Mustafa Komur | Mersin University (original) (raw)

Papers by Mustafa Komur

Children with chronic neurological diseases,including cerebral palsy(CP)are especially susceptibl... more Children with chronic neurological diseases,including cerebral palsy(CP)are especially susceptible to vaccine-preventable infections and face an increased risk of severe respiratory infections and decompensation of their disease.This study aims to examine age-appropriate immunization status and related factors in the CP population of our country. This cross-sectional prospective multicentered survey study included 18 pediatric neurology clinics around Turkey,wherein outpatients children with CP were included in the study.Data on patient and CP characteristics,concomitant disorders as well as vaccination status included in the National Immunization Program(NIP),administration and recommendation of influenza vaccine were collected at a single visit. A total of 1194 patients were enrolled.Regarding immunization records,the most frequently administrated and schedule completed vaccines were BCG(90.8%),hepatitis B(88.9%)and oral poliovirus vaccine (88.5%).MMR was administered to 77.3% and...

Journal of Pediatric Neurosciences

Annals of Indian Academy of Neurology

Medicina

Cardiovascular abnormalities are widespread when a newborn is exposed to a hypoxic-ischemic injur... more Cardiovascular abnormalities are widespread when a newborn is exposed to a hypoxic-ischemic injury in the neonatal period. Although the neuroprotective effects of levetiracetam (LEV) have been reported after hypoxia, the cardioprotective effects of LEV have not been documented. Therefore, we aimed to investigate whether levetiracetam (LEV) has a protective effect on cardiac-contractility and ultrastructure of heart muscle in rats exposed to hypoxia-ischemia (HI) during the neonatal period. A total of 49 seven-day-old rat pups were separated into four groups. For HI induction, a combination of right common carotid artery ligation with 8% oxygen in seven-day-old rat pups for 2 h was performed for saline, LEV100, and LEV200 groups. Just after hypoxia, LEV100 and LEV200 groups were administered with 100 mg/kg and 200 mg/kg of LEV, respectively. The arteries of rats in the control group were only detected; no ligation or hypoxia was performed. At the end of the 16th week after HI, cardia...

Multiple Sclerosis and Related Disorders

Multiple Sclerosis and Related Disorders

The Journal of International Advanced Otology

Axial mesodermal dysplasia complex (AMDC) is a combination of various congenital malformations in... more Axial mesodermal dysplasia complex (AMDC) is a combination of various congenital malformations including the cardiovascular, pulmonary, gastrointestinal, genitourinary, musculoskeletal, and central nervous system abnormalities. AMDC also includes many syndromes such as vertebral, anorectal, cardiac anomalies, tracheo-esophageal fistula, esophageal atresia, renal and limb anomalies (VACTERL), Müllerian duct aplasia, renal agenesis, cervicothoracic somite dysplasia (MURCS), Goldenhar (oculo-auriculo-vertebral spectrum), and Klippel-Feil (cervical vertebra fusion syndrome) [1]. Here in, imaging findings of a 15-year-old boy with AMDC who has bilateral inner ear malformations associated with vestibulocochlear nerve extending to Meckel cave, cervical vertebral segmentation anomalies, maxillary bone anomalies, and cystic lesion in prepontinecistern are presented. CASE PRESENTATION A 15-year-old boy with bilateral congenital hearing loss and congenital cervical scoliosis was admitted to our ENT Department. Physical and audio-logic examination revealed cervical scoliosis, facial asymmetry, bilateral sensorineoral hearing loss, and right nervusabducens paralysis. Temporal bone computed tomography (CT; Toshiba Aquilion 64, Toshiba Medical Systems, Tokyo, Japan) demonstrated the absence of the normal differentiation of the cochlea and vestibule which was replaced by a cystic structure in the left side. These features were classic examples of common cavity malformation (Figure 1). Additionally, CT revealed a right cystic cochlea lacking the entire modiolus, along with an enlarged cystic vestibule. Internal auditory canal (IAC) was hypoplasticon bothsides. These features were components of incomplete partition type I (Figure 2) [2]. Inner ear magnetic resonance imaging (MRI) T2-SPACE (Signa Excite, GE Medical Systems, Milwaukee, WI, USA) sequence showed the left vestibulocochlear nerve coursing toward Meckel cave (Figure 3 a-c).The left cochlear, superior and inferior vestibular nerves were seen entering the Meckel cave. The left trigeminal nerve and Meckel cave were smaller than the right trigeminal nerve (Figure 4). The left facial nerve, the right vestibulocochlear nerve, and the right facial nerve were seen at normal location. The right abducens nerve was not demonstrated due to aplasia. Left abducens nerve was found normal. A cystic lesion was seen in the prepontine cisterna (Figure 5). Cervical radiography showed cervical vertebrae segmentation anomalies at multiple levels, cervical scoliosis, and maxillary bone anomalies (Figure 6).

