Papers by Sherifa A Hamed
BACKGROUND Chronic musculoskeletal pain (CMP) is a functional neurological symptom that manifests... more BACKGROUND Chronic musculoskeletal pain (CMP) is a functional neurological symptom that manifests as real pain originating from the brain due to mental health issues and a combination of factors. AIM To determine the patterns of CMP, the associated emotional, behavioral and social components and predictors of pain's impact on daily life.
Lacosamide-induced myoclonus in patients with acute symptomatic metabolic seizures: A case series
Advanced Neurology, 2025
Fluid and electrolyte imbalances are common causes of seizures and admissions to intensive care u... more Fluid and electrolyte imbalances are common causes of seizures and admissions to intensive care units. This case series describes three female patients who experienced their first seizures. Case 1 was a 64-year-old woman with status epilepticus and severe hypocalcemia (6.8 mg/dL), who presented with generalized tonic–clonic (GTC), focal motor, and myoclonic seizures. Case 2 was a 70-year-old woman with cluster seizures, diagnosed with hypocalcemia (7 mg/dL) and hypomagnesemia (1.2 mg/dL), who also experienced GTC seizures. Case 3 was a 77-year-old woman with status epilepticus, diagnosed with dehydration, hyponatremia (120 mEq/dL), hypocalcemia (8 mg/dL), and hypokalemia (2 mEq/dL), who experienced complex partial seizures. Hospital management included intravenous fluids, electrolyte replacement, and antiseizure medications (ASMs) such as midazolam, levetiracetam, and phenytoin. Lacosamide, administered either to manage focal seizures or as an adjuvant ASM, induced myoclonic j...
The effectiveness of cerebrolysin, a multi-modal neurotrophic factor, for treatment of post-covid-19 persistent olfactory, gustatory and trigeminal chemosensory dysfunctions: a randomized clinical trial
Expert Review of Clinical Pharmacology
Background: This trial aimed to monitor the outcomes of persistent post-covid-19 smell and taste ... more Background: This trial aimed to monitor the outcomes of persistent post-covid-19 smell and taste disorders after cerebrolysin therapy, a NTF, and olfactory and gustatory trainings. Research design and methods: This was a prospective randomized trial. It included 250 patients (male = 93, female = 157; age: 31.3 ± 8.9 years). Patients were randomized into group 1 (n = 150): received cerebrolysin [5 ml/d (IM), 5d/week] and practiced olfactory and gustatory trainings, and group 2 (n = 100): practiced olfactory and gustatory trainings only, for ≥ 8-24 weeks. Measures of outcomes were: a clinical questionnaire; sniffin' odor, taste and flavor identification tests; and global rating scales for smell and taste. Results: The duration of disorders was 11.7 ± 3.7mo (range: 6-24mo). The majority (n = 167; 66.8%) developed parosmia within months (3.6 ± 2.7mo) after anosmia. Objective testing showed anosmia in all and taste, flavor, and trigeminal sensory losses in 18% (n = 45). Analyses for secondary outcome were done on 202 patients (group 1 = 130; group 2 = 72). Recovery was complete in 61.5% (n = 80) with cerebrolysin therapy and partial in 17% (n = 22). There was no recovery with trainings only. There were no predictors for recovery. Conclusions: Cerebrolysin had fast, promising, and constant effect, with cure rate of > 60%. This might be due to its ability to initiate and enhance neuronal regeneration and reorganization of sensory epithelia. Trial registration: NCT04830943.
The effect of antiepileptic drugs on the kidney function and structure
Expert Review of Clinical Pharmacology, Jul 26, 2017
ABSTRACT Introduction: Long-term use of antiepileptic drugs (AEDs) is associated with number of s... more ABSTRACT Introduction: Long-term use of antiepileptic drugs (AEDs) is associated with number of somatic conditions. Data from experimental, cross-sectional and prospective studies have evidence for the deleterious effect of some AEDs on the kidney. Areas covered: This review summarized the current knowledge of the effect of AEDs on the kidney including evidence and mechanisms. Fanconi syndrome was reported with valproate (VPA) therapy in severely disabled children with epilepsy. Renal tubular acidosis and urolithiasis were reported with acetazolamide, topirmate and zonisamide, drugs with carbonic anhydrase inhibition properties. Increased levels of urinary N-acetyl-beta-D-glucosaminidase (NAG) to urinary creatinine (U-NAG/UCr), urinary excretion of α1-micrglobulin, β-galactosidase activity; and urinary malondialdehyde to creatinine (MDA/Cr), markers of renal glomerular and tubular injury, were reported with chronic use of some AEDs (VPA, carbamazepine and phenytoin). The mechanism(s) of kidney dysfunction/injury induced by AEDs is unknown. Experimental and clinical studies have shown that VPA induces oxidative stress, mitochondrial deficits, carnitine deficiency and inflammation and fibrosis in renal tissue in mice and in vitro studies. Expert commentary: It seems reasonable to monitor kidney function during treating patients with epilepsy at high risk of kidney injury (e.g. on combined therapy with more than one AED, severely disabled children, etc).
