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We studied 13 patients with cerebellar haemorrhage diagnosed by computed tomography (CT). Hypertension was accepted to be the etiological factor in 7 patients (53.5%). The most common presentation findings were vertigo, nausea, vomiting... more
We studied 13 patients with cerebellar haemorrhage diagnosed by computed tomography (CT). Hypertension was accepted to be the etiological factor in 7 patients (53.5%). The most common presentation findings were vertigo, nausea, vomiting and headache. In 6 patients haemorrhage was located to left cerebellar hemisphere in 5 to right cerebellar he¬misphere and in 2 to vermis. 3 patients were lost while a patient with a large vermian he¬matoma improved without any sequel. It is decided that the prognosis mostly depends on the level of consciousness from the beginning rather then the localization and the diame¬ter of the hematoma. SEREBELLAR HEMORAJI: Klinik, BT Bulgulari ve Prognoz Bu calismada Bilgisayarli Tomografi (BT) ile tani konulan 13 serebellar hemoraji (SH)'li hasta sunulmaktadir. Yedi olguda (%53.8) etyolojik faktorun hipertansiyon oldugu dusu¬nulmustur. En sik gorulen baslangic bulgulari vertigo, bulanti, kusma ve bas agrisidir. Alti hastada sol serebellar hemisfer, bes h...
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Botulinum Toxin Appliccations in OMU, Department of Neurology: A Retrospective Study Clostridium botulinum toxin type A blocks the cholinergic conduction at the neuromuscular conjunction by blocking acetylcholine secretion at the... more
Botulinum Toxin Appliccations in OMU, Department of Neurology: A Retrospective Study Clostridium botulinum toxin type A blocks the cholinergic conduction at the neuromuscular conjunction by blocking acetylcholine secretion at the presynaptic region and thus produces muscle paralysis. Such effects of the toxin are in use to treat some diseases. The most frequent neurological indications are hemifacial spasm, essential blepharospasm, cervical dystonia, task-specific dystonia and post-stroke spasticity in adults.In this retrospective study, 46 patients who were tracked for botulinum toxin injections in our department between years 2003 and 2006 are reported. Their diagnoses, schemes of therapy, responses to botulinum toxin treatment, side effects, follow-up during injection therapies and subjective evaluations of therapy by patients are presented and discussed p e rta ining the relative literature. Clostridium botulinum tip A toksini, noromuskuler kavsakta presinaptik bolgede asetilkol...
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Sturge-Weber sendromu, santral sinir sistemi anomalileri ve kutanoz anjiomatozis ile giden bir tablodur. Genellikle yuzun bir tarafini kaplayan vaskuler bir nevus, ayni tarafta kranyumda meningial anjiomatozis, epileptik nobetler, glokom... more
Sturge-Weber sendromu, santral sinir sistemi anomalileri ve kutanoz anjiomatozis ile giden bir tablodur. Genellikle yuzun bir tarafini kaplayan vaskuler bir nevus, ayni tarafta kranyumda meningial anjiomatozis, epileptik nobetler, glokom ve mental retardasyonla birliktedir. Olgularin goreceli olarak daha kucuk bir bolumunde kutanoz lezyonlar daha yaygin olabilir. Burada kutanoz anjiomatoz lezyonlari sol yuzun ust ve orta bolumleri haric, sag yuz yarisi ve tum vucutta yaygin olarak izlenen 13 yasindaki bir Sturge-Weber olgusunda klinik, radyolojik ve elektroensefalografik bulgular bildirilmektedir. Solda ust ekstremite hakimiyet-li hemiparezi, sag gozde buftalmus ve glokoma sekonder optik atrofisi saptanan mental retarde olgunun son donemde sikligi artan jeneralize tonik klonik nobetleri mevcuttu. Kontrastli kraniyal MR'inda sag serebral hemisferde yaygin leptomeningial ve dural kontrastlanmasi saptanan olguda, ayrica tutulumu daha seyrek bildirilen koroid pleksus lezyonu da rapo...