JPMA. The Journal of the Pakistan Medical Association, 2016

To determine the effect of fibroblast growth factor 2 on cognitive function in neonatal rats with... more To determine the effect of fibroblast growth factor 2 on cognitive function in neonatal rats with hypoxic-ischaemic brain injury. The randomised controlled study was conducted from January to June 2011 at Mersin University, School of Medicine, Experimental Animals Research Laboratory and Physiology Behaviour Laboratory, Mersin, Turkey. It included 7-d-old male rats that were randomised into four groups: fibroblast growth factor 2-20, fibroblast growth factor 2-40, control and sham. All the rats, except those in the sham group, were kept in a hypoxia chamber containing 8% oxygen for 2 hours following ligation of the right carotid artery. After hypoxic-ischaemic brain injury was induced, 20 ng g-1 or 40 ng g-1 of fibroblast growth factor 2 was administered via the intraperitoneal route. The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labelling method was used to evaluate neuronal apoptosis. The Morris water maze (MWM) test was administered to the ...

Neuro endocrinology letters, Jan 15, 2016

Lyme disease is a vector-associated infectious disease, caused by the agent, spirochete Borrelia ... more Lyme disease is a vector-associated infectious disease, caused by the agent, spirochete Borrelia burgdorferi. Neurologic findings are observed in approximately 12% of the cases and termed Lyme neuroborreliosis (LNB). Lyme neuroborreliosis may manifest with different clinical neurologic manifestations. The study was conducted at tertiary training and research hospital. From January 2014 to September 2015, a total of 75 patients diagnosed with encephalitis, ataxia, Guillain Barre Syndrome (GBS), facial paralysis, acute disseminated encephalomyelitis (ADEM), pseudotumorcerebri were evaluated for inclusion to the study. Among these patients whom investigations of B. burgdorferi antibody IgM and/or IgG ELISA and Western Blot (WB) were detected to be positive, were assessed. Epidemiologic data, tick bite histories, duration of symptoms, clinical findings, radiologic findings, treatment durations and prognosis were investigated. Totally 7 patients had been treated with the diagnosis of Lym...

Neuro endocrinology letters, 2015

Cerebral salt wasting syndrome (CSWS) is characterized by severe natriuresis and volume depletion... more Cerebral salt wasting syndrome (CSWS) is characterized by severe natriuresis and volume depletion in the presence of cerebral pathology. In literature, there are few reports about tuberculous meningitis and cerebral CSWS. In this article, we report two tuberculous meningitis cases with CSWS and present a review of the literature on this topic. Cerebral salt wasting diagnosis was based on hyponatraemia associated with high urinary sodium excretion and inappropriately high urine output in the presence of dehydration. Treatment was made with sodium-fluid replacement plus fludrocortisone therapy in both cases. In agreement with the literature we argue that cerebral salt wasting syndrome might be more common than the syndromes of inappropriate antidiuretic hormone secretion (SIADH) in cerebral disorders. Differentiating the cerebral salt wasting syndrome from the SIADH is very important because unrecognized cerebral salt wasting syndrome can lead to inadequate management and result in un...

