Abstract Background Optic neuritis (ON), the cardinal visual affection in multiple sclerosis (MS), directly contributes to long-term disability. Optical coherence tomography (OCT) provides a quantifiable, sensitive biomarker to monitor the optic nerve affection and disease progression. Aim of the work To study the reliability of OCT in detecting subtle disease progression in patients with relapsing-remitting MS (RRMS). Patients and methods Twenty_ five Egyptian patients presented with RRMS were included, twenty_ five age, sex and educational level matched healthy volunteers were selected as a control group for comparison of Paced Auditory Serial Addition Test (PASAT ) and OCT data, the patients were subjected to neurological examination, assessment of disability, assessment of cognitive function, radiological assessment with Magnetic Resonance Imaging (MRI) brain and cervical spine and ophthalmology evaluation by OCT at baseline and reassessed 9 months later. Results MS patients showed worse performance in the PASAT score and lower OCT parameters than controls. The history of ON was associated with lower retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness and higher focal loss volume (FLV) and global loss volume (GLV). RNFL change rate had a statistically significant positive correlation with PASAT score and the annual relapse rate. A significant positive correlation was found between the rate of RNFL, GCC change and T1 black holes. Conclusions Retinal layers thinning was evident at early stages of RRMS and showed significant association with relapse rate, cognitive impairment and T1 black holes particularly in patients with ON highlighting the role of OCT as useful tool for early detection of neurodegeneration.

Background Coronavirus was primarily discovered in December 2019, causing pneumonia and severe acute respiratory syndrome. It was reported several neurological symptoms associated with COVID-19. Both the central and peripheral nervous systems could be affected which might result in a higher mortality rate in hospitalized patients. This study aimed to determine the spectrum of neurological clinical presentations among patients admitted to Fayoum University Hospital before, during, and after the COVID-19 era and to examine the influence of COVID-19 vaccines mandated by the Egyptian government on neurological disorders.Methods This is a historical cohort study that was conducted on patients admitted to the Neurology Department at Fayoum University Hospital before, during, and after COVID-19 outbreaks from January 1st, 2018, to July 31, 2022. All participants had undergone thorough history taking and neurological examination and the necessary investigations according to the suspected diagnosis. All hospitalized patients during the COVID-19 pandemic were positive for the virus, as determined by either a positive rapid antigen test or a positive real-time reverse transcription polymerase chain reaction (RT-PCR).Results It was shown that the patients hospitalized during the COVID-19 era were notably older, smokers, and diabetic in comparison to other groups. Cerebrovascular disorders were more prevalent in the COVID-19 pandemic. Surprisingly, compared to prior times, individuals with autoimmune-mediated neurological diseases had higher hospitalization rates than those with other neurological disorders. Patients who were not vaccinated reported more vascular complications than those who got them. However, patients who received vaccination exhibited significantly higher neurological complications as regards, exacerbation of paroxysmal disorders.Conclusion It was concluded that the frequency of hospitalizations with cerebrovascular disorders and autoimmune-mediated illnesses was significantly influenced during the pandemic era. Although COVID-19 vaccinations have potential adverse effects, they have played a crucial role in preventing serious neurological problems.

BACKGROUND:Leptin (LEP) is an anti-obesity hormone that regulates food intake, energy expenditure, and glucose metabolism. The genetic variants in LEP and the LEP receptor (LEPR) gene may play an important role in the pathogenesis of type 2 diabetes mellitus (T2DM) and obesity. The current study aimed to investigate the association of serum LEP levels, and LEP polymorphisms in LEP (rs7799039, 2548 G/A) with T2DM in Egyptian patients. METHODS:A total of 205 subjects were included in the present case-control study, consisting of 100 T2DM patients and 105 healthy controls. The anthropometric, psychometric, and biochemical measurements were taken from all the subjects. The genotyping of LEP gene variants was carried out by polymerase chain reaction TaqMan technology. Serum LEP levels were measured by the ELISA technique. RESULTS:T2DM patients had significantly elevated levels of glycated haemoglobin (HbA1c), fasting blood sugar (FBS), postprandial blood sugar (PPBS), international normalisation ratio (INR), creatinine, urea, cholesterol, triglyceride (TG), and low-density lipoproteins (LDL) and significantly decreased high-density lipoprotein (HDL) compared to healthy subjects. serum LEP levels were significantly decreased p (<0.001) as compared to the control group. LEP gene SNP rs7799039 was associated with an increased diabetic risk with A allele being more frequent in T2DM patients than control subjects. The distribution of the AA genotype and GA genotype of LEP SNP rs7799039 was higher in the diabetic group than control one. In addition, AA + GA genotype carriers had significantly elevated HbA1c, FBS, PPBS, TG, and LDL levels and on the contrary, decreased serum LEP levels compared to GG homozygotes. CONCLUSION:The genetic polymorphism rs7799039 showed a highly significant correlation with blood LEP. The co-dominant and dominant models of the LEP genetic polymorphism (rs7799039, 2548 G/A) were shown to have a significant correlation with complicated and uncomplicated diabetes individuals, but we have found that serum LEP levels were inversely related with control and diabetes patients. A positive significant association was found between LEP genetic polymorphism (rs7799039, 2548 G/A) and serum LEP in patients and controls. LEP levels and its rs7799039 genetic variant may play a vital role in increasing T2DM susceptibility.