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Predominantly Sensory Acute Demyelinating Polyneuropathy: Sensory Guillaine-Barre Syndrome? In this paper, owing to be seen rarely a patient with the diagnosis of acute sensorial de¬myelinating polyneuropathy has been presented. Bu yazida... more
Predominantly Sensory Acute Demyelinating Polyneuropathy: Sensory Guillaine-Barre Syndrome? In this paper, owing to be seen rarely a patient with the diagnosis of acute sensorial de¬myelinating polyneuropathy has been presented. Bu yazida akut duysal agirlikli demyelinizan polinoropati tanisi koydugumuz bir has-tamiz, nadir gorulmesi nedeni ile sunulmustur.
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Sturge-Weber sendromu, santral sinir sistemi anomalileri ve kutanoz anjiomatozis ile giden bir tablodur. Genellikle yuzun bir taraf›n› kaplayan vaskuler bir nevus, ayn› tarafta kran- yumda meningial anjiomatozis, epileptik nobetler,... more
Sturge-Weber sendromu, santral sinir sistemi anomalileri ve kutanoz anjiomatozis ile giden bir tablodur. Genellikle yuzun bir taraf›n› kaplayan vaskuler bir nevus, ayn› tarafta kran- yumda meningial anjiomatozis, epileptik nobetler, glokom ve mental retardasyonla birlikte- dir. Olgular›n goreceli olarak daha kucuk bir bolumunde kutanoz lezyonlar daha yayg›n ola- bilir. Burada kutanoz anjiomatoz lezyonlar› sol yuzun ust ve orta bolumleri haric, sayuz yar›s› ve tum vucutta yayg›n olarak izlenen 13 yafl›ndaki bir Sturge-Weber olgusunda klinik, radyolojik ve elektroensefalografik bulgular bildirilmektedir. Solda ust ekstremite hakimiyet- li hemiparezi, sagozde buftalmus ve glokoma sekonder optik atrofisi saptanan mental re- tarde olgunun son donemde s›kl›¤› artan jeneralize tonik klonik nobetleri mevcuttu. Kont- rastl› kraniyal MR'›nda saserebral hemisferde yayg›n leptomeningial ve dural kontrastlan- mas› saptanan olguda, ayr›ca tutulumu daha seyrek bildirilen koroid pleksus lezyonu...
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Facial Nerve Investigation In Diabetic Nevropathy Patients In this study subclinic state were investigated according to the direct and blink reflex R1 response of N.facialis in 33 patients with diabetic neuropathy and 24 normal control.... more
Facial Nerve Investigation In Diabetic Nevropathy Patients In this study subclinic state were investigated according to the direct and blink reflex R1 response of N.facialis in 33 patients with diabetic neuropathy and 24 normal control. In 25% of the patients N.facialis D and blink reflex R1 respons latences were found to be pro¬longed. R1/D was not determined different from the control group. Bu calismada 33 diabetik noropatili hasta ve 24 saglikli kiside N.facialis'in direkt (D) ve blink refleksi R1 cevabi bakilarak subklinik tutulum arastirildi. Hasta grubunun %25'inde N.facialis D ve blink refleksi R1 cevaplan latanslan uzamis olarak bulundu. R1/D orani ise kontrol grubundan farkli bulunmadi.
