• Weill Cornell Medical College, Qatar
  • Title:Complementary and Alternative Medicine (CAM ) for Epilepsy Treatment in the Middle East and North Africa (MENA) Region
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Abstract

Introduction
The aim of this study is to provide the reader with a review on Complementary andAlternative Medicine (CAM) treatment in epilepsy in the Middle East and North Africa(MENA) region, describe the extent and factors associated with its use among patients with epilepsy (PWE), and recommend how effectively we will be able to reduce this alarming use .
Material and Methods
Retrospective literature search from 1945 to December 2019, regarding CAM use in the MENA region , using electronic databases (PubMed, Scopus, Google Scholar,Web of Science ) identified pertinent articles for review.
Conclusion
The use of CAM and consultation of traditional healers for the treatment of epilepsy has so far been widespread practice for centuries in the MENA region. Lack of health professionals and non-adherence to conventional epilepsy treatment are strongly associated with the use of CAM. Improvement in the level of knowledge of epilepsy among PWE, healthcare professionals, including traditional healers, will educate PWE and their caregivers on potentially unsafe practices and promote adherence to Antiseizure Drugs (ASDs). Additionally, randomized controlled trials are needed to study the role and value of various CAM treatment options in PWEs

Biography

Dr Boulenouar Mesraoua is Consultant Neurologist at Hamad Medical Corporation at the Neuroscience Department at Hamad Hospital and also Associate Professor of Clinical Neurology at Weill Cornell Medical College Qatar. He graduated as a Medical Doctor from the University of Oran, Algeria. He then moved to Belgium, the City of Liege, for a Residency in Internal Medicine and Neurology at Liege University. After getting the Belgian Board of Neurology (with high marks),he went to the National Hospital for Nervous Diseases, Queen Square, London,United Kingdom,for a fellowship in Clinical Neurophysiology, under Pr Willison, Dr Mesraoua had also further training in Epilepsy and Continuous EEG Monitoring for two years in the Neurophysiology department of Zurich, Switzerland under late Pr Hans Gregor Wieser, an internationally known clinical epileptologist. Dr B.Mesraoua was until recently Director of the Neurology Fellowship Program at the Neurology Section and is an active member of the Comprehensive Epilepsy Program at Hamad General Hospital, Doha, Qatar. He is also Assistant Director of the Residency Program at the new Qatar Medical School.
Dr B.Mesraoua main interests are Epilepsy, Multiple Sclerosis and Clinical Neurology. He is the Chairman and the Organizer of the well known Qatar Epilepsy Symposium. He is running yearly for the past 14 years and which is considered a landmark in the Gulf region. He has also started last year, together with other epileptologists from Qatar and the region and elsewhere, a yearly International Epilepsy School Course,which was attended by many neurologists from the Area.
Both scientific events are under the umbrella of the international League against epilepsy (ILAE) and the Eastern Mediterranean Region (EMR). Internationally Dr Mesraoua is an active and elected member of the Commission on Eastern Mediterranean Region(EMR)a regional branch of the International League Against Epilepsy (ILAE), where he represents the Middle East and North Africa(MENA ) and where he hold the position of chief of the Epilepsy Epidemiology Section.
Dr Mesraoua is a member of the American Academy of Neurology, the Europeen Academy of Neurology and the American Epilepsy Society.
Dr Mesraoua main objectives are to encourage frequent gathering of the epileptologists/neurologists from the MENA region and the rest of the world , promote Epilepsy Teaching in the MENA Region, and encourage multicenter studies involving neurologists and epileptologists in the MENA region, particularly epilepsy epidemiological studies.
Dr Mesraoua is the recipient of two research Grants, as the Lead Principal Investigator (750.000 USD and 250.000 USD) from the Qatar National Research Fund (QNRF) and the Hamad Hospital Internal Research Grant (IRGC) , on the following topics : “Continuous EEG Monitoring in the ICU “ and on “Alpha-lactoalbumin , proof of concept in the treatment of epilepsy”.
Dr Mesraoua is the author and co-author of many peer reviewed publications and four book chapters in the field of Epilepsy and Clinical Neurology.

