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Bouchaala W, Laroussi S, Mzid Y, Maaloul I, Jallouli O, Zouari S, Ben Nsir S, Mnif Z, Kammoun F, Triki C. Moyamoya Angiopathy: An Underdiagnosed Cause of Ischemic Stroke in a Tunisian Pediatric Cohort. Pediatr Neurol 2024; 150:3-9. [PMID: 37925769 DOI: 10.1016/j.pediatrneurol.2023.09.017] [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: 02/11/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Moyamoya angiopathy is a rare cerebral vasculopathy and an underdiagnosed cause of arterial ischemic stroke in children. We aim to report the clinical and radiological presentations in a Tunisian pediatric cohort. METHODS We identified moyamoya angiopathy in pediatric patients managed at the Child Neurology Department of Hedi Chaker Sfax University Hospital between 2008 and 2020 and reviewed their clinical and radiological data as well as their evolutionary profile. RESULTS We collected 14 patients with median age 40.6 months and a female predominance (sex ratio of 0.75). An arterial ischemic stroke (AIS) revealed the disease in all patients, with the major symptom being a motor deficit. Symptoms related to a transient ischemic attack before the diagnostic consultation were reported in four patients. Carotid territory was, clinically and radiologically, the most frequently involved. Brain magnetic resonance imaging with angiography was performed in 12 patients confirming the diagnosis by revealing the development of collateral vessels. All the investigations concluded to moyamoya disease in 57.2% and moyamoya syndrome in 42.8%. The latter was related to Down syndrome in five patients and neurofibromatosis type 1 in one patient. With a mean follow-up of 2.35 years, two patients had at least two more AISs during the first two years following diagnosis and 42.8% of patients were diagnosed with vascular or poststroke epilepsy. Full recovery was noted in 14.3% of cases. CONCLUSIONS Moyamoya angiopathy in children is a serious condition that needs to be recognized due to the high risk of recurrent ischemic strokes.
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Affiliation(s)
- Wafa Bouchaala
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Sirine Laroussi
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia.
| | - Yosra Mzid
- Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Imen Maaloul
- Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia; Radiology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Olfa Jallouli
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Salma Zouari
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Sihem Ben Nsir
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Zeineb Mnif
- Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia; Radiology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Fatma Kammoun
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Chahnez Triki
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
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Zouari Mallouli S, Jallouli O, Bouchaala W, Ben Nsir S, Kamoun Feki F, Charfi Triki C. Challenges to associate early onset epilepsy with COVID-19 autoimmune encephalitis: A case report. World J Immunol 2023; 13:1-10. [DOI: 10.5411/wji.v13.i1.1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/14/2023] [Accepted: 02/02/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Diagnosis of coronavirus disease 2019 (COVID-19)-related neurological events in the pediatric population is challenging. Overlapping clinical picture of children with altered neurological state and inborn errors of metabolism, in addition to the frequency of asymptomatic COVID-19 cases, pose the main challenges for diagnosis. Diagnostic approaches to the onset post-COVID 19 subacute encephalopathy are still troublesome as seronegative autoimmune encephalitis (AIE) is reported.
CASE SUMMARY A 27-mo-old boy was admitted for stormy refractory seizure of polymorphic semiology and altered mental status followed by various neuropsychiatric features that were suggestive of AIE. Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal. Neither the immunological assessment, including viral serologies, antinuclear antibodies, autoimmune antibodies (NMDA, AMPA, CASPR2, LG11, GABARB, Hu, Yo, Ri, CV2, PNMA2, SOX1, Titin, amphiphysin, Recoverin), nor the metabolic assessment for lactate and pyruvate showed significant anomaly. Both positive history of COVID-19 infection and the findings of characteristic repetitive extreme delta brush played a key role in the diagnosis of COVID-19-related AIE. A remarkable improvement in the state of the child was noted after two pulse doses of intravenous Veino-globulin and high dose of intravenous Corticosteroid.
CONCLUSION Diagnostic biomarkers for AIE might aid effective treatment.
