Sohaila Alshimemeri

Depression and anxiety are among the most common comorbidities in individuals with Parkinson’s disease (PD). Yet their prevalence and contributing factors in Saudi Arabia are poorly examined. This study aimed to estimate the prevalence of depression and anxiety among patients with PD in Saudi Arabia, along with contributors, demographics, and clinical correlates. A cross-sectional study was conducted in Riyadh, Saudi Arabia, in which 130 patients diagnosed with PD completed the validated Arabic versions of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) to ascertain the presence of depression and anxiety, respectively. Sociodemographic, patient-related factors, and clinical data were also collected and analyzed in conjunction with the aforementioned scales using univariate and multivariable logistic regression. Depression and anxiety were present in 67.7% and 62.3% of participants, respectively. Compared with the age group 41–50 years, the 51–60 and 61–70 groups were less likely to be depressed or anxious ( P  = .013 and P  = .008). Lower education (high school or less) was associated with both depression and anxiety ( P  = .021 and P  = .017). Anxiety (GAD-7) was associated with a history of major depressive disorder ( P  = .003). Longer PD duration was associated with higher odds of both anxiety and depression ( P  ≤ .001). Our study shows a high prevalence of anxiety and depression in patients with PD, particularly among those with longer disease duration and lower educational attainment. Routine neuropsychological screening and early multidisciplinary care are warranted.

Objective: Epilepsy is a neurological disorder with profound impacts on various aspects of life. It may lead to significant medical and psychiatric comorbidities, one of which is personality disorders (PDs). This study aims to assess the prevalence of Cluster C PDs among adult patients with epilepsy (PWE) at a tertiary care hospital in Riyadh, Saudi Arabia. Method: This cross-sectional study, conducted between January 2024 and April 2025, enroled 360 adult PWE using convenience sampling. The study tool included the Structured Clinical Interview for DSM Disorders criteria, along with additional demographic and epilepsy-related questions developed by the research team. Results: Cluster C PDs were identified in 30. 6% of the participants. Obsessive-compulsive PD was the most prevalent (17. 8%), followed by avoidant PD (9.7%). No significant gender difference was found in the prevalence of PDs (p > 0.05). Educational level and employment status were significantly associated with PDs (p=0.036 and 0.014, respectively). Participants with PDs had a longer mean epilepsy duration than those without PDs (p < 0.05). Conclusion: Cluster C PDs are prevalent among PWE, with lower educational levels, longer epilepsy duration, and unemployment being significantly associated with a higher prevalence. Screening for PDs among PWE is therefore warranted to enable earlier detection and intervention.

Objective To estimate prevalence and describe clinical and genetic features of Huntington’s disease (HD) in the Middle East, North Africa, and Turkey (MENAT). Methods We conducted a PRISMA-guided systematic review and meta-analysis of EMBASE, PubMed, and Scopus from inception to October 2024. All study designs reporting HD in MENAT countries were eligible. Extracted data included demographics, clinical features, CAG repeat lengths, and prevalence. Random-effects models generated pooled estimates. Results Seventy-five studies (1124 individuals) were included. The pooled literature-derived prevalence was 0.17 per 100,000 (95% CI, 0.12–0.21; I² ≈ 99%), well below global estimates and highly heterogeneous across countries. Highest national estimates were Oman 4.66, Tunisia 1.27, and Turkey 0.73 per 100,000; several countries (e.g., Sudan, Lebanon, Afghanistan) reported only isolated cases (< 0.01 per 100,000). Mean age at onset was 43.3 years in adults and 13.4 years in juvenile cases. Mean CAG repeat length was 45.1 in adults and 67.2 in juvenile-onset HD; overall mean 48.6. Conclusions HD appears underreported in MENAT, with prevalence far below global figures, likely reflecting underdiagnosis and limited genetic testing capacity. Priorities include expanding access to confirmatory testing, establishing national registries, and enhancing clinician awareness to improve detection, care, and regional epidemiologic precision.