Background Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive therapeutic approach that targets particular brain regions that had been used and displayed significant impact in various neurological disorders. This study aimed to explore if high-frequency (HF) rTMS over the parietal cortex could influence sleep quality in Parkinson's disease (PD). Methods This was a prospective sham-controlled study conducted on 40 individuals with PD. The enrolled patients were examined with Unified Parkinson's Disease Rating Scale (UPDRS-III) and Modified Hoehn and Yahr Staging Scale (H&Y staging) for motor disability evaluation and staging. Pittsburgh Sleep Quality Index (PSQI) was used for sleep quality and Epworth Sleepiness Scale (ESS) for excessive daytime sleepiness and Beck Depression Inventory-II (BDI-II) for depression. Patients were classified into 2 groups: patients who underwent real-rTMS positioned over their bilateral parietal cortex. 100% of the motor threshold. Patients had a total of 12 sessions, one every other day. Another group received sham rTMS. Results The patients receiving active rTMS showed significant improvement in UPDRS-III, PSQI, ESS, and BDI-II immediately after the sessions and 1 month later. The follow-up PSQI had a significant positive correlation with the baseline BDI-II ( r = 0.88, P = 0.001), H&Y staging ( r = 0.78, P = 0.001), and UPDRS-III ( r = 0.78, p = 0.001). Multivariate linear regression analysis exhibited that the age of the patients was a significant predictor of sleep quality. Conclusion HF rTMS over the parietal cortex had shown a significant impact on sleep quality by the modulation of affected brain areas and by improving concomitant motor and mood manifestations.

Background:It has been postulated that COVID-19 has a substantial neuro-otological impact such as vertigo or dizziness that is rarely evaluated. The purpose of this research is to study the occurrence of vertigo (whether as presenting symptom or a sequela) and its etiological characteristics in patients with covid 19 infection and close contact. It is a cross-sectional study (convenient sample) conducted on patients that had a previous history of covid 19 infection and another group of contact individuals who presented with the sensation of vertigo. All the included participants underwent full neurological and otological examination, nasopharyngeal swab PCR to confirm COVID-19 infection and video nystgmograghy (VNG).Results:it was included 44 participants, where 7 (15.9%) of the participants were post-COVID-19 patients and 37 (84.1%) were close contacts of COVID patients. It was found that 6(85.7%) of post-COVID-19 patients had vestibular neuritis (VN), and 1(14.3%) patient had Benign Paroxysmal Positional Vertigo (BPPV). 9(23%) of those in close contact had positive PCR for COVID infection, 6(66.7%) of them had VN, and the other 3 (33.3%) had BPPV.Conclusion:Vertigo could be a possible complication or a presenting symptom in patients with COVID patients that is mainly attributed to peripheral vestibular dysfunction.