  • Institute of Biotechnology, Czechia.
  • Title:Requirements for SOX2 in Early Neurosensory Development
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Abstract

SOX2 is essential for maintaining neurosensory stem cell properties and it is involved in the early neurosensory development, in particular the brain and various sensory organs. SOX2 acts by maintaining an undifferentiated pro-neurosensory cell state that allows for proliferation in various developmental systems. SOX2 plays multiple roles in neuronal, sensory, and non-sensory development. At present, it is unclear how SOX2 achieves all these different functions. Interactions of SOX2 with other transcription factors likely represent a potential mechanism allowing for different roles of SOX2 in development. Several transcription factors have been shown to cooperate with SOX2 in different cell lineages, including C-MYC, Pax6, EYA1, SIX1, and CHD7. Additionally, the involvement of SOX2 in the early neurosensory development of cranial placodes remains unclear. To address this, we conditionally deleted Sox2 during eye, ear, and olfactory placode development. Early deletion of Sox2 eradicates all olfactory placode development, and disrupts retinal development and invagination of the lens placode. In contrast to the lens and olfactory placodes, the ear placode invaginates and delaminates NEUROD1 positive neurons. Furthermore, we show that SOX2 is not necessary for early ear neurogenesis, since the early inner ear ganglion is formed with near normal central projections to the hindbrain and peripheral projections to the undifferentiated sensory epithelia of the inner ear.

Biography

Dr. Gabriela Pavlinkova received her Ph.D. in Immunology in 2000 from Charles University, Prague, Czechia. After a postdoctoral training at University of Nebraska Medical Center, USA, she was appointed Assistant Professor at University of Nebraska Medical Center, USA in 2005. Since 2008, she is Head of Laboratory of Molecular Pathogenetics, Institute of Biotechnology Czech Academy of Sciences, Prague, Czechia.

Research interest

My main research interest is to understand molecular aspects of neuronal development. I am focused on genetic mutations affecting transcriptional regulation during embryonic development, the molecular mechanisms of developmental programming, and identification of the molecular causes of abnormal embryonic development and disease predispositions.

  • Guangzhou Medical University, China
  • Title:Electrical status Epilepticus in Sleep Affects Intrinsically Connected Networks in Patients with Benign Childhood Epilepsy with Centrotemporal Spikes
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Abstract

Background: Although outcomes of benign childhood epilepsy with centrotemporal spikes (BECTS) are frequently excellent, some atypical forms of BECTS, especially electrical status epilepticus in sleep (ESES), are characterized by worse outcomes and negative impacts on cognitive development.Methods: To explore specific ESES-related brain networks in BECTS patients, we used resting-state functional magnetic resonance imaging (fMRI) to scan BECTS patients with ESES (n = 9), BECTS patients without ESES (n = 17) and healthy controls (n = 36). Unbiased seed-based whole-brain functional connectivity (FC) was adopted to explore the connectivity mode of three resting-state cerebral networks: the default mode network (DMN), salience network (SN), and central executive network
(CEN).Results: Compared with the other two groups, BECTS patients with ESES showed FC in the SN or in the CEN decreased, but not in the DMN. Moreover, we found the FC in the CEN in BECTS patients without ESES decreased when compared with controls. Our currently intrinsically defined anticorrelated networks strength was disrupted in BECTS and connote greater deactivation than the results from functional connectivity for a seed region in the BECTS children.Conclusion: These results indicated that the BECTS children with ESES showed brain activity altered in the CEN and the SN. The difference of impairment in the SN and CEN may lead to improve understand the underlying neuropathophysiology, and to assess the activity of BECTS patient with ESES, which is crucial for measuring disease
activity, improving patient care and assessing the effect of antiepilepsy therapy.

