentation [PSP-F] + PSP with predominant speech/language disorder [PSP-SL] + PSP with predominant corticobasal syndrome [PSP-CBS]) and PSP-subcortical (PSP with predominant parkinsonism [PSP-P] + PSP with progressive gait freezing [PSP-PGF] + PSP with predominant postural instability [PSP-PI] + PSP with predominant ocular motor dysfunction [PSP-OM] + PSP with cerebellar ataxia [PSP-C] + PSP with primary lateral sclerosis [PSP-PLS]), based on clinical presentation during the first 3 years after symptom onset, which defines the early disease stage. Clinical and neuropsychological assessment data were collected. Genotyping of APOE was performed using restriction fragment length polymorphism polymerase chain reaction and verified by Sanger sequencing. RESULTS We included 112 PSP patients comprising 10 phenotypes classified into 48 PSP-RS, 34 PSP-cortical (PSP-CBS, 17.6%; PSP-F, 9.4%; PSP-SL, 8.2%) and 30 PSP-subcortical (PSP-P, 11.6%; PSP-PI, 8%; PSP-OM, 2.7%; PSP-PGF, 1.8%; PSP-C, 1.8%; PSP-PLS, 0.9%) subgroups. PSP-RS patients were older at disease onset (p = 0.009) and had more akinetic-rigid and levodopa-resistant parkinsonism (p = 0.006), while PSP-cortical patients had more tremors and asymmetric and/or levodopa-responsive parkinsonism (p = 0.025). Cognitive domains were significantly less altered in the PSP-subcortical subgroup. Overall, PSP-APOEε4 carriers developed parkinsonism earlier (p = 0.038), had earlier oculomotor dysfunction (p = 0.052) and had more altered cognitive profiles. The APOEε4 allele was also associated with a younger age of parkinsonism onset in the PSP-RS phenotype group (p = 0.026). CONCLUSION This study demonstrated the wide phenotypic spectrum of PSP among Tunisians. Disease onset and akinetic-rigid and levodopa-resistant parkinsonism were the hallmarks of the PSP-RS phenotype, while milder cognitive impairment was characteristic of the PSP-subcortical subgroup. The APOEε4 allele was associated with earlier parkinsonism and oculomotor dysfunction and seemed to play a role in defining a more altered cognitive profile in PSP patients.
Collapse
Affiliation(s)
- Amina Nasri
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Ikram Sghaier
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Anis Neji
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
| | - Alya Gharbi
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Youssef Abida
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Saloua Mrabet
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Amina Gargouri
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Mouna Ben Djebara
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Imen Kacem
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Riadh Gouider
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| |
Collapse
|
2
|
Gharbi A, Nasri A, Sghaier I, Kacem I, Mrabet S, Souissi A, Ben Djebara M, Gargouri A, Gouider R. Subtypes of Dementia with Lewy Bodies: Clinical Features, Survival, and Apolipoprotein E Effect. J Alzheimers Dis Rep 2023; 7:1277-1288. [PMID: 38143772 PMCID: PMC10741894 DOI: 10.3233/adr-230064] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/01/2023] [Indexed: 12/26/2023] Open
Abstract
Background Dementia with Lewy bodies (DLB) is a progressive neurodegenerative disease with various clinical symptoms. Limited data have described the clinical subtypes of DLB. Objective We aimed to compare clinical subtypes of DLB according to initial symptoms and to study the effect of Apolipoprotein E (APOE) gene in DLB. Methods We included DLB patients classified into three groups based on initial symptoms: non-motor onset (cognitive and/or psychiatric) (NMO-DLB), motor onset (parkinsonism and/or gait disorders) (MO-DLB), and mixed onset (non-motor and motor symptoms) (MXO-DLB). Clinical and APOE genotype associations and survival were analyzed. Results A total of 268 patients were included (NMO-DLB = 75%, MXO-DLB = 15.3%, MO-DLB = 9.7%). Visual hallucinations were more frequent (p = 0.025), and attention was less commonly impaired in MXO-DLB (p = 0.047). When adjusting with APOE ɛ4 status (APOE genotype performed in 155 patients), earlier falls and frontal lobe syndrome were more common in MXO-DLB (p = 0.044 and p = 0.023, respectively). The median MMSE decline was 2.1 points/year and the median FAB decline was 1.9 points/year, with no effect of clinical subtypes. Median survival was 6 years. It was similar in DLB subtypes (p = 0.62), but shorter for patients with memory symptoms at onset (p = 0.04) and for males (p = 0.0058). Conclusions Our study revealed a few differences between DLB clinical subtypes. APOE ɛ4 appears to be associated with earlier falls and a higher prevalence of frontal syndrome in MXO-DLB. However, DLB clinical subtypes did not impact on survival. Nevertheless, survival analysis identified other poor prognosis factors, notably inaugural memory impairment and male gender.
