Search

Introduction Participating in the political life is a key goal of democratic institutions. The main achievement of the Tunisian revolution has been the democratization of political life and the re-conquest of liberties that remain to consecrate and consolidate. Several studies have focused on evaluating the participation of some specific groups in political life (youth, women…) but none have shed a light on the mentally ill. Objective and method Our study aims to assess the participation of patients followed in different psychiatric units of the Razi hospital in activities such as voting, attendance at political meetings, adhesion and contributions to political parties as members, political debates with their neighbors… The investigation focused on 40 patients and relied on a preestablished questionnaire. Results The study group was 40 patients followed at Razi hospital with 25 men and 15 women. The average age of patients was 40 years (24–56). The turnout was very low at 10% (4 male patients) versus an average of 60% of the general population. One patient was an active member of a political party and political meetings. Women seemed to be less interested in political issues. Conclusion The participation of the mentally ill in politics, as in the different aspects of social life, remains very limited in a particularly vulnerable group in society that has suffered considerable discrimination. [ABSTRACT FROM AUTHOR]

Introduction Impulsivity, as defined by Barratt in 1983, is the inability to associate a behavior to context or consequences. It refers to a variety of risky behaviors, inappropriate to the situation and can lead to undesirable consequences. It is well-established that impulsivity is strongly related to bipolar disorder. Currently, we speak of impulsivity trait present even in bipolar patients in euthymia given the hereditary nature of bipolar disorder. In this study, we are interested in assessing impulsiveness in healthy relatives of bipolar patients. Methodology Impulsivity was measured using BARRAT scale [the Barratt impulsiveness Scale-11 (BIS-11)] in 30 healthy subjects who are first degree relatives of bipolar patients treated in Razi hospital; and comparing the results to 30 subjects, witnesses matched for age and sex with no personal or family history of psychiatric disorders. Results The impulsivity score among parents of bipolar patients was significantly higher compared to controls especially for motor impulsivity with average scores 19.15 versus 16.94, respectively. The general impulsivity score among parents of bipolar patients was 61.53 ± 13.83 versus an average score in controls of 47.20 ± 18.26. Limits The small sample size did not allow conclusive results. The difficulties in determining the mental history of the control group (to check the absence of a family history of bipolar disorder). [ABSTRACT FROM AUTHOR]

Objectives: Coronavirus disease 2019 (COVID-19) has profoundly impacted residency and fellowship training and education. However, how and to what extent the COVID-19 pandemic in Lebanon compromised the daily involvement of trainees on the clinical and ethical levels is currently unknown, which this study will shed light on., Methods: We conducted a cross-sectional survey (30 questions) targeting medical residents delivering healthcare services in Lebanon. Residents from different specialties were included in the study to assess the effect of the pandemic on their education and the ethical obstacles they faced when dealing with patients., Results: A total of 221 postgraduate medical students participated in our study. Results showed that about half of the residents (52.1%) were only able to do a basic physical examination rather than a full examination as a mandatory requirement in the residency curriculum. The majority (60%) agreed that the doctor-patient relationship is contravened. In addition, almost all residents suffered from fear and emotional distress that affected their education (83.7%)., Conclusion: The findings of this study identify the effect of COVID-19 on residents' training, which affects treatment outcomes and greatly impacts the mental well-being of both healthcare workers and patients., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Little is known about the acceptance of specific populations of decision makers in Lebanon regarding surrogacy. This study aimed to explore the acceptance and attitude of Lebanese Lawyers and Medical Students regarding surrogacy., Methods: In total 248 medical students and 204 lawyers completed a questionnaire to assess socio-demographic data, attitude toward surrogacy, and three different clinical scenarios to assess patterns of thinking. Finally, we validated a scale to assess the acceptance of surrogacy in these two populations., Results: Concerning medical students, 54.8% reported they were supportive of surrogacy, 35.1% were neutral and 10.1% were against. For lawyers, 52.9% were supportive, 25% were neutral and 22.1% were against. Lawyers were more likely to be against surrogacy (p = 0.001). After conducting a multivariate analysis on the whole studied population to find predictors of acceptance of surrogacy, the best predictors were being single (OR 0.415; 95% CI 0.228, 0.753; p < 0.01), a supportive reported attitude regarding surrogacy (OR 5.464; 95% CI 3.65, 8.13; p < 0.001) and believing that surrogacy is a solution worth discussing in Lebanon (OR 4.186; 95% CI 1.709, 10.256; p < 0.01). Concerning the clinical scenarios, they showed that lawyers were more likely to oppose abortion regardless of the reason (p < 0.01). Also, in a case of gestational surrogacy, lawyers were more likely to give the right to the gestational carrier to keep the baby compared to medical students (p < 0.001)., Conclusion: In conclusion, this study shows that only a minority of medical students and lawyers in Lebanon oppose surrogate pregnancy which warrants exploration of the perspective of other populations of decision makers in Lebanon to better guide legislations., (© 2023. The Author(s).)

