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A Case with Hereditary Neuropathy with Liability to Pressure Palsy
(Derman Medical Publ, 2013) Dağ, Ersel; İnal, Elem; Türkel, Yakup; Gökçe, Nalan; Orkun, Sevim
Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant disease which characterized by recurrent mononeuropathies with focal sensory or motor disturbance precipitated by minor trauma or compression. Clinically, it generally presents with painless pressure palsies, typically in the 2nd and 3rd decades of life, being a rare entity in childhood. We reported a case study of a 22 year-old female who presenting with low back pain, After detection of an Achilles reflex loss in her neurological examination and electrophysiological studies and genetic investigation was done than she diagnosed with HNPP. We want to emphasize that, the diagnosis of hereditary neuropathy with liability to pressure palsy is often delayed because it is rare in the practice of medicine and confused with polyneuropathy, careful neurological examination may be the most important factor in the diagnosis.
Assessment of ovarian reserve and Doppler characteristics in patients with multiple sclerosis using immunomodulating drugs
(Galenos Yayincilik, 2009) Çil, Aylin Pelin; Leventoglu, Alev; Sönmezer, Murat; Soylukoç, Rabia; Oktay, Kutluk
Objective: There is limited data about fertility in multiple sclerosis (MS) patients using immunomodulating drugs and no data exists regarding the ovarian reserve of these patients. Therefore, we aimed to evaluate,the ovarian reserve and doppler characteristics of MS patients using irnmunomodulating drugs. Material and Methods: MS patients using immunomodulating drugs (interferon (1M) beta and glatiramer acetate) and age-matched healthy controls were included in the study. Subjects were examined in the early follicular phase of the menstrual cycle with transvaginal ultrasound to evaluate ovarian volume, antral follicle count (AFC) and ovarian stromal artery Doppler. On the same da blood was taken for determining serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) levels. A subgroup analysis was also carried out between MS patients using only IFN p and controls to compare the same parameters. Results: Mean ovarian volume and total AFC were lower in MS patients using immunomodulating drugs than in the controls. FSH and E2 levels did not show any differences between the groups, but LH levels were, significantly higher in MS patients. All the Doppler parameters of the ovarian stromal artery were higher in MS patients but not significantly. In the subgroup analysis, the same significant differences were found for ovarian volume, AFC and LH levels. In addition, MS patients showed significantly higher mean pulsatility index measurement than the controls. Conclusion: The findings of this study demonstrated diminished ovarian volume and follicular reserve in MS patients using immunomodulating drugs compared to age matched healthy controls. However, further studies are required to elucidate whether compromised ovarian reserve in MS patients is due to drugs or the disease itself.
Idiopathic Hypereosinophilic Syndrome as a Rare Cause of Stroke: A Case Report
(Turkish Neurological Soc, 2021) Turğut, Esra; Alpua, Murat; Yalçın, Selim; Coşkun, Oya; Bilgili, Mirace Yasemin Karadeniz; Açıkgöz, Ergin Ayaşlıoğlu; Coşkun, Özlem
Hypereosinophilic syndrome (HES) is a rare hematological disease that causes organ damage by eosinophil infiltration in the tissue with increased eosinophil production in the bone marrow. HES is a rare but important cause of stroke. Central nervous system involvement findings can be serious and life-threatening. Eosinophil values should be examined as the cause of stroke, and hypereosinophilia should be suspected, especially in young patients with no etiology. Reported herein is a case of a 47-year-old female patient who was followed up with the diagnosis of acute cerebrovascular disease due to idiopathic HES.
Vestibular migraine: A case report and review of the literature
(Kare Publ, 2021) Say, Bahar; Ergün, 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.