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Affiliation(s)
- Salma Zouari Mallouli
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Olfa Jallouli
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Wafa Bouchaala
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Sihem Ben Nsir
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Fatma Kamoun Feki
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Chahnez Charfi Triki
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
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Ben Ayed I, Bouchaala W, Bouzid A, Feki W, Souissi A, Ben Nsir S, Ben Said M, Sammouda T, Majdoub F, Kharrat I, Kamoun F, Elloumi I, Kamoun H, Tlili A, Masmoudi S, Triki C. Further insights into the spectrum phenotype of TRAPPC9 and CDK5RAP2 genes, segregating independently in a large Tunisian family with intellectual disability and microcephaly. Eur J Med Genet 2021; 64:104373. [PMID: 34737153 DOI: 10.1016/j.ejmg.2021.104373] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 10/06/2021] [Accepted: 10/27/2021] [Indexed: 10/20/2022]
Abstract
Intellectual disability (ID) often co-occurs with other neurologic phenotypes making molecular diagnosis more challenging particularly in consanguineous populations with the co-segregation of more than one ID-related gene in some cases. In this study, we investigated the phenotype of three patients from a large Tunisian family with significant ID phenotypic variability and microcephaly and performed a clinical exome sequencing in two cases. We identified, within the first branch, a homozygous variant in the TRAPPC9 gene (p.Arg472Ter) in two cases presenting severe ID, absent speech, congenital/secondary microcephaly in addition to autistic features, supporting the implication of TRAPPC9 in the "secondary" autism spectrum disorders and congenital microcephaly. In the second branch, we identified a homozygous variant (p.Lys189ArgfsTer15) in the CDK5RAP2 gene associated with an heterozygous TRAPPC9 variant (p.Arg472Ter) in one case harbouring primary hereditary microcephaly (MCPH) associated with an inter-hypothalamic adhesion, mixed hearing loss, selective thinning in the retinal nerve fiber layer and parafoveal ganglion cell complex, and short stature. Our findings expand the spectrum of the recently reported neurosensorial abnormalities and revealed the variable phenotype expressivity of CDK5RAP2 defect. Our study highlights the complexity of the genetic background of microcephaly/ID and the efficiency of the exome sequencing to provide an accurate diagnosis and to improve the management and follow-up of such patients.
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Affiliation(s)
- Ikhlas Ben Ayed
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia; Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Tunisia.
| | - Wafa Bouchaala
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Tunisia; Research Laboratory "Neuropédiatrie" LR19ES15, Sfax University, Tunisia
| | - Amal Bouzid
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia; Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Wiem Feki
- Radiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Amal Souissi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Sihem Ben Nsir
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Tunisia; Research Laboratory "Neuropédiatrie" LR19ES15, Sfax University, Tunisia
| | - Mariem Ben Said
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Takwa Sammouda
- Department of Ophthalmology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Fatma Majdoub
- Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Tunisia
| | - Ines Kharrat
- Department of Otorhinolaryngology, University Habib Bourguiba Hospital of Sfax, Tunisia
| | - Fatma Kamoun
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Tunisia; Research Laboratory "Neuropédiatrie" LR19ES15, Sfax University, Tunisia
| | - Ines Elloumi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Hassen Kamoun
- Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Tunisia; Laboratory of Human Molecular Genetics, LR33ES99, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Abdelaziz Tlili
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates; Human Genetics and Stem Cell Laboratory, Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, United Arab Emirates
| | - Saber Masmoudi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Chahnez Triki
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Tunisia; Research Laboratory "Neuropédiatrie" LR19ES15, Sfax University, Tunisia
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Zouari R, Triki C, Bouchaala W, Nsir SB, Kamoun F. Mitochondrial leucoencephalopathies: An under-diagnosed form of mitochondrial disease. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119364] [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]
