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BİR ORTA ANADOLU ÖRNEĞİ OLARAK KIRIKKALE ÜNİVERSİTESİ TIP FAKÜLTESİ NÖROLOJİ KLİNİK VERİLERİ
(2019) Say, Bahar; Ergun, Ufuk; Yardımcı, İlknur; Alpua, Murat
Amaç: Nörolojik hastalıklar, görülme oranlarındaki artış,özürlülük ve sağlık giderlerindeki payı nedeniyle önemli biryere sahiptir. Bu çalışma, orta Anadolu örneği olarakKırıkkale Üniversitesi Tıp Fakültesi Hastanesi Nörolojikliniğinde gördüğümüz nörolojik hastalıklar spektrumunu veoranlarını belirlemek amacıyla planlanmıştır.Gereç ve Yöntem: Bu retrospektif çalışmada, Ağustos2016- Ağustos 2018 tarihleri arasında nöroloji kliniğindeyatırılan hastaların dosyaları incelendi. Dosyalar ve tanıkodları doktor tarafından düzenlenmiş olup, InternationalClassification of Diseases kodlamasına göre olan ana tanı,demografik özellikler dikkate alındı.Bulgular: Toplam 805 (422 kadın, 383 erkek) hasta dosyasıtarandı Servisteki hasta sayısı 712, yoğun bakımdaki ise93’di. Kadın hastalardan 50’si (%10.7), erkek hastalardan43‘ü (%10) yoğun bakımda takip edildi. Yaş dağılımında 70yaş üzeri hasta sayısı fazlaydı. Tanılara göre 413 (%51.3)serebrovasküler hastalık, 119 (%14.7) epilepsi, 62 (%7.7)senkop, 60 (%7.4) başdönmesi, 51 (%6.3) baş ağrısı diğersendromlar, 44 (%5.4) multipl skleroz, 17 (%2.1)enflamatuar polinöropatiler, diğeri, 11 (%1.3) Parkinson, 7(%0.8) Miyastenia Gravis, 7 (%0.8) bunama, 5 (%0.6)normal basınçlı hidrosefali, 4 (%0.4) Guillian BarreSendromu (GBS), 3 (%0.3) motor nöron hastalığı, 1 (%0.1)Lambert Eaton sendromu ve 1 (0.1) Herpes virüs ensefalitigörüldü.Sonuç: Bu çalışma da örneklem sayısı az olsa da ortaAnadolu’da başkentin yanı başındaki bir üniversitehastanesinin iki yıllık klinik verileri analiz edildi. Bulgularliteratür ile uyumlu olup en sık serebrovasküler hastalık,sonra epilepsi izlendi. Hastaların çoğunluğu 70 yaş üzeriydi.Ayrıca solunum kasları tutulumu ile tehlike yaratabilecekMiyastenia Gravis ve GBS olguları dikkat çekiciydi.
Coexistence of Ankylosing Spondylitis and Multiple Sclerosis: Trigger with TNF-alpha Antagonist Therapy or Coincidental?
(Turkish Neurological Soc, 2019) Say, Bahar; Ergun, Ufuk
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Covid-19 perception and self reported impact of pandemic on Parkinson's disease symptoms of patients with physically independent Parkinson's disease
(Asean Neurological Assoc, 2020) Say, Bahar; Ozenc, Betul; Ergun, Ufuk
Objective: The novel coronavirus disease 2019 (Covid-19) pandemic has affected many people with chronic diseases, including Parkinson's disease (PD). We aimed to investigate the perception of Covid-19 and the self-reported impact of the pandemic on PD symptoms of a group of patients with physically independent PD from Turkey. Methods: We applied a questionnaire to idiopathic PD patients aged >= 65 years, who did not have known dementia, who were physically independent and who had at least one visit in the year before the telephone interview. The study patients were selected from the medical records of two different centers in Kirikkale, Turkey. Two neurologists conducted a semi-structured telephone interview to evaluate the perception of Covid-19 and new or worsening PD symptoms after the home quarantine. Results: In total, 86 patients were included in the study. Although most of the patients (97.7%) knew of Covid-19, knowledge of the Covid-19 symptoms was moderate ( 54.7%). Most patients reported that they washed their hands often (100%) and wore a mask (98.8%); 76 (88.4%) of them stayed at home. Compliance with other preventive measures was above 80%. In total, 40 (46.5%) patients (28 male, 12 female) reported worsening bradykinesia. Fatigue (24.4%), daytime sleepiness (20.9%), pain (20.9%) and anxiety (15.2%) were the most common new or worsening non-motor symptoms. Conclusions: The Covid-19 knowledge in a group of patients with PD from Turkey can be considered adequate. They have a high compliance with preventive measures. However, reduced non-exercise physical activity due to the pandemic affected both their motor symptoms and non-motor symptoms.
