Objectives: To describe the prevalence, knowledge and attitudes about complementary and alternative medicine)CAM(use and the proportion that seek advice from their physician about CAM use. Methods: This cross-sectional observational study was performed in multiple sclerosis)MS(clinic of King Fahd Hospital of Universityin Alkhobar, Kingdom of Saudi Arabia from January-June 2017. A total of 133 patients have completed the survey. Results: The mean age of patients was 32.3±7.6 years and 84)63.2 %(were female. Approximately 83.5% of the patients reported the use of CAM. Among all the reported forms of CAM, vitamins were the most prevalent form, followed by cupping, special prayers and meditation. The majority of patients)62%(obtained knowledge of CAM through social media. A significant number of patients)75.6%(did not disclose the use of CAM to their physician. There was a trend for using CAM more in highly educated, older age, and female patients. The most commonly reported rationale to use CAM was overall improvement in health status. Conclusion: The use of CAM among Saudi patients with MS is highly prevalent, without disclosure of its use to physicians. These factors should be taken into account in the doctor-patient consultation to avoid adverse events.

In the context of local culture and misconceptions regarding epilepsy, Saudi practitioners need a careful management plan for women with epilepsy that satisfies all the patients` needs and ensures their spouses` understanding. Such a management strategy needs to incorporate careful selection and monitoring of anti-epileptic drugs and regular counseling of patients. Female epileptic patients in the reproductive age group, no matter whether they are pregnant or not, should be managed by safest drugs from the earliest with folic acid supplementation along with adequate pre-marriage/conception counseling. All antiepileptic drugs are potentially teratogenic. However, valproic acid, phenytoin, phenobarbitone, and topiramate are least favored for use. Monotherapy is preferred over polytherapy, and the least possible dose should be used. During pregnancy, many epileptic women may need monthly drug level monitoring and dose readjustments. Normal vaginal delivery is safe in epileptic women. Post-partum follow-up with anti-epileptic drug titration may be required.

No abstract

No abstract

A thirty-year-old female with cervical cord myelitis and recurrent optic neuritis was diagnosed with neuromyelitis optica (an uncommon demyelinating disorder of central nervous system). Few days after successful treatment of recurrent optic neuritis, she developed painful tonic spasms. Clinical examination and repeated investigations did not reveal any relapse of the disease. The neurologist prescribed oral antiepileptic drugs, which controlled her spasms.