While the fighting in the Syrian civil war has mostly stopped, an estimated 5.6 million Syrians remain living in neighboring countries. Of these, an estimated 1.5 million are sheltering in Lebanon. Ongoing efforts by organizations such as UNHCR to support the refugee population are often ineffective in reaching those most in need. According to UNHCR's 2019 Vulnerability Assessment of Syrian Refugees Report (VASyR), only 44% of the Syrian refugee families eligible for multipurpose cash assistance were provided with help, as the others were not captured in the data. In this project, we are investigating the use of non-traditional data, derived from Facebook advertising data, for population level vulnerability assessment. In a nutshell, Facebook provides advertisers with an estimate of how many of its users match certain targeting criteria, e.g., how many Facebook users currently living in Beirut are "living abroad," aged 18-34, speak Arabic, and primarily use an iOS device. We evaluate the use of such audience estimates to describe the spatial variation in the socioeconomic situation of Syrian refugees across Lebanon. Using data from VASyR as ground truth, we find that iOS device usage explains 90% of the out-of-sample variance in poverty across the Lebanese governorates. However, evaluating predictions at a smaller spatial resolution also indicate limits related to sparsity, as Facebook, for privacy reasons, does not provide audience estimates for fewer than 1,000 users. Furthermore, comparing the population distribution by age and gender of Facebook users with that of the Syrian refugees from VASyR suggests an under-representation of Syrian women on the social media platform. This work adds to growing body of literature demonstrating the value of anonymous and aggregate Facebook advertising data for analysing large-scale humanitarian crises and migration events., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Fatehkia, del Villar, Koebe, Letouzé, Lozano, Al Feel, Mrad and Weber.)

Background: Little is known about the attitudes and practices of intensivists working in Lebanon regarding withholding and withdrawing life-sustaining treatments (LSTs). The objectives of the study were to assess the points of view and practices of intensivists in Lebanon along with the opinions of medical, legal and religious leaders regarding withholding withdrawal of life-sustaining treatments in Lebanese intensive care units (ICU)., Methods: A web-based survey was conducted among intensivists working in Lebanese adult ICUs. Interviews were also done with Lebanese medical, legal and religious leaders., Results: Of the 229 survey recipients, 83 intensivists completed it, i.e. a response rate of (36.3%). Most respondents were between 30 and 49 years old (72%), Catholic Christians (60%), anesthesiologists (63%), working in Beirut (47%). Ninety-two percent of them were familiar with the withholding and withdrawal concepts and 80% applied them. Poor prognosis of the acute and chronic disease and futile therapy were the main reasons to consider withholding and withdrawal of treatments. Ninety-five percent of intensivists agreed with the "Principle of Double Effect" (i.e. adding analgesia and or sedation to patients after the withholding/withdrawal decisions in order to prevent their suffering and allow their comfort, even though it might hasten the dying process). The main withheld therapies were vasopressors, respiratory assistance and CPR. Most of the respondents reported the decision was often to always multidisciplinary (92%), involving the family (68%), and the patient (65%), or his advance directives (77%) or his surrogate (81%) and the nurses (78%). The interviewees agreed there was a law governing withholding and withdrawal decisions/practices in Lebanon. Christians and Muslim Sunni leaders declared accepting those practices (withholding or withdrawing LSTs from patients when appropriate)., Conclusion: Withholding and withdrawal of LSTs in the ICU are known concepts among intensivists working in Lebanon and are being practiced. Our results could be used to inform and optimize therapeutic limitation in ICUs in the country.