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Zouari R, Triki C, Bouchaala W, Nsir SB, Kamoun F. Peripheral neuropathy due to mitochondrial disorders in pediatric patients. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119365] [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: 11/17/2022]
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Zouari Mallouli S, Ben Nsir S, Bouchaala W, Kamoun Feki F, Charfi Triki C. Acute Demyelinating Syndromes: A report of child neurology department of Sfax University Hospital. Mult Scler Relat Disord 2021; 56:103291. [PMID: 34624647 DOI: 10.1016/j.msard.2021.103291] [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: 07/30/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The yearly incidence of Acute Demyelinating Syndromes (ADS) in a multiethnic cohort of children published by Langer-Gould and al in 2011 was estimated at about 1.66 per 100,000. Nevertheless, the real incidence for these disorders is still underestimated as the iterative revision for diagnosis criteria have failed to classify a significant number of children with ADS. PURPOSE This work was aimed to describe clinical and paraclinical characteristics of ADS in a pediatric population. MATERIAL AND METHODS Demographic, clinical and paraclinical data of 42 children (24 females; 18 male; SR = 1.33), were collected from the medical records of patients admitted to the child neurology department of Sfax University Hospital between 2008 and 2021 for clinical events with presumed inflammatory origin. Next, patients were categorized as per M. N. Nouri and al. up dated classification for ADS. Finally, characteristics of different ADS categories were compared. RESULTS The mean age onset was 6 years (± 3.5 years). For a mean follow-up period of 28 months, 69% of patients had a monophasic course. ADS in our pediatric population were Acute disseminated encephalomyelitis (ADEM) (36%), Clinically isolated syndrome (CIS) (24%), Multiple sclerosis (MS) (19%), Neuromyelitis optica spectrum disorder (NMOSD) (7%), Myelin oligodendrocyte glycoprotein antibodies-associated diseases (MOGAD) (2%) and Recurrent demyelinating disease not otherwise specified (RD-NOS) (10%). At presentation, patients showed different clinical picture according to ADS-subtype with more patients with epileptic seizure in ADEM-group (53.3%), optic neuritis in CIS-group (70%), motor deficit in MS-group (62.5%), area postrema syndrome in NMOSD-group (33.3%) and vesico-sphincter dysfunction in RD-NOS-group (75%). Among patients presenting with visual impairment (21.4%), Visual evoked potential (VEP) guided the diagnosis of NMOSD in 22.2% by objectifying axonal optic nerve damage. Different ADS subtypes were identified according to MRI results in 100% of ADEM-patients and 75% of MS-patients and on antibody testing in three patients. The ADS-subtype was recognized based on antibody testing in three patients. Two patients from CIS-group: the first with isolated optic neuritis (ON) was positive for antiaquaporin 4 antibodies (anti-AQP4) and the other with clinically polyfocal ADS was positive for antinuclear antibodies (ANA) type anti-RNP. The remaining patients who presented with ADEM-phenotype was positive for anti-myelin oligodendrocyte glycoprotein (anti-MOG). SIGNIFICANCE Recognizing distinctive features of each ADS category may improve diagnosis accuracy as well as the indication of suitable treatment.
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Affiliation(s)
- Salma Zouari Mallouli
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia.
| | - Sihem Ben Nsir
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia
| | - Wafa Bouchaala
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia
| | - Fatma Kamoun Feki
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia
| | - Chahnez Charfi Triki
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia
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Zouari R, Bouchaala W, Nsir SB, Kamoun F, Triki C. Opsoclonus myoclonus induced by lamotrigine toxicity. Seizure 2021; 91:247-250. [PMID: 34243055 DOI: 10.1016/j.seizure.2021.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Rania Zouari
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Wafa Bouchaala
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia; Search Unit "Neuropédiatrie" UR12ES16, Sfax University, Sfax, Tunisia.
| | - Sihem Ben Nsir
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia; Search Unit "Neuropédiatrie" UR12ES16, Sfax University, Sfax, Tunisia.
| | - Fatma Kamoun
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia; Search Unit "Neuropédiatrie" UR12ES16, Sfax University, Sfax, Tunisia.
| | - Chahnez Triki
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia; Search Unit "Neuropédiatrie" UR12ES16, Sfax University, Sfax, Tunisia.
