The global prevalence of Huntington’s disease: a systematic review and discussion

The ascertained prevalence of Huntington's disease (HD) increased significantly following the provision of diagnostic testing. A systematic review was conducted to estimate the prevalence of HD in the post-diagnostic testing era. Twenty-two studies with original data pertaining to the prevalence of HD (1993–2015) were included and analyzed. A global meta-analysis was not performed due to heterogeneity in study methods and geographical variation. The prevalence of HD is significantly lower in Asian populations compared with western Europe, North America and Australia. The global variation in HD prevalence is partly explained by the average CAG repeat lengths and frequency of different HTT gene haplotypes in the general population. Understanding the prevalence of HD has significant implications for healthcare resource planning

Epileptic and cognitive changes in children with cerebral palsy: an Egyptian study

Hamdy N El-Tallawy, Wafaa MA Farghaly, Ghaydaa A Shehata, Reda Badry, Tarek A Rageh Department of Neurology, Assiut University Hospitals, Assiut, Egypt Background: Cerebral palsy (CP) is the most frequent cause of motor handicap among children. Aim of the study: We aim to study the relation of epilepsy in children with CP to various risk factors that affect the development of seizures. Patients and methods: In a cross-sectional, descriptive, population-based, case-control study, 98 children with CP (48 children with CP with epilepsy, and 50 children with CP without epilepsy) were compared with 180 children without CP or seizures. The children lived in two regions in Egypt: the Al-Kharga District–New Valley and El-Quseir city–Red Sea. These cases were subjected to meticulous neurological assessment, brain magnetic resonance imaging, electroencephalography, and Stanford-Binet (4th edition) examination. Multinomial logistic regression was used to assess the risk factors. Results: Epilepsy was diagnosed in 48.9% of all cases of CP. Mental subnormality was observed more frequently in children with epilepsy than in those without epilepsy (84.6% versus 66.7%). The frequency of epilepsy was highest in patients with the spastic quadriplegic type of illness (58.3%). Multinomial logistic regression revealed that prematurity (<32 weeks of pregnancy), low birth weight (<2.5 kg at birth), neonatal seizures, jaundice, and cyanosis were significantly associated with CP with epilepsy. Conclusion: CP is associated with a high percentage of seizure disorders. Prematurity, low birth weight, neonatal seizures, cyanosis, and jaundice are significant risk factors among patients with CP with epilepsy compared to patients with CP without epilepsy or a healthy control group. Keywords: cerebral palsy, epilepsy, risk factors, Egyp

Prevalence of multiple sclerosis in Al Quseir city, Red Sea Governorate, Egypt

Hamdy N El-Tallawy,1 Wafaa M A Farghaly,1 Reda Badry,1 Nabil A Metwally,2 Ghaydaa A Shehata,1 Tarek A Rageh,1 Mohamed Abd El Hamed,1 Mahmoud R Kandil1 1Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt; 2Department of Neurology and Psychiatry, Al Azhar University Hospital, Assiut Branch, Assiut, Egypt Background: Multiple sclerosis (MS) is a chronic and disabling disorder with considerable social effects and economic sequelae. It is one of the major causes of disability in young adults.Objectives: This study aimed at detecting the prevalence of MS among the population of Al Quseir city.Methods: This study is a part of door-to-door survey of major neurological disorders that was conducted in Al Quseir city, Red Sea Governorate, Egypt. The sample size was 33,285 persons. The youngest patient was 17 years old. The number of people at and above 17 years of age was 21,827. They were screened by three neurologists. Then, the positive cases were subjected to meticulous clinical evaluation by three staff members of Department of Neurology, Assiut University Hospital, Egypt. Essential investigations were done.Results: A total of three cases of MS were diagnosed with an age-specific prevalence ≥17 years of 13.7/100,000. Keywords: prevalence, multiple sclerosis, Al Quseir, door-to-door survey&nbsp

Epidemiology of non-fatal cerebrovascular stroke and transient ischemic attacks in Al Quseir, Egypt