Detecting pain severity with full cup test in painful diabetic peripheral neuropathy
(2020) Say, Bahar; Ergün, Ufuk; Yıldız, Ayşe; Alpua, Murat; Arıkan, Şenay Durmaz; Turgal, Ebru
Objectives: The aim of this study was to test the utility and validity of the full cup test (FCT) to assess the severity of pain in subjects with painful diabetic peripheral neuropathy (PDPN). Methods: Subjects with diabetic PDPN were enrolled for this prospective, cross-sectional study. Other causes of PDPN and subjects with cognitive impairment were excluded. The diagnosis of neuropathic pain was made using the results of a physical examination and the Douleur Neuropathique 4 questionnaire. Pain severity was assessed with a FCT and a visual analog scale (VAS) administered before and after treatment. The correlation of FCT with VAS was evaluated to examine validity. Results: A total of 43 (33 female, 10 male) subjects were included. The mean age was 61.9±8.25 years and the mean disease duration was 13.02±7.6 years. Type I diabetes mellitus (DM) was present in 2 (4.7%) subjects and Type II DM in 41 (95.3%) subjects. The mean glycated hemoglobin level was 8.9±1.9 mmol/mol. When the mean VAS and FCT scores were analyzed, the results were 6.7±2.05 and 66.35±23.2, respectively, pretreatment and 4.6±2.2 and 41.36±23.5 posttreatment, which were both statistically significant (p<0.001, p<0.001). The mean control period was 23.4 days (min–max: 15-30 days). The VAS and FCT scores in pretreatment and posttreatment demonstrated a high positive correlation (rs =0.86, p<0.001; rs =0.843, p<0.001). Conclusion: The FCT can be useful to detect pain severity in PDPN.
Anatomical Considerations: The Relationship Between The Vertebral Artery And Transverse Foramina At Cervical Vertebrae 1 To 6 In Patients With Vertigo
(2018) Kültür, Turgut; Muluk, Nuray Bayar; Iyem, Cihan; Inal, Mikail; Burulday, Veysel; Alpua, Murat; Çelebi, Umut Orkun
Objective: In this study, we aimed to investigate the relationship between the size of the vertebral artery and that of the transverse foramina at the C1 to C6 vertebral level in patients suffering from vertigo thought to be related to vertebrobasilar insufficiency (VBI). Materials and Methods: In this retrospective study, two groups were compared in terms of cervical computed tomography (CT): 22 adult patients with vertigo; and a control group consisting of 23 healthy adult indivıduals. Measurement of the vertebral artery and transverse foramina (i.e. sagittal and transverse dimensions, plus area) were performed bilaterally at levels C (cervical vertebra) 1 to C6. Results: For the cases group, at C6 level the right vertebral artery area, sagittal and transverse diameter were larger than in the control group at the level of statistical significance. At C1 level, the area of the right transverse foramina in the cases group was significantly higher than in the control group. At levels C1 to C5, the values obtained for vertebral artery area were positively correlated with the values for the ipsilateral transverse foramina (transverse foramen sagittal and transverse dimensions plus areas). Where the sagittal or transverse dimensions of the transverse foramina, or the area of the transverse foramina were found to be decreased, vertebral artery areas were also observed to have decreased at C1 to C5 levels. Conclusion: We concluded that a decrease in diameter of the bony structures or transverse foramina may cause a decrease in the cross-sectional area of the vertebral artery on the ipsilateral side. Since it is only the left vertebral artery which is dominant for cerebral blood flow, any compensatory increase in right vertebral artery area cannot offset decreased cerebral blood flow. Decreased blood flow (i.e. VBI) on the left side may play a role in the development of vertigo.
İskemik ve hemorajik inmeli hastalarda elektrokardiyografik anormalliklerin karşılaştırılması
(2004) Doğan, Abdullah; Tunç, Ercan; Öztürk, Mustafa; Erdemoğlu, Ali Kemal
Amaç: Kalp hastalığı öyküsü olmayan akut iskemik ve hemorajik inmeli hastalarda elektrokardiyografik (EKG) anormallikleri karşılaştırmaktır. Yöntem: Bir yıl boyunca, ardışık 222 inme hastası çalışmaya alındı. Onların 162’sinde iskemik, 60’ında hemorajik inme vardı. Bu iki inme grubu arasında EKG değişiklikleri ve aritmiler karşılaştırıldı. Elektrokardiyografik anormallikleri, iskemik EKG değişikliği (ST segment çökmesi veya yükselmesi, anormal T veya U dalgası), QT aralığı uzaması ve aritmiler olarak tanımlandı. Bulgular: İskemik inmeli hastalar, hemorajik inmelilerden daha yaşlıydılar (64±14‘e karşın 57±13 yıl, p=0.003). Diğer klinik özellikler benzerdi. İskemik EKG değişikliği iskemik inmelilerin %65’inde gözlenirken, hemorajik inmelilerin %57’sinde izlendi (p=0.33). Atriyal fibrilasyon iskemik inmede hemorajik inmeye göre daha sıktı (%34’e karşın %13, p=0.01). Diğer bireysel EKG değişiklikleri iki grupta farksızdı. Temporal, frontal ve pariyetal lob tutulumlarında EKG anormalliklerinin daha sık görülme eğilimi vardı. Sonuç: İnmeden sorumlu lezyona bakılmaksızın, bilinen kalp hastalığı olmayan inmeli hastalarda, EKG anormallikleri sık olarak görülür. Bunlar kardiyologlar ve nörologlar için tanısal veya terapötik güçlüklere yol açabilirler.