Electroencephalography (EEG) and Syncope: A Retrospective Study
(2020) Say, Bahar; Yıldız, Ayşe; Alpua, Murat; Ergun, Ufuk
Objectives: Electroencephalography (EEG) is one of the most vital tools in neurology practice. It is used for the diagnosis and differential diagnosis of several clinical conditions. One of them is syncope. In this study, it was planned that a retrospective evaluation of EEGs performed due to syncope in our laboratory and determine the rate of abnormal EEGs. Methods: EEG recordings performed due to syncope were reviewed over a two-years period in this study. The EEG findings were classified as normal and abnormal. The abnormal EEG findings were classified into focal epileptiform discharge, generalized epileptiform discharge, focal slowing and generalized slowing subgroups and analyzed. Results: The results of 298 EEGs were analyzed, which involved 174 (58.3%) female and 124 (41.6%) male subjects, with a mean age of 38.84±17.83 (min-max: 17–90) years. Among subjects with syncope, 90.6% of the EEGs were normal and 9.4% showed abnormal findings. The most common abnormal finding was focal epileptiform discharge (5.03%). Generalized epileptiform discharge was observed in three (1%), focal slowing in seven (2.3%) and generalized slowing in two (0.6%) subjects. Among the EEG results with no abnormal findings, 38 (12.7%) had sleep-deprived EEG and six (2.1%) were found to have focal epileptiform discharge. A total of 113 (37.9%) subjects had electrocardiogram recording and results were normal. Conclusion: The rate of abnormal findings in EEGs performed due to syncope is low. EEG may be helpful in some selected subjects with syncope referred to the laboratory with a good history and neurological examination. EEG may be repeated if necessary
Emotion dysregulation in migraine patients: can it be a hallmark the probability of the transformation from episodIc to chronic?
(Taylor & Francis Ltd, 2023) Kocakaya, Hanife; Say, Bahar; Yorubulut, Serap; Ergun, Ufuk
ObjectiveThe main aim of this study was to examine patients with migraine in terms of emotional dysregulation and to evaluate whether the emotion dysregulation is effective on chronicity in migraine.Materials and MethodsA total of 85 migraine patients and 61 healthy participants were included in this study. All participants were evaluated using Migraine Disability Scale (MIDAS), Visual Analog Scale (VAS), Depression, Anxiety, and Stress Scale (DASS-21), Difficulties in Emotion Regulation Scale (DERS), Pain Catastrophizing Scale (PCS), and the Discomfort Intolerance Scale (DIS). Then, all results were compared between the migraine patients and healthy individuals. In addition, the migraine patients were separated into three groups as patients without an aura, patients with an aura and patients with chronic migraine and then their results were compared among them. Finally, the predictive markers of chronic migraine were explored using regression analyses.ResultsAmong 85 migraine patients, the mean age was 31.5 (SD = 7.98); 83.5% were women. The total and subscale scores of DERS, PCS, DIS, and DASS-21 were significantly higher in patients than in healthy individuals (p < 0.01). Subscale scores of DERS, DIS, and DASS-21 in the chronic migraine patients were found to be higher than in the other two patient groups (p < 0.01). Logistic regression analysis showed that chronic migraine could be associated with 'lack of emotional clarity' (OR = 1.229; p = 0.042), 'lack of awareness' (OR = 1.187; p = 0.032), 'migraine associated disability' (OR = 1.128; p = 0.033), and 'stress' (OR = 1.292; p = 0.027).ConclusionThis study results showed that chronic migraine could be associated with the emotional dysregulation. To our knowledge, this study is the preliminary study in the literature and, therefore, new studies with large samples are needed.