Collapse
Affiliation(s)
- Alya Gharbi
- Neurology Department, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Amina Nasri
- Neurology Department, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Ikram Sghaier
- Neurology Department, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Imen Kacem
- Neurology Department, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Saloua Mrabet
- Neurology Department, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Amira Souissi
- Neurology Department, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Mouna Ben Djebara
- Neurology Department, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Amina Gargouri
- Neurology Department, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Riadh Gouider
- Neurology Department, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| |
Collapse
|
3
|
Kolsi N, Mekki K, Regaieg C, Ben Hamed A, Charfi M, Bouraoui A, Gargouri A, BenThabet A, Hentati N. Congenital Arhinia: A Neonatal Case Report. Ear Nose Throat J 2023:1455613231185038. [PMID: 37480254 DOI: 10.1177/01455613231185038] [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] [Indexed: 07/23/2023] Open
Abstract
Congenital arhinia or nasal absence is a rare condition, with only less than 100 cases published in the literature to date. It is a rare condition that causes respiratory distress during the neonatal period. Although stabilization of the airway is the priority, management is not clearly defined, given the rarity of the malformation. We report a case of arhinia in a female newborn and briefly review the literature.
Collapse
Affiliation(s)
- Nadia Kolsi
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - K Mekki
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - Ch Regaieg
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - A Ben Hamed
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Charfi
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - A Bouraoui
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - A Gargouri
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - A BenThabet
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - N Hentati
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| |
Collapse
|
4
|
Souissi A, Abida Y, Mrabet S, Gharbi A, Nasri A, Gargouri A, Kacem I, Gouider R. Autonomic Disorders in Multiple Sclerosis. Mult Scler Relat Disord 2023. [DOI: 10.1016/j.msard.2022.104302] [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: 04/03/2023]
|
5
|
Mnif M, Souissi A, Abida Y, Gharbi A, Nasri A, Gargouri A, Kacem I, Gouider R. Sleep Disorders in Tunisian Patients with Multiple Sclerosis. Mult Scler Relat Disord 2023. [DOI: 10.1016/j.msard.2022.104303] [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: 04/03/2023]
|
6
|
Souissi A, Mrabet S, Atrous A, Abida Y, Gharbi A, Nasri A, Gargouri A, Kacem I, Gouider R. Impact of Multiple Sclerosis First Relapse on Disease History: Reports of a Tunisian Cohort. Mult Scler Relat Disord 2023. [DOI: 10.1016/j.msard.2022.104304] [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: 04/03/2023]
|
7
|
Nasri A, Gharbi A, Ouali U, Mrabet S, Souissi A, Jomli R, Gargouri A, Bendjebara M, Kacem I, Gouider R. Psychiatric Symptoms in Stiff-Person Syndrome: A Systematic Review and a Report of Two Cases. J Acad Consult Liaison Psychiatry 2023; 64:183-191. [PMID: 35940576 DOI: 10.1016/j.jaclp.2022.07.005] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND The clinical spectrum of stiff-person syndrome (SPS) encompasses a wide range of signs including psychiatric symptoms (PS). OBJECTIVE Our objective was to provide an overview of the spectrum of PS in SPS through a systematic literature search and 2 illustrative case reports. METHODS We reported 2 anti-glutamic acid decarboxylase-positive SPS cases that presented with phobic disorder, and we performed a systematic review by following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles published in PubMed, MEDLINE on Ovid, Embase, and via a manual search before October 20, 2020, were selected by 2 independent reviewers. Original studies, case reports, editorials, commentaries, and letters to the editor reporting cases of SPS with PS were all included. Conference abstracts, reviews and book chapters, unavailable articles, and those not reporting SPS cases or PS were excluded. Quantitative summary data were calculated. RESULTS In addition to our 2 cases, we identified 237 cases of SPS with PS from 74 additional included publications totaling 239 patients. Anxiety (56%) and depression (45%) were the most common PS in SPS. Mean diagnostic delay was 4.7 years. Among the 3 SPS phenotypes, the classic form was predominant (77%), followed by stiff-limb syndrome (13%) and progressive encephalomyelitis with rigidity and myoclonus (10%). The most frequent etiology of SPS with PS was autoimmune (90%), followed by cryptogenic (7%) and paraneoplastic forms (7%). These patients were mainly treated with immune-mediated therapies and GABAergic drugs. CONCLUSIONS Our review revealed that the most common PS of SPS are anxiety and depression occurring mostly in autoimmune and classic forms, allowing a clearer understanding of this entity, which may lead to earlier diagnosis and better outcome.
Collapse
Affiliation(s)
- Amina Nasri
- Department of Neurology, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi University Hospital, Tunis, Tunisia; Department of Psychiatry A, Razi University Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Alya Gharbi
- Department of Neurology, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi University Hospital, Tunis, Tunisia.
| | - Uta Ouali
- Department of Psychiatry A, Razi University Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Saloua Mrabet
- Department of Neurology, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi University Hospital, Tunis, Tunisia; Department of Psychiatry A, Razi University Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Amira Souissi
- Department of Neurology, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi University Hospital, Tunis, Tunisia.