Evaluation of children and adults with post-COVID-19 persistent smell, taste and trigeminal chemosensory disorders: A hospital based study
World Journal of Clinical Pediatrics
BACKGROUND Smell disorders are the most frequent persistent coronavirus disease 2019 (COVID-19) c... more BACKGROUND Smell disorders are the most frequent persistent coronavirus disease 2019 (COVID-19) complications. AIM To describe the patterns and characteristics of persistent smell and taste disorders in Egyptian patients. Hamed SA et al. Post-COVID-19 persistent smell and taste disorders WJCP https://www.wjgnet.com 134 June 9, 2023 Volume 12 Issue 3 smell and taste disorders in children from adults. CONCLUSION The course of small and taste disorders are supportive of the nasal and oral neuronal compromises. Post-COVID-19 taste and trigeminal disorders were less frequent compared to smell disorders. Post-COVID-19 flavor disorders were solely dependent on taste and not smell disorders. There were no demographics, clinical variables at onset or specific profile of these disorders in children compared to adults.
Idiopathic steno-occlusive disease with bilateral internal carotid artery occlusion: A Case Report
World Journal of Clinical Cases
BACKGROUND Moyamoya disease (MMD) is a rare cause of acute stroke and transient ischemic attacks ... more BACKGROUND Moyamoya disease (MMD) is a rare cause of acute stroke and transient ischemic attacks in children. We described clinical, diagnostic features and follow-ups of a young child with acute stroke.
Vestibular evoked potential response in adults with type 1 diabetes
Hearing, Balance and Communication, Nov 7, 2022
Purpose: Vestibular system is critical for maintaining balance. This study aimed to determine the... more Purpose: Vestibular system is critical for maintaining balance. This study aimed to determine the function of the saccule of the otolith organ in adults with type 1 diabetes (T1D) using cervical vestibular evoked myogenic potential (cVEMP) and its independently associated demographic, clinical and laboratory variables. Method: This case-control cross-sectional study included 60 patients (male ¼ 15; female ¼ 45) and 30 healthy adults. They underwent cVEMP. Results: Patients had mean age of 30.63 ± 4.20 years and duration of illness of 14.68 ± 3.65 years. More than 50% had frequent diabetic ketoacidosis (DKA), 30% had frequent hypoglycaemic attack, 35% had comorbid hyperlipidaemia, and 40% had peripheral neuropathy. Dizziness was reported in 30%. Compared to controls, 40% of patients had significantly delayed absolute latencies of P1 and N1 (p ¼ 0.01) either unilateral or bilateral and 80% had reduced P1-N1 amplitudes (p ¼ 0.001). Higher frequencies of abnormalities were present bilaterally. Asymmetry ratio (AR) was reported in 25%. Patients with longer duration of diabetes (>5 year), dizziness, HbA1c (>7%), frequent DKA or hypoglycaemic attacks and peripheral neuropathy had significantly prolonged P1 and N1 latencies and reduced P1-N1 amplitudes compared to those with shorter duration of diabetes, without dizziness, with HbA1c% 7%, low frequency of DKA hypoglycaemic attacks and those without peripheral neuropathy. Multiple regression analysis showed that presence of delayed P1 latencies and reduced P1-N1 amplitudes were significantly correlated with duration of diabetes > 5 years [OR ¼ 3.60 (95%CI ¼ 1.80-6.44), p ¼ 0.01; OR ¼ 4.56 (95%CI ¼ 2.80-7.80), p ¼ 0.01] and HbA1c levels >7% [OR ¼ 5.26(95%CI ¼ 3.83-8.05), p ¼ 0.001; OR ¼ 4.55(95%CI ¼ 2.45-8.55), p ¼ 0.001]. Conclusion: The dysfunctions of the saccule of otolith organ and/or its pathway are prevalent in adults with T1D and correlated with duration and severity of diabetes. Therefore, optimal control of glycemic control is essential.
