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Background Peripheral neuropathy is an underestimated problem of compensated liver cirrhosis despite its negative effect on quality of life. The aim was to assess the role of meticulous electrophysiological screening (nerve conduction responses and quantitative motor unit potential analysis) of subclinical peripheral nerve dysfunction in patients with compensated cirrhosis and also to explore its relations with different characteristics of liver disease. Severity of cirrhosis was assessed by Child–Pugh and albumin-bilirubin (ALBI) scores. Results Prevalence of hepatic neuropathy (HN) was 82%. It involved sensory and motor fibers (66%), and its pathophysiology was axonal (53.7%) or mixed axonal and demyelinating (46.3). The most sensitive discriminating tests were ulnar sensory conduction velocity (area under curve (AUC) = 0.915) and peak latency (AUC = 0.887), peroneal motor conduction velocity (AUC = 0.885), ulnar distal motor latency (AUC = 0.842), and first dorsal interosseous number of phases (AUC = 0.736). HN showed significant correlation with the severity of liver disease assessed by both child (P = 0.029) and ALBI (P = 0.016) scores and also correlated with the low serum albumin level (P = 0.001). Conclusions Subclinical mild axonal polyneuropathy is very common in post-hepatitis C compensated cirrhosis picked up by meticulous electrophysiological testing, and it is related to severity of liver cirrhosis and low serum albumin level.

Purpose: Intensive care unit acquired weakness (ICUAW) has a negative impact on functional outcome and mortality. We aim to determine the incidence of ICUAW in septic ICU patients and to explore its significant correlations with clinical and laboratory findings. Patients and Methods: We included forty ICU patients diagnosed with sepsis on admission or within 48 hours later. Twenty-five ICU patients with no sepsis were included as a control group. All study populations were evaluated using clinical muscle assessment (medical research council, MRC)and muscle ultrasound at two-time points, the first was between days 2 and 5, and the second was between days 10 and 15. Laboratory workup included complete blood count, coagulation profile, arterial blood gases, liver, and kidney function tests. Results: There was a gradual declining neuromuscular function in all study populations and more significant in septic patients' group.The incidence of ICUAW was 60% (by MRC score <48) and 100% (by abnormal muscle ultrasound) at second evaluation point of septic patients. SOFA score, blood haemoglobin level, total leucocytic count and creatinine had significant correlations with neuromuscular dysfunction.

‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬ ‫ــــــــــــــــــــــــ‬ Background and Aim:Epilepsy is a network disease, and its pathological networks could be related to the interictal epileptiform discharges (IEDs). The aim is to explore the effect of IEDs on EEG functional connectivity metrics (coherence and phase lag degree) in patients with focal epilepsy. Methods: The study included 14 patients with focal epilepsy and 14 matched healthy controls. EEGs of the patients were segmented into two-second epochs: a. epochs containing IEDs, b. resting epochs with no IEDs. The selected epochs were analyzed using Fast Fourier Transform to yield four frequency bands: Delta, Theta, Alpha and Beta. Coherence and phase lag degree were computed between the EEG electrodes and were assessed at the intra-hemispheric (frontal-parietal and frontaltemporal) and inter-hemispheric (frontal, temporal and

Background Cognitive decline is a common presentation of Parkinson’s disease (PD) and a continued search exists for a reliable biomarker for early identification and management of this clinical problem. The objective of this study is to select the most useful biomarker in assessment of PD-related cognitive decline. This cross-sectional study included 47 patients with PD and 47 matched healthy controls. All participants were assessed by quantitative electroencephalography (QEEG) spectral (relative power and background peak frequency) and connectivity measures (coherence and phase lag degree), in addition to clinical evaluation using Unified Parkinson’s Disease Rating Scale (UPDRS)and Modified Hoehn and Yahr staging scale and neuropsychological assessment of the patients using Montreal Cognitive Assessment (MoCA). Results PD patients showed significantly higher relative power in all frequency bands over the right temporal region with no significant changes in peak frequency, coherence and phase lag degree compared to healthy controls. PD patients with impaired cognition (MoCA < 26) had significantly lower global relative power, more marked in alpha and beta frequency bands compared to PD patients with normal cognition. Alpha and beta relative power in frontal and temporal regions showed significant correlation with different cognitive domains of MoCA score. Conclusions QEEG measures especially spectral relative power could be used as adjunct to neuropsychological assessment in evaluation of PD-related cognitive decline.

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‫ـــــــ‬ ‫ــــــــ‬ ‫ــــــــ‬ ‫ــــــــــــــــــــــــــــــــــــ‬ ‫ـ‬ ‫ـــــــــــــــــــــــــــــــــــــــــــــــــــ‬ Background and Aim: Neuroinflammation plays an early and prominent role in the pathology of Parkinson disease. Tumor necrosis factor alpha induced protein-8 like-2 (TIPE2) is a relatively new subtype of tumor necrosis factor which may play a role in pathogenesis of Parkinson disease. Our aim was to evaluate the role of serum level of TIPE2 as a risk factor for Parkinson disease and as a serological biomarker of disease severity. Methods: Forty-seven patients diagnosed as idiopathic PD according to diagnostic criteria of the UK Parkinson Disease Society Brain Bank, and 47 healthy individuals were enrolled. All patients were on medical treatment of PD and were evaluated by Unified