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Papers by nevin pazarcı

Research paper thumbnail of Talamik hematomlarda sıvı ve elektrolit dengesizliği

Türk Beyin Damar Hastalıkları Dergisi, 2002

Research paper thumbnail of TH-153. Clinical and electrophysiological characteristics of Guillain-Barré Syndrome before and during the pandemic: The multicenter Istanbul study

Research paper thumbnail of Stigma Scale of Epilepsy--Turkish Version

Research paper thumbnail of Autoimmune encephalitis and paraneoplastic syndromes in Turkey: a multi-centre study

Neurological Sciences, 2022

Autoimmune encephalitis (AIE) and paraneoplastic syndromes (PNS) are both rare groups of neurolog... more Autoimmune encephalitis (AIE) and paraneoplastic syndromes (PNS) are both rare groups of neurological diseases that are difficult to diagnose. We aimed to determine the common and distinct aspects of these two aetiologies of encephalitis as well as the characteristics of our patient group. We respectively analysed the records of the patients including symptoms, demographic features, neurological examination, cranial-magnetic-resonance-imaging (MRI), electroencephalography (EEG) findings, cerebrospinal fluid results (CSF) findings. Autoimmune/paraneoplastic autoantibodies in blood and/or CSF were all documented. Forty-six patients fulfilled the diagnostic criteria. Thirty-eight of them were diagnosed with AIE, and 8 of them were diagnosed with PNS. The PNS group had higher nonconvulsive status epilepticus than the AIE (2/8 vs 0/38; p=0.027). PNS patients were diagnosed with a malignancy in their follow-ups more than those in the AIE group [4/38 vs 8/8] (p<0.001). When the symptoms of antibody-positive and negative patients were compared in the AIE group, the rates of consciousness/memory problems (13/15 vs 11/23; p=0.020) and speech impairment (8/15 vs 2/23; p=0.004) were significantly higher in patients without antibodies (n: 15) than in antibody-positive patients (n: 23). In antibody-negative groups, the rates of memory problems in neurological examination (13/15 vs 12/23 p=0.028) and temporal findings on electroencephalography were more prominent than antibody-positive groups (1/23 vs 5/15; p=0.027). The number of patients with cerebellar signs was higher in antibody-positive patients (6/23 vs 0/15; p=0.038). Although the positivity of autoantibodies is critical in the diagnosis of AIE and PNS, even minor differences in clinical and laboratory findings of patients are helpful in the diagnosis, especially in the autoantibody-negative patients. Comparing the data with other population studies has shown that several inherited and environmental factors may contribute to the pathophysiology of AIE and PNS, as well as clinical and laboratory differences.

Research paper thumbnail of P443: Swallowing difficulty in oculopharyngodistal myopathy: electrophysiological evaluation

Clinical Neurophysiology, 2014

Methods: By screening Medline, existing knowledge and research about LEMG and laryngeal electrost... more Methods: By screening Medline, existing knowledge and research about LEMG and laryngeal electrostimulation was identified. Additionally evidence-based recommendations for the performance and interpretation of LEMG and also for electrostimulation for functional evaluation were considered, as well as published reports based on expert opinion and single-institution retrospective case series. The working group discussed knowledge about LEMG and laryngeal electrostimulation and performed the techniques together. Consensus was achieved on: minimum technical equipment; best practical implementation; criteria for interpreting [1]. To disseminate the techniques, several modalities where used: Presentations using slides and videos, publications in scientific journals, handson-training on patients, animal models, and anatomic specimens, and a web-blog [2]. Results: Co-registration of the laryngeal EMG, voice, and breathing multiplies the scientific and didactic value of the LEMG-recordings. The advantages and disadvantages of the different teaching-modalities will be presented and discussed during this contribution. Conclusion: Successful learning LEMG benefits from multi-sensory teaching concept.

Research paper thumbnail of P037 The activities of the thyroarytenoid and cricopharyngeal sphincter muscles during swallowing

Clinical Neurophysiology, 2008

Research paper thumbnail of Deli̇ryum Tablosu İle Prezente Olan Di̇goksi̇n İntoksi̇kasyonu

Research paper thumbnail of Can development of neuropathy be prevented with good glycemic control in diabetes mellitus

Medical Bulletin of Sisli Etfal Hospital, 2015

Objective: In our study, we aimed to investigate the effect of insulin treatment on peripheral ne... more Objective: In our study, we aimed to investigate the effect of insulin treatment on peripheral nerves in patients with diabetes mellitus (DM) who under the oral antidiabetic therapy changed to insulin treatment. Additionally, we have searched for answer to the question that could F response used for as a parameter on monitoring the course of polyneuropathy with glycemic control. F response which use in the detection of polyneuropathy has been emphasized in previous studies. Material and Method: Ten voluntary diabetic patients who received indication insulin treatment while being monitored with oral antidiabetic treatment and diagnosed according to the American Diabetes Association (ADA) criteria were included in our study. All our patients were outpatients of Şisli Etfal Training and Research Hospital Diabetes Mellitus Clinic. All patients were evaluated for neurological examination, serum glucose and HbA1c levels, total neuropathy score (TNS) and electrophysiological evaluations be...