Hamdy N El-Tallawy,1 Wafaa MA Farghaly,1 Ghaydaa A Shehata,1 Nabil M Abdel-Hakeem,2 Tarek A Rageh,1 Reda Badry,1 Mahmoud R Kandil1 1Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, 2Department of Neurology, Faculty of Medicine, Al-Azhar University, Assiut branch, Assuit, Egypt Background and purpose: Stroke is a medical emergency that can cause permanent neurological damage, complications, and disability. We aim to determine the epidemiology of non-fatal cerebrovascular stroke (CVS) and transient ischemic attacks (TIAs) in Al Quseir City, Red Sea, Egypt. Methods: The total population (n=33,285) was screened through a door to door study by three specialists of neurology and 15 female social workers (for demographic data collection). All suspected stroke patients were subjected to a full clinical examination, computerized tomography (CT) and/or magnetic resonance imaging (MRI) of their brain, blood sugar, lipogram, serum uric acid, complete blood cells, blood urea, and serum creatinine, as well as evaluated by Barthel Index and Scandinavian Stroke Scale. Carotid doppler, echocardiography, and thyroid functions were done for selected cases. Results: CVS was recorded among 130 patients out of 19,848 subjects aged 20 years and more, yielding a total prevalence of 6.55/1,000 population. From June 1, 2010 to May 31, 2011, 36 patients were recorded to have stroke within 1-year, yielding an incidence rate of 1.81/1,000. Prevalence and incidence rates were higher among males than females, and both indices increased steadily with advancing age to reach the highest prevalence (37.02/1,000) and incidence rate (9.5/1,000) among aged persons 60 years and more. Conclusion: The prevalence of non-fatal stroke in Al Quseir city (6.55/1,000) was at the lower range of that recorded in developing countries (5–10/1,000) and slightly higher than that recorded in industrialized countries (5/1,000 population). Ischemic stroke is the most common type of stroke. The prevalence of TIAs was 0.15/1,000. Keywords: stroke, TIAs, epidemiology, Egyp

Construction of standardized Arabic questionnaires for screening neurological disorders (dementia, stroke, epilepsy, movement disorders, muscle and neuromuscular junction disorders)

Hamdy N El Tallawy,1 Wafaa MA Farghaly,1 Tarek A Rageh,1 Ahmed O Saleh,2 Taha AH Mestekawy,3 Manal MM Darwish,4 Mohamed A Abd El Hamed,1 Anwar M Ali,1 Doaa M Mahmoud1 1Department of Neurology and Psychiatry, Faculty of Medicine, 2Psychology Department, Faculty of Education, 3Psychology Department, Faculty of Arts, 4Public Health Department, Faculty of Medicine, Assiut University, Assiut, Egypt Abstract: A screening questionnaire is an important tool for early diagnosis of neurological disorders, and for epidemiological research. This screening instrument must be both feasible and valid. It must be accepted by the community and must be sensitive enough. So, the aim of this study was to prepare different Arabic screening questionnaires for screening different neurological disorders. This study was carried out in three stages. During the first stage, construction of separate questionnaires designed for screening the five major neurological disorders: cerebrovascular stroke, dementias, epilepsy, movement disorders, and muscle and neuromuscular disorders were done. Validation of the screening questionnaires was carried out in the second stage. Finally, questionnaire preparation was done in the third stage. Questions with the accepted sensitivity and specificity in each questionnaire formed the refined separate questionnaires. Keywords: screening questionnaires, neurological disorder

Prevalence of Parkinson’s disease and other types of Parkinsonism in Al Kharga district, Egypt

Hamdy N El-Tallawy,1 Wafaa M Farghaly,1 Ghaydaa A Shehata,1 Tarek A Rageh,1 Nabil M Abdel Hakeem,2 Mohamed Abd Al Hamed,1 Reda Badry1 1Department of Neurology, Assiut University, 2Al-Azhar University – Assiut branch, Assiut, Egypt Abstract: Parkinson’s disease (PD) is a common neurodegenerative disorder in older people. The prevalence of PD varies among ethnic and geographic groups around the world. In this study, we aimed to estimate the prevalence of PD and other types of Parkinsonism in persons aged ≥40 years in the Al Kharga district of Egypt. The study was conducted on the total population of Al Kharga district (62,583 persons) between 2005 and 2009 and involved three neurology specialists and 15 female social workers undertaking a door-to-door survey. Suspected cases of Parkinsonism were subjected to meticulous clinical and neurological examination by three neurology staff members from Assiut University hospital who carried out their examinations separately. Of the total population surveyed, 15,482 persons were aged ≥40 years and 49 of these were identified as having Parkinsonism (prevalence: 316.50 per 100,000 people [95% confidence interval {CI} 240.21–404.98]). Of the 49, 33 fulfilled the diagnostic criteria for PD, giving a prevalence rate of 213.15/100,000 (95% CI 150.51–285.80) while 14 fulfilled those for vascular Parkinsonism, with a prevalence rate of 90.43/100,000 (95% CI 49.60–137.78). Postencephalitic and unspecified Parkinsonism each had a prevalence rate of 6.46/100,000. The prevalence of Parkinsonism was found to increase steadily with age, and the prevalence of all types of Parkinsonism was statistically higher in rural compared with urban communities, with no significant difference between men and women. Keywords: epidemiology, door-to-door survey, PD, postencephalitic Parkinsonis

Epidemiology of nonfatal stroke and transient ischemic attack in Al-Kharga District, New Valley, Egypt