Endothelial and Autonomic Functions in Patients with Migraine
(OXFORD UNIV PRESS, 2020) Dogru, Mehmet Tolga; Dilekoz, Ergin; Alpua, Murat; Eroglu, Oguz; Kandemir, Hilseyin; Alp, Caglar; Bolay, Hayrunnisa
Objective It has been shown that patients with migraine have endothelial dysfunction. Migraine patients with aura, especially, have more clinical manifestations of autonomic nervous system dysfunction. We aimed to evaluate the endothelial and autonomic functions in migraine patients during both migraine headache attack and headache-free periods. Design This was a cross-sectional, randomized study. Subjects and Methods A total of 130 participants (67 male and 63 female patients, minimum age = 19 years, maximum age = 71 years, mean age = 38.812.2years) were enrolled into the study. For the statistical evaluation of data, we classified the participants of the study as follows: group 1: headache (+) aura (+); group 2: headache (+) aura (-); group 3: headache (-) aura (+); group 4: headache (-) aura (-). Noninvasive evaluation of endothelial function was performed by flow-mediated dilation (FMD) and pulse wave analysis methods. Heart rate variability measurements were used for noninvasive evaluation of autonomic functions. Results Group 1 had a higher FMD ratio than the control group, group 3, or group 4 (P<0.001, P<0.001, and P=0.003, respectively). Group 4 had lower FMD ratio levels than the other migraine groups and or the control group (P<0.001). Group 3 had the highest high-frequency (HF) power levels among all migraine groups (P<0.001). Group 2 had higher low-frequency/HF ratio values than other migraineurs (P<0.001). Conclusions We concluded that endothelial dysfunction and headache are closely related. Additionally, higher parasympathetic tonus might be associated with the presence of aura.
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.
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.
The COVID-19 from Neurological Overview
(TURKISH NEUROLOGICAL SOC, 2020) Acar, Turkan; Demirel, Esra Aciman; Afsar, Nazire; Akcali, Aylin; Demir, Gulsen Akman; Alagoz, Aybala Neslihan; Mengi, Tugce Angin
[Özet Yok]
Assessment of sleep quality in spouses of patients with restless legs syndrome; Are they also restless at night?
(SPRINGER JAPAN KK, 2020) Say, B.; Hamamci, M.; Ergun, U.
Purpose The aim of this study was to investigate the sleep quality of spouses of patients with restless legs syndrome (RLS). Methods Total 49 spouses of patients with RLS (Group 1) and 47 age- and sex-matched healthy volunteers (Group 2) were enrolled. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied to all participants. High risk of the sleep apnea was excluded by Berlin Questionnaire. The RLS severity of patients was determined by International Restless Legs Syndrome rating scale. Results The mean age was 44.91 +/- 12.81 in Group 1 (25 female, 24 male) and 41.48 +/- 8.20 in Group 2 (25 female, 22 male). 35 (71.4%) participants in Group 1 and 20 (42.6%) participants in Group 2 had poor sleep quality (p = 0.004). Sleep quality was poor in 84% (n = 21) of female and 58.3% (n = 14) of male in Group 1 (p = 0.05). Sleep quality, insomnia and daytime sleepiness found to be correlated significantly with RLS severity (p < 0.05). Scores of BDI and BAI also correlated with PSQI (p = 0.002, p = 0.03). The significant relationship was observed between subjective sleep quality, sleep latency, and disease severity (p = 0.03, p = 0.005). Conclusion Restless legs syndrome may be a factor that may impair the quality of sleep in spouses of patients. Sleep quality is important in an individual's relationship with his / her health and spouse. In the treatment and follow-up of patients with RLS, their spouses should also be evaluated in this respect.
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.
Nesfatin-1 and caspase-cleaved cytokeratin-18: Promising biomarkers for Alzheimer's disease?
(Comenius Univ, 2019) Alpua, M.; Kisa, U.