Background The thalamus is crucial in the development of idiopathic generalized epilepsy (IGE), which could lead to cognitive dysfunctions, according to data from neuropsychology and advanced neuroimaging investigations. This research aimed to measure the metabolic changes in the thalamus and to assess if could be contributed to cognitive impairment in IGE patients. Thirty IGE patients and thirty healthy volunteers with matched ages, genders, and educational levels participated in this cross-sectional case–control research. The IGE patients and controls were evaluated neuropsychologically using Intelligence Quotient (IQ) to assess general cognitive ability, Digit span for attention, Wechsler memory scale (WMS) for verbal memory, cube drawing test for visuospatial memory, Trail making test for executive functions, and Controlled Oral Word Association test (COWAT) for verbal fluency and quantitative multi-voxel MR spectroscopy (MRS) measurements of N -acetyl aspartate (NAA), choline (Cho), creatine (Cr), NAA/Cr, NAA/Cho and Cho/Cr ratios at 1.5 T scanner. The voxels were located over the right and left thalamus. Results The IGE patients showed worse cognitive performance in IQ, attention, executive function, and verbal and visuospatial memory domains compared to the controls. The IGE patients exhibited a significantly decrease NAA in the right thalamus ( p = 0.004) and a lower NAA/Cr ratio in the left thalamus ( p = 0.01). the mean thalamus NAA level exhibited a positive correlation with CDT ( r = 0.45, p = P = 0.01), and WMS-R ( r = 0.39, p = 0.03) and a negative correlation with trail-making A test ( r = 0.42, P = 0.01). Conclusions it was concluded that IGE patients exhibited poor cognition which could be attributed to thalamic neurometabolic changes due to impaired thalamic cortical circuits.

Background: The severity of stroke-induced disruption to the corticospinal tract (CST) would be predictable to affect motor outcome. Diffusion tensor imaging (DTI) is a noninvasive technique that can be applied to assess the structural integrity of the CST. Aim of the work: To assess the value of DTI in patients early presenting with acute ischemic stroke as a prognostic modality to predict the clinical outcome Patients and methods: Thirty-four patients with acute ischemic stroke underwent clinical assessment using the National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), Medical Research Council (MRC) score, Morticity Index (MI), and DTI to detect the degree of reduction of fractional anisotropy (FA), and pattern of CST at baseline and after 6 months follow up. Seventeen age, sex matched controls underwent DTI assessment. Results: The stroke patients showed a significant reduction in the baseline FA values of the CSTs on the affected sides compared to the contralateral sides and controls. Moreover, they showed lower mean baseline FA lesion side and FA ratio(rFA) compared to follow up. The patients with high baseline FA, rFA showed good recovery response with cut off values of 0.483, 0.948 respectively. There was a significant negative correlation between baseline FA on the lesion side, rFA and follow up NIHSS, and MRS scores and they had a significant positive correlation with follow up MI scores. Conclusion: Patients with higher baseline FA, rFA values were correlated with better motor recovery, and could predict the motor recovery in ischemic stroke patients. (c) 2021 Elsevier Ltd. All rights reserved.

Inflammatory changes in the stomach caused by Helicobacter pylori indirectly and directly affect liver function.Moreover, the bacteria may worsen the course of the liver cirrhosis.The incidence of portal hypertension and esophageal varices correlates with the incidence of H. pylori infection.This study aims to detect H. pylori infection among patients with liver cirrhosis correlation with the degree of liver injury according to Child-Pugh classification and the stage of esophageal varices and its bleeding.This study was conducted in Hepatology and Gastroenterology and Infectious diseases of Al_Azhar medical Department from December 2018 till November 2020.50 patients were included in bleeder group 32 patient had H.pylori and 18 patient negative H.pylori. 50 patient were included in non_bleeder group 28 patient had H.pylori and 22 patient were negative H.pylori. our results indicated statistically significant decrease in the prevalence of H. pylori infection among the bleeder group.

Background Migraine is a common, chronic, multifactorial neurovascular disorder. It may result in hypoperfusion of other areas other than the brain, as the eye. It may lead to change of the retinal nerve fiber layers (RNFL) thickness and axonal loss even up to severe damage of the eye structures, including the retina with frequent headache attacks. This study aimed to quantify the thickness of RNFL which gives a good idea about the condition of axons and loss of ganglion cells in migraine patients. Also, to detect if there is any correlation between these measurements and clinical characteristics of migraine. Results The RNFL thickness was significantly thinner in patients with migraine compared to healthy controls in all quadrants of retina in both sides ( p value < 0.05). However, there was no significant difference in RNFL thickness in migraine patients with aura compared to patients without aura in all retinal quadrants in both sides ( p value > 0.05). The headache intensity was negatively correlated with RNFL thickness in the inferior ( r = − 0.342, P = 0.031) and nasal ( r = − 0.349, P = 0.027) quadrants on LT side, also there was a significant positive correlation between RNFL thickness and both of nausea and tolerability in the RT superior quadrant ( r = 0.467, P = 0.002); ( r = 0.322, P = 0.043), respectively, but there was no significant correlation found between the RNFL thickness and disability, attacks duration, disease duration and frequency in all retinal quadrants on both sides ( P > 0.05). Conclusion The main conclusion of our work was that RNFL thickness was significantly affected in migraine patients in comparison to healthy controls, but there were no significant impact of the migraine characteristics including aura, severity, frequency, or duration of headache attacks on RNFL thickness.

