The PR of epilepsy in Saudi Arabs is within the range of the values reported in most communities. The causes of symptomatic epilepsies revealed a predominance of perinatal and inherited factors. Isolated and non-convulsive seizures were probably under-recognized due to various social and cultural factors as well as to lack of sensitivity of the questionnaire for non-convulsive seizures.

We studied 89 MS patients comprising 38 males and 51 females seen over a 10-year period. The hospital frequency was 25/100,000 patients. The diagnosis was mainly clinical and was supported by neuroimaging, cerebrospinal fluid analysis and neurophysiological tests. Sixty-five patients (73%) were Saudis and the peak age of onset was in the third decade. Fifty-two patients (58.4%) had clinically definite MS, 17 (19.1%) had laboratory-supported definite MS, 15 (16.9%) were clinically probable MS cases and the remaining 5 (5.6%) had laboratory-supported probable MS. The mean age at onset of Saudi patients (25.9 years) was lower than that of the non-Saudis (29.4 years; p < 0.001). Involvement of the pyramidal system was the commonest mode of presentation. The clinical course was relapsing-remitting in 60.7%, progressive-relapsing in 20.2% and primary progressive in 19.1%. The number of systems involved was significantly associated with the duration of disease (p < 0.001). The demographic features and the variability of clinical presentation of Saudi MS patients is similar to the results from neighbouring countries. Combination of clinical features and paraclinical tests is essential for accurate determination of extent of dissemination and for unmasking clinically silent lesions.

S Al-Rajeh, A Ogunniyi, A Awada, A Daif, R Zaidan, Preliminary Assessment of an Arabic Version of the MiniMental State Examination. 1999; 19(2): 150-152 The Mini-Mental State Examination (MMSE) is one of the most widely used instruments for quantitative assessment of cognitive functions and for dementia screening.1,2 It assesses many cognitive domains, including orientation, memory, language, calculation and visual construction. The test, however, shows educational as well as cultural bias, and appears to be more suited to Western culture. [2][3][4] The use of the MMSE in other cultures, therefore, entails translation into the specific languages, modification and/or substitution of some of the items with culturally relevant ones, and pilot-testing these for reliability, sensitivity and specificity. There are many versions and translations of the MMSE, including Chinese, German, Spanish and Nigerian, which have been used for studies in the respective cultures. [4][5][6][7] An Arabic version of the MMSE was developed and pilot-tested on Saudi patients. The results are presented in this report. Materials and MethodsThe MMSE was translated into the Arabic language, with many items left unchanged from the original version. The names of the area of the Kingdom and its location were substituted for the name of the country and the particular state, which appear in the original version. Date (a popular palm produce), chair and money, were the three items most often used. We used serial subtraction of 3s from 100 for assessing calculation, attention and concentration. We omitted spelling "world" backwards because the concept appeared difficult in a predominantly illiterate population. The expression "no ifs, ands or buts" was replaced by an Arabic phrase. The Arabic version produced was then translated back into English to ensure consistency of the items. The questionnaire was then administered by the same interviewer to 33 subjects, comprising 27 males and 6 females, who volunteered to take part in the study. The participants were mainly relations of inpatients at the King Khalid University Hospital, Riyadh (KKUH), who had no evidence of central nervous system dysfunction and were not on medications that could depress cognitive function or alertness. The responses were recorded as either correct or incorrect. The educational status of the individuals was obtained at the end of the administration of the questionnaire. Individuals who had not attended school or had spent less than six years in school were regarded as uneducated.Using sequential analysis, the questionnaire was administered by the same interviewer to four clinically diagnosed demented patients (based on DSM-IV criteria) 8 being managed at KKUH, for the determination of its psychometric properties. The dementia diagnoses were vascular (two cases), probable Alzheimer's disease (one case) and dementia associated with meningioma (one case). The patients included three females and one male, with a mean age of 69.8±11.2 years (range, 54-80 years), who were uned...

The findings agree with the reported prevalence of 10% to 12% in other communities in the Kingdom of Saudi Arabia, but lower than the rates in Western countries. The lower rates are probably related to sociocultural factors.