Research paper thumbnail of Evaluatıon of Electroencephalographıc Fındıngs In Isolated Hypocalcemıa Patıents

Haseki Tıp Bülteni

Amaç: Çalışmamızda hipokalsemi olan hastalardaki elektroensefalografi (EEG) bulgularını araştırma... more Amaç: Çalışmamızda hipokalsemi olan hastalardaki elektroensefalografi (EEG) bulgularını araştırmayı, kalsiyum (Ca) düzeyi ile EEG anormallikleri arasında olası ilişkiyi göstermeyi ve serum kalsiyum düzeyi normale döndüğünde EEG bulgularında değişiklik olup olmadığını göstermeyi amaçladık. Yöntemler: Çalışmamıza "xxxx" Eğitim ve Araştırma Hastanesi Endokrinoloji, Nöroloji, ve Genel Cerrahi polikliniklerine başvurmuş, düzeltilmiş serum Ca değeri <8,5 mg/dL olan ardışık 17 hasta alındı. Tüm hastalara laboratuvar tetkikiyle aynı gün içinde EEG çekimi yapıldı. Başlangıçta anormal EEG bulgusu olan hastalardan, kalsiyum değeri takiplerde normale (>8,5 mg/dl) yükselen hastalara kontrol EEG incelemesi yapıldı. Bulgular: 17 hastanın 9'unda (%53) çeşitli EEG anormallikleri saptanmıştır. EEG bulguları 7 (%41) hastada zemin aktivitesinde yavaşlama, 2 hastada ise (%12) epileptiform anormallikler gösterdi. Takiplerde 7 hastada normokalsemik dönem izlendi. Zemin aktivitesinde yavaşlama olan 5 hastanın 2'sinde, epileptiform aktivitesi olan 2 hastanın 1'inde normokalsemik dönemde EEG bulgularının düzeldiği gözlendi. Sonuç: Çalışmamız izole hipokalsemili hastalarda klinik bulgu olmasa da,zemin aktivitesinde yavaşlama ve epileptiform anormallikler gibi çeşitli EEG bulguları görülebileceğini ve bu EEG bulgularının normokalsemik dönemde düzelebileceğini göstermiştir.

Research paper thumbnail of Patient with Guillain-Barré Syndrome with Posterior Spinal Root Involvement: A Case Report

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital

G uillain-Barré syndrome (GBS) is a rare, rapid-onset, demyelinating polyneuropathy of the periph... more G uillain-Barré syndrome (GBS) is a rare, rapid-onset, demyelinating polyneuropathy of the peripheral nervous system that is the result of an immune system disorder. It is characterized by symmetric loss of muscular strength and areflexia, typically starting in the lower extremities and ascending to the arms, face, and oropharyngeal muscles. The spectrum of GBS includes acute inflammatory demyelinating polyradiculoneuropathy (AIDP), the most common form, and acute motor axonal neuropathy (AMAN), acute motor-sensory axonal neuropathy (AMSAN) and Miller Fisher syndrome. [1] Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy of the peripheral nervous system. Involvement of the dorsal root ganglia and the medulla spinalis in GBS is rare, especially in an axonal form. Herein, we report the case of a 53-year-old woman with classic GBS and involvement of the T8-L1 dorsal root segments. Dorsal root and spinal involvement should be kept in mind in all types of GBS when patients present with segmental or dermatomal sensory impairment.

Research paper thumbnail of Patient with dorsal root involvement with Guillain-Barré syndrome: a case report

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital

Research paper thumbnail of The Importance of Electromyographic Findings in Determining the Etiology of Mastalgia

Medical Bulletin of Haseki

The etiology of mastalgia is not fully understood. We evaluated the relationship between electrom... more The etiology of mastalgia is not fully understood. We evaluated the relationship between electromyography (EMG) measurements of the pectoralis major (PM) muscle and mastalgia in patients with non-cyclic unilateral mastalgia. Methods: Thirty-one patients who were admitted to the breast surgery outpatient clinic due to the complaints of intermittent or continuous unilateral non-cyclic mastalgia for at least one month were included in the study. Data on age, family history, age of menarche, body mass index (BMI), physical examination, breast ultrasonography and mammography findings and amplitudes, latency and cutaneous silent period (CSP) in EMG of the right and left PM muscles were noted. Results: The mean age of the patients was 43.3 (20-65) years; mastalgia affected the left breast and the right breast in 22 (71%) and nine (29%), respectively. Twenty-three patients (74.1%) had a BMI of ≥25 kg/m 2. There was a size difference between the two breasts in eleven patients. The EMG results of PM muscles in healthy and mastalgia sides were compared and there was no significant difference observed between the amplitude and resistance parameters. The mastalgia side had significantly higher CSP values. Conclusion: Prolonged CSP suggests that unilateral mastalgia may be associated with pain modulating mechanisms of the central nervous system.