Introduction: The Montreal Cognitive Assessment (MoCA), a neuropsychological tool for cognitive decline screening is widely used. In the absence of normative data in Lebanon, this study offers normative data for the MoCA in Lebanese community-dwelling older people and compare scores to those of other countries., Methods: 164 literate subjects aged 60 and above were recruited to complete the MoCA., Results: The mean MoCA score observed (24.20 points) was lower than that for normal controls (27.4 points) in the original validation study of the MoCA. Regression analysis showed that fewer years of education were associated with lower MoCA scores (p < .000)., Conclusions: This study presents normative data and the findings suggest that cultural differences are evident in cognitive testing., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Phosphogypsum (PG) is an acidic by-product from the phosphate fertilizer industry and it is characterized by a low nutrient availability and the presence of radionuclides and heavy metals which pose a serious problem in its management. Here, we have applied Illumina MiSeq sequencing technology and five bioinformatics pipelines to explore the phylogenetic communities in Tunisian PG. Taking One Codex as a reference method, we present the results of 16S-rDNA-gene-based metataxonomics abundances with four other alternative bioinformatics pipelines (MetaGenome Rapid Annotation using Subsystem Technology (MG-RAST), mothur, MICrobial Community Analysis (MICCA) and Quantitative Insights into Microbial Ecology (QIIME)), when analyzing the Tunisian PG. Importantly, based on 16S rDNA datasets, the functional capabilities of microbial communities of PG were deciphered. They suggested the presence of PG autochthonous bacteria valorizable into (1) removal of radioactive elements and toxic heavy metals, (2) promotion of plant growth, (3) oxidation and (4) reduction of sulfate. These bacteria can be explored further for applications in the bioremediation of by-products, like PG, by different processes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose: Opioid substitution treatment (OST), such as Buprenorphine, has become a well-established evidence-based approach for the treatment of inmates with opioid use disorder (OUD) in most of the developed world. However, its application in Lebanon remains mainly as a community-based intervention. The purpose of this paper is to highlight the need of its implementation within the Lebanese correctional system., Design/methodology/approach: The work is a pilot cross-sectional study that compares two groups: 30 male adult prisoners with OUD convictions receiving symptomatic treatment and 30 male adult community patients with OUD receiving Buprenorphine. The objective was to measure the difference in the patients' general perception and satisfaction of the treatments available. OUD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria and the level of satisfaction was measured by "Treatment Perceptions Questionnaire (TPQ).", Findings: The prison group reported significantly lower satisfaction when compared to the community group (total TPQ mean scores: M =34.73, SD =4.12 and M =16.67, SD =4.78, respectively, with t (56.76) =15.68, p =0.000). Furthermore, age, marital status, education level and elapsed time in treatment had no significant interactions with the total TPQ score., Originality/value: The major principles of the ethics of care and evidence-based safe practices will be proposed for the introduction of Buprenorphine to Lebanese prisons. This work provides an opportunity for the expansion of the Lebanese OST program and consequently other countries in the region could benefit from this experience.

