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Background: Epilepsy is a disease with incidence throughout life and is commonly self limited with high proportion of patients eventually enter a long term remission and stop medication. However, a lot of patients remain silent about their disease and its treatment. Objective: This study was to assess the magnitude of silent epileptic patients in Mansoura University Neurology outpatient clinic. Methods: Consecutive patients attending the clinic were subject for structured questionnaire regarding their seizures, antiepileptic drugs as a method of treatment and about their adherence to them. Results: 248 patients were recruited. Only seizure freedom was achieved in 21% of them. Non-adherence to medication by stop taking drugs in 37%, dose increase or decrease in 20% or by trying other ways to control seizure like Hegamah and reading Quran were common manifestation of patient silence. Lack of knowledge, impaired cognition and low expectation about therapy were also contributing to patient silence. Conclusion: Silent epilepsy patients are true challenge in epilepsy management that need to be addressed in neurology clinics. [ABSTRACT FROM AUTHOR]

Background: After malaria, schistosomiasis is the second most prevalent tropical disease. The prevalence of oviposition in CNS of infected persons varies from 0.3 to 30%. The conus medullaris is a primary site of schistosomiasis, either granulomatous or acute necrotizing myelitis. Objective: To report the clinical, radiological, and laboratory results of spinal cord schistosomiasis (SCS) and to design proper therapeutic regimens. Materials and Methods: Seventeen patients (13 males and four females) with SCS were enrolled between 1994 and 2009 at Mansoura University Hospitals. Their median age at diagnosis was 19 years (13-30 years). Independent neurological, radiological, and laboratory assessments were performed for both groups, excluding pathological confirmation that was done earlier in eight patients (Group 1). In the group 2 (nine patients), indirect hemagglutination (IHA) test for bilharziasis in blood and cerebrospinal fluid (CSF) was performed. Higher positive titer in CSF than serum indicated SCS plus induction of antibilharzial and corticosteroid protocols for 12 months with a three-year follow-up. Results: Rate of neurological symptoms of granulomatous intramedullary cord lesion was assessed independently in 16 cases and acute paraparesis in one case. All patients in group 2 had positive IHA against Schistosoma mansoni with median CSF and serum ranges 1/640 and 1/320, respectively. Seven patients (41.18%) had complete recovery, eight patients (47.06%) showed partial recovery, and no response was reported in two patients (11.76%) (P = 0.005). There was no recorded mortality in the current registry. Conclusions: Rapid diagnosis of SCS with early medical therapies for 12 months is a crucial tool to complete recovery. [ABSTRACT FROM AUTHOR]

Beta-interferon (beta-IFN) has a proven treatment effect on relapsing-remitting multiple sclerosis (MS), presumably through its regulatory properties on T-cell activation and cytokine production. This paper examines whether combination therapy of beta-IFN with prednisone would enhance immunoregulatory effects of beta-IFN by measuring serum levels of selected proinflammatory cytokines and soluble T-cell activation markers associated with MS. The selected markers were analyzed in MS patients treated with beta-IFN alone (n = 22) and beta-IFN combined with a low daily dose of prednisone (n = 33), as compared with those in 27 healthy controls at baseline and at a three-month interval for one year. The study confirmed that beta-IFN treatment inhibited serum levels of tumor necrosis factor-alpha (TNFalpha) and intracellular adhesion molecule-1 (ICAM-1) in patients with MS. However, combination therapy did not significantly enhance the inhibitory effect of beta-IFN treatment on the production of TNFalpha, interleukin (IL)-12, IL-2R, and ICAM-1, while the addition of prednisone antagonized the effect of beta-IFN on up-regulation of IL-10 and soluble CD95. No difference in the occurrence of binding antibodies to beta-IFN was found between the two treatment groups. The findings are important for the understanding of the role of combination therapy in the treatment of MS.