Neuro endocrinology letters, 2015

Cerebral salt-wasting syndrome (CSWS) is a hypovolemic hyponatremia caused by natriuresis and diu... more Cerebral salt-wasting syndrome (CSWS) is a hypovolemic hyponatremia caused by natriuresis and diuresis, of which the exact pathogenesis is unknown. Although CSWS has been more commonly described to be associated with neurosurgical disorders, increasing numbers of patients are diagnosed and new etiological factors are being identified as the awareness of it increases. The files of the patients who had been hospitalized and treated with the diagnosis of CSWS at the pediatric critical care unit during the last three years were retrospectively reviewed. Totally 9 patients had been treated with the diagnosis of CSWS. The causes of CSWS were identified as tuberculosis meningitis in two patients, status epilepticus in two patients, ketamine infusion in one patient, medulloblastoma in one patient, sepsis in one patient, brain oedema following child abuse in one patient, and cerebral infarct in one patient. All of the patients had received isotonic saline and hypertonic saline while 77.7% of...

Journal of Pediatric Neurosciences, 2015

Infectious mononucleosis due to Epstein-Barr virus (EBV) is a usually benign systemic viral illne... more Infectious mononucleosis due to Epstein-Barr virus (EBV) is a usually benign systemic viral illness common in children. Many studies described nervous system manifestations of infectious mononucleosis with a wide spectrum of neurologic deficits. Neurologic complications of EBV are seen in both acute and reactivate infection. Herein, we describe a patient diagnosed by acute EBV encephalitis with substantia nigra involvement and excellent clinical recovery.

Journal of Clinical Apheresis, 2015

Lyme disease is a rare tick-borne multisystemic infection caused by Borrelia burgdorferi. Differe... more Lyme disease is a rare tick-borne multisystemic infection caused by Borrelia burgdorferi. Different neurological conditions were reported in the disease. In this article, we present a 15-year-old patient hospitalized with ataxia who was diagnosed with Lyme neuroborreliosis. Intravenous immunoglobulin and ceftriaxone treatment was applied to the patient for 4 weeks. However, ataxia did not recover, upper and lower muscle weakness developed, and deep tendon reflexes diminished during follow-up. The patient was diagnosed with Guillain-Barre syndrome arising from B. burgdorferi. Second dose of intravenous immunoglobulin treatment was started for 5 days but the patient didn't recover. Therefore administration of plasmapheresis was decided. All symptoms relieved following the plasmapheresis. The effect of plasmapheresis in pediatric neuroborreliosis has not been documented before. This study highlights that plasmapheresis could be a useful alternative for pediatric neuroborreliosis cases. J. Clin. Apheresis, 2015. © 2015 Wiley Periodicals, Inc.

European Journal of Paediatric Neurology, 2015

Alpha lipoic acid is a powerful antioxidant widely used for the supplementary treatment of diabet... more Alpha lipoic acid is a powerful antioxidant widely used for the supplementary treatment of diabetic neuropathy. Intoxication with alpha lipoic acid is very rare. There is no reported dose of safety in children. A 14-month-old previously healthy girl was referred to our hospital with the diagnosis of drug intoxication. She was admitted to the emergency department with lethargy and continuing involuntary movements for several hours after she had ingested an unknown amount of alpha lipoic acid. On admission she was lethargic and had myoclonic seizures involving all extremities. She had no fever and laboratory examinations were normal except for mild metabolic acidosis. The seizures were unresponsive to bolus midazolam, phenytoin infusion and levetiracetam infusion. She was taken to the pediatric intensive care unit with the diagnosis of status epilepticus. After failure of the treatment with midazolam infusion she was intubated and thiopental sodium infusion was started. Her myoclonic seizures were controlled with thiopental sodium infusion. After 48 h intubation and mechanical ventilation thiopental sodium was gradually reduced and then stopped. Following the withdraw of thiopental sodium, she was seizure free on her discharge on the 8th day. Alpha lipoic acid and derivatives cause side effects in children like refractory convulsions. They are frequently rendered as vitamins by diabetic patients and are left at places where children can easily access them. Therefore, when faced with refractory convulsions in children who have had no disease before, intoxication by medicaments with alpha lipoic acid should be taken into consideration.