In a search for indigenous soil saprotrophic fungi for bioremediation purposes, Fusarium solani, a saprotrophic fungus belonging to the phylum Ascomycota, was isolated from a fossil carbon contaminated soil. The effect of the carbon source, glucose or olive oil, was investigated in vitro on the biomass produced by F. solani and on the degradation of benzo[a]pyrene (BaP) in mineral medium. After only 12 days of incubation, BaP degradation by F. solani was higher (37.4%) with olive oil used as the carbon source than the one obtained with glucose (4.2%). Catalase activity increased in the presence of olive oil (3.4 μkat mg -1 protein) in comparison with glucose (2.1 μkat mg -1 protein). When olive oil was used as the carbon source, BaP degradation increased up to 76.0% in the presence of a specific catalase inhibitor, 3-Amino-1,2,4-triazole (2 mM). This metabolic engineering strategy based both on the use of olive oil as carbon source (cultivation strategy) and on the blocking of the catalase activity could be an innovative and promising approach for fungal biodegradation of BaP and consequently for bioremediation of soil contaminated with polycyclic aromatic hydrocarbons.

Objective: Prevention and treatment of dementia is a global concern that requires involvement of international samples. The purpose of this study is to develop culturally sensitive norms based on normal older Lebanese adults using multiple cognitive screening measures translated into Arabic for regional use., Methods: Participants were 164 community dwelling older Lebanese adults without cognitive complaints. They were administered the following cognitive measures in Arabic: Alzheimer's Disease 8-item questionnaire, Montreal Cognitive Assessment, Mini Mental Status Exam, Modified Mini Mental Status, Brief Visuospatial Memory Test-Revised, Lebanese Digit Span, Cross-Linguistic Naming Test, and phonemic and semantic fluency tests., Results: Sample characteristics and descriptive statistics for the demographically unadjusted raw scores are first presented (N = 164). Same-form test-retest reliability for each test were computed for 24 participants retested over 2-5 weeks, with reliabilities ranging from .55 to .90; Cronbach alpha coefficients ranged from .34 to .93. Two sets of normative data were constructed. First, base-rates for demographically unadjusted raw scores for the 5th, 10th and 15th percentiles are presented to identify relatively rare occurring performances. Second, using standardized regression-based procedures demographically corrected normative information adjusted for age, education and sex were generated for normative interpretation., Conclusions: Adapting cognitive tests for use in culturally and linguistically diverse regions of the world not only requires careful translation of test instructions and materials, but construction of culturally sensitive local norms. Our normative data should allow for more accurate identification of cognitive impairment and dementia in Arabic-speaking patients, especially those living in Lebanon.

Neuropsychological tests (NPTs) are highly dependent on education, culture differences as well as age and sex. It is therefore essential to take these factors into consideration when translating NPTs to be used in screening for cognitive impairment. Translations into Arabic must respect the principles of linguistic relativity and cultural specificity of the population under study. The objective is to assess feasibility and outcome of translating neuropsychological tests to Arabic. A team of Lebanese professionals selected a battery of screening NPTs. These tests were translated into Arabic and independently back translated by a team of sociolinguists and cultural specialists. The translations were adapted to suit the Lebanese culture. The final NPT translated versions were reached by consensus of an expert panel and tested on a group of independently living community-dwelling elderly. Translated items had to be modified when: (1) terms could not be translated using one word as required by the test; (2) Concepts were foreign to the culture; (3) Translated words carried multiple meanings; (4) Words were rarely used in Lebanon; (5) Sentences did not have an equivalent; and (6) Words had letters pronounced differently by subgroups in Lebanon. Despite all measures to maintain cultural sensitivity in translations, non-linguistic challenges remained. A battery of cognitive screening tests were translated into Arabic and adapted for the Lebanese population. These adaptations allow for a better assessment of cognitive abilities since they reflect the thought patterns of the population. The challenge is to establish local normative data.

