University hospital of Fez

Fès, Morocco

University hospital of Fez

Fès, Morocco
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Sennou A.S.,University Hospital of Fez | Boujraf S.,Clinical Neurosciences Laboratory | Belahsen M.F.,University Hospital of Fez | Messouak O.,University Hospital of Fez | Messouak O.,Clinical Neurosciences Laboratory
Journal of Neurosciences in Rural Practice | Year: 2014

Previous research indicates that the onset of psychiatric disorders is sometimes associated with multiple sclerosis (MS) evolving several years later. However, information on why this might occur, and on the outcomes of such patients, is still lacking. We aim to discuss these limitations with the current paper. We describe a 51-year-old female who demonstrated severe anxiety disorder and depression years before developing MS neurological symptoms. The patient was treated for these psychiatric disorders over 20 years. In the last 3 years of her treatment, the patient demonstrated a choreic-type of movement disorder in all her limbs. This disorder is consistent with relapsing-remitting MS. Clinical and magnetic resonance imaging (MRI) examinations demonstrated aspects of MS, without MS being diagnosed conclusively. The visual evoked potential indicated a diagnosis of conduction abnormalities. The established diagnosis was slow relapsing MS. The patient underwent methylprednisolone bolus (1 g/day). This case-study suggests that health professionals should conduct a full neurological assessment when they find atypical psychiatric symptoms in a patient. This would make sure that patients receive a better standard of care, and thus experience a better quality of life. © 2014 Journal of Neurosciences in Rural Practice.

Labib S.,University Hospital of Fez | Berdai A.,University Hospital of Fez | Harandou M.,University Hospital of Fez
Saudi Journal of Anaesthesia | Year: 2014

Colchicine is an alkaloid extracted from autumnal Colchicum plant which is used primarily for its anti-inflammatory therapy effect. Acute intoxication with colchicine is uncommon but often severe and results in multiple visceral organ dysfunctions. The intoxication severity and mortality are directly depending on the ingested dose. The treatment is manly symptomatic. However, the development of specific anti-colchicine immunotherapy would offer a new therapeutic perspective. Authors report a case of a young patient that ingested 40 tablets colchicine, which caused a multiple organ failure and with fatal outcome.

PubMed | The Clinical Neuroscience Laboratory, University Hospital of Fez and University Sidi Mohammed Ben Abdellah
Type: Journal Article | Journal: Journal of integrative neuroscience | Year: 2016

This work purpose was to estimate the implication of suspected adrenal function deficiencies, which was influenced by oxidative stress (OS) that are generating brain plasticity, and reorganization of the functional control. This phenomenon was revealed in two-hemodialysis patients described in this paper. Blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) revealed a significant activation of the motor cortex. Hemodialysis seems to originate an inflammatory state of the cerebral tissue reflected by increased OS, while expected to decrease since hemodialysis eliminates free radicals responsible for OS. Considering adrenal function deficiencies, sensitivity to OS and assessed hyponatremia and hypercalcemia, adrenal function deficiencies is strongly suspected in both patients. This probably contributes to amplify brain plasticity and a reorganization of functional control after hemodialysis that is compared to earlier reported studies. Brain plasticity and functional control reorganization was revealed by BOLD-fMRI with a remarkable sensitivity. Brain plastic changes are originated by elevated OS associating indices of adrenal function deficiencies. These results raise important issues about adrenal functional deficiencies impact on brain plasticity in chronic hemodialysis-patients. This motivates more global studies of plasticity induced factors in this category of patients including adrenal functional deficiencies and OS.