JPMA. The Journal of the Pakistan Medical Association, 2014

To evaluate the degree of consistency between the referral diagnosis and that based on electroneu... more To evaluate the degree of consistency between the referral diagnosis and that based on electroneuromyography. The retrospective study was conducted at the Paediatric Neurology Laboratory of Mersin University School of Medicine, Turkey, and comprised all electroneuromyographies carried out between January 2005 and December 2010. Demographic data, referral diagnosis and post-procedure diagnosis were recorded for each patient, and were classified into groups. Consistency between the two groups was compared using SPSS 13. Of the total 294 patients, polyneuropathy was the reason for referral in 104 (35.4%), peripheral nerve injury in 54 (18.4%), brachial plexus injury in 52 (17.7%), myopathy in 52 (17.7%), hypotonia in 23 (7.8%), and facial paralysis in 9 (3.0%) patients. There was consistency between the two diagnoses in 179 (60.9%) patients. Electroneuromyography is an uneasy, painful and stressfull procedure for children, and, therefore, it should be recommended only in cases where th...

Asian Pacific journal of cancer prevention : APJCP, 2010

Several studies have suggested that the presence of myeloid antigens is a poor prognostic factor ... more Several studies have suggested that the presence of myeloid antigens is a poor prognostic factor in patients with acute lymphoid leukemia (ALL). We aimed to assess this possibility in Turkish patients. Seventy-three children with a diagnosis of ALL-L1 and 38 with ALL-L2 were included. Flow cytometry and fluorescein-isothiocynate conjugated antibodies were used to determined surface antigens on blasts. Myeloid antigens were positive in 48.4% with ALL-L1 and 60.5% with ALL-L2, the difference not being significant. Overall survival rates of myeloid antigen positive patients at 36, 60, and 72 months were 76%, 58%, and 48%, respectively, comparable to the corresponding 70%, 56%, and 46% in myeloid antigen negative patients (p >0.05). We did not find any association between myeloid antigen positivity and clinical and laboratory features of ALL.

Asian Pacific journal of cancer prevention : APJCP, 2010

Acute myeloblastic leukemia (AML) accounts for 15 to 25 percent of childhood acute leukemias. The... more Acute myeloblastic leukemia (AML) accounts for 15 to 25 percent of childhood acute leukemias. The most common genetic abnormalities seen in pediatric AML patients are AML1-ETO, PML-RARα and CBFB-MYH11 genes resulting in t(8;21), t(15;17) and inv(16). These genetic defects are seen in approximately 20-25% of AML patients. We investigated in this study, incidence and prognostic significance of the AML1-ETO, PML-RARα and CBFB-MYH11 genes in children with AML. The authors analyzed 34 children with AML using the real time-polymerase chain reaction for AML1-ETO, PML-RARα and CBFB-MYH11 genes. Of the patients, 8.8% were positive for t(8;21), 8.8% for t(15;17) and 3% for inv(16). There were a statistically significant differences between 48 month overall survival rates of the patients positive and negative for t(8;21), t(15;17) and inv(16). It was concluded that t(15;17), t(8;21) and inv(16) impact on disease prognosis positively, but comprehensive studies with larger patient series are now...

Asian Pacific journal of cancer prevention : APJCP, 2010

Several studies have focused on the immunophenotype of the leukemic population at the time of rel... more Several studies have focused on the immunophenotype of the leukemic population at the time of relapse compared to that observed at diagnosis. The question of whether differences exist between surface antigens levels on blasts at the time of diagnosis and at relapse in cases of acute lymphoblastic leukemia (ALL) was addressed. A total of 25 All patients were included. Flow cytometry and fluorescein-isothiocynate conjugated antibodies were used to determined surface antigens levels. The most frequently detected five antigens were I2 (n=21), CD10 (n=17), CD41 (n=16), CD2 (n=14) and CD7/CD19 (n=13/n=13) at the time of diagnosis and CD41 (n=21), I2 (n=20), CD10 (n=14), CD19 (n=16) and CD2 (n=12) at the time of relapse. There was a significant difference only between CD41 levels at the time of diagnosis and at the time of relapse (p=0.041). We found changes in antigen expressions at the time of relapse in ALL patients. This condition ought to be evaluated with reference to prognosis of le...