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Venoz tromboembolizm kanserli hastalarda gorulebilen bir komplikasyondur. Literaturde lenfoma’yi iceren hematolojik malinitelerde gorulen venoz tromboembolizm konusu yeterince bilinmemektedir. Hiperkalsemi lenfoma hastalarinda gorulebilen... more
Venoz tromboembolizm kanserli hastalarda gorulebilen bir komplikasyondur. Literaturde lenfoma’yi iceren hematolojik malinitelerde gorulen venoz tromboembolizm konusu yeterince bilinmemektedir. Hiperkalsemi lenfoma hastalarinda gorulebilen bir elektrolit bozuklugudur. Bu yazida kavernoz sinus trombozu ve hiperkalsemi ile prezente olan diffuz buyuk B hucreli lenfoma olgusunu sunuyoruz
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Background: SBMA or Kennedy’s disease, is a disorder of the motor neurons characterized by the adult onset and slow progression of proximal muscle weakness and atrophy associated with fasciculations, tremor and muscle cramps. SBMA occurs... more
Background: SBMA or Kennedy’s disease, is a disorder of the motor neurons characterized by the adult onset and slow progression of proximal muscle weakness and atrophy associated with fasciculations, tremor and muscle cramps. SBMA occurs only in males. Patients often show gynocomastia, testicular atrophy, and reduced fertility due to androgen insensitivity.All patients with SBMA have expansion of CAG trinucleotid repeats (>35 CAGs) in the androgen receptor (AR) gene. Methods: In this study, DNA was extracted with standart method, then AR gene’s CAG region was amplified with PCR. PCR products were evaluated with agarose gel electrophoresis. Results: The proband (patient 1) had expanded allele (with 50 CAG repeats), his son had normal allele (18 CAG). His daughters had one normal allele (20 CAG), one expanded allele (47 CAG) and one normal allele (18 CAG), one expanded allele (50 CAG), respectively. His sister had one normal allele (21 CAG) and one expanded allele (52 CAG), his fat...
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Miyelopati, radyoterapinin ender gorulen bir komplikasyonudur. Radyasyon miyelopatisi, iyonizan radyasyon ile karsilasildiktan belli bir sure sonra spinal kordun beyaz cevher hasari ile gelisir. Radyasyon dozu, uygulamalar arasindaki sure... more
Miyelopati, radyoterapinin ender gorulen bir komplikasyonudur. Radyasyon miyelopatisi, iyonizan radyasyon ile karsilasildiktan belli bir sure sonra spinal kordun beyaz cevher hasari ile gelisir. Radyasyon dozu, uygulamalar arasindaki sure veya lineer enerji transferi gibi bazi faktorler miyelopatinin olusumunu ve siddetini etkiler. Bu olgu sunumunda, mide adenokarsinomu tanisiyla yapilan operasyondan sonra kemoterapi ve radyoterapi uygulanan 56 yasindaki erkek hastada, iki ay sonra gelisen ilerleyici paraparezi bildirilmektedir.Bu olgu, radyoterapi tedavisi sonrasi norolojik disfonksiyon gelisen hastalara ornektir. Radiation Myelopathy: Case Report Myelopathy is an uncommon complication of radiotherapy. Radiation myelopathy is principally a white matter injury of the spinal cord induced by ionizing radiation after a certain latent period. Several factors, such as radiation dose, fractination or linear energy transfer, modify its occurrence and severity. A 56-year old man with gastri...
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Paraneoplastic neurological syndromes (PNS) are defined as distant effects of tumors on the nervous system other than metastasis, direct invasion, and metabolic and vascular effects. Despite being rarely encountered diseases of neurology,... more
Paraneoplastic neurological syndromes (PNS) are defined as distant effects of tumors on the nervous system other than metastasis, direct invasion, and metabolic and vascular effects. Despite being rarely encountered diseases of neurology, they are important as early indicators of systemic cancer. There are rare cases reported in the literature of paraneoplastic peripheral neuropathy associ-ated with the development of ovarian malignancy. Our case exhibited positive anti-Yo, ovarian adenocarcinoma, and peripheral ne-uropathy. Tümörlerin metastaz, direkt yay›l›m, metabolic ve vasküler etkilerinin d›fl›nda sinir sistemi üzerindeki uzak etkileri paraneoplastik nöro-lojik sendromlar olarak tan›mlan›r. Nörolojinin oldukça nadir karfl›lafl›lan hastal›klar› olmalar›na karfl›n, sistemik bir kanserin erken ha-bercisi olmalar› nedeniyle önem tafl›rlar. Literatürde ovaryan maligniteye ba¤l› geliflmifl paraneoplastik periferal nöropati olgular› nadir-dir. Olgumuzda anti Yo pozitifli¤i, over kars...