| | - Rabaa Jomli
- Department of Psychiatry A, Razi University Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Amina Gargouri
- Department of Neurology, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi University Hospital, Tunis, Tunisia; Department of Psychiatry A, Razi University Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Mouna Bendjebara
- Department of Neurology, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi University Hospital, Tunis, Tunisia; Department of Psychiatry A, Razi University Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Imen Kacem
- Department of Neurology, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi University Hospital, Tunis, Tunisia; Department of Psychiatry A, Razi University Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Riadh Gouider
- Department of Neurology, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi University Hospital, Tunis, Tunisia; Department of Psychiatry A, Razi University Hospital, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| |
Collapse
|
8
|
Nasri A, Gharbi A, Sghaier I, Mrabet S, Souissi A, Gargouri A, Djebara MB, Kacem I, Gouider R. Determinants of cognitive impairment in multiple system atrophy: Clinical and genetic study. PLoS One 2022; 17:e0277798. [PMID: 36508411 PMCID: PMC9744291 DOI: 10.1371/journal.pone.0277798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/03/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Classically, cognitive impairment (CI) was not considered as a paramount feature of multiple system atrophy(MSA) in both parkinsonian(MSA-P) and cerebellar(MSA-C) motor-subtypes. Yet, growing evidence indicates currently the commonness of such deficits among MSA patients in different populations. Our aim was to evaluate the cognitive profile of MSA Tunisian patients and to analyze the underlying clinical and genetic determinants. METHODS In a retrospective cross-sectional study, clinically-diagnosed MSA patients were included. All subjects underwent clinical and neuropsychological assessments to characterize their cognitive profile. The associations with their APOE genotype status were analyzed. Determinant of CI were specified. RESULTS We included 71 MSA patients. Female gender(sex-ratio = 0.65) and MSA-P subtype(73%) were predominant. Mean age of disease onset was 59.1years. CI was found in 85.7% of patients(dementia in 12.7% and Mild cognitive impairment(MCI) in 73% of patients mainly of multiple-domain amnestic type(37.3%)). Mean MMSE score was lower among MSA-P compared to MSA-C(23.52 vs. 26.47;p = 0.027). Higher postural instability gait disorder(PIGD) and MDS-UPDRS-III scores were noted in demented MSA patients(p = 0.019;p = 0.015 respectively). The main altered cognitive domain was attention(64.8%). Executive functions and mood disorders were more affected in MSA-P(p = 0.029,p = 0.035 respectively). Clinical and neurophysiological study of dysautonomia revealed no differences across cognitive subtypes. APOE genotyping was performed in 51 MSA patients with available blood samples. Those carrying APOEε4 had 1.32 fold higher risk to develop CI, with lower MMSE score(p = 0.0001). Attention and language were significantly altered by adjusting the p value to APOEɛ4 carriers(p = 0.046 and p = 0.044 respectively). Executive dysfunction was more pronounced among MSA-PAPOEε4 carriers(p = 0.010). CONCLUSION In this study, the main determinants of CI in Tunisian MSA patients were MSA-P motor-subtype, mainly of PIGD-phenotype, disease duration and APOEε4 carrying status, defining a more altered cognitive phenotype. This effect mainly concerned executive, attention and language functions, all found to be more impaired in APOEε4 carriers with variable degrees across MSA motor-subtypes.
Collapse
Affiliation(s)
- Amina Nasri
- Neurology Department, LR18SP03, Razi Universitary Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi Universitary Hospital, Tunis, Tunisia
| | - Alya Gharbi
- Neurology Department, LR18SP03, Razi Universitary Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi Universitary Hospital, Tunis, Tunisia
| | - Ikram Sghaier
- Neurology Department, LR18SP03, Razi Universitary Hospital, Tunis, Tunisia
- Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi Universitary Hospital, Tunis, Tunisia
| | - Saloua Mrabet
- Neurology Department, LR18SP03, Razi Universitary Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi Universitary Hospital, Tunis, Tunisia
| | - Amira Souissi
- Neurology Department, LR18SP03, Razi Universitary Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi Universitary Hospital, Tunis, Tunisia
| | - Amina Gargouri
- Neurology Department, LR18SP03, Razi Universitary Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi Universitary Hospital, Tunis, Tunisia
| | - Mouna Ben Djebara
- Neurology Department, LR18SP03, Razi Universitary Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi Universitary Hospital, Tunis, Tunisia
| | - Imen Kacem
- Neurology Department, LR18SP03, Razi Universitary Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi Universitary Hospital, Tunis, Tunisia
| | - Riadh Gouider
- Neurology Department, LR18SP03, Razi Universitary Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) "Neurosciences and Mental Health", Razi Universitary Hospital, Tunis, Tunisia
- * E-mail:
| |
Collapse
|
9
|
Rekik A, Nasri A, Mrabet S, Gharbi A, Souissi A, Gargouri A, Kacem I, Gouider R. Non-motor features of essential tremor with midline distribution. Neurol Sci 2022; 43:5917-5925. [DOI: 10.1007/s10072-022-06262-x] [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] [Received: 04/18/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
|
10
|
Rekik A, Mrabet S, Kacem I, Nasri A, Ben Djebara M, Gargouri A, Gouider R. Eye Movement Abnormalities in Amyotrophic Lateral Sclerosis in a Tunisian Cohort. Neuroophthalmology 2022; 46:227-235. [PMID: 35859634 PMCID: PMC9291663 DOI: 10.1080/01658107.2022.2038638] [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] [Indexed: 10/19/2022] Open
Abstract
Few studies have reported abnormal ocular movements in cases of amyotrophic lateral sclerosis (ALS) and their link with other disease features. Our study aimed to describe and analyse eye movement abnormalities in ALS patients. Specifically, we set out to investigate the correlation between non-motor signs and oculomotor impairment in order to understand the pathogenesis of the disease. All ALS patients seen from 2018 to 2020 in the department of Neurology of Razi hospital underwent the recording of saccadic eye movements. Results were compared with healthy controls. Sixty-two patients were included. Altered saccadic eye movements (72.6%) correlated with tongue atrophy and bladder dysfunction. The most common finding was altered smooth pursuit (56.5%), which showed correlation with bladder dysfunction and altered frontal assessment battery (FAB) scores. Prolonged latencies of horizontal saccades (34%) correlated with sensory and extrapyramidal signs. Our study is the first to examine the characteristics of eye movements in a large African cohort of ALS patients and to show correlations with extra-motor clinical signs. Our findings showed extra-motor cortex dysfunction in ALS with greater frequency of eye movement abnormalities in comparison with previous studies. Altered horizontal pursuit, the core abnormality, confirmed the extension of the neurodegenerative process to the frontal and prefrontal cortices. Prolonged horizontal saccade latencies reflect mainly the involvement of the parietal eye field. Anti-saccadic abnormalities were the least common finding and showed, paradoxically, no link with executive dysfunction.