Evaluation of putamen area and cerebral peduncle with surrounding cistern in patients with Parkinson's disease: is there a difference from controls in cranial MRI?
(Taylor & Francis Ltd, 2024) Say, Bahar; Muluk, Nuray Bayar; Inal, Mikail; Goncuoglu, Alper; Yorubulut, Serap; Ergun, Ufuk
Objectives Nigrostriatal dopaminergic neuron loss is essential in pathogenesis of Parkinson's disease (PD). The purpose of this study was to evaluate nigrostriatal structures including the putamen, cerebral peduncle, widths of interpeduncular cistern, and ambient cistern around the midbrain with conventional cranial magnetic resonance images (MRI) in patients with PD.Methods The MRI of 56 subjects was included, which was selected from the radiological data system for this retrospective study. The 29 patients with idiopathic PD were included and their disease duration, Hoehn&Yahr stage, and Levodopa equivalent dose (LED) were recorded. The 27 controls had a normal neurologic examination and cranial MRI. All subjects in the patient and control groups had right-hand dominance. Putamen and cerebral peduncle areas and widths of interpeduncular and ambient cisterns were measured in T2 sequences of MRI. Further statistical analysis was applied to exclude gender and age effect on areas.Results The areas of putamen and cerebral peduncles were significantly reduced in patients with PD compared to the control bilaterally (p < 0.001). Enlargement of interpeduncular and ambient cisterns in patients was higher than in controls, and it was significant (p < 0.001). A correlation was not observed between measurement results and clinical characteristics of patients with PD. Only the cerebral peduncle area/ambient cistern width ratio was significantly correlated with disease duration positively (right r = 0.46 p = 0.012, left r = 0.389 p = 0.037).Conclusion Clinicians should be careful with conventional MRIs of patients with idiopathic PD in practice. It may be different from controls without any neurological disorder, particularly putamen, cerebral peduncles, interpeduncular, and ambient cisterns.
First Admission Neutrophil-Lymphocyte Ratio May Indicate Acute Prognosis of Ischemic Stroke
(Rambam Health Care Campus, 2021) Alpua, Murat; Say, Bahar; Yardimci, Ilknur; Ergun, Ufuk; Kisa, Ucler; Ceylan, Ozlem Dogan
Objectives: Our study aimed to determine the relationship between serum periostin levels, and the neutrophil-lymphocyte ratio (NLR) with ischemic stroke subtypes, clinical stroke scales, and acute prognosis in patients with acute ischemic stroke. Materials and Methods: Forty-two ischemic stroke patients and 39 age- and sex-matched healthy volunteers were included in our study. Demographic characteristics including age and gender were recorded. Blood serum periostin and NLR values were evaluated in the first 24 hours after admission. Serum periostin levels were compared with healthy controls of similar age and sex. Lesion localization was determined by cranial CT or diffusion MRI of the patients. Stroke scales were recorded on days 1 and 7 of hospitalization in the study group. Results: The mean serum periostin levels were higher than in the control group, but no statistically significant difference was found. There was no correlation between serum periostin levels and prognosis of stroke. First admission NLRs were statistically higher than in the control group. The first admission NLRs were positively correlated with the first admission National Institute of Health Stroke Scale score and the day 7 modified Rankin score. Conclusion: Our study is the first study to evaluate both NLR and serum periostin levels in all types of acute ischemic stroke. While our study did not show that first admission serum periostin levels can be used as a biomarker in ischemic stroke, it did indicate that the first admission NLR can be used for acute prognosis of ischemic stroke.