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ABSTRACT Patients with hereditary neuropathy at high risk of severe vincristine neurotoxicity are well known. Here, along with a review of the literature, we described two patients with unrecognized hereditary neuropathy who developed... more
ABSTRACT Patients with hereditary neuropathy at high risk of severe vincristine neurotoxicity are well known. Here, along with a review of the literature, we described two patients with unrecognized hereditary neuropathy who developed foot drop following low dose vincristine therapy. With this report, we wanted to emphasize the importance of detailed neurologic examination and history taking before initiating therapy. Keywords: Hereditary neuropathy, Vincristin, Neurotoxicity
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Central pontine myelinolysis is a neurological disorder characterized by loss of myelin in the central pons as well as in the other parts of the brain like basal ganglia, lateral geniculate bodies, external and internal capsules, and... more
Central pontine myelinolysis is a neurological disorder characterized by loss of myelin in the central pons as well as in the other parts of the brain like basal ganglia, lateral geniculate bodies, external and internal capsules, and cerebellum. We report the clinical and radiological findings of three patients with central pontine myelinolysis and one patient with both pontine and extrapontine myelinolysis.
Behcet`s disease is characterized by small vessel vasculitis and involvement of multiple systems. In neuro-Behcet cases, spinal cord involvement is approximately 10-18%. Spinal cord lesions are often associated with cerebral or brainstem... more
Behcet`s disease is characterized by small vessel vasculitis and involvement of multiple systems. In neuro-Behcet cases, spinal cord involvement is approximately 10-18%. Spinal cord lesions are often associated with cerebral or brainstem lesions, and isolated spinal cord involvement in Behcet`s disease is very rare. Here, we report a case with an isolated lesion of the cervical spine.
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Axillary neuropathy due to entrapment of the nerve in the quadrilateral space is seen rarely. Here, we describe a 24-year-old patient diagnosed with isolated axillary neuropathy that mimicked quadrilateral space syndrome. Quadrilateral or... more
Axillary neuropathy due to entrapment of the nerve in the quadrilateral space is seen rarely. Here, we describe a 24-year-old patient diagnosed with isolated axillary neuropathy that mimicked quadrilateral space syndrome. Quadrilateral or quadrangular space syndrome (QSS), first described by Cahill and Palmer in 1983, was defined as the entrapment of the distal branch of the axillary nerve and the posterior humeral circumflex artery (PHCA) in the quadrangular shaped anatomic space. We tracked the follow up of the patient for one year both clinically and electrophysiologically. Our aim in reporting this case is to stress the point that cases of such a nature usually represent situations of diagnostic and treatment challenges, where multidisciplinary approaches are required.
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Behçet's disease (BD) is a systemic disorder of unknown cause. In our study, we investigated the utility of Tc-99m HMPAO SPECT and MRI in patients with neuro-Beh,cet's disease (n-BD). Twelve patients (two females, ten males; mean... more
Behçet's disease (BD) is a systemic disorder of unknown cause. In our study, we investigated the utility of Tc-99m HMPAO SPECT and MRI in patients with neuro-Beh,cet's disease (n-BD). Twelve patients (two females, ten males; mean age 33 +/- 9.6 yr; age range 18-45 yr) with n-BD, fulfilling the criteria of the International Study Group for BD, were included in the study. MRI was performed according to a standard protocol with 1 or 1.5 T imagers. Brain SPECT data were obtained using a single head gamma camera after 555 MBq Tc-99m HMPAO injections. Following image reconstruction, regional cerebral perfusion was evaluated both visually and semi quantitatively. Neurological examination showed parenchymal brain involvement in 6 of 12 patients (50%). All 6 patients had white matter lesions on MRI, while only 5 of them showed perfusion defects on brain SPECT. Out of 6 patients (50%) without clinical signs of parenchymal brain involvement, 1 patient showed a pathological brain SPECT ...