Epidemiology, Nov 25, 2013
She was a part of a multidisciplinary research program concerning disease gene identifi cation of... more She was a part of a multidisciplinary research program concerning disease gene identifi cation of muscular dystrophies. She served as a reviewer for 30 medical journals and has a least 70 international publications in the fi elds of Neurology, Neurogenetics and Neuropsychopharmacology.
Vestibular function in children with generalized epilepsy and treated with valproate
Expert Review of Clinical Pharmacology
Background: Studies that evaluated vestibular function with epilepsy are fewer than auditory stud... more Background: Studies that evaluated vestibular function with epilepsy are fewer than auditory studies. We assessed vestibular function in children with epilepsy in inter-ictal period. Research design and methods: This cross-sectional study included 35 children with generalized epilepsy (boys=15; girls=20; age=11.20±1.21 years; epilepsy duration=3.54±1.80 years) and treated with valproate (VPA) and 24 healthy children. Vestibular evaluation was conducted using videonystagmography (VNG) and cervical vestibular evoked myogenic potentials (cVEMPs). Results: Dizziness was the vestibular symptom in 22.86% of cases. Vestibular dysfunctions (VDs) were found in 65.71%. Manifestations of peripheral VD (65.71%) included unilateral caloric weakness and reduced cVEMP amplitudes. Manifestations of central VD (28.57%) included oculomotor abnormalities, positional nystagmus with normal calorics, and prolonged cVEMPs latencies. Significant correlations were found between VDs and duration of epilepsy and its treatment [r =-0.368, P=0.01] and VPA dose [r =-0.286, P=0.02] and level [r =-0.355, P=0.01]. Logistic regression analysis showed that duration of epilepsy and its treatment [OR = 3.55 (95% CI = 2.54-6.50), P=0.001] were independently associated with VDs. Conclusions: VDs are common in children with epilepsy. Bilateral peripheral VD was more common than central VD, suggesting an adverse effect of VPA. However, epilepsy cannot be excluded as a cause of central VD.
Cortical excitability in epilepsy and the impact of antiepileptic drugs: transcranial magnetic stimulation applications
Expert Review of Neurotherapeutics, 2020
ABSTRACT Introduction Epileptic conditions are characterized by impaired cortical excitation/inhi... more ABSTRACT Introduction Epileptic conditions are characterized by impaired cortical excitation/inhibition balance and interneuronal disinhibition. Transcranial magnetic stimulation (TMS) is a neurophysiological method that assesses brain excitation/inhibition. Area covered This review was written after a detailed search in PubMed, EMBASE, ISI web of science, SciELO, Scopus, and Cochrane Controlled Trials databases from 1990 to 2020. It summarizes TMS applications for diagnostic and therapeutic purposes in epilepsy. TMS studies help to distinguish different epilepsy conditions and explore the antiepileptic drugs’ (AEDs’) effects on neuronal microcircuits and plasticity mechanisms. Repetitive TMS studies showed that low-frequency rTMS (0.33–1 Hz) can reduce seizures’ frequency in refractory epilepsy or pause ongoing seizures; however, there is no current approval for its use in such patients as adjunctive treatment to AEDs. Expert opinion There are variable and conflicting TMS results which reflect the distinct pathogenic mechanisms of each epilepsy condition, the dynamic epileptogenic process over the long disease course resulting in the development of recurrent spontaneous seizures and/or progression of epilepsy after it is established, and the differential effect of AEDs on cortical excitability. Future epilepsy research should focus on combined TMS/functional connectivity studies that explore the complex cortical excitability circuits and networks using different TMS parameters and techniques.
Types and mechanisms of cognitive deficits in childhood epilepsy
Journal of Pediatric Epilepsy, 2012
Many human studies on cognition have focused on infants, preschool, and school age children. This... more Many human studies on cognition have focused on infants, preschool, and school age children. This period is characterized by peak hippocampal and cortical regional development, as well as myelinogenesis, dendritogenesis, and synaptogenesis. The presence of epilepsy and its treatment during the period of maximal white-matter growth might result in impairment in spatial learning, memory processes and other aspects of cognition. Several variables are associated with cognitive impairment in epilepsy, which includes maternal-related, seizure-related and medication-related variables. Paroxysmal seizures and electroencephalography epileptic discharges may cause transient, persistent or progressive cognitive impairment. Transient disruption of cognitive processing may occur with paroxysmal epileptic activity. Repeated seizure activity selectively impairs myelin accumulation, consumes, and reduces hippocampal plasticity available for information processing. High doses of antiepileptic drugs ...