Research paper thumbnail of Evaluation of Electroencephalography Findings in Isolated Hypocalcemia Patients

Medical Bulletin of Haseki

In our study, we aimed to analyze electroencephalography (EEG) findings in patients with hypocalc... more In our study, we aimed to analyze electroencephalography (EEG) findings in patients with hypocalcemia and to investigate possible relationship between calcium (Ca) level and EEG abnormalities and whether there was any change in EEG findings when serum Ca level returns to normal. Methods: Seventeen consecutive patients, who were admitted to the Endocrinology, Neurology and General Surgery Clinics at İstanbul Şişli Hamidiye Etfal Training and Research Hospital with a corrected serum Ca level of <8.5 mg/dL, were included in our study. EEG examination was performed in all patients in the same day with laboratory examination. Control EEG was performed in patients who had abnormal EEG findings and in those calcium levels were normalized (>8.5 mg/dL) in follow-up. Results: EEG abnormalities were detected in nine (53%) of 17 patients. EEG examination revealed slow background activity in seven patients (41%) and epileptiform abnormalities in two (12%) patients. In follow-up, normocalcemic period was observed in seven patients. EEG findings were improved in two of eight patients who had slow background activity and one of two patients with epileptiform activity in the normocalcemic period. Conclusion: Our study showed that various EEG findings, such as slowed background activity and epileptiform abnormalities, may be seen in isolated hypocalcemia patients even in the absence of clinical findings and these EEG findings may improve in normocalsemic period.

Research paper thumbnail of Does Valproic Acid/Na Valproate Suppress Auditory Startle Reflex in Patients With Epilepsy?

Clinical EEG and neuroscience, 2017

Auditory startle response (ASR) was normal in juvenile myoclonic epilepsy whereas it was suppress... more Auditory startle response (ASR) was normal in juvenile myoclonic epilepsy whereas it was suppressed in progressive myoclonic epilepsy. However, both groups were using valproic acid/Na valproate (VPA) in different doses. Therefore, we aimed to analyze whether VPA has an impact on ASR in a cohort of epilepsy. For this purpose, we included patients with epilepsy and analyzed ASR in patients who were using VPA. We included 51 consecutive patients who had epilepsy and were using VPA between January 2014 and January 2016. Two control groups of 37 epilepsy patients using other antiepileptic drugs (AEDs) and of 25 healthy subjects were also constituted. All participants underwent investigations of ASR and startle response to somatosensory inputs (SSS) under similar conditions. An analysis of patients using VPA, not using VPA and healthy subjects revealed significantly longer latency and lower probability of orbicularis oculi (O.oc) and sternocleidomastoid responses after auditory stimulatio...

Research paper thumbnail of A Drop Foot Case Report After Having a Common Femoral Artery Cannulation for Venoarterial Extracorporeal Membrane Oxygenation: Case Report

Noro Psikiyatri Arsivi, 2017

The drop foot cases that are associated with developing neuropathies as a result of acute compart... more The drop foot cases that are associated with developing neuropathies as a result of acute compartment syndrome or femoral artery ischemia after having cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO) have been reported rarely in literature. In this case report, female patients who are 21 years old and developed drop foot depending on ECMO during the process of lung transplantation will be presented as both to be one of the rare neurological complications connected to ECMO and its possible causes will be analyzed.

Research paper thumbnail of Startle Response in Progressive Myoclonic Epilepsy

Clinical EEG and neuroscience, Jan 11, 2016

Cortical reflex myoclonus is a typical feature of progressive myoclonic epilepsy (PME) in which i... more Cortical reflex myoclonus is a typical feature of progressive myoclonic epilepsy (PME) in which it is accompanied by other types of mostly drug-resistant seizures and progressive neurological signs. Although PME is characterized by cortical hyperexcitability, studies have demonstrated atrophy and degenerative changes in the brainstem in various types of PME. Thus, we have questioned whether any stimuli may trigger a hyperactive response of brainstem reticular formation in PME and investigated the startle reflex in individuals with PME. We recorded the auditory startle response (ASR) and the startle response to somatosensory inputs (SSS) in patients with PME, and compared the results with healthy volunteers and patients with other types of drug-resistant epilepsy. All patients were using antiepileptic drugs (AEDs), 12 were on multiple AEDs. The probability of ASR was significantly lower and mean onset latency was longer in patients with PME compared with other groups. SSS responses o...

Research paper thumbnail of Post-injection Sciatic Neuropathy: Clinical and Electrophysiological Findings

... Search result page. Title: Post-injection Sciatic Neuropathy: Clinical and Electrophysiologic... more ... Search result page. Title: Post-injection Sciatic Neuropathy: Clinical and Electrophysiological Findings. Author: Nevin Kuloğlu PAZARCI ; Dilek Necioğlu ÖRKEN ;Münevver Gökyiğit ÇELİK ; Lale Gündoğdu ÇELEBİ ; Şenay AYDIN. ...