Purpose: Placebo use, both in clinical trials and patient care, is a problematic ethical issue surrounded by opposing arguments from those who advocate its use versus those who do not. This problematic aspect of placebo is more challenging in Lebanon where religious ideologies dominate people's beliefs, and where laws that guide medical care are vague. This paper aims to highlight the cultural ideologies that dominate medical care and the perspectives of people associated with the field., Methods: The method relied on semi-structured interviews with religious leaders, representatives of society and healthcare professionals. Panel discussions incorporating healthcare professionals, academics, scientists and medical researchers were also organized., Findings: The legal environment in Lebanon is characterized by lack of an appropriate legislative guideline that categorically clarifies the value of the human person in medical care. There is a lack of a common ethical standard within a society characterized by social and political dissent. The culturally upheld principles and actual application of the principles of ethics surrounding patient autonomy were overviewed. Medical practitioners failed to agree to a general outline that should guide the use of placebo where it became evident that each practitioner adopted a subjective framework which ultimately undermines patient autonomy., Implications: The paper proposes that until a new legislative code that clarifies ethical principles properly guiding medical care is coined, the process of placebo use will continue to be subject to the paternalistic assessments of medical professionals., (Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.)

Quality of health care is largely dependent on a holistic approach to human person (HP). In Lebanon, the medical field, including neurology, seems to be ignorant to the integrity of the human person. The objective of this study is to provide an insight to the importance of reintegrating the HP in the medical field attempting to offer a basis for scientists interested in carrying out similar research in face of the complete lack of studies in Lebanon. This requires the contribution of various health care support systems to bring the topic into public dialogue allowing for a reassessment of the issue. The method utilized included semi-structured interviews, seminars and open discussion panels hosting a variety of representatives from society avoiding medical corporatism. These revealed a contradiction between ideological understanding of the importance of the value of the human person and practical application of this value. Most people who participated in the study acknowledged the importance of catering to the human in suffering as a whole focusing on the physiological aspect of illness but equally so on the spiritual, psychological and mental. However, those same people acknowledged that the situation in Lebanon was not considerate to the principle of unity of human person. The reasons for this discrepancy had their socio-economic and cultural roots and hindered the quality of care delivered to suffering individuals. This cannot be ratified except when all those concerned with medical care acknowledge the problem and show a willingness to deal with it through taking necessary positive action.

Clinical trials represent new steps in the progress of knowledge. Yet in spite of all the norms, guidelines and good clinical practices established since 1947, trials are still being published which seem to be, but in fact are not, well-conducted. Experts in planning and analyzing trial results have determined the factors that may affect clinical investigations at different phases. Among articles published over the last 30 years selected from Medline, one-third were biased. These biased articles were cited 2034 times. Clinical trials are designed to improve the treatment of particular diseases and to reduce mortality and morbidity. Nevertheless, other factors still appear to have an essential influence on the way clinical trials are conducted. It is surprising to see how often trials conclude that the drug of the pharmaceutical company initiating the study or funding it has the same efficiency, and sometimes is more efficient, than the drug it is being judged against. Perhaps, journals should objectively describe clinical trial protocols before publishing their results. Poor populations are still being abused by the pharmaceutical industry and more thought should be given to the notions of volunteers participating in trials and the compensation they receive. In Lebanon, the majority of these difficulties are encountered not only in multicenter international trials but are also seen in the lack of requirements for minimum safety measures and ethical standards when conducting national and regional trials. These insufficiencies raise important questions concerning their real objective., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Surrogate decision making is advocated to protect the vulnerable patient. Family members of patients in intensive care units (ICUs) are prone to develop depressive symptoms which may undermine their decisional capacity. Lebanon is a multicultural country where paternalism still dominates the physician-patient relationship and ethics are far from being the subject of research and studies. This multicenter observational study in the Greater Beirut area attempts to estimate the prevalence of depressive symptoms among surrogates deciding on behalf of ICU patients and to correlate their severity with sociodemographic factors. During the period March-May 2011, direct interviews were conducted and the Patient Health Questionnaire-9 (PHQ-9) was administered to 56 family members who had given consent, regarding therapeutic options, on behalf of ICU patients in seven university hospitals. We looked for relationships, in these surrogates, between severity of depression and age, sex, marital status, level of education, religion and status as the patient's spouse. The prevalence of major depression among surrogates was 61% using a cutoff of 10 on the PHQ-9 scale. Among the surrogates with depression, 15% had untreated moderate-to-severe depression. Severity of depression and suicidal ideation were not related to any of the studied factors. Depressive symptoms are prevalent among family members deciding on behalf of ICU patients, rendering them vulnerable. Appropriate measures should be taken to identify and treat them.