Collapse
Affiliation(s)
- Arwa Rekik
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Manouba, Tunisia
| | - Saloua Mrabet
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Manouba, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Imen Kacem
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Manouba, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Amina Nasri
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Manouba, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Mouna Ben Djebara
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Manouba, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Amina Gargouri
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Manouba, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Riadh Gouider
- Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Manouba, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia,CONTACT Riadh Gouider Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, LR 18SP03, 1, Orangers Street, Manouba, Tunis2010, Tunisia
| |
Collapse
|
11
|
Kacem I, Abida Y, Ferchichi W, Mrabet S, Sghaier I, Gharbi A, Souissi A, Nasri A, Gargouri A, Ben Djebara M, Gouider R. Arabic adaptation of the Edinburgh cognitive and behavioural Amyotrophic lateral sclerosis screen (ECAS-AR). Rev Neurol (Paris) 2022; 178:817-825. [DOI: 10.1016/j.neurol.2021.12.015] [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] [Received: 10/19/2021] [Revised: 12/14/2021] [Accepted: 12/27/2021] [Indexed: 10/18/2022]
|
12
|
Mrabet S, Boudriga S, Souissi A, Gharbi A, Nasri A, Djebara MB, Gargouri A, Kacem I, Gouider R. Depression, Anxiety and Alexithymia in Tunisian Patients with Multiple Sclerosis. Mult Scler Relat Disord 2022. [DOI: 10.1016/j.msard.2022.103596] [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: 10/18/2022]
|
13
|
Nasri A, Sghaier I, Gharbi A, Mrabet S, Ben Djebara M, Gargouri A, Kacem I, Gouider R. Role of Apolipoprotein E in the Clinical Profile of Atypical Parkinsonian Syndromes. Alzheimer Dis Assoc Disord 2022; 36:36-43. [PMID: 35001031 DOI: 10.1097/wad.0000000000000479] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Atypical Parkinsonian syndromes (APS) encompass a spectrum of neurodegenerative diseases including dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal syndrome (CBS). The effects of the Apolipoprotein E (APOE) gene on APS clinical features are controversial and understudied in several populations. We aimed to explore the influence of APOE genotype on clinical features in an APS Tunisian cohort. METHODS We included clinically diagnosed APS patients genotyped for APOE, and analyzed the clinical and APOE genotype associations. RESULTS A total of 328 APS patients were included, comprising 184 DLB, 58 PSP, 49 MSA, and 37 CBS. Significant differences in initial Mini-Mental State Examination and Frontal Assessment Battery scores according to APOE genotypes (P=0.05 and 0.0048) were found. Executive dysfunction (P=0.026) disorientation (P=0.025), and hallucinations (P<0.001) were more pronounced among APOE-ɛ4 carriers particularly in DLB. Memory disorders were also correlated to APOE-ɛ4 allele (P=0.048) and were more frequent among DLB and PSP carriers. Depression was associated to APOE-ε4 (P=0.042), more markedly in APOE-ε4-CBS and MSA carriers. CONCLUSIONS Our findings suggested a role of APOE-ε4 in defining a more altered cognitive phenotype with variable degrees across subgroups in APS patients, especially in DLB carriers. This effect mainly concerned executive, memory and orientation functions as well as hallucinations.