Full cup test (FCT) for symptom severity assessment in carpal tunnel syndrome/comparing scores with clinical and neurophysiological findings
(2020) Say, Bahar; Ergun, Ufuk; Agir, Hatice; Karaca, Gulten; Keskin, Esra Dilek
Abstract Aim: Carpal tunnel syndrome (CTS) is a compression neuropathy. There is neuropathic pain in the clinic. Treatment is planned according to electrodiagnostic testing (EDX) and symptom severity. This study was planned to evaluate of full cup test (FCT) to demonstrate symptom severity in CTS and investigate the relationship between FCT and EDX. Material and Methods: This study included patients with idiopathic CTS. The self-administered Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and FCT were used to determine the severity of clinical symptoms. The severity of CTS was classified as mild, moderate and severe according to EDX. Results: A total of 97 hands (55 right, 42 left) were evaluated. 29 patients had bilateral symptoms. The severity of CTS was 51.5% mild, 44.3% moderate, and 4.1% severe. The mean FCT score was 51.13 ± 20.80 (min: 6.6-max: 100). The mean symptom severity scale (SSS) of the BCTQ was 24.25 ± 7 and the functional severity scale (FSS) was 13.26 ± 4.55. The score of FCT was significantly correlated with SSS and the FSS (r=0.60 p <0.001, r=0.65 p <0.001). Significant correlation was observed between FCT and EDX (r=0.57, p=0.001). Conclusion: FCT can be used to assess the severity of neuropathic pain in CTS and may be a guide in planning treatment.
Genome-wide association and whole exome sequencing studies reveal a novel candidate locus for restless legs syndrome
(Elsevier, 2021) Ergun, Ufuk; Say, Bahar; Ergun, Sezen Guntekin; Percin, Ferda Emriye; Inan, Levent; Kaygisiz, Sukran; Asal, Pinar Gelener
Introduction: The restless legs syndrome (RLS) is a common heritable neurologic disorder which is characterized by an irresistible desire to move and unpleasant sensations in the legs. Methods: We aim to identify new variants associated with RLS by performing genome-wide linkage and subsequent association analysis of forty member's family with history of RLS. Results: We found evidence of linkage for three loci 7q21.11 (HLOD = 3.02), 7q21.13-7q21.3 (HLOD = 3.02) and 7q22.3 (HLOD = 3.09). Fine-mapping of those regions in association study using exome sequencing identified SEMA3A (p-value = 8.5.10(-)(4)), PPP1R9A (p-value = 7.2.10(-4)), PUS7 (p-value = 8.7.10(-4)), CDHR3 (p-value = 7.2.10(-4)), HBP1 (p-value = 1.5.10(-4)) and COGS (p-value = 1.5.10(-4)) genes with p-values below significance threshold. Conclusion: Linkage analysis with subsequent association study of exome variants identified six new genes associated with RLS mapped on 7q21 and q22.
HALLUCINATION AND RISK FACTORS IN PATIENTS WITH PARKINSON’S DISEASE
(2019) Say, Bahar; Ünal, Yasemin; Tunç, Tuğba; Ergun, Ufuk; Ergün, Ufuk
Objective: Hallucination is one of the non-motor symptoms inParkinson disease (PD). Several factors may affect the presenceof hallucination. In the present study, we aimed to compare PDpatients presenting with and without hallucinations, to determinerisk factors, and to find out common hallucination types.Material and Methods: Idiopathic Parkinson patients regardingto UK Parkinson Disease Society Brain Bank with and withouthallucinations were compared. The patients with psychoticsymptoms due to metabolic, infectious, and structural causeswere excluded. Disease severity was evaluated by UnifiedParkinson Disease Rating Scale and Hoehn and Yahr staging.Cognitive status was assessed by Minimental State Examinationtest. Depression was diagnosed on the basis of DSM-V Tr.Description of hallucination, treatment, co-morbidity, sleepdisturbances, REM sleep behavioral disorder, age, gender,scores of test and scale, stage of disease were recorded.Results: A total of 91 (59 female, 32 male) patients withidiopathic PD were enrolled. The group with hallucinations(Group 1) had 40 (43.9%) patients and the one withouthallucinations (Group 2) had 51 (54.9%) patients. Total score ofUnified Parkinson Disease Rating Scale was significantly higherin Group 1 than Group 2 (37.83±16.65; 30.18±14.83; p=0.028).Sleep disturbances were high in Group 1 (n=24, 60%) whencompared to Group 2 (n=14, 27.4%) (p=0.007). The meanduration of hallucinations was 24.87±56.47 months in Group 1.Twenty-one patients (23.9%) had visual hallucinations; 15(16.5%) patients had illusions (minor hallucinations); and four(4.4%) patients had auditory hallucinations.Conclusion: Disease severity in Parkinson's disease may be afactor in the presence of hallucinations. Hallucinations may alsooccur with sleep disorders. Minor hallucinations are frequentlyobserved in early stages, with visual hallucinations being themost common hallucinations that may occur in every diseasestage.