Children with chronic neurological diseases,including cerebral palsy(CP)are especially susceptibl... more Children with chronic neurological diseases,including cerebral palsy(CP)are especially susceptible to vaccine-preventable infections and face an increased risk of severe respiratory infections and decompensation of their disease.This study aims to examine age-appropriate immunization status and related factors in the CP population of our country. This cross-sectional prospective multicentered survey study included 18 pediatric neurology clinics around Turkey,wherein outpatients children with CP were included in the study.Data on patient and CP characteristics,concomitant disorders as well as vaccination status included in the National Immunization Program(NIP),administration and recommendation of influenza vaccine were collected at a single visit. A total of 1194 patients were enrolled.Regarding immunization records,the most frequently administrated and schedule completed vaccines were BCG(90.8%),hepatitis B(88.9%)and oral poliovirus vaccine (88.5%).MMR was administered to 77.3% and...

Journal of Pediatric Neurosciences

Annals of Indian Academy of Neurology

Medicina

Cardiovascular abnormalities are widespread when a newborn is exposed to a hypoxic-ischemic injur... more Cardiovascular abnormalities are widespread when a newborn is exposed to a hypoxic-ischemic injury in the neonatal period. Although the neuroprotective effects of levetiracetam (LEV) have been reported after hypoxia, the cardioprotective effects of LEV have not been documented. Therefore, we aimed to investigate whether levetiracetam (LEV) has a protective effect on cardiac-contractility and ultrastructure of heart muscle in rats exposed to hypoxia-ischemia (HI) during the neonatal period. A total of 49 seven-day-old rat pups were separated into four groups. For HI induction, a combination of right common carotid artery ligation with 8% oxygen in seven-day-old rat pups for 2 h was performed for saline, LEV100, and LEV200 groups. Just after hypoxia, LEV100 and LEV200 groups were administered with 100 mg/kg and 200 mg/kg of LEV, respectively. The arteries of rats in the control group were only detected; no ligation or hypoxia was performed. At the end of the 16th week after HI, cardia...

Multiple Sclerosis and Related Disorders

Multiple Sclerosis and Related Disorders

The Journal of International Advanced Otology

Axial mesodermal dysplasia complex (AMDC) is a combination of various congenital malformations in... more Axial mesodermal dysplasia complex (AMDC) is a combination of various congenital malformations including the cardiovascular, pulmonary, gastrointestinal, genitourinary, musculoskeletal, and central nervous system abnormalities. AMDC also includes many syndromes such as vertebral, anorectal, cardiac anomalies, tracheo-esophageal fistula, esophageal atresia, renal and limb anomalies (VACTERL), Müllerian duct aplasia, renal agenesis, cervicothoracic somite dysplasia (MURCS), Goldenhar (oculo-auriculo-vertebral spectrum), and Klippel-Feil (cervical vertebra fusion syndrome) [1]. Here in, imaging findings of a 15-year-old boy with AMDC who has bilateral inner ear malformations associated with vestibulocochlear nerve extending to Meckel cave, cervical vertebral segmentation anomalies, maxillary bone anomalies, and cystic lesion in prepontinecistern are presented. CASE PRESENTATION A 15-year-old boy with bilateral congenital hearing loss and congenital cervical scoliosis was admitted to our ENT Department. Physical and audio-logic examination revealed cervical scoliosis, facial asymmetry, bilateral sensorineoral hearing loss, and right nervusabducens paralysis. Temporal bone computed tomography (CT; Toshiba Aquilion 64, Toshiba Medical Systems, Tokyo, Japan) demonstrated the absence of the normal differentiation of the cochlea and vestibule which was replaced by a cystic structure in the left side. These features were classic examples of common cavity malformation (Figure 1). Additionally, CT revealed a right cystic cochlea lacking the entire modiolus, along with an enlarged cystic vestibule. Internal auditory canal (IAC) was hypoplasticon bothsides. These features were components of incomplete partition type I (Figure 2) [2]. Inner ear magnetic resonance imaging (MRI) T2-SPACE (Signa Excite, GE Medical Systems, Milwaukee, WI, USA) sequence showed the left vestibulocochlear nerve coursing toward Meckel cave (Figure 3 a-c).The left cochlear, superior and inferior vestibular nerves were seen entering the Meckel cave. The left trigeminal nerve and Meckel cave were smaller than the right trigeminal nerve (Figure 4). The left facial nerve, the right vestibulocochlear nerve, and the right facial nerve were seen at normal location. The right abducens nerve was not demonstrated due to aplasia. Left abducens nerve was found normal. A cystic lesion was seen in the prepontine cisterna (Figure 5). Cervical radiography showed cervical vertebrae segmentation anomalies at multiple levels, cervical scoliosis, and maxillary bone anomalies (Figure 6).