Wafaa MA Farghaly,1 Hamdy N El-Tallawy,1 Ghaydaa A Shehata,1 Tarek A Rageh,1 Nabil M Abdel-Hakeem,2 Mohamed A Abd Elhamed,1 Bastawy MA Al-Fawal,3 Reda Badry1 1Department of Neurology, Faculty of Medicine, Assiut University, Assiut, 2Department of Neurology, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, 3Aswan Health Insurance Hospital, Ministry of Health, Aswan, Egypt Background: Stroke is a medical emergency. Nonfatal stroke may cause permanent neurologic damage, complications, and disability. The aim of this study was to determine the epidemiology of nonfatal stroke in Al-Kharga District, New Valley, Egypt. Methods: The total population (62,583) was screened via a door-to-door study by three neurology specialists and 15 female social workers for demographic data collection. All subjects with probable stroke were subjected to a full clinical examination, neuroimaging (computed tomography and/or magnetic resonance imaging of the brain), and laboratory investigations including blood sugar, lipid profile, serum uric acid, a complete blood count, blood urea, and serum creatinine. Stroke severity and outcome were assessed using the Scandinavian Stroke Scale and Barthel Index. Carotid Doppler, echocardiography, and thyroid function tests were done in selected cases. Results: During the study period (June 1, 2005 to May 31, 2008), 351 subjects were diagnosed as having suffered a cerebrovascular stroke at some point during their lives, yielding a total lifetime prevalence of 5.6 per 1,000 population. Of these, 156 subjects were identified as having suffered a stroke during the year from January 1 to December 31, 2007, with an incidence rate of 2.5 per 1,000. Both prevalence and incidence rates were higher in urban (5.8 per 1,000 and 2.6 per 1,000, respectively) than rural communities (5.2 per 1,000 and 2.3 per 1,000), and were higher in males (6.1 per 1,000 and 2.7 per 1,000, respectively) than in females (5.1 per 1,000 and 2.3 per 1,000). Thrombotic stroke had the highest prevalence and incidence rates (4.2 per 1,000 and 1.7 per 1,000, respectively), whereas subarachnoid hemorrhage had the lowest prevalence and incidence rates (0.03 per 1,000 and 0.02 per 1,000). Conclusion: The prevalence of cerebrovascular accident in Al-Kharga lies in the lower range of that in developing countries, and is similar to that in industrialized countries. Keywords: prevalence, incidence, stroke, Egyp

Prevalence of dementia in Al-Quseir city, Red Sea Governorate, Egypt [Corrigendum]

El Tallawy HN, Farghly WM, Badry R, et al. Clinical Interventions in Aging. 2014;9:9–14.On page 13, before the Disclosure statement the following section was omitted.AcknowledgmentWe acknowledge LundBeck Pharmaceutical company, Middle East for their support in conducting this research.Read the original articl

Prevalence of dementia in Al-Quseir city, Red Sea Governorate, Egypt

Hamdy N El Tallawy,1 Wafaa M Farghly,1 Reda Badry,1 Tarek A Rageh,1 Ghaydaa A Shehata,1 N Abdel Hakeem M,2 Mohamed Abd El Hamed,1 Mohamed AM Sayd,3 Yasser Hamed,2 Mahmoud R Kandil11Department of Neurology, 2Department of Neurology Faculty of Medicine, Assiut University, Assiut Egypt; 3Department of Neurology, Faculty of Medicine, Sohag University, Sohag, EgyptAbstract: Dementia is one of the most important public health problems as a result of the rapid increase in the number of elderly persons worldwide. Improvement of prevention strategies and caring for people with dementia should be undertaken. We performed a door-to-door study to screen all subjects aged 50 years and older (n=4,329 of 33,285 inhabitants) in Al-Quseir city. The screening was performed by 3 neuropsychiatrists, using a modified form of the Mini-Mental State Examination. Suspected cases were subjected to case ascertainment according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria for dementia; full clinical assessment; psychometric assessment using Cognitive Abilities Screening Instruments, Hachinski Ischaemic Score, Instrumental Activities of Daily Living Scale and the Geriatric Depression Scale; neuroimaging (computed tomography and/or magnetic resonance imaging); and laboratory investigations for selected patients when indicated. The prevalence of dementia was 2.01% for participants aged 50 years or older and 3.83% for those aged 60 years or older. It increased steeply with increasing age to a maximum of 13.5% for those aged 80 years or older. Alzheimer's dementia (48.3%) was the most common subtype, followed by vascular dementia (36.8%), dementia resulting from general medical conditions (11.5%), and last, dementia resulting from multiple etiologies (3.4%).Keywords: Alzheimer's dementia, epidemiology, vascular dementia, EgyptCorrigendum for this paper has been publishe