Research paper thumbnail of Reappraisal of epileptic pain as a rare symptom of seizures

Epilepsy & Behavior, 2016

To draw attention to epileptic pain which is a rare seizure symptom mostly causing wrong diagnosi... more To draw attention to epileptic pain which is a rare seizure symptom mostly causing wrong diagnosis and delayed treatment. We present nine patients in whom pain was a prominent initial or early ictal symptom. We reviewed the records of 4736 patients, and found nine patients who had pain as an aura or an early prominent symptom of their seizures. Seizure semiology, EEG, and cranial imaging features were evaluated retrospectively. Age at seizure onset ranged from 6months to 50years, and the mean age during the study was 37.7±11.9years. Pain was predominantly peripherally localized in four patients, whereas cephalic pain was detected in three patients, and abdominal pain was detected in two patients. Electroencephalography (EEG) revealed epileptic abnormalities on the temporoparietal and frontotemporal regions in three patients each. Photosensitive generalized epileptic discharges were detected in one and diffuse background slowing in the remaining two other patients. Electroencephalography abnormalities were lateralized to the contralateral site of the pain in four patients with strictly localized pain. Three patients revealed no abnormality on the cranial MR imaging, whereas others showed different types of abnormality such as heterotopias (n:1), mesial temporal lobe atrophy (n:1), white and gray matter sequela lesions (n:1), diffuse white matter lesion (n:1), chronic encephalomalacia and gliosis (n:1), and perivascular space dilatation (n:1). Epileptic pain is a neglected, but important, semiologic symptom with localization and lateralization value in the patients with somatosensorial seizures of parietal as well as temporal lobe origin. It occurs mainly as peripherally localized, cephalic, or abdominal pain and is usually associated with a symptomatic etiology. Awareness of epileptic pain is important to avoid misdiagnosis and delayed treatment.

Research paper thumbnail of Mechanisms, clinical features and risk factors for stroke in the posterior cerebral artery infarcts

Türk Nöroloi Dergisi, 2015

Amaç: Çalışmamızda posterior serebral arterin (PSA) kortikal ve derin sulama alanı enfarktlarında... more Amaç: Çalışmamızda posterior serebral arterin (PSA) kortikal ve derin sulama alanı enfarktlarında risk faktörleri, klinik özellikler ve inme mekanizmaları arasındaki ilişkiyi ortaya koymayı amaçladık.

Research paper thumbnail of Periferik fasiyal paralizi nedeni ile gabapentin kullanımında sinkinezi gelişimi

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2013

Periferik fasiyal paralizi nedeni ile gabapentin kullanımında sinkinezi gelişimi Amaç: Sinkinezi,... more Periferik fasiyal paralizi nedeni ile gabapentin kullanımında sinkinezi gelişimi Amaç: Sinkinezi, fasiyal paralizi sonrası görülen en sık komplikasyonlardan biridir. Sinkinetik hareketler fasiyal sinirden innerve olan kasların anormal senkronizasyonu sonucu meydana gelir. Bu çalışmada fasiyal paralizi sonrasında Gabapentin kullanımının klinik sinkinezi gelişimine etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza 2008-2010 yılları arasında Şişli Etfal Eğitim ve Araştırma Hastanesi Acil Nöroloji Polikliniği ve Nöroloji Polikliniğinde akut periferik fasiyal paralizi kliniği olan toplam 76 hasta alındı. Kırkiki hastaya standart kortikosteroid tedavisi ve periaurikuler ağrı nedeniyle 800 mg/ gün Gabapentin tedavisi başlandı. Kontrol grubu olan 34 hastaya, akut periferik fasiyal paralizide uygulanan standart kortikosteroid tedavisi başlandı. Tüm hastalarda fasiyal paralizinin ağırlık derecesi House-Brackmann skalasına göre derecelendirildi. İki grup sinkinezi gelişimi açısından takibe alındı. Bulgular: Gabapentin grubuna, ortalama yaşı 43,1±14,9 olan, 16'sı kadın toplam 42 hasta alındı. Kontrol grubuna, ortalama yaşı 45,9±16,5 olan 25'i kadın toplam 34 hasta alındı. Gabapentin başlanan hasta grubundaki 7 hastada (%16,7) ve kontrol grubundaki 13 hastada (%38,2) sinkinezi geliştiği saptandı. İki grup arasında klinik olarak sinkinezi gelişimi açısından istatistiksel olarak anlamlı fark saptandı (p<0,034). Gabapentin grubu ile kontrol grubu arasında klinik sinkinezi görülme zamanı arasında istatistiksel olarak anlamlı fark saptanmadı (p:0.816). İki grubun takip süreleri arasında istatistiksel olarak anlamlı fark saptanmadı (P:0.303). Sonuç: Sinkinezi, periferik fasiyal paralizinin bir komplikasyonudur ve önlenmesi ya da tedavi yöntemlerinin geliştirilmesi önemlidir. Bu çalışma Gabapentinin sinkinezi tedavisinde etkili olduğunu göstermektedir. Bizim sonuçlarımızın yapılacak çift kör plasebo kontrollü randomize planlanmış daha ileri çalışmalara temel oluşturacağına inanıyoruz.