Olfactory bulbus volume and olfactory sulcus depth in migraine patients: an MRI evaluation
(Springer, 2018) Dogan, Adil; Muluk, Nuray Bayar; Sahan, Mehmet Hamdi; Asal, Nese; Inal, Mikail; Ergun, Ufuk
To compare the measurements of olfactory bulb volume and olfactory sulcus depth in patients with migraine and a control group. The study included the cranial MRI (1.5 T) images of 200 adults diagnosed with migraine and a control group of 100 subjects without migraine. The control group mainly consisted of the patients with non-migraneous headache. The measurements were obtained from coronal T2-weighted images for standard olfactory bulb (OB) volume and olfactory sulcus (OS) depth. The OB volume and OS depth values were lower in the migraine group than in the control group. In the migraine group, left OB volume of the males was significantly lower than those of the females. In both the migraine and control groups separately, the left-side OB volume values and the right side OS depth values were significantly greater than those of the contralateral side. There were positive correlations between right and left OB volume, and right and left OS depth values. No change was seen in OB volume and OS depth values according to gender. In older patients, a decrease was determined in the right and left OB volume, and the left-side OS depth values. There was a negative correlation between osmophobia and OB volume values. In migraine patients with osmophobia, the OB volume values were significantly decreased. OB volume values were lower in migraine patients. When osmophobia was present, the OB volume was lower than that of the non-osmophobia migraine patients. Olfactory function monitoring with olfactory tests and olfactory volume monitoring on MRI can be recommended for all migraine patients to diagnose olfactory dysfunction earlier, especially those with osmophobia. Because their OB volume values were detected as lower than those of the migraine patients without osmophobia, it may be thought that blood flow changes and osmophobia may affect the olfactory bulb volume shrinkage in migraine patients.
Peripheral nerve conductions in relapsing remitting multiple sclerosis (RRMS) patients
(ELSEVIER SCI LTD, 2020) Gorgulu, Umit; Ergun, Ufuk; Ertugrul, Levent
Purpose: The purpose of this study was to investigate with Elektromioneurografija (EMNG) whether there is any affection on peripheral nerves in (RRMS) patients. Material and Method: Motor and sensory nerve conductions were studied in the control group including 33 RRMS patients and 25 healthy individuals. Expanded Disability Status Scale (EDSS) scores, mean annual attack frequency, duration of disease and treatments of RRMS patients were recorded. Results: There was a statistically significant (p < 0.05) elongation in motor distal latency of the right peroneal nerve, slowing in the left peroneal nerve conduction velocity, and an elongation in the F-wave response in the RRMS group compared to the control group. It was observed that motor nerve conduction velocities were slower, albeit not statistically significant, and F wave latencies were longer than control group. Conclusion: There are studies in the literature related to the association between MS and peripheral neuropathy. In this study, we found demyelinating type changes, differing significantly from the control group, in motor nerve conductions in RRMS patients. There may be demyelinating type affection in peripheral nervous system with common autoimmune mechanism in MS, a demyelinating disease of the central nervous system. (C) 2020 Elsevier Ltd. All rights reserved.
Response to Letter to the Editor: First Admission Neutrophil-Lymphocyte Ratio May Indicate Acute Prognosis of Ischemic Stroke
(Rambam Health Care Campus, 2021) Alpua, Murat; Say, Bahar; Yardimci, Ilknur; Ergun, Ufuk; Kisa, Ucler; Ceylan, Ozlem Dogan
[Abstract No tAvailable]
Retrospectif Analysis of 1545 Patients: Neuroimaging in Headache
(Gazi Univ, Fac Med, 2020) Say, Bahar; Ergun, Ufuk; Tunc, Mehmet; Alpua, Murat; Dogan, Adil
Objective: Neuroradiological imaging is also used to differentiate between primary and secondary headaches. The aim of this study was to evaluate retrospectively the significant abnormal neuroradiological imaging results and rates in the primary headache group. In addition, it was also planned to analysis the results of all headaches with imaging and discuss the imaging in the headache with the literature. Methods: Medical records of headache patients of the neurology outpatient clinic at the tertiary care center were reviewed. Patients who required brain imaging and did not have any disease that could cause pathology in imaging were included. Neuroradiological images were grouped as brain computed tomography (CT), brain magnetic resonance imaging (MRI) and others. Results were normal, significant abnormal findings and others. Results: Total 1545 patients were included. Primary headache 992, secondary headache 91, painful cranial neuropathies and other headaches were observed in 462 patients. Significant abnormal radiological findings were found to be 4.3% in primary headache, 14.3% in secondary headache, and 6.6% in painful cranial neuropathy and other headaches. Significant findings in primary headache were Arnold Chiari Malformation, sinus thrombosis, intracranial mass, choroid plexus xanthogranuloma, hydrocephalus, vascular malformation. Conclusion: In this series, the rate of significant findings in neuroradiological imaging in primary headache is low. Secondary headaches require neuroimaging because of the presence of underlying life-threatening causes, although the rate of abnormal neuroradiological imaging is low. History, examination, and red flags in headache may lead to imaging, but patient and physician concerns may also increase imaging rates.