Biography

Hongsheng Liu was born in Hubei Province, China in 1972. He received the B.S. degrees in clinical medicine from Tongji Medical University, Wuhan, in1995, the M.S. degrees in imaging and nuclear medicine from China Medical University, Shenyang, in 2003, and the M.D. degree in imaging and nuclear medicine from Southern
Medical University, Guangzhou, in 2010. From February to August 2007, he was a visiting scholar, Astrid Lindgrens
Children’s Hospital, Karolinska University. From 2011 to 2017, he was director of MRI Department of Guangzhou Women and Children Medical Center. Since 2017, he has been director of Radiology Department of Guangzhou Women and Children Medical Center. He is the editor-in-chief of “Fetal Magnetic Resonance Imaging Diagnostics”,
more than 70 articles, and more than 8 scientific research projects. His research interests include gynecology and pediatrics imaging diagnosis, especially in children’s central nervous system, bones and fetus. He held more than 3 national continuing education courses, such as New advances in pediatric neuroimaging diagnosis. Dr. liu is deputy leader of Gynecology and Pediatrics Group of Guangdong Radiological Society and member of more than 9 societies.

  • University of Passo Fundo, Brazil
  • Title:Initial Experience with a Flow Redirection Endoluminal Device Stent-A Brazilian Multicenter Study
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Abstract

The endovascular approach has become the therapy of choice for intracranial aneurysms. The development of flow-diverter (FD) stents has offered the potential of aneurysm occlusion by vessel reconstruction, and these devices are an excellent choice for treating wide-necked, large, and fusiform aneurysms. The classic FDs are the Pipeline Embolization Device and SILK Flow Diverter, but other models have become available on the market in recent years. The Flow Re-direction Endoluminal Device (FRED) stent is a relatively new device with certain particular characteristics that distinguish it from older FDs. We report a retrospective series of 28 patients with 38 aneurysms treated with 29 FREDs from August 2016 to July 2017. Cases were treated at three different centers by three interventional neuroradiologists with similar expertise in using FDs. Our objective was to explore the differences of this device compared to past FDs, its safety, and its complication rates during early follow-up. We conclude the FRED stent is a safe device, with high success rates at deployment and low rates of clinical complications. Its modified architecture makes it much easier to navigate, but it may not expand well in tight curves. In this event, it is preferable to resheath the stent and attempt to deliver it again than to attempt balloon angioplasty across an incomplete opening, as the stent mesh is very difficult to cross. Our results are consistent with those of other case series.

  • National Technical University of Athens, Greece
  • Title:Urban Livability: Tracking the Connection Between Stress Levels and Spatial Stimuli in Copenhagen City, Denmark
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Abstract

Cities can often be stressful environments for both subjects and design providers and can affect people’s subjective wellbeing. Studies indicate that high levels of stress-related problems during navigation are observed mostly. This study focuses on the spatial variables causing mental and emotional stress in a particular urban area. An experiment assessed how subjects exposed to a specific urban environment form composite precepts that trigger certain emotional states. The proposed experiment has been performed on a path in Copenhagen city center. Tracking the subject’s emotional reactions in response to specific spatial features of the path could lead to the highlighting of the association between stress levels, memory, and spatial stimuli during navigation. Also, it could cause the design of improved spatial configurations for the urban environment. Eye-tracking glasses and skin sensors were administered for the experiment in twenty participants. The findings indicated that although subjects characterized the path as livable, many participants could not recall the spatial stimuli observed during the navigation process. The primary reasons were found to a high level of stress in the path, be crowded, be noise, and be narrow. The outcome of research suggests that the effect of stressors is connected to spatial features that are crucial for the wellbeing of human beings and the livability of the built environment. The research aims to introduce a new approach to designing less stressful urban environments easier to recall.