Research paper thumbnail of Talamik hematomlarda sıvı ve elektrolit dengesizliği

Türk Beyin Damar Hastalıkları Dergisi, 2002

Research paper thumbnail of TH-153. Clinical and electrophysiological characteristics of Guillain-Barré Syndrome before and during the pandemic: The multicenter Istanbul study

Research paper thumbnail of Stigma Scale of Epilepsy--Turkish Version

Research paper thumbnail of Autoimmune encephalitis and paraneoplastic syndromes in Turkey: a multi-centre study

Neurological Sciences, 2022

Autoimmune encephalitis (AIE) and paraneoplastic syndromes (PNS) are both rare groups of neurolog... more Autoimmune encephalitis (AIE) and paraneoplastic syndromes (PNS) are both rare groups of neurological diseases that are difficult to diagnose. We aimed to determine the common and distinct aspects of these two aetiologies of encephalitis as well as the characteristics of our patient group. We respectively analysed the records of the patients including symptoms, demographic features, neurological examination, cranial-magnetic-resonance-imaging (MRI), electroencephalography (EEG) findings, cerebrospinal fluid results (CSF) findings. Autoimmune/paraneoplastic autoantibodies in blood and/or CSF were all documented. Forty-six patients fulfilled the diagnostic criteria. Thirty-eight of them were diagnosed with AIE, and 8 of them were diagnosed with PNS. The PNS group had higher nonconvulsive status epilepticus than the AIE (2/8 vs 0/38; p=0.027). PNS patients were diagnosed with a malignancy in their follow-ups more than those in the AIE group [4/38 vs 8/8] (p<0.001). When the symptoms of antibody-positive and negative patients were compared in the AIE group, the rates of consciousness/memory problems (13/15 vs 11/23; p=0.020) and speech impairment (8/15 vs 2/23; p=0.004) were significantly higher in patients without antibodies (n: 15) than in antibody-positive patients (n: 23). In antibody-negative groups, the rates of memory problems in neurological examination (13/15 vs 12/23 p=0.028) and temporal findings on electroencephalography were more prominent than antibody-positive groups (1/23 vs 5/15; p=0.027). The number of patients with cerebellar signs was higher in antibody-positive patients (6/23 vs 0/15; p=0.038). Although the positivity of autoantibodies is critical in the diagnosis of AIE and PNS, even minor differences in clinical and laboratory findings of patients are helpful in the diagnosis, especially in the autoantibody-negative patients. Comparing the data with other population studies has shown that several inherited and environmental factors may contribute to the pathophysiology of AIE and PNS, as well as clinical and laboratory differences.

Research paper thumbnail of P443: Swallowing difficulty in oculopharyngodistal myopathy: electrophysiological evaluation

Clinical Neurophysiology, 2014

Methods: By screening Medline, existing knowledge and research about LEMG and laryngeal electrost... more Methods: By screening Medline, existing knowledge and research about LEMG and laryngeal electrostimulation was identified. Additionally evidence-based recommendations for the performance and interpretation of LEMG and also for electrostimulation for functional evaluation were considered, as well as published reports based on expert opinion and single-institution retrospective case series. The working group discussed knowledge about LEMG and laryngeal electrostimulation and performed the techniques together. Consensus was achieved on: minimum technical equipment; best practical implementation; criteria for interpreting [1]. To disseminate the techniques, several modalities where used: Presentations using slides and videos, publications in scientific journals, handson-training on patients, animal models, and anatomic specimens, and a web-blog [2]. Results: Co-registration of the laryngeal EMG, voice, and breathing multiplies the scientific and didactic value of the LEMG-recordings. The advantages and disadvantages of the different teaching-modalities will be presented and discussed during this contribution. Conclusion: Successful learning LEMG benefits from multi-sensory teaching concept.

Research paper thumbnail of P037 The activities of the thyroarytenoid and cricopharyngeal sphincter muscles during swallowing

Clinical Neurophysiology, 2008

Research paper thumbnail of Deli̇ryum Tablosu İle Prezente Olan Di̇goksi̇n İntoksi̇kasyonu

Research paper thumbnail of Can development of neuropathy be prevented with good glycemic control in diabetes mellitus

Medical Bulletin of Sisli Etfal Hospital, 2015

Objective: In our study, we aimed to investigate the effect of insulin treatment on peripheral ne... more Objective: In our study, we aimed to investigate the effect of insulin treatment on peripheral nerves in patients with diabetes mellitus (DM) who under the oral antidiabetic therapy changed to insulin treatment. Additionally, we have searched for answer to the question that could F response used for as a parameter on monitoring the course of polyneuropathy with glycemic control. F response which use in the detection of polyneuropathy has been emphasized in previous studies. Material and Method: Ten voluntary diabetic patients who received indication insulin treatment while being monitored with oral antidiabetic treatment and diagnosed according to the American Diabetes Association (ADA) criteria were included in our study. All our patients were outpatients of Şisli Etfal Training and Research Hospital Diabetes Mellitus Clinic. All patients were evaluated for neurological examination, serum glucose and HbA1c levels, total neuropathy score (TNS) and electrophysiological evaluations be...