Serum levels of ischemia-modified albumin and prolidase in migraine subjects
(2020) Say, Bahar; Badem, Nermin Dindar; Ergun, Ufuk
Objective: Migraine is one of the most common neurological diseases with headache attacks. Although its pathophysiology is still unclear, it is thought to be multifactorial. Oxidative stress is one of the topics discussed in the pathophysiology of migraine. The aim of this study was to investigate ischemia-modified albumin (IMA) and prolidase levels, which are oxidative stress markers in migraine. Material and Method: In this study, 35 migraine and 35 healthy controls were included. Serum IMA and prolidase levels were measured in serum obtained after centrifugation from venous blood samples by ELISA. Prolidase and IMA in migraine patients were compared with the control group. Results: The mean age was 40.06±11.14 years in migraine (34 female, 1 male) and 34.31±8.26 in controls (31 female, 4 male). There was no significant difference between the groups in terms of age and gender (p=0.08, p=0.29). Interictal IMA and prolidase levels of migraine subjects were significantly higher than the control group (p=0.02, p<0.001). Prolidase was significantly higher in the attack period than the control group (p<0.001), but there was no significant difference in IMA levels (p=0.34). Prolidase and IMA levels during the attack were higher than an interictal period in migraine but there was no significant difference (p>0.05). Conclusion: Prolidase and IMA may be an indicator of oxidative stress in migraine patients. Prolidase, one of the oxidative stress indicators, also correlates with the frequency of attacks in migraine. It is thought that these markers may lead to antioxidant agent studies in the prophylactic treatment of migraine.
Validity and reliability of the full cup test in patients with chronic low back pain
(Kare Publ, 2022) Agir, Hatice; Aras, Muyesser; Keskin, Esra Dilek; Ozer, Hafsa Feyza; Karaca, Gulten; Ergun, Ufuk; Yorubulut, Serap
Objectives:This study aims to determine the validity and reliability of the full cup test (FCT), evaluating the pain severity in patients with chronic low back pain. Methods: A total of 100 patients (70 women and 30 men) aged over 18 years with mechanical low back pain were enrolled in the study. Demographic and clinical characteristics were recorded. Pain severity was evaluated using the visual analog scale (VAS) and FCT, the functional state was assessed by the Oswestry Disability Index (ODI), and the quality of life was assessed using the Nottingham Health Profile (NHP). FCT was performed on the 1st day by two independent observers (G1 and G2) and 3 days after the first application, patients were readministered the FCT by G1. Results:The mean age of participants was 56.04 +/- 12.33 years and mean body mass index was 27.7 +/- 4.3 kg/m(2). The reliability of the FCT and intraclass correlation coefficient (ICC) was found to be 0.989 for intrarater compliance, ICC was found to be 0.984 for inter-rater compliance, and Cronbach's alpha reliability coefficient was alpha=0.994. External construct validity of the scale was confirmed with expected correlations with all subgroups of NHP except for social isolation, VAS and ODI (p<0.01). Conclusion:This study concludes that the FCT provides a reliable and valid instrument for measuring pain severity and loss of the function in patients with chronic mechanical back pain. We consider that FCT is a simple and easy test in patients with low education and advanced age.