Objective: The objective was to reflect on the nurse's role and on the determinants of a responsible choice. In order to do it, we tried to answer the following questions: (1) Are the role and the mission of the nursing body well acquired in Lebanon? (2) Are there international and national norms which govern the accomplishment of this mission? (3) At what point does the mission accomplished by the nursing body procure the patient's safety? (4) What are the factors that modify the performance of the nursing body in Lebanon? And, (5) What are the challenges of a good-quality nursing performance?, Methods: We conducted a double arm survey. The first one is made on 160 nurses working in 19 hospitals that succeeded to establish until July 2008 (end of study) at least an ethical committee for medical care. The second one was conducted on the heads of the nursing departments in 49 private institutes, 34 public institutes and 16 universities., Results and Discussion: The investigated nurses don't know very well the medical and nursing ethics' principles that are very well highlighted in the Husted decisional model and expressed by justice, autonomy, confidentiality, beneficience, veracity and fidelity. This result underlines a fact that affects the nurse's mission and so on the patients' safety. Ninety-four per cent of the nurses think that the education and the communication with the patient is not a priority during their daily work, which hinders the three essential times (analysis, communication and assessment) required to elaborate a freely informed decision. Ethics don't have a solid basis in education., Conclusion: We must be concerned by this diagnostic, but it leads to the hope of being able to find together, through a common reflection, the essential characteristics to assume our responsibilities whether in the medical or nursing domain., (© 2010 Société Française de Pharmacologie et de Thérapeutique.)

Unlabelled: In Lebanon, as in other developing countries, most of the clinical trials are achieved without considering any rule adopted in the industrialized countries, which causes serious ethical problems. This study aims to review the different Lebanese texts related to clinical trials in order to show the existing legislative frame, and to formulate suggestions that help the legislator defining better this activity. We reviewed and analyzed the Lebanese legislation related to the clinical trials especially the Lebanese law project about "therapeutic trials on human subjects" and conducted semi-directive interviews with actors from the society., Results: We noticed a legislative gap in this domain, highlighting the fragility of the social link in the health domain, and reverberating negatively on the physician/physician, physician/hospital, physician/industrial and industrial/hospital relationships, in addition to many gaps affecting the skills of physicians-investigators. In spite of the promising institutional effort, the national frame of clinical trials does not seem to be sufficient regarding the ignorance of applied legislative texts, the industrial promoter's weight, and the pressures. This is applied to the absence of a powerful national coordinator, the inexistence of a pharmacovigilance system or a skillful authority for the sanitary security of health products, and the confusion in the concepts of medical ethics and deontology. In conclusion were presented for achieving improvements on many levels: an objective criticism of the law project proposed in 2002 followed by a call to review its content and improve it in order to reach an instructive and applicable global legislation ; an action that can be realized only through educating adequately the investigators, and informing the large public in order to guide the governors towards a legislation allowing people in Lebanon to "live well " with complete dignity.

Introduction: The nuclear syndrome of the oculomotor nerve, first described in 1981, is characterized by ipsilateral third nerve palsy and elevation paresis of the contralateral eye., Case Report: A 59-year-old man suddenly developed diplopia and headache. Neurological examination showed nuclear ophthalmoplegia of the left third nerve without any other neurological abnormality. MRI findings demonstrated a typical, popcorn-like, smoothly circumscribed left posterior lesion. Surgical resection was not performed because of the deep localization. Spontaneous bleeding developed., Conclusion: This neuro-ophthalmological complication of a cavernous angioma, as seen in our patient, has rarely been described in the literature. The clinical presentation and anatomic elements of the nuclear oculomotor syndrome are discussed. This exceptional localization provides a useful illustration of anatomoclinical correlations.