PubMed | University Hospital of Fez and University Hospital of Oujda
Type: Journal Article | Journal: Journal of medical signals and sensors | Year: 2016

The goal is assessing the diffusion magnetic resonance imaging (dMRI) method efficiency in characterizing focal hepatic lesions (FHLs). About 28-FHL patients were studied in Radiology and Clinical Imaging Department of our University Hospital using 1.5 Tesla MRI system between January 2010 and June 2011. Patients underwent hepatic MRI consisting of dynamic T1- and T2-weighted imaging. The dMRI was performed with b-values of 200 s/mm(2) and 600 s/mm(2). About 42 lesions measuring more than 1 cm were studied including the variation of the signal according to the b-value and the apparent diffusion coefficient (ADC). The diagnostic imaging reference was based on standard MRI techniques data for typical lesions and on histology after surgical biopsy for atypical lesions. About 38 lesions were assessed including 13 benign lesions consisting of 1 focal nodular hyperplasia, 8 angiomas, and 4 cysts. About 25 malignant lesions included 11 hepatocellular carcinoma, 9 hepatic metastases, 1 cholangiocarcinoma, and 4 lymphomas. dMRI of soft lesions demonstrated higher ADC of 2.26 0.75 mm(2)/s, whereas solid lesions showed lower ADC 1.19 0.33 mm(2)/s with significant difference (P = 0.05). Discrete values collections were noticed. These results were correlated to standard MRI and histological findings. Sensitivity of 93% and specificity of 84% were found in diagnoses of malignant tumors with an ADC threshold of 1.6 10(-3) mm(2)/s. dMRI is important characterization method of FHL. However, it should not be used as single criteria of hepatic lesions malignity. MRI, clinical, and biological data must be correlated. Significant difference was found between benign and solid malignant lesions without threshold ADC values. Hence, it is difficult to confirm ADC threshold differentiating the lesion classification.

Housni A.,University Hospital of Fez | Boujraf S.,University of Fez
Neurosciences | Year: 2013

Multimodal MRI has an important contribution to cancer research. This technique is completely non-invasive and non-ionizing, it provides major information for diagnosis, and answers the questions of therapists before, during, and after treatment. Hence, in this paper we review the interest of these MRI modalities and their impact on the diagnosis, during and after therapeutic care of brain tumors. The MRI modalities allow specifying the localization of the expanding pathological tumoral process, the differential diagnosis between brain tumors and confined lesions of different categories, the diagnosis of the tumoral type of the lesion, assessing the histological grade in cases of glial tumor, and its local extension as well as the therapeutic follow-up. The multimodal MRI approach has a major contribution to the advanced care of brain tumors.

Chaouki S.,University Hospital of Fez | Boujraf S.,University Hospital of Fez | Atmani S.,University Hospital of Fez | Elarqam L.,University Hospital of Fez | Messouak W.,University Hospital of Fez
Journal of Pediatric Neurosciences | Year: 2013

Gelastic seizures (GS) is an uncommon seizure type characterized by sudden inappropriate attacks of uncontrolled and unmotivated laugh and its diagnostic criteria were elaborated by Gascon. These criteria included stereotypical recurrence of laugh, which is unjustified by the context, associated signs compatible with seizure, and ictal or interictal abnormalities. GS can be cryptogenic or symptomatic of a variety of cerebral lesions, the most common being hypothalamic hamartoma. However, GS associated with other types of cerebral lesions are exceedingly rare. The physiopathologic mechanisms of this type of seizure are still undefined. Two reports have described a non-lesional GS arising from a parietal focus. In this paper, we report the first case of lesional GS associated to the parietal area of the brain in a child and this case has associated fever that is likely an ictal symptom.

Oudghiri B.,University Hospital of Fez | Benzagmout M.,University Hospital of Fez | Boujraf S.,Clinical Neurosciences Laboratory | Belahcen F.,University Hospital of Fez | Ibrahimi A.,University Hospital of Fez
Journal of Global Infectious Diseases | Year: 2012

Sarcoidosis is a chronic multisystemic granulomatous disease that is triggered by an autoimmune process. Nowadays, this pathology represents a well-recognized but uncommon complication for antiviral treatment in hepatitis C virus (HCV) infection. Herein, we report a remarkable case of 47-year-old woman treated for chronic HCV infection; the patient has developed interferon alfa-induced sarcoidosis involving the central nervous system. The evolution was fatal despite disrupting the antiviral therapy and initiating a high-dose corticotherapy. This complication of interferon alfa treatment was reported in the literature in only one case. Through this case and a review of the literature, we aim to underline the importance of screening for sarcoidosis before and during the follow-up of HCV patients undergoing antiviral therapy.