The childbearing years including the peripartum periods [pregnancy and the first 6-12 months post... more The childbearing years including the peripartum periods [pregnancy and the first 6-12 months postpartum, particularly the first 4 weeks to 3 months] are periods characterized by biological [marked physiological], psychological and social changes [adaption to new roles and responsibilities of motherhood] making women highly vulnerable to a wide range of psychological distress conditions and disorders. They include antepartum and postpartum depression [1-4], antepartum and postpartum anxiety [3,5,6], insomnia [7,8], postpartum blues [9-11], psychosis [12-14], obsessive compulsive disorder (OCD) [15,16], post-traumatic stress disorder (PTSD) [17,18] and maternal suicide [19-21]. Studies concerned with mother mental health reported the followings in some women in the peripartum periods (a) different incidences of mental disorders throughout the three trimesters of pregnancy [1,22], (b) some mental disorders just begin or become worse in pregnancy [13], (c) high relapse rates of mood dis...
Cerebrolysin as a nerve growth factor for treatment of acquired peripheral nervous system diseases
Neural Regeneration Research, 2011
Cerebrolysin is a drug consisting of low-molecular-weight neurotrophic peptides and free amino ac... more Cerebrolysin is a drug consisting of low-molecular-weight neurotrophic peptides and free amino acids. Cerebrolysin has been shown to ameliorate the effects of oxidative stress, reduce apoptosis, and promote neuronal growth in several degenerative and acquired central nervous system insults, including dementias, stroke, and traumatic injuries. Little is known about its therapeutic efficacy in peripheral nervous system diseases. In this study, we clinically evaluated the effects of cerebrolysin on peripheral nervous system lesions. We evaluated the clinical efficacy of cerebrolysin in six patients with the following conditions who failed to respond to conventional therapies: (1) atonic bladder due to inflammatory radiculitis; (2) paraplegia due to inflammatory radiculoneuropathy; (3) post-traumatic brachial plexopathy; (4) compressive radial nerve injury; (5) post-traumatic facial nerve paralysis; and (6) diabetic ophthalmoplegia. Our results showed that cerebrolysin was more associat...
Renal dysfunctions/injury in adult epilepsy patients treated with carbamazepine or valproate
Expert Review of Clinical Pharmacology, 2018
ABSTRACT Objectives: Clinical and subclinical laboratory evidence of renal proximal tubular dysfu... more ABSTRACT Objectives: Clinical and subclinical laboratory evidence of renal proximal tubular dysfunction had been reported in children with epilepsy as an adverse effect of some antiepileptic drugs (AEDs). This study aimed to determine kidney function in adult patients with monosymptomatic epilepsy of unknown etiology and treated with valproate (VPA) or carbamazepine (CBZ). Methods: This study included 60 patients [mean age of 33.97 ± 6.70 years and treated with VPA (n = 24) or CBZ (n = 36) for mean duration of treatment of 6.03 ± 2.81years. Measurements of serum creatinine (sCr), urinary creatinine, creatinine clearance (CrCl) and serum kidney injury molecule 1 (KIM-1), markers of renal dysfunction/injury were done. Results: Compared to controls, patients had higher sCr, KIM-1 and lower CrCl levels. Compared to patients on VPA, those on CBZ had relatively higher KIM-1 and lower CrCl levels. We reported only significant correlations between KIM-1 with sCr (r = 0.324, p = 0.001) and duration of treatment with AEDs (r = 0.301, p = 0.02). Conclusion: Chronic VPA and CBZ therapy may be associated with subclinical renal glomerular and/or proximal tubular dysfunctions or injuries. The treating neurologist have to consider this while selection of AED on start treating patients or modifying the AED for patients at high risk of kidney injury.
SAGE Open Medical Case Reports, 2020
Cerebrovascular stroke caused by skull base meningioma has been rarely reported. A 30-year-old ma... more Cerebrovascular stroke caused by skull base meningioma has been rarely reported. A 30-year-old male presented (April 2015) with acute right-sided hemiplegia. His brain neuroimaging (computerized tomography and magnetic resonance imaging) showed left ischemic infarction in the territory of middle cerebral artery. Magnetic resonance imaging also showed a right parasellar solid lesion which extended to the right basisphenoid and cavernous sinus and attenuated the right internal carotid artery. It also had left smaller parasellar extension. The lesion enhanced uniformly and strongly following gadolinium injection. Digital subtraction angiography using selective catheterization of both common carotid and left vertebral arteries (07/13/2015) showed occlusion of both internal carotid arteries and faint visualization of left terminal internal carotid artery and its bifurcation. The right internal carotid artery and its branches were not visualized. Left vertebral injection showed prominent ...
