Plateforme Télé-Enseignement de l'Université Oran 1 Ahmed Ben Bella
Publications et Ouvrages des Enseignants
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Abstract
Purpose: The goal of this retrospective study is to identify early predictors of in- tractable epilepsy.
Methods: This case-control study conducted from January 2007 to December 2012 included 106 patients with drug-resistant epilepsy and 212 controls with well-con- trolled epilepsy.Univariate and multivariate analysis of predictive factors of refractoriness were performed using logistic regression. Results: in the final model, four factors significantly associated with intraitable epilepsy were identifier: aetiology (p=0.001), high initial seizure fréquence (p<0.0001), status epilepticus (p=0.002) and initial myoclonic seizures (p<0.0001). Conclusion: Our findings suggest that the Risk of developing drug résistant epilepsy could be predicted at an early stage of the disease by some clinicat features. This could help the cliniciens to make the best therapy décisions and improve patient's Quality of Life.
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Although several studies have documented a strong association between epilepsy and some psychiatric comorbidities, either before or after the diagnosis of epilepsy, depression and other disorders remain under diagnosed and undertreated in People With Epilepsy (PWE) [1].
According to epidemiological data, 25-48% of PWE suffer from mood disorders, and 14-31% from anxiety [2]. Moreover, depression represents one of the most common psychiatric disorders in PWE, with a point prevalence ranging from 12-37% in community settings [3]. In clinical studies, depressive symptoms in epilepsy have been associated with several variables such as poor seizure control, duration of epilepsy, having complex partial seizures or temporal lobe epilepsy, unemployment and the use of antiepileptic polytherapy.
Recent reports have suggested a bidirectional relationship between epilepsy and depression [4]. Both conditions are episodic and may involve common pathogenic mechanisms. Indeed, epilepsy can lead to depression through its specific psychosocial consequences such as poor patient acceptance of his epilepsy, stigma and anticipatory anxiety associated with the unpredictable occurrence of seizures. On the other hand, Depressive symptoms in epilepsy impair patients’ health-related Quality Of Life (QOL) and may affect the clinical course of epilepsy.
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Abstract
Objectives - This study aims to investigate the surrounding family when several cases of epileptics are found, the goal is to establish inheritance patterns and to identify genetic variants and to document the genotype/phenotype correlation. Materials and methods - Affected members from extended families with familial epilepsy were assessed at the University Hospital of Oran between December 2011 and December 2016. All participants underwent neurological examination, EEG and brain MRI. Epileptic syndromes have been classified according to the International League Against Epilepsy (LICE) criteria, and the modes of inheritance have been established through genealogical analysis. After genomic DNA extraction, genetic variants of susceptibility to epilepsy were investigated by comparative genomic hybridization on DNA microarrays (CGH-array) and next-generation sequencing (NGS). Results - Sixty-five epileptic families participated in this study. The mean age of seizure onset was 9.5 ± 6.1 years with a slight male predominance (sex ratio: 1.35). 50% had generalized seizures and 40% experienced focal seizures. The consanguinity rate among parents of affected was 50% with phenotypic concordance observed in 2/3 of families. According to pedigree analysis, epilepsy was inherited in an AD mode with or without reduced penetrance in 29 families (44.6%) and AR mode in 23 families (35.4%). Genetic analyzes have identified mutations in the EPM1 gene in patients with progressive myoclonic epilepsy, a mutation in the RELN gene in individuals with temporal lobe epilepsy and schizophrenia, and both benign and pathogenic CNVs. In addition, a de novo mutation (p.A39E) in the GAL gene was identified in monozygotic twins with temporal lobe epilepsy. Functional analysis strongly supports GAL as the causal gene for the TLE in this family. Conclusion - This study described the epileptic phenotype and determined the mode of transmission of epilepsy in large multigenerational Algerian families, and identified known genetic variants but also interesting neomutations.