Aim of the work: To study the effect of vitamin D levels on clinical and laboratory characteristics of rheumatoid arthritis (RA), and to evaluate a possible relationship with neuropathic pain (NP). Patients and methods: Sixty RA patients with neuropathic pain symptoms and 60 healthy controls were included. All patients were assessed by Leeds assessment of neuropathic symptoms and signs (LANSS) to confirm the presence of NP, modified health assessment questionnaire (MHAQ), disease activity score (DAS-28) and visual analogue scale (VAS). Anti-cyclic citrullinated peptide (anti-CCP), glycolysated hemoglobin (HbA1C) and 25-hydroxy vitamin D levels were assessed. Nerve conduction velocity study (NCVS) was performed in those with confirmed NP. Results: Mean age of patients was 42.4 +/- 10.9 years, disease duration 5.3 +/- 4.2 years and 91.7% were females. RA patients showed significant lower vitamin D levels than controls (23.5 +/- 14.03 ng/ml vs 37.8 +/- 13.8 ng/ml; p < 0.001). There was a significant difference between RA patients with NP (n = 30; 18.3 +/- 5.5 ng/ml), and patients without (n = 30; 28.8 +/- 17.7 ng/ml) regarding 25-hydroxyvitamin D (p = 0.003), LANSS, VAS, MHAQ (all p < 0.001), DAS-28 and TJC (p = 0.04). Carpal tunnel syndrome (CTS) was found in 46.7%; 42.3% of the females and 75% of males, mononeuritis multiplex (MM) in 23.3%; 25% males and 23.1% females. Patients, with deficient vitamin D had either CTS or MM (85.7% each). RA patients with NP had significant delayed latency and reduction of conduction velocity of motor and sensory branches of median, ulnar and tibial nerves. Conclusion: Vitamin D deficiency could be a plausible cause for neuropathic pain in RA patients. (c) 2021 THE AUTHORS. Publishing services by ELSEVIER B.V. on behalf of The Egyptian Society of Rheumatic Diseases This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Body-weight-supported treadmill training (BWSTT) is a treatment method to help patients with incomplete spinal cord injuries to restore the capability to walk again. This study aimed to assess the effects of different percentages of body-weight-support locomotor training on the enhancement of gait for persons with incomplete spinal cord injuries. Twenty male paraplegic persons, with the statistical parameters [mean ± SD] age 32.53 ± 1.793 years, height 175.71 ± 1.658 cm, weight 71.59 ± 2.442 kg, and body mass index 23.18 ± 0.828 kg/m2) were picked by convenience sampling. Ten patients were randomly allocated to the body-weight treadmill training 30% group (Group A); and ten patients to the body-weight treadmill training 40% group (Group B). The two groups were exercised for 1h every set, at two sets weekly for 1.5 months. Body-weight-supported treadmill training was divided into a 15-min warm-up on a stationary bicycle, 45-min body-weight-supported treadmill training with 30 and 40% body weight and finally, a 10-min cool down as we started loading with 10% of body weight of each patient until reach 30% or 40% according to his group. The resultant data revealed that there are significant distinctions between the body-weight treadmill training 30% and the with body-weight treadmill training 40% groups in regards to alterations in the walking speed, step length, and stride length (p < 0.001), cadence (p = 0.009). Body-weight-supported treadmill training 40% in comparison with body-weight-supported treadmill training 30% can enhance both the quantity and quality of gait in paraplegic patients (ASIA B, C, and D classification).

