Objectives: To assess the etiology of status epilepticus )SE( among the pediatric patients of a tertiary center in Jeddah, Kingdom of Saudi Arabia )KSA(. Methods: Data from 88 cases was obtained retrospectively from 2006 to 2017 from King Abdulaziz University Hospital )KAUH(. Patients aged between 28 days and 14 years with the symptoms of SE were selected for this study. Original ArticlesResults: The data show that the proportions of SE etiologies were 30.5% for febrile seizure, 11.9% for electrolytes imbalance, 8.5% for hydrocephalus, 6.8% for CNS infections, and 6.8% for neoplasm. The other etiologies of SE were trauma, fever, intractable epilepsy, cerebrovascular accident, hemorrhagic stroke, etc. There were no clear etiologies in 8 cases. Most of the patients were not of Saudi origin )64.3%(, boys )67.8%(, and had generalized epilepsy types )91.8%(, and 58.6% of the patients complied with epilepsy medications. Conclusion:The most prevalent etiology of convulsive status epilepticus was a febrile seizure, followed by electrolyte imbalance and hydrocephalus. However, a nationwide study in KSA must be conducted to determine the major etiologies of SE for its effective management and prevention. Educating families and patients regarding antiepileptic drugs is necessary.

Rationale: The manufacturer of perampanel (PER) suggests an initial adult dose of 2–4 mg/day and an upward dose titration of 2 mg at no more frequently than 1- or 2-week intervals when used with enzyme-enhancing antiepileptic drugs (AEDs) or nonenzyme-enhancing AEDs, respectively. The general practice in our clinic is an initial dose of PER 2 mg/day and titrated by 2 mg/4 weeks to an initial target of 6 mg/day. Methods: Retrospective chart audit of patients starting PER in an adult epilepsy clinic between September 2013 and November 2016 with at least one 6-month follow-up visit was reviewed. Data collection included patient demographics, seizure characteristics, past and concurrent therapy, monthly seizure frequency before PER and at 6-month visit, and characteristics of PER discontinuation. Efficacy of treatment was assessed with the Engel classification and 50% responder rate. Results: N = 102 patients; mean age = 40 years and 54% females. Focal onset seizures 85%, generalized 13%, and unknown 2%. Median prior AED exposure = 6 (range 3–20); median concomitant AED use = 2 (range 1–5). Follow-up range was 6–37 months. The median seizure frequency/month prePER treatment was 6 (range 0–30) for focal onset seizures and 1 (range 0–6) for generalized seizures. The retention rate amongst all patients at 6 months was 78.4%. At 6-month follow-up, 36% of all patients achieved Engel class I (seizure freedom) (30.7% of patients with focal onset seizures and 63.6% with generalized epilepsy). The 50% responder rate was 52% and 82% for focal and generalized epilepsy, respectively. Conclusion: PER has a good retention rate when titrated slowly and thus encouraging seizure freedom results in an otherwise medically refractory epilepsy population.

A 48-year-old male was diagnosed with both drug resistant epilepsy and psychogenic nonepileptic seizures. Both diagnoses were confirmed by video-EEG monitoring. His epileptic seizures were a consequence of right mesial temporal sclerosis. He was diagnosed by a psychiatrist to have depression and posttraumatic stress disorder (PTSD). Following a right anterior temporal resection he became seizure free (both epileptic and nonepileptic) with a remarkable improvement in his psychiatric comorbidities leading to significant reduction in his psychotropic medications.No reports have been identified in the literature of patients with epilepsy and PNES with coexisting PTSD having epilepsy surgery.

Background: Dementia is one of the most common neurological diagnoses in older patients. Previous reports have proposed that heart failure could be a risk factor for dementia. Other studies have suggested that cardiovascular function could have a critical role in the pathogenesis of dementia. Aim: This study aimed to identify the prevalence of heart failure in patients diagnosed with dementia. Method: This was a chart review of medical records of patients followed at King Abdul-Aziz University Hospital and diagnosed with dementia with at least one echocardiogram completed after the diagnosis of dementia. Demographic variations and comorbidities of these patients were collected. Result: A total of 200 patients met the inclusion criteria, with a mean age of 76.28 years. In 10.5% of the participants, the ejection fraction was less than 40%. The dominant type of dementia in the participants was mixed/unspecified type (78.5%). Conclusion: The prevalence of systolic heart failure seems to be higher in patients with dementia when compared to similar age group populations reported in other studies. Multiple limitations are present in this study, and additional research is needed to further assess this possible correlation. Key words: Systolic heart failure, dementia, Saudi Arabia