OBJECTIVES: To investigate the use of nesfatin-1 and caspase-cleaved cytokeratin-18 serum levels as biomarkers in Alzheimer's disease. METHODS: The study group consisted of 39 patients with Alzheimer's disease (AD) and 39 controls. Demographic characteristics including gender, age, body mass index, mini-mental status examination (MMSE) and duration of disease were recorded. The ELISA method was used to measure serum nesfatin-1 and CCCK-18 levels in serum samples. RESULTS: Serum nesfatin-1 levels were statistically significantly higher in the AD patient group than in controls. There was no significant difference between the groups with regards to serum CCCK-18 levels. Pearson analysis showed no significant correlation between serum nesfatin-1, serum CCCK-18 levels, mini-mental status examination and disease duration. CONCLUSION: This study proved that serum nesfatin-1 levels can be used as a biomarker in Alzheimer's disease by showing a statistically significant high level of serum nesfatin-1 in patients with Alzheimer's disease. This is the first study to suggest that nesfatin-1 can be used as a biomarker in Alzheimer's disease. In addition, our study showed that CCCK-18 can be used as a prognostic biomarker for Alzheimer's disease. Further comprehensive studies should be done to clarify the use of serum nesfatin-1 and CCCK-18 levels as biomarkers for Alzheimer disease (Tab. 3, Fig. 2, Ref. 25).
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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Bilateral Subdural Hematoma After Ventriculoperitoneal Shunt Surgery
(Emergency Medicine Physicians Assoc Turkey, 2019) Yuksel, Ulas; Akkurt, Ibrahim; Ogden, Mustafa; Bakar, Bulent; Keskil, Semih
Background: Bilateral subdural hematoma (SDH) following ventriculoperitoneal (V/P) shunt application was discussed in present case. Case Report: 8-year-old girl was operated due to thoracolumbar meningomyelocele immediately after birth. V/P shunt was inserted in right posterior parietal region due to hydrocephalus when she was 3 month-old. At age of 3 years, V/P shunt dysfunction was considered, and second V/P shunt was inserted in left posterior parietal region. One year after, patient was reevaluated, and CT images showed bilateral subacute SDH. Hematoma evacuation was not considered, but right ventricular catheter was ligated. At four years follow-up, no additional neurological impairment was observed in patient and CT scan revealed that SDHs were retracted greatly. Concusion: It should be kept in mind that SDH could develop after V/P shunt surgery. Additionally, it could be said that one of most important factor in determination of treatment of this complication was primarily neurological examination findings of patient.
Cold effect in median nerve conductions in clinical carpal tunnel syndrome with normal nerve conduction studies
(Elsevier Sci Ltd, 2019) Say, Bahar; Ergün, Ufuk; Turgal, Ebru; Yardımcı, İlknur
Clinical diagnosis of carpal tunnel syndrome (CTS) is confirmed by nerve conduction studies (NCS). In some cases, NCS may be normal. We aimed to demonstrate changes of distal motor latency (DML) and nerve conduction velocity (NCV) pathology of demyelination in entrapment neuropathy with cold application in case of clinical CTS with normal NCS. This prospective, cross-sectional, randomise, case-control involved 15 patients (25 hands) with clinically definite unilateral or bilateral CTS and normal nerve conduction studies (NCS), and 11 controls (22 hands). Ice pack was applied to median nerve trasse at wirst with monitoring skin temperature. NCS of median nerve were examinated again. Increases of DML, decrease of velocity of median nerve were observed in two groups after post-cooling. The change in NCV was greater than the change in DML. Cold effect was evident in DML and NCV in the patient group. This could be sign of the demyelination pathology. We think that cold application is influential to determine electrophysiologic abnormalities in clinic CTS with normal NCS. (C) 2018 Elsevier Ltd. All rights reserved.
Is there a relationship between basilar artery tortuosity and vertigo?