Vestibular migraine: A case report and review of the literature
(Kare Publ, 2021) Say, Bahar; Ergun, Ufuk
Vestibular migraine ( VM) is one of the most common causes of episodic vertigo, but it can be missed in patients complaining of dizziness. This report describes the case of a 46-year-old woman with episodic vertigo attacks and a history of migrainous headaches. Some of the vertigo attacks were accompanied by a migraine. Gaze-induced nystagmus was present during attacks, but regressed with medication. Ear, nose, and throat evaluation; laboratory; imaging findings; and hearing test results were normal. Treatment with 500 mg valproic acid led to a rapid response in this case. VM should be considered in neurological examinations on the basis of clinical symptomatology.
Vitreous Humor Diffusion Changes in Behcet's Disease and Multiple Sclerosis
(Bentham Science Publ Ltd, 2018) Inal, Mikail; Sahan, Mehmet Hamdi; Ergun, Ufuk; Bilgili, Mirace Yasemin Karadeniz
Objective: The aim of this study is to examine the diffusional changes in the vitreous humor in multiple sclerosis and Behcet's disease. Materials and Methods: Apparent diffusion coefficient values were investigated in diffusion magnetic resonance imaging scans of a total 111 vitreous, 31 of which were Behcet's disease patients, 40 had multiple sclerosis and 40 were healthy volunteers. Then, multiple sclerosis and Behcet's disease group were statistically compared with healthy volunteers and their apparent diffusion coefficient values amongst themselves. Results: There was no significant difference in terms of age and sex distribution among the three study groups (p>0.05). While there was no significant difference between multiple sclerosis and control groups (p>0.05), apparent diffusion coefficient values of Behcet's patients were significantly lower than multiple sclerosis and control groups (p<0.001). There was no significant difference between the patients with uveitis and those without uveitis in Behcet's disease. The apparent diffusion coefficient value of 2934,3(x10(-6) mm(2)/s) had a very high sensitivity and specificity (72.42-92.5%) for the Behcet's group, and by the use of ROC curve analysis, the detected cut off value for Behcet's disease was <= 2934,3(x10(-6) mm(2)/s). Conclusion: Our study showed that diffusion values in the vitreous humor were found to be decreased in patients with Behcet's disease, in comparison with the multiple sclerosis and the control groups. To the best of our knowledge, this has not been reported before.
Why do multiple sclerosis and migraine coexist?
(ELSEVIER SCI LTD, 2020) Hamamci, Mehmet; Gocmen, Ayse Yesim; Say, Bahar; Alpua, Murat; Badem, Nermin Dindar; Ergun, Ufuk; Inan, Levent Ertugrul
Background: Migraine coexistence, which is high in multiple sclerosis (MS), is reported. To better understand the etiology of the coexistence of MS and migraine and the outcomes of this relationship, the vitamin D, vitamin D-binding protein (VITDBP), vitamin D receptor (VITDR), high-sensitivity C-reactive protein (hs-CRP), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), total antioxidant status (TAS), total oxidant status (TOS), and Oxidative Stress Index (OSI) values were examined in patients with the coexistence of relapsing-remitting multiple sclerosis (RRMS) and migraine. Methods: This study was conducted between January 1, 2019, and July 25, 2019, at the neurology and biochemistry clinics of two different tertiary hospitals simultaneously. Overall, 50 RRMS patients with migraine, 50 RRMS patients without migraine, and 50 healthy volunteers were included in the study. The participants' vitamin D, VITDBP, VITDR, hs-CRP, SOD, CAT, GSH-Px, TAS, TOS, and OSI values were measured. Results: The vitamin D and VITDR values of the RRMS patients with migraine were lower than those of the RRMS patients without migraine (respectively, p = 0.014, p < 0.001). There was no significant difference between the RRMS patients with and without migraine in terms of their VITDBP values (p = 0.570). The SOD, CAT, GSH-Px, and TAS values of the RRMS patients with migraine were lower than those without migraine (all p < 0.001). The hs-CRP and TOS values of the RRMS patients with migraine were higher than those without migraine (all p < 0.001). Conclusion: To the best of our knowledge, this is the first study on this topic to date. Based on the results, our study may shed light on the etiopathogenesis of the coexistence of MS and migraine and new treatments. However, more studies are needed to better understand the etiology of this relationship and its negative effects.

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