Dyke-Davidoff-Masson syndrome is a condition characterized by seizures, facial asymmetry, contralateral hemiplegia or hemiparesis and mental retardation. We report the clinical and imaging features in two patients with epilepsy revealing a Dyke-Davidoff-Masson syndrome. Brain MRI showed unilateral loss of cerebral volume with hypertrophy and hyperpneumatization of the paranasal sinuses and mastoid cells. Ipsilateral fronto-parietal polymicrogyria was present in one patient.

In 1975, Sharpe and Silversides described a neurological entity in a Chinese family. Clinical picture was characterized by paralysis of horizontal gaze, pendular nystagmus and progressive scoliosis. To date, 43 cases have been reported. The pathogenesis remains unclear. The Authors report four Tunisian families with 12 affected individuals. The age of patients ranges from 6 to 34 Years. All examined patients have complete lateral gaze palsy, pendular nystagmus and progressive scoliosis. Blood routine tests, cerebrospinal fluid (CSF), evoked potentials, electromyography (EMG), muscle biopsy, CT scan and cerebral MRI were normal. Autosomal recessive (AR) mode of inheritance is the most probable pattern.

Introduction: Mesiotemporal epilepsy (MTLE) is a clinical syndrome characterised by the association of a history of febrile seizures, a homogenous clinical presentation of seizures, temporal interictal and ictal EEG recordings and an underlying pathology that is mesial sclerosis. MTLE is the most common type of medically intractable partial epilepsy with a drug-resistance in 90% of cases., Object: The aim of this study is to describe the clinical, EEG and MRI findings of 9 patients with MTLE attending the outpatient clinic of Charles Nicolle Hospital., Results: The median age of our study population was 30 years. A history of febrile seizures was found in 5 patients. Hippocampal atrophy was found in all the cases right in 4 cases and left in 5 cases. Drug-resistance was observed in 7 patients. No patient underwent surgery., Conclusion: It is important in front of medically intractable partial epilepsy to evoke MTLE, to confirm the diagnosis with neuro-imaging and to propose an interdisciplinary therapeutic approach including neurologists, epileptologists and neurosurgeons.

Extramedullary hematopoiesis is an unusual cause of spinal cord compression. We report the case of a 39-year-old man who presented symptoms of progressive dorsal spinal cord compression. Hemogramm showed erythrocytosis with microcytosis. Hemoglobin electrophoresis revealed heterozygous beta-thalassemia. Diagnosis of extramedullary hematopoiesis was based on magnetic resonance imaging findings. Radiological and therapeutic options in this rare condition are briefly discussed.

Behcet's disease is a chronic relapsing multisystem disorder of unknown etiology. Neurological complications are frequent, occurring in 10 to 49% of cases. We report 4 cases with Behcet's disease (3 females and 1 male) who had symptomatic intracranial hypertension due to cerebral venous sinus thrombosis within a mean delay of 2 years. The mean age at onset was 31 years and the mean age on referral was 39.5 years. The predominant manifestation in our series were headache, papilledema, seizures and pyramidal syndromes. CT Scan showed non specific abnormalities in all of them and the sinus venous thrombosis was confirmed by MRI in 3 cases. The authors emphasize on the importance of MRI with angio MRI for the diagnosis, the outcome and the evaluation of the cerebral venous thrombosis after treatment.

Clinical diabetic neuropathy in childhood is rare, but electrophysiological involvement of the peripheral nerve is more frequent. We assessed clinically and electrophysiologically the peripheral nervous system of 69 children and adolescents suffering from diabetes mellitus (DM). The mean age of the patients was 12.8 years and the mean age at onset of DM was 6.8 years with a mean disease duration of 6.3 years. Seven patients (10%) had clinical neuropathy of which ankle jerk reflex abolition was the most frequent sign. Twenty patients (29%) had a neurophysiological neuropathy prevalently affecting the lower limbs. Peripheral neuropathy was correlated with patient age, older age at onset, duration of DM, height and poor glycaemic control.