Research paper thumbnail of Evaluatıon of Electroencephalographıc Fındıngs In Isolated Hypocalcemıa Patıents

Haseki Tıp Bülteni

Amaç: Çalışmamızda hipokalsemi olan hastalardaki elektroensefalografi (EEG) bulgularını araştırma... more Amaç: Çalışmamızda hipokalsemi olan hastalardaki elektroensefalografi (EEG) bulgularını araştırmayı, kalsiyum (Ca) düzeyi ile EEG anormallikleri arasında olası ilişkiyi göstermeyi ve serum kalsiyum düzeyi normale döndüğünde EEG bulgularında değişiklik olup olmadığını göstermeyi amaçladık. Yöntemler: Çalışmamıza "xxxx" Eğitim ve Araştırma Hastanesi Endokrinoloji, Nöroloji, ve Genel Cerrahi polikliniklerine başvurmuş, düzeltilmiş serum Ca değeri <8,5 mg/dL olan ardışık 17 hasta alındı. Tüm hastalara laboratuvar tetkikiyle aynı gün içinde EEG çekimi yapıldı. Başlangıçta anormal EEG bulgusu olan hastalardan, kalsiyum değeri takiplerde normale (>8,5 mg/dl) yükselen hastalara kontrol EEG incelemesi yapıldı. Bulgular: 17 hastanın 9'unda (%53) çeşitli EEG anormallikleri saptanmıştır. EEG bulguları 7 (%41) hastada zemin aktivitesinde yavaşlama, 2 hastada ise (%12) epileptiform anormallikler gösterdi. Takiplerde 7 hastada normokalsemik dönem izlendi. Zemin aktivitesinde yavaşlama olan 5 hastanın 2'sinde, epileptiform aktivitesi olan 2 hastanın 1'inde normokalsemik dönemde EEG bulgularının düzeldiği gözlendi. Sonuç: Çalışmamız izole hipokalsemili hastalarda klinik bulgu olmasa da,zemin aktivitesinde yavaşlama ve epileptiform anormallikler gibi çeşitli EEG bulguları görülebileceğini ve bu EEG bulgularının normokalsemik dönemde düzelebileceğini göstermiştir.

Research paper thumbnail of Patient with Guillain-Barré Syndrome with Posterior Spinal Root Involvement: A Case Report

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital

G uillain-Barré syndrome (GBS) is a rare, rapid-onset, demyelinating polyneuropathy of the periph... more G uillain-Barré syndrome (GBS) is a rare, rapid-onset, demyelinating polyneuropathy of the peripheral nervous system that is the result of an immune system disorder. It is characterized by symmetric loss of muscular strength and areflexia, typically starting in the lower extremities and ascending to the arms, face, and oropharyngeal muscles. The spectrum of GBS includes acute inflammatory demyelinating polyradiculoneuropathy (AIDP), the most common form, and acute motor axonal neuropathy (AMAN), acute motor-sensory axonal neuropathy (AMSAN) and Miller Fisher syndrome. [1] Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy of the peripheral nervous system. Involvement of the dorsal root ganglia and the medulla spinalis in GBS is rare, especially in an axonal form. Herein, we report the case of a 53-year-old woman with classic GBS and involvement of the T8-L1 dorsal root segments. Dorsal root and spinal involvement should be kept in mind in all types of GBS when patients present with segmental or dermatomal sensory impairment.

Research paper thumbnail of Patient with dorsal root involvement with Guillain-Barré syndrome: a case report

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital

Research paper thumbnail of The Importance of Electromyographic Findings in Determining the Etiology of Mastalgia

Medical Bulletin of Haseki

The etiology of mastalgia is not fully understood. We evaluated the relationship between electrom... more The etiology of mastalgia is not fully understood. We evaluated the relationship between electromyography (EMG) measurements of the pectoralis major (PM) muscle and mastalgia in patients with non-cyclic unilateral mastalgia. Methods: Thirty-one patients who were admitted to the breast surgery outpatient clinic due to the complaints of intermittent or continuous unilateral non-cyclic mastalgia for at least one month were included in the study. Data on age, family history, age of menarche, body mass index (BMI), physical examination, breast ultrasonography and mammography findings and amplitudes, latency and cutaneous silent period (CSP) in EMG of the right and left PM muscles were noted. Results: The mean age of the patients was 43.3 (20-65) years; mastalgia affected the left breast and the right breast in 22 (71%) and nine (29%), respectively. Twenty-three patients (74.1%) had a BMI of ≥25 kg/m 2. There was a size difference between the two breasts in eleven patients. The EMG results of PM muscles in healthy and mastalgia sides were compared and there was no significant difference observed between the amplitude and resistance parameters. The mastalgia side had significantly higher CSP values. Conclusion: Prolonged CSP suggests that unilateral mastalgia may be associated with pain modulating mechanisms of the central nervous system.

