Search

Serebral silent ischemia is a complication of carotid stenting. If silent ischemia occurs 24 h later of carotid stenting, it called early serebral silent ischemia. The aim of this study was to evaluate the effect of heparin infusion on the prevention of early silent ischemia in patients who underwent carotid stenting. We included 26 patients who underwent carotid stenting. Patients who had carotid stenting, we randomized into two groups. The first group of patients were given continuously heparin infusion a maximum of 20,000 units for 24 h, and screened the aPTT value each 6 h. The aPTT value aimed a range of 2–3 times to up baseline. The second group didn't take heparin infusion. Diffusion weighted magnetic resonance imaging (DWI-MRI) and gradient echo (GRE) sequences performed in all patients at the 24 h of carotid stenting. Early serebral silent ischemia was detected by DWI-MRI in 13 (50%) of 26 patients who underwent carotid stenting. Seven (53.80%) of 13 patients whit early serebral silent ischemia did not receive heparin treatment, while 6 (46.20%) received heparin treatment. There was no symptomatic or asymptomatic acute hemorrhage in patients who treated with heparin. In our study, the continuation of anticoagulant therapy for 24 h to prevent early silent ischemia was not statistically significant. Also there is no reduction for count of serebral silent ischemia between two groups. However, due to the small number of patients in the study, future studies are required with more patients. [ABSTRACT FROM AUTHOR]

Ictal religious speech and gestures, rare ictal semiological findings, sign the epileptic focus at the non-dominant temporal lobe in the literature. Therefore, we aim to present non-dominant temporal lobe semiological findings, including ictal praying and religious gestures in three cases. [ABSTRACT FROM AUTHOR]

Introduction and Aim: Valproic acid (Na valproate) is a broad-spectrum anti-seizure medication used in children and adolescents. It is thought to have fewer adverse effects; however, recent studies have restricted its use in women of reproductive age due to the teratogenic impacts on cognition. Although alternative drugs have been used to treat patients in clinical follow-up, some patients have to return to using valproic acid. Our study aimed to determine the rate of return to valproic acid treatment in female patients with follow-up in our centre and the reasons for the return. Materials and Methods: Female patients with genetic generalized epilepsy who were followed up in our centre were included in the study. Patient data were retrospectively obtained from file records. The patients were grouped by seizure subgroups, antiepileptic treatment used, electroencephalography characteristics, and seizure treatment response. Results: Sixty-three (31.7%) of the 199 patients had to return to VPA treatment. When the reasons for the discontinuation of other drugs were examined, non-response to treatment was found in 80.0% of patients, adverse medication effects in 18.3%, and 1.7% continued voluntarily. Patients who are JAE subtypes were more likely to return to VPA treatment than GTCS alone subtypes. A total of 7.4% of patients converted to VPA therapy had continued myoclonic seizures compared with 20.4% of patients treated with alternative drugs. Conclusion: VPA treatment is not used as the first choice in females of reproductive age; however, some patients will only achieve seizure control with valproate, especially those with myoclonic seizures and JAE. [ABSTRACT FROM AUTHOR]

Introduction: Medial femoral cutaneous (MFC) sensory nerve action potentials (SNAPs) can be easily recorded using distal stimulation. This study aimed to identify a new parameter using MFC SNAPs for the early electrophysiological diagnosis of length‐dependent axonal polyneuropathy (LDAP) associated with uremic neuropathy. Methods: Patients with chronic renal failure who were referred to the electrodiagnostic laboratory due to symptoms suggesting polyneuropathy were included. Assessments encompassed neurological examination, Michigan Neuropathy Screening Instrument (MNSI), and Semmes–Weinstein monofilament test. Antidromic radial, median, ulnar, MFC, sural, and superficial peroneal sensory; median, ulnar, tibial, and peroneal motor nerve conduction studies were performed. Sural‐to‐radial amplitude ratio (SRAR) and sural‐to‐medial femoral cutaneous amplitude ratio (SMFCAR) were calculated, and their diagnostic sensitivities were compared with the age and sex matched healthy controls. Results: Thirty‐two chronic renal failure patients (mean age 60.0 ± 9.6 years) and 37 controls (60.6 ± 9 years) were included. MNSI indicated clinical polyneuropathy in 59.4% of patients, while sural SNAP amplitude was diagnostic in 78%. Median SRAR and SMFCAR values were significantly lower in patients than controls (p <.001 for both). The cut‐off values for SMFCAR and SRAR were <1.82 and <0.30, respectively, both with a sensitivity of 59% and a specificity of 94%. Discussion: Sural SNAP is the most sensitive parameter in the diagnosis of LDAP. SMFCAR is not superior to SRAR. If the sural SNAP amplitude is normal, SMFCAR can serve as an alternative to SRAR in dialysis patients with bilateral arteriovenous fistulae or in those unable to undergo radial NCS. [ABSTRACT FROM AUTHOR]

Intermittent rhythmic delta activities are electroencephalographic discharges with uniform morphology, at a frequency of 4 Hz or less, containing at least six cycles, lost by eye opening and stimulation. These are called "plus" if concomitant theta or higher frequency rapid activity or spike, sharp wave activity is present. This group has a stronger relationship with epileptiform abnormality. We aimed to discuss the clinical presentations, and nomenclature of intermittent rhythmic delta activities with three case reports. [ABSTRACT FROM AUTHOR]

Visual sensitivities include photosensitivity, eye closure sensitivity, fixation off-eye closed and pattern sensitivity. Fixation off-eye closed sensitivity occurs while eye closed and the period lasting for more than 3 s and persisting as long as the eyes remain closed or when fixation was interrupted. In this case report, a 19 years old female patient had a history of a single generalized seizure one year ago. Although there is no more seizure, electroencephalography (EEG) examination like as a status epilepticus at different times. When we examined EEG, we recognized these discharges became when eyes closed and persisted as long as eyes closed. In addition, video recording showed us eyelid myoclonus without absence during eyes closed and discharged on EEG. It is aimed to discuss the fixation-off sensitivity and eyelid myoclonus accompanied by literature with this case report. [ABSTRACT FROM AUTHOR]

Background: Intravenous immune globulin (IVIg) is frequently used in some neurological diseases and is also the first-line therapy in Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. We aimed to evaluate the frequency and characteristics of headaches, which is one of the most common side effects of IVIg treatment. Methods: Patients who received IVIg treatment for neurological diseases were prospectively enrolled in 23 centers. Firstly, the characteristics of patients with and without IVIg-induced headaches were analyzed statistically. Then, patients with IVIg-induced headaches were classified into three subgroups determined by their history: no primary headache, tension-type headache (TTH), and migraine. Results: A total of 464 patients (214 women) and 1548 IVIg infusions were enrolled between January and August 2022. The frequency of IVIg-related headaches was 27.37% (127/464). A binary logistic regression analysis performed with significant clinical features disclosed that female sex and fatigue as a side effect were statistically more common in the IVIg-induced headache group. IVIg-related headache duration was long and affected daily living activities more in patients with migraine compared to no primary headache and TTH groups (p = 0.01, respectively). Conclusion: Headache is more likely to occur in female patients receiving IVIg and those who develop fatigue as a side effect during the infusion. Clinicians' awareness of IVIg-related headache characteristics, especially in patients with migraine, may increase treatment compliance. [ABSTRACT FROM AUTHOR]