Research Interests: Nonparametric Statistics, Magnetic Resonance Imaging, Nuclear medicine, Adolescent, Medicine, and 15 moreBrain, Humans, Neuroradiology, Female, Male, Statistical Significance, Clinical Sciences, Middle Aged, Single Photon Emission Computed Tomography, Adult, Clinical Signs, Detection Rate, Neurosciences, White Matter Lesions, and Brain SPECT
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In advanced Parkinson's disease (PD), deep brain stimulation (DBS) may be an alternative option for the treatment of motor symptoms. Side effects associated with subthalamic nucleus (STN) DBS in patients with PD are emerging as the... more
In advanced Parkinson's disease (PD), deep brain stimulation (DBS) may be an alternative option for the treatment of motor symptoms. Side effects associated with subthalamic nucleus (STN) DBS in patients with PD are emerging as the most frequent sensory and motor symptoms. DBS-related syncope is reported as extremely rare. We wanted to discuss the mechanisms of syncope associated with STN DBS in a patient with Parkinson's disease.Case report.Sixty-three-year-old female patient is followed up with diagnosis of idiopathic Parkinson's disease for 6 years in our clinic. The patient has undergone STN DBS due to painful dystonia and drug resistant tremor. During the operation, when the left STN was stimulated at 5 milliampere (mAmp), the patient developed presyncopal symptoms. However, when the stimulation was stopped symptoms improved. During the early period after the operation, when the right STN was stimulated at 1.3 millivolts (mV), she developed the pre-yncopal symptoms ...
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Background:Behcet's disease is a multisystemic vascular inflammatory disorder of unknown origin. It is relatively rare and central nervous system involvement is seen in 5% of affected individuals. Somatosensory evoked potentials... more
Background:Behcet's disease is a multisystemic vascular inflammatory disorder of unknown origin. It is relatively rare and central nervous system involvement is seen in 5% of affected individuals. Somatosensory evoked potentials (SEPs) can provide information that shows the presence of clinically unsuspected lesions in the central nervous system of these patients. However, the effects of changing the stimulus frequencies on latencies of SEP potentials and central conduction time (CCT) in patients with neuro-Behcet's disease (NB) have not been studied yet. In this study, our aim was to reveal these effects to investigate whether the change of stimulus frequencies could be of convenient use in obtaining more accurate CCT estimations in SEP studies of these patients.Methods:We performed median nerve SEPs of 14 patients with NB and 15 healthy volunteers. We changed the stimulus frequency: 2 Hz, 4Hz, 6Hz and 9Hz in successive recordings and statistically compared the changes on S...
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Central nervous system (CNS) involvement in patients with familial Mediterranean fever (FMF) is considerably rare. Patients with FMF may exhibit clinical and radiologic symptoms similar to multiple sclerosis (MS). However, the impact of... more
Central nervous system (CNS) involvement in patients with familial Mediterranean fever (FMF) is considerably rare. Patients with FMF may exhibit clinical and radiologic symptoms similar to multiple sclerosis (MS). However, the impact of the Familial Mediterranean Fever Gene (MEFV) mutations on the clinical course of MS is not fully understood as yet. In our study, we investigated the presence of probable MEFV mutations in patients diagnosed with definite MS and the association of these mutations with the clinical course, radiologic characteristics and disability status of the individuals. A total of 105 patients diagnosed with definite MS according to the McDonald criteria and a control group of 112 non-symptomatic individuals were included in the study. Thirty-seven patients (35.2%) had MEFV gene mutations; three were compound heterozygotes (M694V/E148Q; M694V/V726A; P369S/E148Q) and one was homozygous for P369S. No statistically significant differences were found among patients with MS and healthy individuals with respect to existing mutations. In addition, we did not observe a statistically significant relationship between MEFV mutations and the gender of the patients, oligoclonal band (OCB) positivity, Expanded Disability Status Scale (EDSS), disease onset age, clinical presentation, affected neurologic systems, existence of spinal lesions, response to immunomodulatory treatment, time to reach EDSS scores of 3 and 6, the number of attacks and the average number of lesions on a brain MRI. Our results indicate that MEFV gene mutations do not affect the neurologic prognosis in patients with MS. However, additional research studies involving more patients with MS and clinical forms are warranted to confirm our results.