Patients with acute ischemic stroke are at a higher risk of developing cognitive impairment which could be often attributed to cytokine activation. To explore the relationship between the cognitive performance and the inflammatory markers in the ischemic stroke patients at the early stage. A cross-sectional case-control study was performed on 44 ischemic stroke patients. The patients underwent the following battery of evaluation: (A) assessment of stroke disability by modified Rankin Scale (mRS) and National Institute of Health Stroke Scale (NIHSS). (B) neuropsychological evaluation using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) scale, trail making test (TMT), and Controlled Oral Word Association Test (COWAT). (C) Assessment of depression was done by using Beck Depression Inventory (BDI). Measurement of the serum levels of ESR, C-reactive protein, and IL-8 was done. This study included 44 ages, sex, and educational level matched controls for comparison of neuropsychological tests and serum level of IL-8. The patients showed worse performance in neuropsychological tests (MMSE, MoCA, COWAT, TMT) than the controls. There was a significant negative correlation between the serum level of IL-8 and (MoCA) (r = − 0.43, p = 0.004), verbal fluency (r = − 0.56, p < 0.001), and positive significant correlation between IL8 and executive functions (r = 0.61, p < 0.001). The cognitive impairment in early acute ischemic stroke is highly correlated to the serum level of IL-8.

Introduction: Multiple sclerosis (MS) is an immune-mediated disorder. Long noncoding RNAs (lncRNAs, LncR, Linc RNA) have role in many autoimmune and inflammatory disorders, including MS. LincR-Gng2-5 AS locus in T helper 1 cell (TH1) and LincR-Epas1-3AS in T helper 2 cell (TH2) cell were located in a genomic region rich in genes code for proteins with immune regulatory function. Our aim was to evaluate the LincR-Gng2-5 ' and LincR-Epas1-3 ' AS fold change in blood of MS patients versus healthy controls and correlate it with disease severity, assessed based on Expanded Disability Status Scale (EDSS). Material and Methods: Sixty MS patients 42 relapsing remitting (RR, RRMS), 18 Secondary progressive (SP, SPMS) and sixty controls (age-matched and sex-matched) were studied. Blood of patients and control group undergone the investigation of LincR-Gng2-5 ' and LincR-Epas1-3 ' AS fold change by real-time PCR. Fold change >2 and p < .05 represent significant result. Results: LincR-Gng2-5 ' was significantly upregulated in MS patients with mean fold change (2.559) and (p = .03). Meanwhile, LincR-Epas1-3 ' AS levels were significantly downregulated with mean fold change (0.5964) and (p < .004). Patients with SP showed a significantly higher level of LincR-Gng2-5-fold change (3.71 +/- 0.7) than that of RR (1.33 +/- 0.3). LincR-Epas1-3 ' AS was markedly reduced among SP (0.43 +/- 0.2) than that of RR (0.66 +/- 0.1) but with no significant difference. As regards disease severity (EDSS); there was a significant positive correlation with LincR-Gng2-5 and negative correlation with LincR-Epas1-3 ' AS. LincR- Gng2-5and LincR-Epas1-3 ' AS, both are dysregulated in MS patient suggesting a role in disease pathogenesis. Conclusion: LincR-Gng2-5 AS and LincR-Epas1-3 ' AS fold change are correlated to MS severity (EDSS).

Background: Clinically isolated syndrome (CIS) is the first neurologic episode of multiple sclerosis (MS). Clinical presentation, neurophysiological studies, and magnetic resonance imaging (MRI) are used to predict risk of conversion to MS. There is little information regarding the risk factors of CIS conversion to MS so far in the Egyptian patients. This study aimed to evaluate the predictors of early conversion of the Egyptian patients with CIS to MS. Methods: A longitudinal prospective study was conducted on 43 Egyptian patients diagnosed as CIS according to the McDonald criteria (2010). The CIS patients underwent clinical assessment of disability using Expanded Disability Status Scale(EDSS), brain imaging by magnetic resonance imaging (MRI), and visual evoked potential (VEP) at baseline and after 1-year follow-up. Results: Eight patients (19.6%) with CIS converted to clinically definite MS after 1 year. A logistic regression analysis revealed that the CIS patients with initial clinical presentation with optic neuritis and higher MRI brain lesion number were associated with early conversion to MS (p = 0.003, p = 0.002, respectively). The total MRI brain T-2 lesion number that predicts early conversion to MS was four lesions with sensitivity (100%) and specificity (85.7%). Conclusions: The patients with CIS that early presented with optic neuritis and higher MRI brain lesion number are at higher risk for conversion to clinically definite MS.