JPMA. The Journal of the Pakistan Medical Association, 2016

To determine the effect of fibroblast growth factor 2 on cognitive function in neonatal rats with... more To determine the effect of fibroblast growth factor 2 on cognitive function in neonatal rats with hypoxic-ischaemic brain injury. The randomised controlled study was conducted from January to June 2011 at Mersin University, School of Medicine, Experimental Animals Research Laboratory and Physiology Behaviour Laboratory, Mersin, Turkey. It included 7-d-old male rats that were randomised into four groups: fibroblast growth factor 2-20, fibroblast growth factor 2-40, control and sham. All the rats, except those in the sham group, were kept in a hypoxia chamber containing 8% oxygen for 2 hours following ligation of the right carotid artery. After hypoxic-ischaemic brain injury was induced, 20 ng g-1 or 40 ng g-1 of fibroblast growth factor 2 was administered via the intraperitoneal route. The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labelling method was used to evaluate neuronal apoptosis. The Morris water maze (MWM) test was administered to the ...

Neuro endocrinology letters, Jan 15, 2016

Lyme disease is a vector-associated infectious disease, caused by the agent, spirochete Borrelia ... more Lyme disease is a vector-associated infectious disease, caused by the agent, spirochete Borrelia burgdorferi. Neurologic findings are observed in approximately 12% of the cases and termed Lyme neuroborreliosis (LNB). Lyme neuroborreliosis may manifest with different clinical neurologic manifestations. The study was conducted at tertiary training and research hospital. From January 2014 to September 2015, a total of 75 patients diagnosed with encephalitis, ataxia, Guillain Barre Syndrome (GBS), facial paralysis, acute disseminated encephalomyelitis (ADEM), pseudotumorcerebri were evaluated for inclusion to the study. Among these patients whom investigations of B. burgdorferi antibody IgM and/or IgG ELISA and Western Blot (WB) were detected to be positive, were assessed. Epidemiologic data, tick bite histories, duration of symptoms, clinical findings, radiologic findings, treatment durations and prognosis were investigated. Totally 7 patients had been treated with the diagnosis of Lym...

Neuro endocrinology letters, 2015

Cerebral salt wasting syndrome (CSWS) is characterized by severe natriuresis and volume depletion... more Cerebral salt wasting syndrome (CSWS) is characterized by severe natriuresis and volume depletion in the presence of cerebral pathology. In literature, there are few reports about tuberculous meningitis and cerebral CSWS. In this article, we report two tuberculous meningitis cases with CSWS and present a review of the literature on this topic. Cerebral salt wasting diagnosis was based on hyponatraemia associated with high urinary sodium excretion and inappropriately high urine output in the presence of dehydration. Treatment was made with sodium-fluid replacement plus fludrocortisone therapy in both cases. In agreement with the literature we argue that cerebral salt wasting syndrome might be more common than the syndromes of inappropriate antidiuretic hormone secretion (SIADH) in cerebral disorders. Differentiating the cerebral salt wasting syndrome from the SIADH is very important because unrecognized cerebral salt wasting syndrome can lead to inadequate management and result in un...