Journal of Neurology and Experimental Neuroscience, 2019
Schizophrenia is a clinical brain syndrome with neuroanatomical, biological and molecular complex... more Schizophrenia is a clinical brain syndrome with neuroanatomical, biological and molecular complexities. A wide range of aberrant motor functioning has been reported in 40-80% of patients with schizophrenia and some do overlap with patients' cognitive and negative symptoms.
World Journal of Clinical Cases, 2017
The patient involved in this study gave her written informed consent authorizing use and disclosu... more The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Sexual Dysfunctions Induced by Pregabalin
Clinical Neuropharmacology, 2018
Objectives Pregabalin (PGB) is a gabapentinoid (ie, GABA analog), which has been Food and Drug Ad... more Objectives Pregabalin (PGB) is a gabapentinoid (ie, GABA analog), which has been Food and Drug Administration–approved for treatment of partial epilepsy in adults and neuropathic pain. It also has off-label uses for the treatment of generalized anxiety disorders, fibromyalgia, and tension headache and prevention of migraine. Few cases were reported with sexual dysfunctions (SDs) as adverse effects of PGB and gabapentin, and the majority were dose related (≥900 mg/d for gabapentin). This study aimed to determine the frequency and types of SDs induced by PGB and the temporal relation to its use. Methods We presented case series of patients (n = 75) treated with PGB for different indications (sciatica, atypical facial pain, chronic tension headache, transformed migraine, fibromyalgia, and generalized anxiety disorder and developed different aspects of SDs). Results and Conclusions In this case series, SDs were noticed with PGB in 41.33% (n = 31) (men, 13 [50%]; women, 18 [36.73%]), whi...
Neurologic conditions and disorders of uremic syndrome of chronic kidney disease: presentations, causes, and treatment strategies
Expert Review of Clinical Pharmacology, 2019
ABSTRACT Introduction: Uremic syndrome of chronic kidney disease (CKD) is a term used to describe... more ABSTRACT Introduction: Uremic syndrome of chronic kidney disease (CKD) is a term used to describe clinical, metabolic, and hormonal abnormalities associated with progressive kidney failure. It is a rapidly growing public health problem worldwide. Nervous system complications occur in every patient with uremic syndrome of CKD. Areas covered: This review summarized central and peripheral nervous system complications of uremic syndrome of CKD and their pathogenic mechanisms. They include cognitive deterioration, encephalopathy, seizures, asterixis, myoclonus, restless leg syndrome, central pontine myelinolysis, stroke, extrapyramidal movement disorders, neuropathies, and myopathy. Their pathogenic mechanisms are complex and multiple. They include (1) accumulation of uremic toxins resulting in neurotoxicity, blood–brain barrier injury, neuroinflammation, oxidative stress, apoptosis, brain neurotransmitters imbalance, ischemic/microvascular changes, and brain metabolism dysfunction (e.g. dopamine deficiency), (2) metabolic derangement (as acidosis, hypocalcemia, hyperphosphatemia, hypomagnesemia, and hyperkalemia); (3) secondary hyperparathyroidism, (4) erythropoietin and iron deficiency anemia, (5) thiamin, vitamin D, and other nutritional deficiencies, (6) hyperhomocysteinemia, and (7) coagulation problems. Expert commentary: Nervous system complications of uremia contribute to the patients’ morbidity and mortality. Optimizing renal replacement therapy, correction of associated metabolic and medical conditions, and improved understanding of possible pathogenic mechanisms of these complications is a major target for their prevention and treatment.
We know the previously described relationship between the cocaine consumption and the development... more We know the previously described relationship between the cocaine consumption and the development of clinical inmuno-meditated conditions, so frequently mimicking ANCA-vasculitides. We made a detailed revision of the current knowledge about this topic, also pointing out the changes in the clinical and laboratory findings that seems to occur in the last decades, and their suspected relation with the broad use of levamisole as cutting agent. Finally we summarised the management options described in the literature.
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Papers by Sherifa A Hamed