Background Stroke is the third leading cause of death and leading cause of adult disability worldwide. Long-term disability is a significant problem among survivors; post-stroke inflammation is well known to contribute to the expansion of the ischemic lesion resulting in significant morbidity and disability. To study the impact of serum level of IL-8 on severity of disability in patients with acute ischemic stroke in the first 48 h post stroke. Methods A cross-sectional case control study was conducted on 44 patients with acute ischemic stroke (in the first 48 h). The patients were subjected to full neurological examination, computed tomography (CT) and magnetic resonance imaging (MRI) of the brain, and assessment of stroke disability using the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Measurement of the serum levels of IL-8, erythrocyte sedimentation rate, and C-reactive protein (CRP) was done. Forty-four matched control subjects for their age and sex were included for comparison of serum level of IL-8. Results The level of IL-8 was significantly higher in the patients than in the control subjects ( p < 0.001).There was a statistically significant positive correlation between serum level of IL-8 and disability assessed by NIHSS ( r = 0.42, p = 0.004). The patients with moderate disability showed significant higher IL-8 levels than those with minor disability ( p = 0.02). Conclusion The severity of disability in early acute ischemic stroke is highly correlated to the serum level of IL-8.

Background: It has been suggested that vitamin D influences the immunoregulation and subsequently affects the risk for conversion of clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (MS). There is little information regarding the relationship between levels of vitamin D and CIS conversion to MS in Egyptian patients. Objective: It is to study contribution of vitamin D deficiency to conversion of CIS to clinically definite multiple sclerosis (CDMS) and correlation of vitamin D level to cognitive and magnetic resonance imaging (MRI) results. Patients and methods: A longitudinal prospective case control study was conducted on 43 Egyptian patients diagnosed as CIS according to McDonald criteria (2010). Clinical presentation, brain MRI and 25-hydroxyvitamin D levels were evaluated at baseline and after one-year follow-up. Results: The CIS patients that converted to MS showed significant lower vitamin D level (p < 0.001) than the non-convertors. Multivariate logistic regression analysis revealed that the CIS patients with lower 25-hydroxyvitamin D level (p < 0.001) are at higher risk for early conversion to MS. There was a significant positive correlation between the vitamin D level and PASAT (r = 0.36, p = 0.02). It was found that there was a significant negative correlation between vitamin D level and MRI T-2 load (r = -0.38, p = 0.01). Conclusion: The low level of 25-hydroxyvitamin D may predict early conversion to clinically definite MS. Early vitamin D supplementation is recommended in patients with CIS.

Objective: Neurocognitive impairment is one of the most common systemic lupus erythematosus (SLE) manifestations. However, its pathophysiology is still poorly understood. Vitamin D deficiency is a possible risk factor for cognitive impairment. The aim of this study was to evaluate the relationship between 25-dihydroxy(OH) D3 levels and cognitive performance in patients with SLE. Methods: This was a cross-sectional, case-control study that included 30 Egyptian patients diagnosed with SLE and 20 age, sex, and educational level-matched controls. Study participants were subjected to a battery of neuropsychological evaluation using the California Verbal Learning Test (CVLT- II), Controlled Oral Word Association Test (COWAT), and Trail Making Test and evaluation of depression using Beck Depression Inventory (BDI). Serum levels of 25(OH) D3 were measured in the SLE group and control group. Results: The patients with SLE performed worse on total recall of verbal memory and executive function tests than the healthy controls. There was no significant difference between the patients and controls in Beck Depression Inventory (BDI). There was a significant negative correlation between vitamin D levels and executive function assessed by Trail Making Test (r=-0.399, p=0.03). Conclusion: Vitamin D deficiency could have a significant impact on cognitive performance in patients with SLE.

BackgroundIdiopathic intracranial hypertension (IIH) is seen typically in obese women in their child-bearing age, management of patients with IIH during pregnancy can be problematic.ObjectiveThe purpose of this study is to assess spinal tapping as a single modality for treatment of IIH during pregnancy.Patients and methodsThis was a prospective case series of seven pregnant women with IIH who underwent full neurological and ophthalmological evaluation including perimetry and neuroimaging studies. They were followed up and treated using only spinal tapping.ResultsSpinal tapping either single or multiple sessions can control IIH safely during pregnancy with a success rate of 86%.ConclusionSpinal tapping is recommended as a single treatment modality in pregnant women with IIH.