Souirti Z.,University Hospital of Fez | Messouak O.,University Hospital of Fez | Belahsen F.,University Hospital of Fez
Pan African Medical Journal | Year: 2014

Cerebral venous thrombosis (CVT) is a rare origin of stroke, the clinical presentation and etiologies vary. The prognosis is shown to be better compared to arterial thrombosis. Magnetic Resonance Imaging (MRI) and MR Venograpgy (MRV) are currently important tools for the diagnostic. We studied 30 cases of CVT diagnosed in the department of neurology of the University Hospital of Fez (Morocco). Patients diagnosed with CVT signs between January 2003 and October 2007 were included in the study. Cerebral CT-scan was performed in 27 cases (90%) while the MRI examination was done in 18 patients (67%); and most patients (90%) received anticoagulant therapy. The mean age of our patients was of 29 years (age range between 18 days and 65 years). A female predominance was observed (70%). The clinical presentation of patients was dominated by: headache in 24 cases (80%), motor and sensory disability in 15 cases (50%), seizures in 10 cases (33%), consciousness disorder in 10 cases (33%). CVT was associated to post-partum in 10 cases (33%), infectious origin in 8 cases (26%), Behcet disease in 2 cases (7%), pulmonary carcinoma in 1 case, thrombocytemia in 1 case and idiopathic in 7 cases (23%). The evolution was good in 20 cases (67%), minor squelaes were observed in 6 patients (20%), while major squelaes was observed in 2 cases. Two cases of death were registered. The CVT is a pathology of good prognosis once the diagnosis is promptly established and early heparin treatment initiated. © Zouhayr Souirti et al.

PubMed | University Hospital of Fez
Type: | Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia | Year: 2016

The aim of this study is to determine the clinical, paraclinical, therapeutic and outcome aspects of drug resistant patients with epilepsy in our region and consequently to discuss methods that may improve the management of these patients.This paper presents a retrospective study of 25 adult patients that were followed for focal drug resistant epilepsy in epileptology unit of the University Hospital of Fez, Morocco.This study recorded 25 patients including 48% of males and 52% of females. The mean age of patients was 24years-old. Hippocampal sclerosis was present in 28.5% of patients (7 cases); brain malformations were found in 19% of patients (5 cases); tumors were found in 24% of patients (6 cases); post-traumatic, post-surgical and anoxic-ischemic lesions were found in 28.5% of patients (7 cases). Resective epilepsy surgery was performed in 28,5% of patients (7 cases). Post surgical outcome was good for 5/7 patients (Engel I and II).The clinical characteristics, etiologies and clinical course of medically refractory focal epilepsy in our region are similar to that reported in the global literature. We also demonstrated a long delay between onset of seizures and surgery (15years range 8-34years) and barriers to epilepsy surgery.

PubMed | University Hospital of Fez and Military Hospital Moulay Ismail
Type: Journal Article | Journal: Case reports in oncology | Year: 2016

Krukenberg tumor is a well-known ovarian metastasis, usually of signet ring cell carcinoma in female patients. In the literature, there are a few documented cases of ocular metastasis in patients with Krukenberg tumor.We report the case of a 35-year-old single Moroccan woman. She presented chronic pelvic pain, hematemesis and blurring of vision in the left eye. Clinical examination showed a pelvic mass and an exophthalmos with a divergent strabismus in the left eye. Pelvic and abdominal ultrasound showed a right tissular ovarian mass. Computed tomography (CT) scan of the abdomen and pelvis revealed an ovarian tumor and bone metastasis. Orbital magnetic resonance imaging (MRI) showed a hypertrophy of the left inferior rectus muscle behind the exophthalmos. Stomach endoscopy revealed an ulcerated and protruded mass of the antro-fundic junction. Histopathology and immunohistochemistry showed an infiltration of the gastric mucosa by atypically isolated signet ring cells similar to the tumor cells found in the ovarian histopathological exams.Krukenberg tumor is an uncommon metastatic tumor of the ovary. This article provides an overview of the major pathological manifestations of Krukenberg tumor, patient characteristics, clinical and laboratory features of the disease, prognostic factors, and current knowledge about its pathogenesis.

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