Biography

Maria Christofi is currently a Ph.D. candidate in Architectural Technology- Cognitive and Computational Architecture in the National Technical University of Athens (NTUA), Department of Architecture. Her recent research explores the intersections between architecture, cognition, and computing. She investigates how our environment’s perception adapts to the alterations of the built environment. Her methodology is based on a situated computing practice that investigates spatial-cognitional phenomena across different scales. Her research also includes the development of a spatial application called FUMapp, under the guidance of Professors Miltiades Katsaros, Sotirios D. Kotsopoulos, and Louis Emilio Bruni. Her work has been published in scientific and design journals, as well as Computation and Architecture conferences. She has taught design studios at NTUA and the University of Cyprus (UCY). As a researcher, Maria has collaborated with Augmented Cognition Lab (AAU), MesArch Lab (UCY), Franklin and Marshall University for ‘Drones above the Stones’ project, while most recently, she started a collaboration with KIOS Research Center (UCY). She holds a BSc in Architecture from UCY, an MSc in Design-Space-Culture and Cognitive Architecture from the NTUA. She is a registered architect in the EU since 2013 and has several years of experience in architectural practice. During her studies, Maria received the Athanasios Ktorides Foundation Fellowship, the Sylvia Ioannou Fellowship, the Cyprus State Scholarship Foundation Fellowship, the DOMES International Magazine Award, and the International Allplan Young Architects Award.

  • Gamal Abdel Nasser University of Conakry, Guinea
  • Title:What is the Nutritional Status of your Patients Suffering from Stroke
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Abstract

Strokes can significantly affect the autonomy and the ability of the patient to feed properly. Malnutrition after strokes increases the length of stay in hospital, increases mortality and aggravates disability. Nutritional support is a therapeutic that can be useful in the management of strokes and during the rehabilitation period. It may help to reduce the occurrence of complications due to the physical dependence associated with this condition. The objective of our study was to evaluate, through a questionnaire, the opinion of prescribing doctors working in the Department of Neurology of The FANN National Teaching Hospital in Dakar. The interest of the question resides in the fact that the Center does not have a dedicated nutritionist for inpatients. This was an opinion poll about their concerns about the nutritional status of patients in the therapeutic projects they propose during the stroke. The type of the chosen opinion poll was elementary, type random. The questionnaire was individual and consisted of five items of single-response and multiple-choice questions. The results of this study reveal that while the nutritional status of patients with limited autonomy in the service was a concern in the intentions of the prescribers, in practice it was not taken into account in therapeutic projects. To date, no structured protocol is available in cases of proven nutritional deterioration in patients. Nutritional management must be integrated into the overall management of Neurology patients, particularly in elderly victims of strokes.

  • State University of Maringa, Brazil
  • Title:Juvenile Physical and Psychological Stress has Opposite Effects on the Hippocampus of Adult Rats - Unsuccessful and Successful Adaptation
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Abstract

Studies point out that predictable stress models with a short time duration do not lead to a toxic effect, on the contrary, they cause adaptation and can collaborate to elucidate the mechanisms of resilience. This study investigated the long-term behavioral and neuroanatomical effects in two low-stress models (psychological and physical) experienced in the early phase. Male Wistar rats (n=42) were arranged into three groups: Control (C), Physical Stress (Restraint) e Psychological Stress (Predator-Cat). As juvenile (P25 to P27), each group was submitted to the respective stress model, and their behavior was analyzed on P60. The Elevated Plus Maze (EPM) test was used to verify the anxiety-like behavior exhibited by the rats, and Novel Object Preference Task was used to verify their memory in three different instants: after 15 minutes (T1), 24 hours (T2), and 72 hours (T3). On P80, after perfusion, their brains were prepared and the sections were processed to verify the hippocampus volume which were analyzed through the Nissl staining method, and the hippocampus’ dendritic spine in their regions CA1, CA3, and dentate gyrus (DG) was analyzed through Golgi-Cox.
The data obtained in the EPM revealed no effect on exploration in the open and closed arm and anxiety index, thus suggesting resistance to develop anxious behavior in both types of stresses. Regarding their cognitive behavior, there was no significant effect on the rats’ performance in the memory tests, in all tests T1, T2, and T3, therefore suggesting that both types of stresses had no long-term impact.
The neuroanatomical analysis revealed that there was no change in the volume of the hippocampus, this result was obtained by analyzing the surface area of the neurons layer in the regions CA1, CA3, as well as DG. However, the analysis of dendritic spines revealed a pattern of biological responses: while the Physical Stress decreased the dendritic spines’ density, the Psychological Stress increased it, in comparison to the control group. These effects were observed in three analyzed regions, CA1, CA3, and DG hipocampus’. Our data suggest that physical stress has a negative long-term effect, whereas, the psychological stress causes effect considered a successful adaptation, and the next question is answer why.