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Zone Abid I, Jarrar E, Feki J, Kamoun F, Triki C, Ben Nsir S. Early Onset and Severe Progression of Neuro-ophthalmological Manifestations in a Case with Parry–Romberg Syndrome. Journal of Pediatric Neurology 2020. [DOI: 10.1055/s-0039-1692136] [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: 10/26/2022]
Abstract
AbstractParry–Romberg syndrome is a rare disorder characterized by unilateral facial atrophy affecting the skin, subcutaneous tissue, and muscles, and sometimes extending to the osteocartilaginous structures. Ophthalmological and neurological involvements are relatively rare. We present a case of an early onset of left hemifacial atrophy, a progressive severe left ocular impairment, and the presence of a neurological disorder in the left hemisphere of the brain. The neuro-ophthalmological manifestations on the left side include enophthalmos, mild pseudoptosis, moderate asymmetry of the eyebrows, diffuse chorioretinal atrophy, reduced visual acuity, reduced central retinal thickness (162 µm) with the interruption of the ellipsoid zone, and the alteration of the outer nuclear layer, with associated reduced responses in photopic and scotopic amplitudes. The patient reported high intensity left brain white matter and a brief clinical focal seizure. This case report adds to the repertoire spectrum of this rare syndrome. The presentation calls for a multidisciplinary care for patients like our case.
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Affiliation(s)
- Imen Zone Abid
- Unité de Recherche “Neuropédiatrie,” UR12ES16, Faculté de médecine de Sfax, Sfax, Tunisia
- Service d'ophtalmologie, CHU Habib Bourguiba, Sfax, Tunisia
| | - Emna Jarrar
- Service de Neurologie Pédiatrique, CHU HédiChaker, Sfax, Tunisia
| | - Jamel Feki
- Unité de Recherche “Neuropédiatrie,” UR12ES16, Faculté de médecine de Sfax, Sfax, Tunisia
- Service d'ophtalmologie, CHU Habib Bourguiba, Sfax, Tunisia
| | - Fatma Kamoun
- Unité de Recherche “Neuropédiatrie,” UR12ES16, Faculté de médecine de Sfax, Sfax, Tunisia
- Service de Neurologie Pédiatrique, CHU HédiChaker, Sfax, Tunisia
| | - Chahnez Triki
- Unité de Recherche “Neuropédiatrie,” UR12ES16, Faculté de médecine de Sfax, Sfax, Tunisia
- Service de Neurologie Pédiatrique, CHU HédiChaker, Sfax, Tunisia
| | - Sihem Ben Nsir
- Unité de Recherche “Neuropédiatrie,” UR12ES16, Faculté de médecine de Sfax, Sfax, Tunisia
- Service de Neurologie Pédiatrique, CHU HédiChaker, Sfax, Tunisia
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Rania Z, Bouchaala W, Ben Nsir S, Kamoun F, Chahnez T. Les complications neurologiques de la maladie de CriglerNajjar. Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.155] [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]
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Ben Nsir S, Belguith S, Bouchaala W, Fourati E, Kamoun F, Triki C. L’hypertension intracrânienne chez l’enfant : expérience du service de neurologie pédiatrique de Sfax. Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.149] [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]
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Zouari S, Kacem HH, Kamoun F, Damak M, Nsir SB, Mhiri C, Triki C. Ictal epileptic headache: Is it a rare phenomenon? Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.05.037] [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: 10/14/2022] Open
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Hela Z, Chayma E, Ben Nsir S, Triki L, Kamoun I, Masmoudi K, Chahnez T. Syndrome de Guillain Barré : quels critères diagnostiques électroneuromyographiques utilisés ? Rev Neurol (Paris) 2018. [DOI: 10.1016/j.neurol.2018.01.156] [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: 11/15/2022]
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Ben Nsir S, Damak M, Bouchhima I, Turki E, Imed Miladi M, Mhiri C. Cavernomes cérébraux et épilepsie : à propos de 12 cas. Rev Neurol (Paris) 2015. [DOI: 10.1016/j.neurol.2015.01.220] [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]
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