Comparison by multivariate auto-regressive method of seizure prediction for real patients and virtual patients

International audienceEpilepsy is one of the most widespread neurological pathologies, which is characterized by localized or generalized brain dysfunction due to abnormal or excessive paroxysmal electrical discharges. These discharges lead to neuronal hyperactivities causing prolonged and involuntary muscle contractions or periods of loss or altered consciousness. A patient's quality of life could be greatly improved with an effective alarm system able to predict future crises. Our article presents a fully specified model for automated seizure prediction based on autoregressive multivariate modeling and stability state analysis from clinical and simulated electroencephalography (EEG) data. Our model allows the calculation of a stability index whose analysis in content makes it possible to predict crises. The approach is validated on 29 crises recorded for 8 patients from a database available in free access and 14 simulated subjects also called virtual patients generated by neuro-computer platform TVB (The Virtual Brain:www.thevirtualbrain.org) using Epileptor as mass neural model for gray matter and “john Doe” matrix as white matter. Our preliminary results exhibit a detection accuracy of 97.87 %, a sensitivity of 100 % and an average prediction time for the eight real patients of 237.21 s and a detection accuracy of 100 %, a sensitivity of 93 % and an average prediction time of 4.427 s for the simulated subjects

Association between an angiotensin-converting enzyme gene polymorphism and Alzheimer’s disease in a Tunisian population

Abstract Background The angiotensin-converting enzyme gene (ACE) insertion/deletion (I/D or indel) polymorphism has long been linked to Alzheimer’s disease (AD), but the interpretation of established data remains controversial. The aim of this study was to determine whether the angiotensin-converting enzyme is associated with the risk of Alzheimer’s disease in Tunisian patients. Methods We analyzed the genotype and allele frequency distribution of the ACE I/D gene polymorphism in 60 Tunisian AD patients and 120 healthy controls. Results There is a significantly increased risk of AD in carriers of the D/D genotype (51.67% in patients vs. 31.67% in controls; p = .008, OR = 2.32). The D allele was also more frequently found in patients compared with controls (71.67% vs. 56.25%; p = .003, OR = 2.0). Moreover, as assessed by the Mini-Mental State Examination, patient D/D carriers were more frequently found to score in the severe category of dementia (65%) as compared to the moderate category (32%) or mild category (3%). Conclusions The D/D genotype and D allele of the ACE I/D polymorphism were associated with an increased risk in the development of AD in a Tunisian population. Furthermore, at the time of patient evaluation (average age 75 years), patients suffering with severe dementia were found predominantly in D/D carriers and, conversely, the D/D genotype and D allele were more frequently found in AD patients with severe dementia. These preliminary exploratory results should be confirmed in larger studies and further work is required to explore and interpret possible alternative findings in diverse populations

Parsonage–Turner syndrome of the brachial plexus secondary to COVID‐19 vaccine: A case report

Abstract Parsonage–Turner syndrome (PTS) is a peripheral inflammatory neuropathy of unknown etiology. We present a rare case of a 50‐year‐old male patient with PTS post‐COVID‐19 BNT162b2 mRNA vaccine. Symptoms occurred 15 days after the second dose. He was treated with corticosteroids, analgesics, and physical rehabilitation with a partial recovery

Neuro-meningeal cryptococcal infection revealing a multiple myeloma

Rare cases of Cryptococcus have been documented in patients living with multiple myeloma. To date there has been no documented evidence of cryptococcosis revealing multiple myeloma. We reported a 63-year-old man who had a 2-months history continuous holocranial headaches, morning vomiting, complaining of blurred vision and fever. The biologic and the imaging showed a Cryptococcus meningoencephalitis. The search for a cause of immunodeficiency revealed a multiple myeloma. The diagnosis for Cryptococcus was confirmed according to an India ink stain, blood and cerebrospinal fluid culture. The patient's treatment for multiple myeloma was initiated with a chemotherapy regimen. The evolution was good without complication. Cryptococcosis, especially in the neuro-meningeal form, is a serious, deadly opportunistic infection. The search of an underlining immunodeficiency must be systematic. In this case, it was associated with early stage multiple myeloma