Research paper thumbnail of Evaluation of Electroencephalography Findings in Isolated Hypocalcemia Patients

Medical Bulletin of Haseki

In our study, we aimed to analyze electroencephalography (EEG) findings in patients with hypocalc... more In our study, we aimed to analyze electroencephalography (EEG) findings in patients with hypocalcemia and to investigate possible relationship between calcium (Ca) level and EEG abnormalities and whether there was any change in EEG findings when serum Ca level returns to normal. Methods: Seventeen consecutive patients, who were admitted to the Endocrinology, Neurology and General Surgery Clinics at İstanbul Şişli Hamidiye Etfal Training and Research Hospital with a corrected serum Ca level of <8.5 mg/dL, were included in our study. EEG examination was performed in all patients in the same day with laboratory examination. Control EEG was performed in patients who had abnormal EEG findings and in those calcium levels were normalized (>8.5 mg/dL) in follow-up. Results: EEG abnormalities were detected in nine (53%) of 17 patients. EEG examination revealed slow background activity in seven patients (41%) and epileptiform abnormalities in two (12%) patients. In follow-up, normocalcemic period was observed in seven patients. EEG findings were improved in two of eight patients who had slow background activity and one of two patients with epileptiform activity in the normocalcemic period. Conclusion: Our study showed that various EEG findings, such as slowed background activity and epileptiform abnormalities, may be seen in isolated hypocalcemia patients even in the absence of clinical findings and these EEG findings may improve in normocalsemic period.

Research paper thumbnail of Does Valproic Acid/Na Valproate Suppress Auditory Startle Reflex in Patients With Epilepsy?

Clinical EEG and neuroscience, 2017

Auditory startle response (ASR) was normal in juvenile myoclonic epilepsy whereas it was suppress... more Auditory startle response (ASR) was normal in juvenile myoclonic epilepsy whereas it was suppressed in progressive myoclonic epilepsy. However, both groups were using valproic acid/Na valproate (VPA) in different doses. Therefore, we aimed to analyze whether VPA has an impact on ASR in a cohort of epilepsy. For this purpose, we included patients with epilepsy and analyzed ASR in patients who were using VPA. We included 51 consecutive patients who had epilepsy and were using VPA between January 2014 and January 2016. Two control groups of 37 epilepsy patients using other antiepileptic drugs (AEDs) and of 25 healthy subjects were also constituted. All participants underwent investigations of ASR and startle response to somatosensory inputs (SSS) under similar conditions. An analysis of patients using VPA, not using VPA and healthy subjects revealed significantly longer latency and lower probability of orbicularis oculi (O.oc) and sternocleidomastoid responses after auditory stimulatio...

Research paper thumbnail of A Drop Foot Case Report After Having a Common Femoral Artery Cannulation for Venoarterial Extracorporeal Membrane Oxygenation: Case Report

Noro Psikiyatri Arsivi, 2017

The drop foot cases that are associated with developing neuropathies as a result of acute compart... more The drop foot cases that are associated with developing neuropathies as a result of acute compartment syndrome or femoral artery ischemia after having cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO) have been reported rarely in literature. In this case report, female patients who are 21 years old and developed drop foot depending on ECMO during the process of lung transplantation will be presented as both to be one of the rare neurological complications connected to ECMO and its possible causes will be analyzed.

Research paper thumbnail of Startle Response in Progressive Myoclonic Epilepsy

Clinical EEG and neuroscience, Jan 11, 2016

Cortical reflex myoclonus is a typical feature of progressive myoclonic epilepsy (PME) in which i... more Cortical reflex myoclonus is a typical feature of progressive myoclonic epilepsy (PME) in which it is accompanied by other types of mostly drug-resistant seizures and progressive neurological signs. Although PME is characterized by cortical hyperexcitability, studies have demonstrated atrophy and degenerative changes in the brainstem in various types of PME. Thus, we have questioned whether any stimuli may trigger a hyperactive response of brainstem reticular formation in PME and investigated the startle reflex in individuals with PME. We recorded the auditory startle response (ASR) and the startle response to somatosensory inputs (SSS) in patients with PME, and compared the results with healthy volunteers and patients with other types of drug-resistant epilepsy. All patients were using antiepileptic drugs (AEDs), 12 were on multiple AEDs. The probability of ASR was significantly lower and mean onset latency was longer in patients with PME compared with other groups. SSS responses o...

Research paper thumbnail of Post-injection Sciatic Neuropathy: Clinical and Electrophysiological Findings

... Search result page. Title: Post-injection Sciatic Neuropathy: Clinical and Electrophysiologic... more ... Search result page. Title: Post-injection Sciatic Neuropathy: Clinical and Electrophysiological Findings. Author: Nevin Kuloğlu PAZARCI ; Dilek Necioğlu ÖRKEN ;Münevver Gökyiğit ÇELİK ; Lale Gündoğdu ÇELEBİ ; Şenay AYDIN. ...