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Multifocal motor neuropathy is characterized by progressive, asymmetric weakness of the limbs with persistent conduction blocks (CB). Sensory loss is very rare and it also rarely presents with cranial nerve involvement and hyperreflexia.... more
Multifocal motor neuropathy is characterized by progressive, asymmetric weakness of the limbs with persistent conduction blocks (CB). Sensory loss is very rare and it also rarely presents with cranial nerve involvement and hyperreflexia. Here we ...
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... HANDE TURKER1,∗ , MEFTUN UNSAL2 and MUSA K. ONAR1 ... According to the Eastern Cooperative Oncology Group Common Tox-icity Criteria (ECOG CTC), his neuro-sensory score was 3 and neuro-motor score was 0.9 According to the Eastern... more
... HANDE TURKER1,∗ , MEFTUN UNSAL2 and MUSA K. ONAR1 ... According to the Eastern Cooperative Oncology Group Common Tox-icity Criteria (ECOG CTC), his neuro-sensory score was 3 and neuro-motor score was 0.9 According to the Eastern Cooperative Oncology ...
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... AYSE OYTUN BAYRAK * , HANDE TÜRKER and MUSA KAZIM ONAR ... Topical medications The 5% lidocaine patch has positive effects in PHN and other neuro-pathies.46 Local skin absorption can modulate sodium channels, reducing ectopic... more
... AYSE OYTUN BAYRAK * , HANDE TÜRKER and MUSA KAZIM ONAR ... Topical medications The 5% lidocaine patch has positive effects in PHN and other neuro-pathies.46 Local skin absorption can modulate sodium channels, reducing ectopic discharges in involved sensory ...
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The aims of this study were to electrophysiologically evaluate polyneuropathy in rheumatoid arthritis (RA) patients and to examine the relationships among polyneuropathy and demographic, clinical and laboratory findings. Sixty consecutive... more
The aims of this study were to electrophysiologically evaluate polyneuropathy in rheumatoid arthritis (RA) patients and to examine the relationships among polyneuropathy and demographic, clinical and laboratory findings. Sixty consecutive patients (51 women and nine men) with a clinical diagnosis of RA were examined electrophysiologically for the evidence of polyneuropathy. Parameters including age, gender, subcutaneous nodules, erosions, joint deformities, laboratory parameters, duration of RA, as well as dose, duration and type of disease modifying anti-rheumatic drug (DMARD) and steroid usage were recorded. RA activity was assessed using a 28-joint disease activity score (DAS28). The functional status of patients was measured using the health assessment questionnaire (HAQ). The symptoms and signs of polyneuropathy were quantified using the neuropathy symptoms score (NSS) and the neuropathy disability score (NDS), respectively. Ten patients (17%, eight women and two men) had polyneuropathic involvement as defined by nerve conduction studies (NCS). Two patients had mild symmetric sensory neuropathy and eight patients had mild symmetric sensorimotor axonal polyneuropathy. There was no significant difference in age, gender, subcutaneous nodules, erosions, joint deformities, rheumatoid factor, as well as dose, duration and type of DMARD and steroid therapy administered. We found a significant relationship among polyneuropathy and duration of RA, DAS28, HAQ, as well as abnormal NSS and NDS values. The durations of RA and DAS28 were also associated with a four- and three-fold increase in the risk of polyneuropathy, respectively. Mild symmetric sensory or sensorimotor axonal polyneuropathies are common in RA patients and it is difficult to distinguish the symptoms of polyneuropathy from those of arthritis. An electrophysiological examination should be routinely carried out especially when patients have had a long disease duration and high scores for DAS28, HAQ, NSS and NDS.