Keywords
Epilepsy, genetics, mutation, CGH array, exome sequencing
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Abstract
Introduction - Epilepsy is a chronic neurological disease whose risk factors are very heterogeneous from one population to another. The role attributed to inbreeding in the development of genetically determined diseases has been well documented. However, its association with epilepsy has been suggested by some studies and refuted by others. The goal of this case-control study was to identify the significance of consanguinity and other risk factors of epilepsy in a population of western Algeria. Patients and methods - Unrelated epileptic patients upwards of 16 years, who attended the Neurology Department of Oran University Hospital between October 2013 and March 2014, were included in the study. Controls matched for age and sex, were selected among non- epileptic patients attending the same department during the same period for another neurological disorder. The risk factors evaluated were: consanguinity, family history of epilepsy, perinatal complications, infection of the central nervous system, mental retardation, neurological impairment, history of febrile seizures, severe head trauma, stroke and addiction. Results - 101 cases and 202 controls participated in the study. Multivariate logistic regression identified five factors significantly associated with epilepsy: first-degree parental consanguinity (p=0.029), history of epilepsy in first-degree relatives (p<10-4), antecedent of febrile seizures (p=0.005), severe head injury (p=0.020) and mental retardation (p=0.006). Conclusion - This case-control study identified risk factors associated with epilepsy, and demonstrated familial aggregation of epilepsy in a population of western Algeria. The implementation of a strategy for prevention and awareness of the impact of consanguineous marriages as well as genetic counselling for couples with a family history of epilepsy are needed.
keywords
Epilepsy, Consanguinity, Risk factors, Algeria
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Abstract
Introduction - Several studies have shown a strong relationship between schizophre- nia and epilepsy. This association implies a common genetic susceptibility for both conditions. This study aims to identify genetic variants of susceptibility to epilepsy and schizophrenia in an Algerian family.
Patients and methods - All available members of this family underwent clinical and electroencephalographic evaluation. Genetic analysis by whole exome sequencing was performed after DNA extraction.
Results - In this study, we report a family with two brothers having temporal lobe epi- lepsy associated to schizophrenia in one, and to recurrent depressive disorder in the other. Exome sequencing identified homozygous single nucleotide variant in the RELN gene (rs55689103) in patient with schizophrenia. His brother was heterozygous for the same variant.
Conclusion - The polymorphism rs55689103 could be involved in schizophrenic pheno- type in this family, but not in epilepsy phenotype. Further investigations of blood Reelin level and RELN promoter methylation are key components to interpreting the results of this study.
Keywords
Reelin, RELN, Polymorphism, epilepsy, schizophrenia
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Abstract
Eating epilepsy is one of the rare forms of reflex epilepsy with less than a hundred cases reported worldwide. The exact pathogenesis still remains unknown and most cases reported in literature are drug resistant. We report the first Algerian case of eating epilepsy presenting with partial complex seizures. Clinical examination was normal. Interictal EEG recording showed asymmetric background activity of lower amplitude and isolated epileptiform activity over the right frontotemporal region. Cerebral MRI revealed right opercular atrophy and treatment with Carbamazepine was successful. Eating epilepsy is often an under-recognized entity whereas its diagnosis is relatively easy. The prognosis varies from one individual to another, but early treatment can improve the Quality of Life of thèse patients.
Keymords
Reflex epilepsy, eating epilepsy, Algeria
Journal of Neurology and Neurosurgery 2017. Doi: http://dx.doi.org/10.19104/jnn.2017.35
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Résumé
Introduction: Bien qu’elle soit la comorbidité psychiatrique la plus fréquente chez les patients épileptiques, la dépression demeure large- ment sous-diagnostiquée et non traitée. Cette étude a pour objectif de déterminer la fréquence hospitalière ainsi que les facteurs de risque associés à la dépression chez les patients épileptiques suivis au service de neurologie du CHU d’Oran. Patients et méthodes : Il s’agit d’une étude rétrospective cas- témoins, menée au service de neurologie du CHU d’Oran entre Juin 2016 et Juin 2017. La dépression a été dépistée par le questionnaire NDDI-E et confirmée par la version arabe de l’échelle Hamilton. Les facteurs de risque de dépression ont été analysés par régression logistique. Résultats : Au total, 332 patients épileptiques ont participé à cette étude. L’âge moyen était de 29,8±13 ans avec une légère prédominance masculine (sex-ratio : 1.13). La dépression a été diagnostiquée chez 98 patients (29.5 %). L’analyse multivariée par régression logis- tique a retenu cinq variables dans le modèle final : le faible niveau d’instruction, la fréquence élevée des crises, les crises partielles complexes, la polythérapie et la perception de stig- matisation. Conclusion : Notre étude met l’accent sur la fré- quence élevée de la dépression chez les patients épileptiques, d’où l’intérêt d’un dépistage systématique, en particulier chez les patients analphabètes stigmatisés, souffrant de crises fo- cales complexes réfractaires.
