Objectives: To assess social awareness of ischemic stroke amongst Saudi citizens in Medina city. Methods: In a cross-sectional study conducted between February and September 2019, we used a validated questionnaire to conduct face-to-face interviews and collect data, at 4 shopping malls and 5 supermarkets in Medina city, KSA. Results: Five hundred and nineteen participants completed the questionnaire. Of the respondents, 57.4% correctly defined stroke, 42.6% correctly chose ≥2 stroke signs and made ≤one mistake, 23.1% knew of blood clot-dissolving drugs, 32.8% correctly identified ≥ 4 risk factors with ≤ one mistake, 85.93% knew that going to the Emergency Room (ER) was the correct action, and 35.84% identified ≥ 3 post-discharge requirements, with ≤one mistake. Most participants (65.77%) cited internet and social media as information sources. In the univariate comparison, older age (p<0.001) and family history of stroke (p=0.001) better predicted stroke knowledge. In a multivariate logistic regression, the only predictor for stroke recognition was the educational level. The gender and family history were predictors for stroke signs knowledge. Educational level and the family history of stroke were predictors for risk factors knowledge respectively. Conclusion: We observed a significant stroke knowledge deficit in our Saudi cohort, thus there is a need to increase public awareness about stroke risk factors, warning signs and emphasizing prevention approaches.

Introduction: Various inflammatory diseases have been associated with the administration of various vaccines. Several reports have associated vaccine administration with the demyelinating diseases of the central nervous system (CNS). However, no clear or strong scientific evidence exists to support the association of vaccine administration with the onset of demyelinating diseases. Some CNS demyelination diseases such as acute disseminated encephalomyelitis (ADEM) and neuromyelitis optica spectrum disorders (NMOSD) were reported following the administration of COVID-19 vaccines. In this study, new onset multiple sclerosis (MS) following COVID-19 vaccine administration was reported. Methods: In this longitudinal observational case-control study, a total of 65 participants were studied, who were divided into two groups. Group A included 32 MS patients who were diagnosed post-COVID-19 vaccine administration and group B included 33 participants who received COVID-19 vaccines and did not develop MS. Group B was used as a control. The Chi-square test and logistic regression analysis were carried out using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Armonk, NY) software. Results: Univariate and multivariate logistic regression analysis was performed and a significant correlation between the risk factors and the development of MS post-COVID-19 vaccination was identified. Conclusion: The risk factors, identified in this study, can be used as significant independent predictors for developing MS post-COVID-19 vaccinations.

Multiple sclerosis (MS) is a chronic autoimmune-mediated neurodegenerative disease that affects young adults. The diagnosis of MS currently based on the McDonald criteria, which based on four core principles: the presence of a symptomatic demyelinating syndrome, an objective neurologic finding, the dissemination in space (DIS), and the dissemination in time (DIT). In addition, the diagnosis of MS relies on the exclusion of any alternative diagnosis. This may implicate the absence of systemic non-neurological symptoms and signs, such as rheumatological, cutaneous, or ophthalmological findings. Nevertheless, the non-neurological symptoms are commonly observed in patients with MS either at the onset of MS, which therefore can delay the diagnosis and the incrementation of a disease-modifying therapy, or during the course of the disease progression. The purpose of our review is to highlight non-neurological symptoms of MS that frequently go undiagnosed or mistakenly linked to other conditions, aiming for the more accurate and earlier diagnosis of MS.

Background and objectives: Congenital myasthenic syndromes (CMSs) are rare inherited diseases characterized by muscle weakness and fatigability on exertion resulting from defects in the neuromuscular junctions. Mutations in 32 genes have been reported as the underlying causes of CMS, with mutations in the cholinergic receptor nicotinic epsilon subunit (CHRNE) being the most common cause of the disease. Methodology and Materials: This study investigated a large consanguineous family with multiple individuals suffering from abnormal fatigue and muscle weakness in the ocular and limb regions. Moreover, the affected individuals were followed up for 18 years to observe the clinical course of the disease. Results: High-quality exome sequencing followed by bidirectional Sanger sequencing revealed a homozygous duplication variant (NM_000080.4: c.1220-8_1227dup) in the splice acceptor site of exon 11 of the CHRNE gene. This variant is predicted to cause frameshift and premature termination (p.Cys410ProfsTer51). Both parents had heterozygous duplication variants with no clinical symptoms. The personalized treatment of the affected individuals resulted in a marked improvement in the clinical symptoms. More than 80% of the disease symptoms in the affected individuals subsided after the use of pyridostigmine and salbutamol (4 mg). Conclusions: This is the first report of long-term follow up of cases with homozygous insertion (c.1220-8_1227dup) in the CHRNE gene. Furthermore, this report expands the phenotypic symptoms associated with the CHRNE mutation.

Multiple sclerosis (MS) is an inflammatory neurological illness common in young adults. The prevalence and incidence of MS are regionally and globally increasing. Recent data from Saudi Arabia (SA) estimate the prevalence to be 40.40 cases per 100,000 population, and 61.95 cases per 100,000 population for Saudi nationals. With the increasing availability of treatment options, new challenges for treatment selection and approaches have emerged. There is a clear need for national guidelines to standardize practice, guide the personalization of decisions, and contain increasing costs. A multidisciplinary expert panel was formed to develop evidence-based Saudi consensus recommendations on the diagnosis and clinical care of MS, to aid healthcare practitioners in advising patients on treatment decisions. The recommendations were agreed upon after a thorough review, an evaluation of existing international guidelines, and the latest emerging evidence.

Background There is an increasing number of individuals with dementia due to the rapid aging process worldwide. AD is a major public health problem and the most prevalent form of dementia. It affects mainly older people and causes a significant decline in cognitive abilities, thus affecting the quality of life and independence. Understanding AD is fundamental for early diagnosis and reducing caregiver burden. Aim and objective to assess the public awareness, knowledge, and attitude toward AD in Medina City, Saudi Arabia. Methods A cross-sectional study of a convenient sample from Madina city, Saudi Arabia collected via validated Arabic face-to-face interviews conducted in shopping malls in Al-Madina city, KSA from August 2022 to September 2022. This study included only Madina's residents, between the age of 20 and 65. Data collected via the interview included sociodemographic, knowledge, and attitude towards Alzheimer’s disease. Results The study included 391 participants with a mean age between 18–29 years. The majority of the participants were able to identify aging and AD as causes of memory loss (86.2% and 65.7%) respectively. The overall AD knowledge was measured out of 12 points given to correct responses to the marked questions in table 2. The mean knowledge level was 7 ± 2 out of 12 possible points. Simple linear regression models were performed for the following predictors: age group, gender, and educational level. Data showed that only age groups (B = -0.351, SE = 0.103 (95% CI: -0.553 to -0.149), p < 0.001, R2 = 0.029), predicted the total awareness level related to AD (Table 3). 72.4% of the participants believed that Alzheimer’s patients are not capable of making decisions. Furthermore, 83.4% believe that Alzheimer’s patients need continuous monitoring and 70.8% think they may cause a psychological or societal burden. Conclusion Knowing the signs and symptoms of AD can allow clinicians to early diagnoses, treatment, preventing complications and decreasing the burden on families. So, it's important to guarantee enough public awareness of AD and the importance of managing risk factors that can minimize the risk of AD.