Sleep-related breathing disorders are said to be common in patients with established cerebrovascular accidents. The aim of this study was to assess the frequency and characteristics of sleep-related breathing disorders in ischemic stroke and transient ischemic attacks. All patients were subjected to neurologic assessment, Berlin questionnaire (Arabic version), brain computed tomographic scan, and polysomnography along 6 to 8 hours overnight with special emphasis to apnea/hypopnea indices. All assessments were done for 30 patients who had stroke and transient ischemic attacks as well as 20 age- and sex-matched controls. Overall, 13.3% of patients had mild sleep apnea (apnea/hypopnea index, >5), 13.3% had moderate sleep apnea (apnea/hypopnea index, >15), and 34% had severe sleep apnea (apnea/hypopnea index, >30). The sensitivity and specificity of Berlin questionnaire for obstructive sleep apnea diagnosis were 55% and 100%, respectively, for mild sleep apnea, 56.3% and 85.7% for moderate sleep apnea, 66.7% and 83.3% for severe condition. Berlin questionnaire is a moderate sensitive but highly specific screening test for sleep apnea in cerebrovascular diseases. Those who scored high risk should consider polysomnography to specify the type and severity of apnea.

BackgroundCentral post-stroke pain (CPSP) is an under-recognized complication of stroke although it can lead to deterioration in quality of life and impairment in activities of daily living. Its estimated prevalence varies between 18.6 and 49%.ObjectiveTo investigate the prevalence and predictors of CPSP in ischemic stroke patients and to find its relationship with somatosensory evoked potentials (SSEPs) and magnetic resonance imaging.Patients and methodsSixty five consecutive patients with recent first attack of ischemic stroke who were admitted to the Neurology Department, Suez Canal University Hospitals were recruited. Patients were subjected to clinical assessment, Hamilton depression rating scale, brain MRI, short-form McGill Pain Questionnaire (SF-MPQ), daily pain rating scale (DPRS), stimulus evoked pain, and SSEPs.ResultsThe total prevalence rate of CPSP was 35.4% (n = 23). The mean age of the patients developed CPSP was significantly lower than those without CPSP (p = 0.004). Deep sensory dysfunction was statistically significantly higher among CPSP group than non-CPSP group (p = 0.001). CPSP group showed statistically significant higher prevalence of thalamic stroke (p = 0.007), as well as significant abnormalities in inter-peak interval (IPL) of median and tibial nerves SSEPs (p < 0.05). Thalamic group showed higher abnormalities in IPL of median and tibial nerves compared to extra-thalamic group, but without statistically differences.ConclusionThe prevalence of CPSP was found to be 35.4%. Predictors of CPSP include; deep sensory dysfunction, prolongation of tibial N21–P40 IPL, smoking history, age < 50 years, presence of thalamic stroke and prolongation of median N9–N20 IPL.

R2C is the most sensitive parameter in the blink reflex, which can help in the diagnosis of subclinical diabetic cranial neuropathy.

Purpose: Serious concerns about the effect of mobile phone radiation on cognition are growing. This study aimed to assess the possible effect of mobile phone radiation in persons with epilepsy and in normal subjects. Methods: The amplitude and reaction time of auditory event–related potentials (P300) and occipital alpha frequency were compared before and after exposure with a 30-minute call in 30 persons with epilepsy and in 30 control subjects. Alpha power was monitored before, during, and after exposure to mobile phone radiation. Moreover, correlations with clinical aspects were analyzed. Results: Increased reaction time and decreased P300 amplitude were more evident in persons with epilepsy. A significant decrease in alpha power was noted in control subjects and persons with epilepsy and was associated with an increased bilateral alpha frequency. In persons with epilepsy, such changes significantly correlated with the time since the last seizure and with the therapy regimen. Conclusions: Thirty-minute exposure to mobile phone radiation has a significant effect on the electrophysiological correlates of cognition, especially in persons with epilepsy.

Background: Recently, an exceptional increase was witnessed in cell phone users. The brain has greater exposure to the electromagnetic field (EMF) created during mobile phone use than the rest of the body, which may impair its function. In persons with epilepsy, the brain has more tendencies towards electrical instability. Objectives: The current study aims at investigating the effect of mobile phone radiation (MPR) on the electroencephalogram (EEG) of persons with epilepsy as well as healthy adults. Subjects and methods: Thirty patients with idiopathic epilepsy and 30 matching controls underwent EEG recording including 15 min of sham exposure followed by 30 min of real exposure to MPR and a final postexposure recording for extra 15 min. The number of abnormal EEG events was counted during sham and real exposure for each subject. Correlation analysis was done between the number of epileptic events detected during the real exposure to MPR and the patients' clinical data Results: In the control group, the EEG under real MPR exposure showed no abnormal discharges. In persons with epilepsy, all those with abnormal EEG during sham exposure MPR (33%) showed an increase in the number of events with real exposure to MPR. One patient showed a change in the pattern of discharge from interictal changes to an ictal rhythm. Another patient with normal EEG during sham record developed temporal epileptiform discharges during real exposure.Conclusion: Mobile phone radiation shows recognizable effects on the brain rhythm of persons with epilepsy. These results should be confirmed by future studies to establish a recommendation addressing the use of such devices in epileptic patients.

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Purpose: Bell palsy is the most common cause of acute facial nerve paralysis. Ultrasound has proved its ability in detecting structural lesions along the course of the affected nerves.The current work aimed at studying the accuracy of ultrasound to predict the prognosis of Bell palsy in correlation to the clinical scale and nerve conduction studies. Methods: The study included 20 cases of acute Bell palsy treated with prednisolone and physiotherapy. The participants were examined using the House–Brackmann (HB) scale, electrophysiologically and neurosonologically in the affected side and healthy side that served as a control. Results: There was significant correlation between HB outcomes with onset of HB results. There was significant increase in the distal facial nerve diameter on the affected side compared with the normal side (P < 0.001). Although ultrasound at onset did not predict the outcome, nerve conduction studies did predict the outcome. Conclusions: Baseline HB clinical assessment of Bell palsy gives information on the clinical outcome of the disease. In addition to that, initial nerve conduction studies proved to be superior to ultrasound in predicting the outcome.