Biography

Professor (Neuroanatomy- State University of Maringa -Brazil) since 1991, received the Ph.D in Biological Science from State University of São Paulo (Brazil), a Post-doc position in Neuroscience from University of Lethbridge (Canada), and Philipps-Universität Marburg (Germany).The main research activities are in the fields about brain plasticity relatet to stress and resilience.

  • Maine Medical Research Institute (MMCRI), USA
  • Title:Metabolic Aspects of Parkinson’s Disease
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Abstract

α-Synuclein is a polypeptide encoded by the Snca gene, highly expressed in neurons, but it is also found in bones and adipose tissue. Aggregation of α-Synuclein is the principal component of Lewy bodies in the central nervous system of PD (Parkinson’s Disease) and PDD (Parkinson’s Disease Dementia) patients. Symptoms include progressive immobilization and a range of -often unnoticed – nonmotor symptoms, including osteopenia, body composition alterations and insulin resistance. The aim of this talk is to discuss PD pathophysiology emphasizing potential α-Synuclein’s intrinsic role in bone health and metabolism.
By using a variety of conditional deletion and overexpression of α-Synuclein mice models we tested the effects of α-Synuclein in skeletal metabolism and microarchitecture, and adipose tissue during estrogen deficiency and diet-induced obesity. In vitro models of loss and overexpression of α-Synuclein showed a dose dependent effect in mitochondrial morphology, adipogenesis and insulin signaling.
Future research is essential to understand the local and systemic effects of α-Synuclein signaling on bone remodeling and adipose metabolism to shed light into possible treatment targets for osteoporosis and insulin resistance in PD patients.

Biography

Dr. Figueroa graduated with honors from Bachelor in Science, biology major from University of Chile (U. Chile) in 2009. Her formal scientific beginning was on developmental biology and human infertility research. In 2015, she obtained her Master’s degree at U. Chile from her work on the role of BMP-2 in lineage commitment in bone mesenchymal stem cells from postmenopausal osteoporotic women. She joined Dr. Rosen Laboratory at Maine Medical Center Research Institute (MMCRI) to study the role of α-Synuclein in bone and adipose tissue by using relevant PD mice models. She obtained her Ph.D. from University of Maine in July 2020. She has presented several occasions at the American Society of Bone and Mineral Research (ASBMR), has two first author publications and two supporting author publications. She is currently working in her third first author publication and participating as a lecturer in a “Osteoporosis in Parkinson’s Disease” course (UCB, Spain).

  • Instituto de Investigation Medica M y M Ferreyra, INIMECCONICET, Argentina
  • Title:PERK Signaling Mediates Neurite Atrophy and Apoptosis in a GM2-Gangliosidosis
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Abstract