Research Interests: Nonparametric Statistics, Rheumatoid Arthritis, Medicine, Activities of Daily Living, Humans, and 15 moreInternal Medicine, Female, Male, Health Status, Clinical Sciences, Neurological, Middle Aged, Questionnaires, Adult, Joints, Electrodiagnosis, Neurosciences, Severity of Illness Index, Polyneuropathy, and Disability Evaluation
Objective: To compare the incidence of glaucomatous optic disk appearance between patients with symptomatic atherosclerotic stroke and healthy individuals with normal intraocular pressures (IOP). Subjects and Methods: 46 patients with... more
Objective: To compare the incidence of glaucomatous optic disk appearance between patients with symptomatic atherosclerotic stroke and healthy individuals with normal intraocular pressures (IOP). Subjects and Methods: 46 patients with ischemic stroke with evident lacunar infarction or large vessel atherosclerosis, and 93 age- and sex-matched healthy individuals, all with normal IOP, were included. Patients and controls were examined for the presence of high cup-to-disk ratios (>0.5). Results: Seven patients (15.22%) in the ischemic cerebrovascular disease (CVD) group and 3 controls (3.23%) had glaucomatous optic disk appearance. All subjects with glaucomatous optic disk appearance in the control group and 3 patients in the study group had visual field defects in concordance with normal-tension glaucoma (NTG). The incidence of glaucomatous optic disk appearance was significantly higher in the group with symptomatic atherosclerotic CVD. Conclusion: Atherosclerotic CVD is a risk fac...
Research Interests: Ophthalmology, Atherosclerosis, Medicine, Multivariate Analysis, Humans, and 15 moreHypertension, Cerebrovascular Disease, Glaucoma, Female, Male, Intraocular Pressure, Ischemic Stroke, Aged, Middle Aged, Concordance, Adult, Cerebrovascular Disorders, Control Group, Case Control Studies, and Normal Tension Glaucoma
Research Interests: Endocrinology, Clinical Neuroscience, Bone Metabolism, Medicine, Humans, and 15 moreInternal Medicine, Functional Capacity, Female, Bone Density, Alkaline phosphatase, Clinical Sciences, Middle Aged, Amino Acids, Adult, Bone Mineral Density, Bone remodeling, Bone and Bones, Control Group, Disability Evaluation, and Functional independence measure
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Pellagra is caused by deficiency of niacin or its precursor tryptophan. While cutaneous lesions are the most prominent feature of the disease, gastrointestinal, neurological and psychiatric signs and symptoms are the other characteristics... more
Pellagra is caused by deficiency of niacin or its precursor tryptophan. While cutaneous lesions are the most prominent feature of the disease, gastrointestinal, neurological and psychiatric signs and symptoms are the other characteristics of the disease. In this case report, we present a 29-year-old female patient with discoloration of hands and feet diagnosed with pellagra.
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The aim of this study is to investigate the prognostic value of serum acetylcholinesterase levels and their relationship with neurological syndromes (Type 1 syndrome, intermediate syndrome, and delayed polyneuropathy) in acute... more
The aim of this study is to investigate the prognostic value of serum acetylcholinesterase levels and their relationship with neurological syndromes (Type 1 syndrome, intermediate syndrome, and delayed polyneuropathy) in acute organophosphate poisoning. Thirty-two consecutive patients with acute organophosphate poisoning admitted to the Ondokuz Mayis University Emergency Department from June 1999 to January 2001 were evaluated. Patients were assessed according to admission time, symptoms, and results of clinical exams and their serum acetylcholinesterase levels were determined on days 1, 2, 3, 7, and the last day. There was no significant difference between the first-day serum acetylcholinesterase of the patients with severe poisoning (n = 22, 68.75%) and of the patients with mild poisoning (n = 10, 31.25%; NS). There was no discernible difference between the serum acetylcholinesterase obtained on days 1 and 3 after poisoning from the patients with intermediate syndrome (n = 5, 15.6%; means: 0.90 +/- 0.65 vs. 0.88 +/- 0.53, 19.35 vs. 18.92%; NS, sensitivity = 80%; specificity = 87.5%). There was a significant difference between the serum acetylcholinesterase obtained on days 1 and 3 from the patients with nonintermediate syndrome (n = 24, 75%; means: 1.05 +/- 0.24 vs. 1.68 +/- 0.29, 22.58 vs. 36.12%; p < 0.001). There was no discernible significant difference in serum acetylcholinesterase between the patients with organophosphorus-induced delayed polyneuropathy (n = 7, 21.8%) and nonorganophosphorus-induced delayed polyneuropathy. In the patients who died (n = 5, 15.6%), serum acetylcholinesterase showed no discernible increase day 1-the last day (means: 0.50 +/- 0.25 vs. 0.46 +/- 0.26, 10.75 vs. 9.89%; NS). There was a significant difference between the serum acetylcholinesterase levels obtained on days 1 and the last day from the patients who survived (n = 27, 84.3%; means: 1.14 +/- 0.25 vs. 2.32 +/- 0.26, 24.51 vs. 49.89%; p < 0.001). In the acute phase of organophosphate poisoning, low serum acetylcholinesterase (> 50% of minimum normal value) supports the diagnosis of organophosphate poisoning but it does not show a significant relationship to the severity of poisoning (NS). The serum acetylcholinesterase activity may be a useful parameter in following the acute prognosis of organophosphate poisoning.