Collapse
Affiliation(s)
- Amina Nasri
- Department of Neurology, LR18SP03, Clinical Investigation Centre "Neurosciences and Mental Health", Razi University Hospital
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ikram Sghaier
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Alya Gharbi
- Department of Neurology, LR18SP03, Clinical Investigation Centre "Neurosciences and Mental Health", Razi University Hospital
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Saloua Mrabet
- Department of Neurology, LR18SP03, Clinical Investigation Centre "Neurosciences and Mental Health", Razi University Hospital
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Mouna Ben Djebara
- Department of Neurology, LR18SP03, Clinical Investigation Centre "Neurosciences and Mental Health", Razi University Hospital
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Amina Gargouri
- Department of Neurology, LR18SP03, Clinical Investigation Centre "Neurosciences and Mental Health", Razi University Hospital
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Imen Kacem
- Department of Neurology, LR18SP03, Clinical Investigation Centre "Neurosciences and Mental Health", Razi University Hospital
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Riadh Gouider
- Department of Neurology, LR18SP03, Clinical Investigation Centre "Neurosciences and Mental Health", Razi University Hospital
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| |
Collapse
|
14
|
Nasri A, Kacem I, Farhat N, Gharbi A, Sakka S, Souissi A, Zidi S, Damak M, Bendjebara M, Gargouri A, Mhiri C, Gouider R. Heart rate variability and sympathetic skin response for the assessment of autonomic dysfunction in leucine-rich repeat kinase 2 associated Parkinson's disease. Neurophysiol Clin 2022; 52:81-93. [DOI: 10.1016/j.neucli.2021.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 12/18/2022] Open
|
15
|
Souissi A, Mrabet S, Nasri A, Ben Djebara M, Gargouri A, Kacem I, Gouider R. Clinical predictors of disease progression in a cohort of Tunisian progressive Multiple Sclerosis. Mult Scler Relat Disord 2021; 56:103232. [PMID: 34619488 DOI: 10.1016/j.msard.2021.103232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/11/2021] [Accepted: 08/29/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Knowledge about progressive Multiple Sclerosis (MS) is mainly based on Caucasian studies. In our North-African context, MS exhibits particular characteristics that are mainly related to a more severe phenotype. Given the limited data available, there is an imminent need to characterize progressive MS in our latitudes. OBJECTIVE To describe the specificities of progressive MS and identify the inherent clinical predictors of disability accrual with a Tunisian cohort. METHODS A retrospective, hospital-based study was conducted in the department of neurology of Razi hospital. Patients, who had been diagnosed with MS, were divided into relapsing MS (RRMS), secondary progressive MS (SPMS) and primary progressive MS (PPMS). Epidemiological, clinical and paraclinical data were compared among the three groups. RESULTS Of the 504 patients, a progressive MS was described among 115 patients. This percentage of (22.8%) is divided into 13.9% SPMS and 8.9% PPMS. During the first clinical attack, motor symptoms have revealed to be predominant during PPMS (91.1%). For SPMS onset, the median time was 10 years, and was significantly delayed for patients with visual onset or full recovery from the first relapse. Patients with progressive MS exhibited a more rapid disability accumulation. CONCLUSION Compared to Caucasians, Tunisians exhibited a faster rate of conversion to SPMS. According to our natural progressive MS history, early clinical features are predictors of MS disability accrual.
Collapse
Affiliation(s)
- A Souissi
- Department of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, Razi Universitary Hospital, Manouba, Tunis, Tunisia
| | - S Mrabet
- Department of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, Razi Universitary Hospital, Manouba, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia
| | - A Nasri
- Department of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, Razi Universitary Hospital, Manouba, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia
| | - M Ben Djebara
- Department of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, Razi Universitary Hospital, Manouba, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia
| | - A Gargouri
- Department of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, Razi Universitary Hospital, Manouba, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia
| | - I Kacem
- Department of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, Razi Universitary Hospital, Manouba, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia
| | - R Gouider
- Department of Neurology, LR 18SP03, Clinical Investigation Centre Neurosciences and Mental Health, Razi Universitary Hospital, Manouba, Tunis, Tunisia; Faculty of medicine, University Tunis El Manar, 1007, Tunis, Tunisia.
| |
Collapse
|
16
|
Nasri A, Ben Djebara M, Sghaier I, Mrabet S, Zidi S, Gargouri A, Kacem I, Gouider R. Atypical parkinsonian syndromes in a North African tertiary referral center. Brain Behav 2021; 11:e01924. [PMID: 33179436 PMCID: PMC7821582 DOI: 10.1002/brb3.1924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/06/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Data on epidemiology of atypical parkinsonian syndromes (APS) in North African countries are limited. Our objective was to study the epidemiological features of APS in a Tunisian population. METHODS We conducted a 17-year retrospective cross-sectional descriptive study in the Department of Neurology at Razi University Hospital. We included all patients responding to consensus diagnosis criteria of APS. We recorded demographic and clinical data. Group differences were assessed with a post hoc ANOVA with a Bonferroni error correction. RESULTS We included 464 APS patients. Hospital prevalence of APS among all parkinsonism cases was 20.6%. Mean annual increase of incidence defined as newly diagnosed APS cases per year reached 38.8%/year. APS were divided into 4 etiological subgroups: dementia with Lewy bodies (DLB; 56.7%); progressive supranuclear palsy(PSP; 16.2%); multiple system atrophy (MSA; 14.6%); and finally corticobasal syndrome (CBS; 12.5%). Sex-ratio was 1.2. This male predominance was found in all subgroups except MSA (p = .013). Mean age at onset was 68.5 years, most belated in DLB (69.7 years; p < .001). Young-onset parkinsonism (<40 years) was found only in MSA subgroup (p = .031). Parkinsonism was of late onset (>70 years) in 50.7% of patients and was significantly associated with DLB subgroup (p = .013). Inaugural parkinsonism was associated with CBS and MSA (p = .0497), and gait disorders at disease onset were associated with PSP and MSA (p = .0062). Cognitive and mood disorders were more marked in DLB and most preserved in MSA. Consanguinity was more marked in CBS (p = .037), and family history of dementia and psychiatric diseases was more common in DLB. Thirty-seven families with similar cases of APS were identified. CONCLUSIONS This is the largest African epidemiological study on APS. In our population, APS were frequent and dominated by DLB. The age of onset of parkinsonism was the most decisive feature for differential diagnosis.