(Elsevier Science Bv, 2019) Burulday, Veysel; Dogan, Adil; Akgul, Mehmet Huseyin; Alpua, Murat; Cankaya, Imran
Objective: The aim of this study was to investigate the relationship between basilar artery (BA) tortuosity, hypogenesis/agenesis of the vertebral artery (VA), and vertigo, with the use of magnetic resonance imaging (MRI). Patients and methods: This case-control study included patients admitted to the outpatient clinics, who were aged 18-80 years, without any known systemic diseases. All patients were evaluated with a 1.5-tesla MRI system. BA Tortuosity, VA agenesis, and VA asymmetry were noted. BA diameter (central) and length (longitudinal) were measured. Results: A total of 154 vertigo patients (46 M, 108 F; mean age of 48.95 +/- 17.3 years) and 346 control subjects (112 M, 234 F; mean age of 45.12 +/- 17.0 years) were included. The mean age of the vertigo patients was significantly higher than that of the control group (48.95 vs 45.12 years) (p = 0.021). The rate of BA tortuosity was higher in patients with vertigo (p = 0.030). When the participants were divided into two groups according to median age ( < 45 vs. >= 45 years) there was no statistically significant difference between the groups in terms of VA asymmetry (p = 0.070) and hypogenesis/agenesis (p = 0.577). There was a statistically significant difference between the groups in respect of BA tortuosity (p = 0.033), BA diameter (p < 0.001), and BA length (p < 0.001). When the study populations were divided into two groups according to the presence of vascular tortuosity, the mean age, BA diameter, and BA length values were higher in the tortuosity ( + ) group (all p < 0.001). Conclusion: These results demonstrated that vertigo and BA tortuosity rates seem to increase with age. Likewise, BA diameter and length increased with age, although there was no significant relationship with vertigo. Patients with tortuosity were significantly older, and had higher rates of VA asymmetry/agenesis, and increased BA diameter compared to subjects without tortuosity.
Reliability and validity of the Turkish version of Parkinson's Disease Sleep Scale
(Asean Neurological Assoc, 2019) Say, Bahar; Tunc, Tugba; Ivan, Levent Ertugrul
Objective: The aim of this study was to determine the reliability and validity of the Parkinson's Disease Sleep Scale (PDSS)-Turkish version. 48 patients with idiopathic Parkinson's disease and 48 healthy controls were included in this cross-sectional study. The patients' Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn-Yahr Stage (HYS), and the drugs were recorded. Mini-Mental State Examination was performed in the study population. The professional translation of the PDSS (English to Turkish and Turkish to English) was done by a neurologist and a language educator who was a native English speaker and well versed in Turkish, and it was approved by a certified translation agency as well. PDSS and Epworth Sleep Scale (ESS) tests were performed to 96 subjects. PDSS was repeated 15 days later. Conclusions: The scale was found to be reliable by the first and second assessment of PDSS to 96 subjects (Cronbach's alpha= 0.721 and 0.77). Intra-class correlation coefficient (ICC) 90%, was found to be high. A statistically significant negative correlation was found between the total ESS and the total PDSS scores when tested in the 96 cases included in the study (rs = -0.306, p = 0.02; rs = -0.340 p = 0.01, respectively). PDSS was found to be reliable and valid in our study with Parkinson's patients who were monitored at our outpatient clinic.
Evaluation of the Optic Nerve by Strain and Shear Wave Elastography in Patients With Migraine
(Wiley, 2019) Sahan, Mehmet Hamdi; Dogan, Adil; Inal, Mikail; Alpua, Murat; Asal, Nese
Objectives To investigate the optic nerve's elastic properties using shear wave and strain elastography in patients with migraine compared to healthy individuals. Methods The migraine group consisted of 30 patients (16 with visual auras and 14 without auras) who had previously had a diagnosis of migraine. These were age and sex matched with healthy participants to form the control group. The findings from shear wave and strain elastography in the groups were compared. The elastographic examination was performed with a 6-15-MHz multifrequency linear array transducer. Results The evaluation involved 30 patients with migraine (3 male and 27 female), whose mean age +/- SD was 34.63 +/- 10 years, and 30 healthy participants (3 males, 27 females), whose mean age was 36.4 +/- 10.5 years. In strain elasticity patterns, a statistically insignificant hardening of the optic nerve in the patients with migraine was observed (P = .052). Analysis of the shear wave elastic modulus values (9.8 +/- 3.34 and 12.3 +/- 5.25 kPa; P = .03) revealed that differences between the healthy participants and patients with migraine were statistically significant. The results for elasticity patterns and the shear modulus suggested that the differences between migraines with and without visual auras were insignificant (P > .05). A positive correlation was discovered between the duration of the disease and the shear modulus in the patients with migraine (r = 0.496; P < .01). Conclusions Histopathologic changes in the optic nerve may be seen in patients with migraine due to possible fibrotic changes. Elastographic techniques can be useful diagnostic tools for investigating these changes.

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