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Background: The pandemic of COVID-19 has resulted in multiple precautions to control the infection, one of which is transforming students’ schools into virtual classrooms. These new situations may pose additional challenges for some individuals such as epilepsy patients who account for 5.5% of school children (6–18 years). This study aimed to determine the effect of virtual learning on seizure control among epilepsy patients. Methods: This is an online-based cross-sectional study that was performed between 17 February to 27 June 2021 among patients with epilepsy who attend virtual learning classes. The questionnaire was distributed to the patients at a single-center neurology clinic in Mecca, Saudi Arabia. We included all patients who were diagnosed with epilepsy at any hospital, aged between 10 to 30 years, and living in Saudi Arabia. Results: A total number of 70 patients were included in the study. Patients’ gender was nearly equally distributed between the two groups with females predominant (51%). The average time of more than 10 hours spent on screens and electronic devices was remarkably increased during COVID-19 (20.0% to 45.7%). The average number of seizures per year has a double-fold increase during the pandemic for ≥7 attacks (increased from 10% to 20%). More than half of the patients had a significant increase in their seizure frequencies during virtual learning (60%). Patients with focal epilepsy, a history of photosensitivity, and patients with disturbed sleep patterns are significant risk factors associated with increased seizure frequencies during virtual learning. Conclusions: Focal epilepsy, history of photosensitivity, and disturbed sleep pattern associated with increased seizure frequencies during virtual learning. Time spent on screen has no significant relation to increasing seizure frequencies. Identifying the patients’ risk and taking a serious step in reducing its sources is important in order to provide a better quality of life.

To assess awareness of the neurological manifestation of COVID-19 on the Saudi population.This was a cross-sectional study conducted using a Google Form survey to obtain responses randomly from the Saudi population between February and March 2021 using social media.A total of 831 participants completed the questionnaire. The distribution of the identified isolated neurological manifestations of COVOD-19 infections by participants' age was assessed among the respondents. Loss of smell (88.9%), loss of taste (86.8%), and headache (72.6%) were the most identified first manifestations among all the age groups, while stroke (13.4%) was the least identified for all ages with no statistical significance (The study concluded that awareness of COVID-19's neurological symptoms could help detect an atypical case, which can help in early intervention and its medical treatment. Moreover, the study also suggested conducting educational programs that emphasize the early identification of neurological symptoms of COVID-19.

Despite the recent advancements in the treatment of acute ischemic stroke, the delayed patient arrival to emergency department or hospital serve as crucial factor for the selection of appropriate intervention program. This study was aimed to identify factors associated with late hospital arrival for patients with acute ischemic stroke in Makkah, Saudi Arabia. A prospective cross-sectional study was carried out at Al-Noor Specialist Hospital among 98 enrolled patients with the mean age of 60.4 ± 10.3 years over the period of March 2019 and June 2019. The data were collected through review of patient records and interview of patients and attendants. Fifty-four of these (55%) presented early (within 4.5 hours) and 44 (45%) presented late (after 4.5 hours). Factor associated with late arrival included low educational level (P = .01) and unemployment status (P = .033). The relationship between time of presentation and computed tomography findings showed statis,tically significant relationship between the former and early computed tomography findings (P = .017). A statistically significant relationship between time of presentation and knowledge of stroke was also observed (P = .013). Increased public awareness is important in order to minimize the time between stroke onset and emergency room presentation.

Amal M Alkhotani,1 Alaa M Alkhotani2 1Department of Medicine, Umm Al-Qura University, Makkah, 21955, Saudi Arabia; 2Department of Pathology, Umm Al-Qura University, Makkah, 21955, Saudi ArabiaCorrespondence: Amal M Alkhotani, Department of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia, Email amkhotani@uqu.edu.saBackground: Epilepsy is a neurological disorder characterized by a persistent propensity to generate recurring epileptic seizures. Young adults such as university students can bridge the gap and improve attitudes toward patients with epilepsy and reduce stigma. This study aims to assess the knowledge and attitude of university students in the city of Makkah about epilepsy.Methods: This cross-sectional descriptive study was carried out at main universities in the Makkah region of Saudi Arabia. The study was conducted after getting approval from Umm Al-Qura University’s ethics and research committee. A total of 394 participants were enrolled in the study, and a stratified random sampling (probability sampling) technique was used to select respondents.Results: The study included students with a mean age of 20.9 ± 4.6 (18– 28 years), 271 (68.8%) students were females, 374 (94.9%) of the students agreed that epilepsy is not contagious, and 215 (54.6%) refused the impact of epilepsy on patients’ marital status, relationships and fertility, respectively, 213 (54.1%) of the students reported that they feel scared to witness a seizure. About 334 (84.8%) respondents believed that epilepsy is an affliction, and 123 (31.2%) reported that they thought epilepsy was a supernatural phenomenon or black magic.Conclusion: The study concluded a satisfactory level of awareness among university students in Makkah related to dealing with patients with epilepsy. Further scientific studies will help build student’s positive attitudes through simulation programs and interventional studies.Keywords: people with epilepsy, stigma, epileptic seizures, Saudi community, neurological disorder