Mots-clés
Facteurs de risque, dépression, épilepsie, cas-témoin, Algérie.
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Résumé
Objectif : La prévalence des crises d’épilepsie est plus élevée chez les sujets atteints de maladie d’Alzheimer par rapport à la population générale du même âge. L’objectif de la présente étude est de déterminer la fréquence et les facteurs de risque d’épilepsie chez les patients atteints de la maladie d’Alzheimer suivis au service de neurologie du CHU d’Oran. Matériels et Méthodes : Il s’agit d’une étude descriptive rétrospective menée au service de neurologie du CHU d’Oran sur une période de cinq ans (de janvier 2015 à Décembre 2019). Les variables étudiées étaient : les caractéristiques sociodémographiques, métaboliques, cardiovasculaires, cognitives et thérapeutiques. Résultats : À partir des dossiers de 441 patients référés au service de neurologie du CHU d’Oran pour plainte mnésique, 105 patients atteints de maladie d’Alzheimer ont été identi- fiés, dont 11 (10,5%) avaient présenté au moins une crise d’épilepsie après l’installation des troubles cognitifs. Les facteurs de risque identifiés étaient la durée d’évolution de la maladie d’Alzheimer, la sévérité des troubles cogni- tifs et l’hypercholestérolémie. Conclusions : Les crises d’épilepsie sont fréquentes dans la maladie d’Alzheimer et souvent méconnues. Un interrogatoire minutieux et un examen clinique et paraclinique rigoureux s’imposent chez tout patient atteint de maladie d’Alzheimer afin d’identifier les patients à haut risque.
Mots clés
Maladie d’Alzheimer, démence, épilepsie, crise, facteurs de risque.
El Hakim N°29, Avril 2020, ISSN 2478-0227 Dépôt légal : 442-2016
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Résumé
La maladie cœliaque est une maladie auto-immune fréquente qui affecte l’intestin grêle d’individus génétiquement prédisposés. Cette mala- die peut s’exprimer par un large éventail de signes extra-digestifs comprenant des anomalies cutanées, endocriniennes, hépatiques, squelettiques, hématolo- giques, gynécologiques ou encoredentaires.
L’existence de manifestations neurologiques de la maladie cœliaque est connue de longue date. Les troubles sont dominés par l’ataxie et les neuropathies pé- riphériques. D’autres atteintes du système nerveux central et périphérique ont été également décrites ; cependant, elles restent volontiers méconnues, de même que certaines présentations psychiatriques.
Cette revue systématique a pour objectifs de décrire les manifestations neuro- logiques et psychiatriques liéesà la maladie cœliaque, sur la base des données les plus récentes de la littérature.
MOTS CLÉS
Maladie coeliaque,manifestations neuro-psychiatriques,régime sans gluten
https://www.asjp.cerist.dz/en/article/111569
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Les syndromes médullaires regroupent l’ensemble des signes et symptômes traduisant une lésion de la moelle épinière. Les syndromes médullaires sont fréquents et polymorphes, leur expression clinique dépend de la topographie de la lésion dans le plan transversal et longitudinal. Ils sont responsables de déficits fonctionnels majeurs, d’où l’urgence du diagnostic et du traitement pour éviter les séquelles irréversibles. L’imagerie par résonance magnétique (IRM) est un examen incontournable pour confirmer le diagnostic et identifier l’étiologie.