Research paper thumbnail of Reappraisal of epileptic pain as a rare symptom of seizures

Epilepsy & Behavior, 2016

To draw attention to epileptic pain which is a rare seizure symptom mostly causing wrong diagnosi... more To draw attention to epileptic pain which is a rare seizure symptom mostly causing wrong diagnosis and delayed treatment. We present nine patients in whom pain was a prominent initial or early ictal symptom. We reviewed the records of 4736 patients, and found nine patients who had pain as an aura or an early prominent symptom of their seizures. Seizure semiology, EEG, and cranial imaging features were evaluated retrospectively. Age at seizure onset ranged from 6months to 50years, and the mean age during the study was 37.7±11.9years. Pain was predominantly peripherally localized in four patients, whereas cephalic pain was detected in three patients, and abdominal pain was detected in two patients. Electroencephalography (EEG) revealed epileptic abnormalities on the temporoparietal and frontotemporal regions in three patients each. Photosensitive generalized epileptic discharges were detected in one and diffuse background slowing in the remaining two other patients. Electroencephalography abnormalities were lateralized to the contralateral site of the pain in four patients with strictly localized pain. Three patients revealed no abnormality on the cranial MR imaging, whereas others showed different types of abnormality such as heterotopias (n:1), mesial temporal lobe atrophy (n:1), white and gray matter sequela lesions (n:1), diffuse white matter lesion (n:1), chronic encephalomalacia and gliosis (n:1), and perivascular space dilatation (n:1). Epileptic pain is a neglected, but important, semiologic symptom with localization and lateralization value in the patients with somatosensorial seizures of parietal as well as temporal lobe origin. It occurs mainly as peripherally localized, cephalic, or abdominal pain and is usually associated with a symptomatic etiology. Awareness of epileptic pain is important to avoid misdiagnosis and delayed treatment.

Research paper thumbnail of Mechanisms, clinical features and risk factors for stroke in the posterior cerebral artery infarcts

Türk Nöroloi Dergisi, 2015

Amaç: Çalışmamızda posterior serebral arterin (PSA) kortikal ve derin sulama alanı enfarktlarında... more Amaç: Çalışmamızda posterior serebral arterin (PSA) kortikal ve derin sulama alanı enfarktlarında risk faktörleri, klinik özellikler ve inme mekanizmaları arasındaki ilişkiyi ortaya koymayı amaçladık.

Research paper thumbnail of Periferik fasiyal paralizi nedeni ile gabapentin kullanımında sinkinezi gelişimi

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2013

Periferik fasiyal paralizi nedeni ile gabapentin kullanımında sinkinezi gelişimi Amaç: Sinkinezi,... more Periferik fasiyal paralizi nedeni ile gabapentin kullanımında sinkinezi gelişimi Amaç: Sinkinezi, fasiyal paralizi sonrası görülen en sık komplikasyonlardan biridir. Sinkinetik hareketler fasiyal sinirden innerve olan kasların anormal senkronizasyonu sonucu meydana gelir. Bu çalışmada fasiyal paralizi sonrasında Gabapentin kullanımının klinik sinkinezi gelişimine etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza 2008-2010 yılları arasında Şişli Etfal Eğitim ve Araştırma Hastanesi Acil Nöroloji Polikliniği ve Nöroloji Polikliniğinde akut periferik fasiyal paralizi kliniği olan toplam 76 hasta alındı. Kırkiki hastaya standart kortikosteroid tedavisi ve periaurikuler ağrı nedeniyle 800 mg/ gün Gabapentin tedavisi başlandı. Kontrol grubu olan 34 hastaya, akut periferik fasiyal paralizide uygulanan standart kortikosteroid tedavisi başlandı. Tüm hastalarda fasiyal paralizinin ağırlık derecesi House-Brackmann skalasına göre derecelendirildi. İki grup sinkinezi gelişimi açısından takibe alındı. Bulgular: Gabapentin grubuna, ortalama yaşı 43,1±14,9 olan, 16'sı kadın toplam 42 hasta alındı. Kontrol grubuna, ortalama yaşı 45,9±16,5 olan 25'i kadın toplam 34 hasta alındı. Gabapentin başlanan hasta grubundaki 7 hastada (%16,7) ve kontrol grubundaki 13 hastada (%38,2) sinkinezi geliştiği saptandı. İki grup arasında klinik olarak sinkinezi gelişimi açısından istatistiksel olarak anlamlı fark saptandı (p<0,034). Gabapentin grubu ile kontrol grubu arasında klinik sinkinezi görülme zamanı arasında istatistiksel olarak anlamlı fark saptanmadı (p:0.816). İki grubun takip süreleri arasında istatistiksel olarak anlamlı fark saptanmadı (P:0.303). Sonuç: Sinkinezi, periferik fasiyal paralizinin bir komplikasyonudur ve önlenmesi ya da tedavi yöntemlerinin geliştirilmesi önemlidir. Bu çalışma Gabapentinin sinkinezi tedavisinde etkili olduğunu göstermektedir. Bizim sonuçlarımızın yapılacak çift kör plasebo kontrollü randomize planlanmış daha ileri çalışmalara temel oluşturacağına inanıyoruz.