Introduction Multiple sclerosis (MS) is a chronic disease of progressive demyelination in the central nervous system and carries a significant risk for depression and other psychological difficulties associated with low quality of life. There is a paucity of data on the prevalence of anxiety and depression in Saudi Arabia among patients with MS. We conducted a cross-sectional study to determine the prevalence of anxiety and depression in Saudi Arabia among patients with MS by age, disease severity, compliance to medication, and social support. Methods This cross-sectional study measured the prevalence of anxiety and depression in 184 adult patients with MS. The patients were selected through a random sampling method from a pool of MS societies in Saudi Arabia. The participants completed self-administered questionnaires that included demographic variables. The participants also completed the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7) questionnaire. Results Depression was detected among 139 (75.5%) patients with MS, with most participants having mild depression (31%). More women (83.1%) experienced depression than men (62.1%; p = 0.002). Anxiety disorder was present in 123 (66.8%) patients with MS, and most had mild anxiety (n = 56; 30.4%). Conclusion We found a very high rate of depression and anxiety among patients with MS in Saudi Arabia. Our results highlight the need for periodic screening and examination of patients with MS by psychiatrists to facilitate the early detection and treatment of these comorbidities, potentially improving patient quality of life and health outcomes.

Objectives: To assess and quantify the impact COVID-19 has had thus far on ischemic stroke admission rate and severity (National Institutes of Health Stroke Scale (NIHSS) score) at a single tertiary center in Makkah, Saudi Arabia. Methods: This is a retrospective analysis performed on admitted cases with definitive final diagnoses of transient ischemic attack (TIA) and ischemic stroke at King Abdullah Medical City in Makkah between January 1, 2020 and July 2020. Results: Sixty-nine patients were included in our study, 41 of whom presented at our facility before the pandemic and 29 during the pandemic. No statistical significance was observed between rate of admission, stroke severity, and rate of thrombolysis before the COVID-19 pandemic and after the outbreak. We observed a reduction of mean arrival time after the pandemic began, as well as a reduction of hospital stay days. Conclusion: A 29% reduction of admission secondary to acute ischemic stroke was noted during the pandemic. However, COVID-19 did not affect acute stroke care at our institute. The study is limited because of its small sample size, as we assessed just one medical center.

Epilepsy is a common neurological disease. Patients with epilepsy are at risk of developing seizure at any time. The aim of this study was to assess the effects of health education on schoolteachers' first aid management of epileptic seizure.A self-administered questionnaire was distributed to participating primary school teachers in the city of Makkah. It included baseline demographic data, a teacher's awareness about epilepsy, as well as first aid measures. An educational lecture was later delivered to teachers and was followed by a discussion. Awareness and attitude were re-assessed using the same questionnaire.A total of 259 female primary school teachers completed the study. Before intervention, 134 (51.7%) of the teachers had good awareness regarding epilepsy, which was significantly increased to 86.9% after the intervention. For seizure first aid, 45.9% of teachers correctly reported that would make sure the person is safe and ask for help in the case of witnessing a seizure attack, which was improved to 84.2% after intervention, with a percent change of 38.2% (p = 0.001). In addition, rolling a person onto their side and asking for help after the end of a seizure was known by 53.3% of the teachers before the intervention and increased to 84.6% after the intervention, showing a percent change of 31.2% (p = 0.001).The health education program resulted in significant improvements to teachers' responses to seizure and improvements in all aspects of epilepsy awareness.