GM2-gangliosidosis, a subgroup of lysosomal storage disorders, is caused by deficiency of hexosaminidase activity, and comprises the closely related TaySachs and Sandhoff diseases. The enzyme deficiency prevents normal metabolization of ganglioside GM2, usually resulting in progressive neurodegenerative disease. The Endoplasmic Reticulum (ER) plays a critical role in a variety of cellular processes. A disturbance of any of these functions imposes stress to the ER and subsequently leads to accumulation of unfolded protein in the lumen organelar. This condition activates a signal transduction pathway called the Unfolded Protein Response (UPR) that attempts to restore homeostasis in the ER, but if the stress persists the signaling switches and induce apoptosis. The molecular mechanisms whereby GM2 accumulation in neurons triggers neurodegeneration remain unclear. We found that ganglioside GM2 accumulation in the ER induce decrease in the luminal Ca2+ content. This in turn activate PERK (protein kinase RNA [PKR]-like ER kinase) signaling, one of UPR branches, which shows two phases: one acute,
where the cytoprotective calcineurin is up regulated, and another where is enhanced the expression of pro-apoptotic transcription factor C/EBP homologous protein (CHOP). Moreover, we present evidence showing that pharmacological as
well as molecular modulation of PERK signaling changes the vulnerability of neurons to undergo neurite atrophy and apoptosis.

Biography

Dr Mariana Bollo graduated as a Microbiologist at the National University of Rio IV,Argentina and obtained her Ph.D. in Biology Sciences at the same University in 2003. Then, she was a post-doctoral fellow in the Department of Physiology, University of Texas Health Science Center at San Antonio (UTHSCSA), USA. She is currently Associate
Researcher (Faculty e.q.) of the National Council for Scientific and Technical Research (CONICET), Argentina.
Her laboratory focuses on understanding the signaling pathway underlying the calcium regulation of Endoplasmic Reticulum perturbation and its relationship to pathological conditions. One specific area of research is an investigation of the underlying protective mechanisms mediated by Calcineurin β and moderated cytosolic Ca2+ rise after brain injury. A second area of research focused on the role of the unfolded protein response (UPR) in change the susceptibility of neurons to undergo apoptosis in GM2-gangliosidosis.

  • University of San Martín, Argentina
  • Title:
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Abstract

Depression affects hundreds of people. Despite its complex etiology, it is accepted that chronic stress is a key factor in its onset. Since stress main effects occur in the brain, an inaccessible area, we focused in detecting stress molecules in peripheral fluids such as blood or saliva. We have shown that the neural glycoprotein M6a can be detected in serum. M6a contributes to the neuronal plasticity promoting neurite and filopodium growth
and synaptogenesis (Alfonso 2004, Brocco 2010, Formoso 2016). Next, we demonstrated that M6a is carried in extracellular vesicles (EVs). EVs are delivered by cells in physiological and pathological conditions, can be isolated from almost all fluids and are used in the diagnosis of several diseases. Then, we showed that M6a-carrying EVs, but not EVs without M6a, induced a phenotypical change in COS-7 cells observed as filopodium formation. This indicates that M6a coupled to EVs might participate in cellular communication and contribute to cellular plasticity maintenance. Since M6a has also been related to several neuropsychiatric disorders, we studied serum M6a levels in chronically stressed animals. We found that stress altered M6a levels in blood. Thus, we proposed M6a as a putative stress biomarker (Monteleone, 2017). Furthermore, using patient saliva samples we showed that M6a levels positively correlated with the scores for the perceived stress scale in individuals diagnosed with depression. This reinforces the idea of M6a as a stress-responsive protein whose levels changes when the individual experiences stress. In addition, saliva samples of depressed patients treated with classic antidepressants (SRI) or with benzodiazepines differed in their M6a levels with respect to untreated patients. This suggests a potential use of M6a for evaluation of antidepressant treatment efficacy (Monteleone 2020). These findings encourage us to continue the study of M6a as a putative stress biomarker and also to determine if EVs can per se be messengers of the stress signal.

Biography

Dr Melisa Monteleone is an Argentinian molecular biologist. She is a researcher from the National Council for Scientific and Technological Research (CONICET) at the Institute for Research in Biotechnology in the Neurobiology of Stress laboratory from the University of San Martin (UNSAM). She obtained her Ph.D. in molecular biology and biotechnology from the UNSAM and received a postdoctoral training with Dr Alberto Frasch in the field of neurobiology. Dr Monteleone has centered her research on the role of chronic stress, prenatal and during adulthood, on individual genetics, epigenetics and behavioral alterations and how these effects could be detected in a simple way using extracellular vesicles. She is also a teaching assistant in the B.Sc. career of UNSAM and a member of
the B.Sc. student tutoring and mentoring committee.