Collapse
Affiliation(s)
- Amina Nasri
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Mouna Ben Djebara
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Ikram Sghaier
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
| | - Saloua Mrabet
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Sabrina Zidi
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
| | - Amina Gargouri
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Imen Kacem
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Riadh Gouider
- Neurology Department, LR18SP03, Clinical Investigation Center (CIC) "Neurosciences and Mental Health"Razi University HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| |
Collapse
|
17
|
Souissi A, Mrabet S, Gharbi A, Nasri A, Gargouri A, Kacem I, Gouider R. Évaluation des facteurs pronostiques précoces au cours de la Sclérose en Plaques. Rev Neurol (Paris) 2020. [DOI: 10.1016/j.neurol.2020.01.344] [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: 11/30/2022]
|
18
|
Gharbi A, Mrabet S, Nasri A, Larnaout F, Gargouri A, Gargouri A, Kacem I, Gouider R. Prognostic Factors Stratification in Multiple Sclerosis. Mult Scler Relat Disord 2020. [DOI: 10.1016/j.msard.2019.11.009] [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: 10/24/2022]
|
19
|
Ellouze AS, Mrabet S, Nasri A, Nour MA, Gargouri A, Djebara MB, Kacem I, Gouider R. Functional and Dysfunctional Impulsivity in Relapsing Multiple Sclerosis. Mult Scler Relat Disord 2020. [DOI: 10.1016/j.msard.2019.11.008] [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: 11/28/2022]
|
20
|
Kacem I, Sghaier I, Bougatef S, Nasri A, Gargouri A, Ajroud-Driss S, Gouider R. Epidemiological and clinical features of amyotrophic lateral sclerosis in a Tunisian cohort. Amyotroph Lateral Scler Frontotemporal Degener 2019; 21:131-139. [DOI: 10.1080/21678421.2019.1704012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Imen Kacem
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | - Ikram Sghaier
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
| | - Sabrine Bougatef
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | - Amina Nasri
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | - Amina Gargouri
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | | | - Riadh Gouider
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| |
Collapse
|
21
|
Nasri A, Sghaier I, Gharbi A, Mrabet S, Gargouri A, Jebara MB, Kacem I, Gouider R. Early onset APOE Ɛ4-positive Alzheimer's disease patients: Are they different? J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1014] [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: 10/25/2022]
|
22
|
Ammar S, Sellami S, Sellami I, B Hamad A, Jarraya A, Zouari M, Zitouni H, Charfi M, Hbaieb M, Gargouri A, Ben Dhaou M, Mhiri R. Management of esophageal atresia and early predictive factors of mortality and morbidity in a developing country. Dis Esophagus 2019; 32:5369048. [PMID: 30828713 DOI: 10.1093/dote/doy135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/07/2018] [Accepted: 12/24/2018] [Indexed: 12/11/2022]
Abstract
The aim of this study is to investigate management and outcome in esophageal atresia (EA) and to identify early predictive factors of morbidity and mortality in a developing country. Charts of neonates with repaired EA from 2007 to 2016 were reviewed. Patients' characteristics, operative details, and postoperative outcomes were collected. Statistical analyses were performed to identify predictors of complicated evolution. Forty-two cases were collected. There were 14 girls and 28 boys. Only one patient had antenatal diagnosis (2.3%). The mean gestational age was 38 weeks. Nine patients (21.4%) weighed less than 2.5 kg. Seventeen (40.4%) patients had associated malformations most commonly cardiac (9/17). Thirteen patients had delayed diagnosis (30.9%). Thirty-nine (92.8%) patients underwent primary esophageal anastomosis. Overall survival was 76.2%. Nineteen patients (57% of survivals) had complicated evolution before the age of one year and 15 patients (46.8% of survivals) developed complications after the age of one year. Perinatal variables associated with mortality were prematurity (p = 0.004, OR = 5.4, IC95% = [1.13-25.80]), low birth weight (p = 0.023, OR = 7, IC95% = [1.38-35.47]), cardiac malformations (p = 0.006, OR = 10.5, IC95% = [2.03-54.27]) and delayed diagnosis (p = 0.005, OR = 10.11, IC95% = [2.005-50.980]). Variables associated with short-term and middle-term complications were duration of intubation (p = 0.019, OR = 0.118, IC95% = [0.019-0.713]) and the presence of short-term complications (p = 0.016, OR = 7.33, IC95% = [1.467-36.664]) respectively. These factors may be used to identify patients who will benefit from more intensive follow-up program.