Research Interests: Gastroenterology, Adolescent, Medicine, Insecticides, Emergency Medical Services, and 15 moreHumans, Internal Medicine, Female, Male, Clinical Toxicology, Acetylcholinesterase, Anesthesia, Organophosphorus Compounds, Aged, Middle Aged, Organophosphate, Adult, Antidotes, Organophosphate poisoning, and Pharmacology and pharmaceutical sciences
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Studies documenting the association between rapid eye movement sleep behavior disorder (RBD) and motor subtypes in... more
Studies documenting the association between rapid eye movement sleep behavior disorder (RBD) and motor subtypes in Parkinson's disease (PD) are rare. Our hypothesis is that RBD may be more severe in non-tremor dominant (NTD) patients with RBD than those tremor dominant (TD) with RBD. In this study, we investigated the association between motor subtypes and clinical RBD in PD. We evaluated 104 consecutive patients older than 18 years presenting with PD to the Neurology Clinic of the University Hospital for one year in this study. The clinical diagnosis of RBD was based on the minimal diagnostic criteria of International Classification of Sleep Disorders, revised. The Stavanger Sleepiness Questionnaire was used to rate the severity of clinical RBD. The patients were divided into two subgroups as TD and NTD. The patient and control groups were compared with each other for severity and frequency of clinical RBD, and the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn-Yahr stage scores. The correlation between severity of clinical RBD and clinical severity of PD was analyzed in the patient groups. Of the patients, 45.2% (n=47) had the NTD subtype of PD and 54.8% (n=57) had the TD subtype of PD. There was no significant difference among the groups in terms of frequency and severity of clinical RBD. For the NTD patients, there was a weak positive correlation between severity of clinical RBD and clinical severity of PD. However, there was no correlation in the TD subgroup. In our study, frequency of clinical RBD was unrelated to motor subtypes of PD. However, in the present study, we found a weak correlation between clinical severity (UPDRS and the Hoehn-Yahr) of PD and severity of clinical RBD in the NTD subtype but not in the TD subtype.
Research Interests: Neurology, Medicine, Comorbidity, Prospective studies, Humans, and 15 moreFemale, Disease, Male, Clinical Sciences, Rating Scale, Aged, Middle Aged, REM sleep behavior disorder, Questionnaires, Parkinson´s Disease, Neurosciences, Parkinson Disease, Case Control Studies, Cohort Studies, and Severity of Illness Index
Brain stem masses may mimic Myasthenia gravis (MG), clinically and electrophysiologically. We present a 38 year-old female patient with a brain stem mass, who has clinical features similar with MG, and revealed a decremental response to... more
Brain stem masses may mimic Myasthenia gravis (MG), clinically and electrophysiologically. We present a 38 year-old female patient with a brain stem mass, who has clinical features similar with MG, and revealed a decremental response to repetitive nerve stimulation. Brain stem mass was removed by surgery. In the postoperative period, her complaints were regressed. Control repetitive nerve stimulation examination was normal.