  • The Research Institute of Ophthalmology, Egypt
  • Title:Successful Oral Treatment of Third Cranial Nerve Palsy and Optc Neurits from Neglected Herpes Zoster in an Immunocompetent Patentt
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Abstract

Purpose: Herpes zoster (HZ) is an acute viral erupton caused by the reactvaton of varicella zoster virus (VZV), a herpes virus causing chicken pox in children. We aimed to report a 3- month neglected case of acute herpes zoster-induced third nerve palsy and optc neurits, followed by a late-onset keratouveits in an immunocompetent young adult.
Observations: A 36-year old immunocompetent Egyptan male patent presented with 3- month complaints of blurred vision and drooping of his lef upper eyelid that appeared 4 days after a herpetc rash. He had been diagnosed with herpes zoster ophthalmicus (HZO) of the lef eye. However, he had not received any systemic antviral treatment. The patent had an abnormal head posture with post-eruptve scars on the lef forehead and the nose tp. Examinaton revealed weakness of elevation and adducton, partal ptosis, and mid-dilated non-reactve pupil in the lef eye. A relatve afferent pupillary defect (RAPD) was present in the affected eye. His blood sugar and blood pressure were within normal limits. Contrast magnetc resonance imaging (MRI) showed no space-occupying lesion. However, there were
enhancement and enlargement of the lef optc nerve on T1-weighted images, denotng optc neurits. A diagnosis of acute lef third nerve palsy with pupil involvement and optc neurits secondary to HZO was made. Despite late treatment with oral acyclovir and prednisolone, the patent recovered. One and a half months later, he developed a late-onset
keratouveits about 8 months afer the rash onset. Afer the resoluton of the episode, oral acyclovir was contnued at a prophylactc dose (444 mg BID).
Conclusions aod importance: HZ is a rare cause of third nerve palsy with pupil involvement and optic neurits. Oral acyclovir and steroids were effective in the delayed treatment in this case. Abnormal optc nerve enhancement on MRI 3 months afer the appearance of vesicular rash may suggest chronic HZ activity. Concurrent optic neurits and third cranial nerve palsy in the absence of other signs of orbital apex syndrome can be seen in cases of HZO. Regular follow-up of patents with HZ is important for detectng recurrence and initatng prompt treatment.

Biography

My name is Samah Ahmed Osman. I am a Consultant in Ophthalmology. I had obtained my Bachelor degree in Medicine and Surgery from the faculty of Medicine of Alexandria University in Egypt. I worked in French hospitals as a resident in Emergency & Surgery departments for one and half year. I returned home and I had obtained a Master degree in General Surgery from the faculty of Medicine of Cairo University. As I was always passionate about Ophthalmology, I made a ‘career shif’, and I had obtained a diploma in Ophthalmology from the faculty of Medicine of El Azhar University, as a second specialty. I believe in contnual learning and practcing in Medicine. Therefore, I joined The Egyptan Fellowship training program in Ophthalmology for 4 years. I had practced in specialized ophthalmology insttutes in several subspecialty departments. I had obtained The Fellowship of The Egyptan Board of Ophthalmology [FEBO]. I also succeeded in the examinatons of part 2 of The Fellowship of The Royal College of Physicians and Surgeons (FRCS) of Glasgow. I intend to take the examinatons of part 3 FRCS (Glasgow) next year. I took many visitor posts in The Research Insttute of Ophthalmology in Strabismus, Oculoplastcs, and Vitreo-Retnal departments. I am honored to have my frst publicaton (this case report) in The Americao Jouroal of Ophthalmology Case Reports. I work in a private clinic.

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