Collapse
Affiliation(s)
- S Ammar
- Pediatric Surgery Department, Hedi Chaker Hospital, Sfax, Tunisia.,University of Medicine of Sfax, Sfax, Tunisia
| | - S Sellami
- Pediatric Surgery Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - I Sellami
- University of Medicine of Sfax, Sfax, Tunisia
| | - A B Hamad
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - A Jarraya
- Anesthesiology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Zouari
- Pediatric Surgery Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - H Zitouni
- Pediatric Surgery Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Charfi
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Hbaieb
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - A Gargouri
- Neonatology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - M Ben Dhaou
- Pediatric Surgery Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - R Mhiri
- Pediatric Surgery Department, Hedi Chaker Hospital, Sfax, Tunisia
| |
Collapse
|
23
|
Gharbi A, Nasri A, Mrabet S, Kacem I, Gargouri A, Ben Djebara M, Gouider R. Spectre de l’atteinte cognitive dans l’atrophie multisystématisée : qu’est-ce qui reste des drapeaux rouges ? Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.049] [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: 11/25/2022]
|
24
|
Souissi A, Mrabet S, Nasri A, Djebara M, Larnaout F, Gargouri A, Kacem I, Gouider R. Multiple Sclerosis New Criteria Are Also More Relevant in North Africans. Mult Scler Relat Disord 2018. [DOI: 10.1016/j.msard.2018.10.033] [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: 11/26/2022]
|
25
|
Larnaout F, Nasri A, Ameur O, Mrabet S, Kacem I, Gargouri A, Djebara M, Gouider R. Multiple Sclerosis and Autoreactive Antibodies. Mult Scler Relat Disord 2018. [DOI: 10.1016/j.msard.2018.10.069] [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: 10/27/2022]
|
26
|
Larnaout F, Mrabet S, Nasri A, Hmissi L, Djabara M, Gargouri A, Kacem I, Gouider R. Interplay Between Fatigue and Sleep Disturbances in Patients with Multiple Sclerosis. Mult Scler Relat Disord 2018. [DOI: 10.1016/j.msard.2018.10.072] [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: 10/27/2022]
|
27
|
Mrabet S, Souissi A, Larnaout F, Kacem I, Hmissi L, Gargouri A, Djebara M, Gouider R. Spinal Cord Lesions Predict Disability Progression in Relapsing Multiple Sclerosis. Mult Scler Relat Disord 2018. [DOI: 10.1016/j.msard.2018.10.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
28
|
Nasri A, Kacem I, Sidhom Y, Djebara MB, Gargouri A, Gouider R. Isolated spinal cord compression syndrome revealing delayed extensive superficial siderosis of the central nervous system secondary to cervical root avulsion. J Spinal Cord Med 2018; 41:490-495. [PMID: 28580859 PMCID: PMC6055980 DOI: 10.1080/10790268.2017.1329053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT Cervical root avulsion secondary to traumatic plexus injury is a rare etiology of superficial siderosis (SS) of the central nervous system (CNS). We describe the case of an isolated progressive compressive myelopathy revealing this complication and discuss the pathogenesis of such a presentation, its clinical and imaging peculiarities with a literature review. FINDINGS We report on the case of a 48-year-old man with history of left brachial plexus injury at the age of 2 years. Since the age of 38 years, he had presented with a progressive paraplegia, bladder and erectile dysfunction, neuropathic pain and sensory level. The diagnosis was made by spinal cord and brain magnetic resonance follow-up imaging revealing hypointensity T2-weighted gradient echo linear dark rim around the entire neuraxis and cervical dural pseudomeningoceles. These MRI findings were suggestive of extensive hemosiderin deposition consolidating the diagnosis of SS of CNS. CONCLUSION/CLINICAL RELEVANCE Our case report illustrates diagnosis difficulties in unusual or paucisymptomatic presentations of SS. A history of brachial plexus trauma with nerve root avulsion should prompt gradient-echo T2-weighted imaging to bring out such a complication. Superficial siderosis of the CNS should be included in the panel of differential diagnosis of the parethospastic syndromes and compressive myelopathy.
Collapse
Affiliation(s)
- Amina Nasri
- Department of Neurology, Razi Hospital, Tunis, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Imen Kacem
- Department of Neurology, Razi Hospital, Tunis, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Youssef Sidhom
- Department of Neurology, Razi Hospital, Tunis, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Mouna Ben Djebara
- Department of Neurology, Razi Hospital, Tunis, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Amina Gargouri
- Department of Neurology, Razi Hospital, Tunis, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Riadh Gouider
- Department of Neurology, Razi Hospital, Tunis, Tunisia,Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia,Correspondence to: Pr Riadh Gouider, Department of Neurology, Razi hospital, 2015, Tunis, Tunisia.