Neuro endocrinology letters, 2015

Cerebral salt-wasting syndrome (CSWS) is a hypovolemic hyponatremia caused by natriuresis and diu... more Cerebral salt-wasting syndrome (CSWS) is a hypovolemic hyponatremia caused by natriuresis and diuresis, of which the exact pathogenesis is unknown. Although CSWS has been more commonly described to be associated with neurosurgical disorders, increasing numbers of patients are diagnosed and new etiological factors are being identified as the awareness of it increases. The files of the patients who had been hospitalized and treated with the diagnosis of CSWS at the pediatric critical care unit during the last three years were retrospectively reviewed. Totally 9 patients had been treated with the diagnosis of CSWS. The causes of CSWS were identified as tuberculosis meningitis in two patients, status epilepticus in two patients, ketamine infusion in one patient, medulloblastoma in one patient, sepsis in one patient, brain oedema following child abuse in one patient, and cerebral infarct in one patient. All of the patients had received isotonic saline and hypertonic saline while 77.7% of...

Journal of Pediatric Neurosciences, 2015

Infectious mononucleosis due to Epstein-Barr virus (EBV) is a usually benign systemic viral illne... more Infectious mononucleosis due to Epstein-Barr virus (EBV) is a usually benign systemic viral illness common in children. Many studies described nervous system manifestations of infectious mononucleosis with a wide spectrum of neurologic deficits. Neurologic complications of EBV are seen in both acute and reactivate infection. Herein, we describe a patient diagnosed by acute EBV encephalitis with substantia nigra involvement and excellent clinical recovery.

Journal of Clinical Apheresis, 2015

Lyme disease is a rare tick-borne multisystemic infection caused by Borrelia burgdorferi. Differe... more Lyme disease is a rare tick-borne multisystemic infection caused by Borrelia burgdorferi. Different neurological conditions were reported in the disease. In this article, we present a 15-year-old patient hospitalized with ataxia who was diagnosed with Lyme neuroborreliosis. Intravenous immunoglobulin and ceftriaxone treatment was applied to the patient for 4 weeks. However, ataxia did not recover, upper and lower muscle weakness developed, and deep tendon reflexes diminished during follow-up. The patient was diagnosed with Guillain-Barre syndrome arising from B. burgdorferi. Second dose of intravenous immunoglobulin treatment was started for 5 days but the patient didn't recover. Therefore administration of plasmapheresis was decided. All symptoms relieved following the plasmapheresis. The effect of plasmapheresis in pediatric neuroborreliosis has not been documented before. This study highlights that plasmapheresis could be a useful alternative for pediatric neuroborreliosis cases. J. Clin. Apheresis, 2015. © 2015 Wiley Periodicals, Inc.

European Journal of Paediatric Neurology, 2015

Alpha lipoic acid is a powerful antioxidant widely used for the supplementary treatment of diabet... more Alpha lipoic acid is a powerful antioxidant widely used for the supplementary treatment of diabetic neuropathy. Intoxication with alpha lipoic acid is very rare. There is no reported dose of safety in children. A 14-month-old previously healthy girl was referred to our hospital with the diagnosis of drug intoxication. She was admitted to the emergency department with lethargy and continuing involuntary movements for several hours after she had ingested an unknown amount of alpha lipoic acid. On admission she was lethargic and had myoclonic seizures involving all extremities. She had no fever and laboratory examinations were normal except for mild metabolic acidosis. The seizures were unresponsive to bolus midazolam, phenytoin infusion and levetiracetam infusion. She was taken to the pediatric intensive care unit with the diagnosis of status epilepticus. After failure of the treatment with midazolam infusion she was intubated and thiopental sodium infusion was started. Her myoclonic seizures were controlled with thiopental sodium infusion. After 48 h intubation and mechanical ventilation thiopental sodium was gradually reduced and then stopped. Following the withdraw of thiopental sodium, she was seizure free on her discharge on the 8th day. Alpha lipoic acid and derivatives cause side effects in children like refractory convulsions. They are frequently rendered as vitamins by diabetic patients and are left at places where children can easily access them. Therefore, when faced with refractory convulsions in children who have had no disease before, intoxication by medicaments with alpha lipoic acid should be taken into consideration.