Marchiafava-Bignami disease (MBD) is a rare neurological disorder typically occurring in alcoholic patients. The main disease mechanism is hypothesized to be vitamin B-complex deficiency due to malnutrition. In the literature, there have been few reported cases of the disease occurring in patients who have undergone bariatric surgery. This paper presents a case study of a 45-year-old non-alcoholic female who underwent a laparoscopic sleeve gastrectomy presenting with progressive worsening weakness of her lower limbs and slurred speech. Her condition continued to deteriorate, and she became mute and bedbound. The MRI revealed distinctive characteristics consistent with MBD. The diagnosis was confirmed following the exclusion of all other possible diagnoses. She was treated with multivitamins and had a significant improvement. Additionally, we conduct a review of similar cases of this condition occurring after bariatric surgery. This report sheds light on the occurrence of this uncommon condition after the bariatric procedures.

Introduction: Prolonged postictal encephalopathy in elderly patients can be difficult to manage, especially when standard treatments fail. Amantadine, a dopaminergic agent with NMDA antagonist properties, is approved for use in Parkinson’s disease and has demonstrated efficacy in enhancing recovery in TBI. However, its role in nontraumatic etiologies such as postictal states is not well established. Case Presentation: We describe a 95-year-old man with multiple comorbidities who remained somnolent and minimally responsive for 14 days after convulsive status epilepticus, despite seizure control and metabolic correction. EEGs showed no epileptiform activity, and imaging revealed no acute pathology. A trial of amantadine 100 mg daily was initiated for suspected postictal encephalopathy. Within 48 h, the patient showed significant improvement in alertness, orientation, and interaction, returning near baseline by day 10. Conclusion: This case suggests a potential role for amantadine in treating prolonged postictal encephalopathy in elderly patients. Further research is needed to assess its efficacy in nontraumatic disorders of consciousness.

Background: There is limited information on rare spinocerebellar ataxia (SCA) variants, particularly in the Canadian population. This study aimed to describe the demographic and clinical features of uncommon SCA subtypes in Canada and compare them with international data. Methods: We conducted a case series and literature review of adult patients with rare SCA subtypes, including SCA5, SCA7, SCA12, SCA14, SCA15, SCA28, SCA34, SCA35 and SCA36. Data were collected from medical centers in Ontario, Alberta and Quebec between January 2000 and February 2021. Results: We analyzed 25 patients with rare SCA subtypes, with onset ages ranging from birth to 67 years. Infantile and juvenile-onset cases were observed in SCA5, SCA7, SCA14 and SCA34. Most patients presented with gait ataxia, with no significant differences across groups. Additional common features included saccadic abnormalities (22 of 25), dysarthria (19 of 25) and nystagmus (12 of 22, except in SCA7). Less common findings included dystonia (8 of 25), cognitive impairment (7 of 25), tremor (9 of 25) and parkinsonism (3 of 25). Conclusion: Our study highlights the heterogeneity of rare SCA subtypes in Canada. Ongoing longitudinal analysis will improve the understanding, management and screening of these disorders.

Background: Parkinson’s disease (PD) is a disabling neurodegenerative movement disorder. Most PD patients are looked after by caregivers who are close to them regardless of their relationship. Caregivers may experience a notable impact on their mental health as they dedicate a significant amount of time to the patient while observing the progression of the disease. Objective: The aim of this study was to evaluate the level of burden, depression, anxiety, and stress among caregivers of PD patients. Methods: We conducted a cross-sectional analysis between July and September 2023 among caregivers of PD patients following in the Movement Disorders Clinic at King Khalid University Hospital in Riyadh, Saudi Arabia, and through the Saudi Parkinson’s Society. The data collection was done anonymously through an electronic self-administered questionnaire. Caregiver burden was assessed by using the validated Arabic version of the Zarit Burden Interview (ZBI) scale, and the Depression Anxiety Stress Scale (DASS) was used to assess the presence and level of anxiety and depression. Results: There were 118 caregivers (53.39% female, 33.9% aged between 35– 45 years, and 73.73% were sons/daughters) caring for 118 patients (57.63%, male, 38.98% aged between 66– 76). The ZBI score was highest among sibling caregivers. Moreover, burden scores were higher among those who provided care more frequently than others. Conclusions: Our study revealed that PD caregivers face a high risk of care burden, especially those who are siblings and spend longer periods in patient care. Additionally, female caregivers reported higher rates of depression, anxiety, and stress.