| |
Collapse
|
29
|
Laatar F, Kacem I, Nasri A, Ben Djebara M, Gargouri A, Gouider R. Generalized dystonia : unusual mode of revelation of Moyamoya disease. Tunis Med 2017; 95:504-505. [PMID: 29878297] [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: 06/08/2023]
|
30
|
Sidhom Y, Kacem I, Ouerdiane A, Nasri A, Amara N, Gargouri A, Ben Djebara M, Gouider R. Antinuclear and antiphospholipid antibodies in patients with multiple sclerosis: Frequency and disease course in a Tunisian cohort. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2997] [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: 11/16/2022]
|
31
|
Ben Djebara M, Gharbi A, Sidhom Y, Nasri A, Kacem I, Gargouri A, Gouider R. Spectrum of dementia syndromes in synucleinopathies: Findings from a tunisian cohort of 174 patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2867] [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: 10/18/2022]
|
32
|
Kacem I, Nasri A, Sidhom Y, ELmabrouk E, Ben Djebara M, Gargouri A, Gouider R. Sympathetic skin response in Parkinsonian syndromes: A possible discriminating tool? J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2589] [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: 10/18/2022]
|
33
|
Nasri A, Kacem I, Sidhom Y, Ben Younes T, Gargouri A, Ben Djebara M, Gouider R. Autonomic dysfunction and its impact on the quality of life in essential tremor. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2080] [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: 10/18/2022]
|
34
|
Rais L, Hassen M, Gargouri A, Jbali H, Khedher R, Smaoui W, Krid M, Mami I, Beji S, Ben Fatma L, Gouider R, Zouaghi K. SP452PERIPHERAL DIABETIC NEUROPATHY IN PATIENTS ON CHRONIC HEMODIALYSIS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx149.sp452] [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: 11/14/2022] Open
|
35
|
Aloulou-Abdelkefi M, Trigui-Lahiani H, Gargouri A. Autoclaved mycelium induces efficiently the production of hydrolytic enzymes for protoplast preparation of autologous fungus. APPL BIOCHEM MICRO+ 2017. [DOI: 10.1134/s000368381702003x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
36
|
Ketata J, Sidhom Y, Kacem I, Nasri A, Djebara MB, Gargouri A, Gouider R. Le phénomène d’Uhthoff dans la sclérose en plaques : étude d’une population tunisienne. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.210] [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: 10/20/2022]
|
37
|
Laatar F, Gargouri A, Abdelkefi I, Nasri A, Sidhom Y, Imen K, Gouider R. Étude épidémiologique d’une série hospitalière d’épilepsie myoclonique juvénile. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.036] [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: 11/30/2022]
|
38
|
Mrabet S, Gargouri A, Laatar F, Abdelkefi I, Imen K, Djebara MB, Gouider R. Troubles cognitifs et étude des mouvements oculaires au cours de l’épilepsie myoclonique juvénile. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.017] [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: 11/28/2022]
|
39
|
Kacem I, Sidhom Y, Nasri A, Gargouri A, Gouider R. Étude clinique et évolutive dans une population tunisienne. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.107] [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: 10/20/2022]
|
40
|
Kacem I, Djebara MB, Nasri A, Sidhom Y, Gargouri A, Gouider R. Profil cognitif des patients atteints de sclérose latérale amyotrophique dans une population tunisienne. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.106] [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: 10/20/2022]
|
41
|
Achour NB, Turki A, Gargouri A, Benrhouma H, Kraoua I, Gouider R, Turki I. Sous-types électrocliniques du syndrome de Guillain Barré chez l’enfant : étude de 70 cas. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.125] [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: 10/20/2022]
|
42
|
|
43
|
Ben Amou B, Kacem I, Nasri A, Ben Djebara M, Sidhom Y, Gargouri A, Gouider R. Intrafamilial phenotypic variability in idiopathic Fahr's disease. Tunis Med 2016; 94:565-567. [PMID: 28603832] [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: 06/07/2023]
|
44
|
Kessentini N, Gargouri A, Imen K, Nasri A, Sidhom Y, Ben Djebara M, Gouider R. Les particularités des polyradiculoneuropathies inflammatoires chroniques associées dans une population tunisienne. Rev Neurol (Paris) 2016. [DOI: 10.1016/j.neurol.2016.01.332] [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: 11/26/2022]
|
45
|
Gnaichia C, Kacem I, Nasri A, Sidhom Y, Ben Djebara M, Gargouri A, Gouider R. Particularités cliniques et biologiques des syndromes neurologiques paranéoplasiques non classiques. Rev Neurol (Paris) 2016. [DOI: 10.1016/j.neurol.2016.01.063] [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: 11/30/2022]
|
46
|
Nasri A, Ben Djebara M, Jardak F, Kacem I, Sidhom Y, Gargouri A, Gouider R. Parkinson-plus syndromes: epidemiological findings from a Tunisian cohort of 210 patients. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.941] [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: 10/22/2022]
|
47
|
Sellami L, Ben Djebara M, Belhouane I, Kacem I, Sidhom Y, Hizem Y, Gargouri A, Gouider R. P2‐100: Early‐onset versus late‐onset Alzheimer's disease in tunisia. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | - Imen Kacem
- UR12SP21, NeurologyRazi HospitalTunisTunisia
| | | | - Yosr Hizem
- UR12SP21, NeurologyRazi HospitalTunisTunisia
| | | | | |
Collapse
|
48
|
Elleuch A, Ben Thabet A, Ben Dhaw M, Bahri Y, Bouraoui A, Charfi M, Ben Hmed A, Mhiri R, Hmida N, Gargouri A. P-024 – Association rare entre hydrocolpos et malformations rénales. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30209-8] [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: 10/23/2022]
|
49
|
Bahri Y, Ben Thabet A, Bouraoui A, Elleuch A, Regaieg I, Charfi M, Regaieg R, Hamida N, Gargouri A. P-433 – Devenir des enfants issus de grossesses compliquées de RPM avant 34 SA. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30610-2] [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: 10/23/2022]
|
50
|
Regaieg C, Ben Thabet A, Ben Dhaou M, Bouraoui A, Louati H, Charfi M, Hmida N, Turki H, Mhiri R, Gargouri A. P-023 – Association sténose hypertrophique du pylore à révélation néonatale etépidermolyse bulleuse congénitale: à propos un cas. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30208-6] [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: 11/25/2022]
|