JPMA. The Journal of the Pakistan Medical Association, 2014

To evaluate the degree of consistency between the referral diagnosis and that based on electroneu... more To evaluate the degree of consistency between the referral diagnosis and that based on electroneuromyography. The retrospective study was conducted at the Paediatric Neurology Laboratory of Mersin University School of Medicine, Turkey, and comprised all electroneuromyographies carried out between January 2005 and December 2010. Demographic data, referral diagnosis and post-procedure diagnosis were recorded for each patient, and were classified into groups. Consistency between the two groups was compared using SPSS 13. Of the total 294 patients, polyneuropathy was the reason for referral in 104 (35.4%), peripheral nerve injury in 54 (18.4%), brachial plexus injury in 52 (17.7%), myopathy in 52 (17.7%), hypotonia in 23 (7.8%), and facial paralysis in 9 (3.0%) patients. There was consistency between the two diagnoses in 179 (60.9%) patients. Electroneuromyography is an uneasy, painful and stressfull procedure for children, and, therefore, it should be recommended only in cases where th...

Asian Pacific journal of cancer prevention : APJCP, 2010

Several studies have suggested that the presence of myeloid antigens is a poor prognostic factor ... more Several studies have suggested that the presence of myeloid antigens is a poor prognostic factor in patients with acute lymphoid leukemia (ALL). We aimed to assess this possibility in Turkish patients. Seventy-three children with a diagnosis of ALL-L1 and 38 with ALL-L2 were included. Flow cytometry and fluorescein-isothiocynate conjugated antibodies were used to determined surface antigens on blasts. Myeloid antigens were positive in 48.4% with ALL-L1 and 60.5% with ALL-L2, the difference not being significant. Overall survival rates of myeloid antigen positive patients at 36, 60, and 72 months were 76%, 58%, and 48%, respectively, comparable to the corresponding 70%, 56%, and 46% in myeloid antigen negative patients (p >0.05). We did not find any association between myeloid antigen positivity and clinical and laboratory features of ALL.

Asian Pacific journal of cancer prevention : APJCP, 2010

Acute myeloblastic leukemia (AML) accounts for 15 to 25 percent of childhood acute leukemias. The... more Acute myeloblastic leukemia (AML) accounts for 15 to 25 percent of childhood acute leukemias. The most common genetic abnormalities seen in pediatric AML patients are AML1-ETO, PML-RARα and CBFB-MYH11 genes resulting in t(8;21), t(15;17) and inv(16). These genetic defects are seen in approximately 20-25% of AML patients. We investigated in this study, incidence and prognostic significance of the AML1-ETO, PML-RARα and CBFB-MYH11 genes in children with AML. The authors analyzed 34 children with AML using the real time-polymerase chain reaction for AML1-ETO, PML-RARα and CBFB-MYH11 genes. Of the patients, 8.8% were positive for t(8;21), 8.8% for t(15;17) and 3% for inv(16). There were a statistically significant differences between 48 month overall survival rates of the patients positive and negative for t(8;21), t(15;17) and inv(16). It was concluded that t(15;17), t(8;21) and inv(16) impact on disease prognosis positively, but comprehensive studies with larger patient series are now...

Asian Pacific journal of cancer prevention : APJCP, 2010

Several studies have focused on the immunophenotype of the leukemic population at the time of rel... more Several studies have focused on the immunophenotype of the leukemic population at the time of relapse compared to that observed at diagnosis. The question of whether differences exist between surface antigens levels on blasts at the time of diagnosis and at relapse in cases of acute lymphoblastic leukemia (ALL) was addressed. A total of 25 All patients were included. Flow cytometry and fluorescein-isothiocynate conjugated antibodies were used to determined surface antigens levels. The most frequently detected five antigens were I2 (n=21), CD10 (n=17), CD41 (n=16), CD2 (n=14) and CD7/CD19 (n=13/n=13) at the time of diagnosis and CD41 (n=21), I2 (n=20), CD10 (n=14), CD19 (n=16) and CD2 (n=12) at the time of relapse. There was a significant difference only between CD41 levels at the time of diagnosis and at the time of relapse (p=0.041). We found changes in antigen expressions at the time of relapse in ALL patients. This condition ought to be evaluated with reference to prognosis of le...