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.

Objectives ‐ To describe the pattern of presentation, the types of dementia and the associated conditions in Saudi patients. Materials and methods ‐Hospital‐based study using DSM‐IV and ICD 10 criteria for consensus diagnosis of cases from clinical information and results of investigations. Dementia subtypes were made according to NINCDS‐ADRDA, NINDS‐AIREN and ICD 10 criteria while CDR was used for severity grading. Results ‐ A total of 77 demented patients (49 males, 28 females) were studied. The hospital frequency was 19.3/100,000 patients. The mean age at presentation was 74.6 years and age at onset was below 65 years in 17 patients. The types of dementia were: Alzheimer's disease (51.9%), vascular dementia (18.2%), mixed cases (15.6%), dementia with Parkinson's disease (7.8%) and treatable dementia (5.2%). Only 3 patients were in the severe clinical stage and infections were important causes of deterioration. Conclusion ‐ The hospital frequency appears to be low probably because of the relatively young population. The pattern of dementia with preponderance of AD is similar to that in western countries and intervention directed at the risk factors for stroke could reduce the burden of vascular dementia.

Background/Objective: Herpes simplex encephalitis usually has a progressive cause. Sudden neurological deficits are unusual. Method: Case study. Results: A 17-year-old girl presented with an acute onset focal neurological deficit followed one week later by the more classical feature of altered level of consciousness, fever and focal seizures. The diagnosis of hepetic encephalitis was made by magnetic resonance imaging (MRI) and by the significant increase in cerebrospinal fluid titres of antibodies against herpes simplex type I. Conclusion: Herpetic encephalitis should be considered in the differential diagnosis of acute stroke in young patients even in the absence of encephalitic features, if common etiological factors such as embolization and intracerebral bleed are excluded. RESUME: Hemiparesie a debut subit due a une encephalite herpetique. Introduction et objectif: Nous decrivons un cas d'encdphalite, due au virus de l'herpes simplex, dont le mode de presentation clinique a 6t6 inhabituel par le d6but subit de l'hfimiparesie, a la fa?on d'un ictus ceY6bral. Methode: Une jeune fille de 17 ans a pr&ente' un deficit neurologique suivi, une semaine plus tard, par les manifestations plus classiques: une alteration de la conscience, de Phyperthermie et des convulsions focales. Resultat: Le diagnostic reposait sur les manifestations observers a 1'imagerie par resonance magnetique (MRI) et sur l'augmentation significative des titres d'anticorps contre le virus de l'herpes simplex I dans le liquide cephalo-rachidien. Conclusions: L'enc6phalite herp6tique devrait etre incluse dans le diagnostic differentiel de l'ictus cerebral aigu chez le jeune patient, m6me en l'absence de manifestations d'encfiphalite, si les principaux facteurs dtiologiques courants, tels l'embolie ou l'h6morragie intracerebrale, ont 6te exclus.Can. J. Neurol. Sci. 1995; 22: 320-321 Herpes simplex virus (HSV) infections are distributed worldwide.1 HSV infection of the central nervous system is among the most severe of all human viral infections of the brain, 2 and causes an acute necrotizing encephalitis with edema, necrosis and hemorrhage that selectively affects the temporal and frontal lobes.3 The usual clinical presentation is with fever, headache, focal neurological deficit and focal seizures, with progression to confusion, disorientation and possibly coma within a few days. 3In this report, we describe a case presenting like an acute stroke. CASE REPORTA 17-year-old girl was admitted to Security Forces Hospital with the complaint of headache and left-sided weakness. The patient was healthy until ten hours prior to admission, when she developed severe right hemicranial throbbing headache, associated with nausea, and followed one hour later by sudden weakness of the left upper and lower limbs with deviation of the mouth to the right side. The headache improved with the onset of the weakness. The patient had no other medical problems and was taking no medication. There was no history of migraine, nor of heart disease, nor any hist...

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A review of 36 interictal EEGs compatible with the diagnosis of benign childhood epilepsy with centro-temporal spikes (BECTS) was made in this study. These children constituted 31% of the children with focal epileptic EEG activity observed in the same period. The dipolic spikes occurred either as a single focus (78%) or as two independent foci with a greater preponderance to the right (22%). The onset of seizures before the age of 5 years (Group I) is 53% and between 6 and 10 years (Group II) is 47%. Clinical evaluation showed that 60% of the patients in Group I and 75% in Group II had lateralized seizures, although all of them were initially diagnosed as nocturnal generalized tonic-clonic seizures. A follow-up study showed 31% complete recovery, 47% seizure-free under medications, 8% occasional seizures, 8% frequent seizures, and the rest 6% had a single seizure without medication. It is therefore concluded that the syndrome is common in Saudi Arabia and is usually unrecognized by the general physicians. The follow-up of our patients so far confirms the excellent prognosis.

Brucellosis is a systemic infection that rarely involves the nervous system. This paper describes 21 cases of neurobrucellosis affecting different parts of the peripheral and central nervous system. The various presentations closely simulated acute meningoencephalitis, myelitis, cerebral ischaemia, radiculopathy or multisystem degeneration. All patients received adequate combined antimicrobial therapy of trimethroprim-sulfamethoxazole, doxycycline, and/or rifampicin. The improvement was quick and complete in meningoencephalitic patients, while others with structural changes in the nervous system did not recover and ended up with permanent deficits. The combination regimen and duration of therapy are the focus of this study.

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