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13th European Congress on Epileptology -- AUG 26-30, 2018 -- Vienna, AUSTRIA WOS: 000451817900742 …

Aim: Realizing migraine comorbidities is particularly important for physiopathology, treatment, and progress of the disease. In the present study, we aimed to assess the comorbid conditions in patients with migraine. Method: This retrospective study was conducted by the Turkish Headache Database Study Group, at 23 headache centers. Diagnosis of migraine was established by a physician based on the International Classification of Headache Disorders-II criteria. Comorbidities of migraine were determined based on the patients' self reports. Results: A total of 3478 cases, which have been diagnosed with migraine were evaluated. (mean age 43.5±11.2, 81.8% female). Comorbidity was detected in 55.7% (n:1937) of overall cases. Psychiatric diseases have been reported to be the most prevalent comorbidity in these patients (31.5%, p?0.0001). Cardiovascular diseases (16.5%), and hypertension (16.3%) have been found to be more prevalent in migraine with aura. Prevalence of neurological comorbidity, also, was higher in migraine with aura. Epilepsy (1.5%) and vertigo (4.6%) were detected in migraine with aura cases. Difficulty in falling asleep was found in 35.4% of the cases (p?0.0001). Prevalence of non-headache pain was found to be 2.9% (p>0.0001).?0.0001). Patients with comorbidities were more sensitive to migraine triggers and accompanied symptoms were more severe (p?0.0001). Conclusion: Comorbidity of migraine is the important component of complex nature of the disease. The present study is important in terms of being the first multicenter study exposing migraine comorbidities and their reflections in clinical practice.

Cluster headache is characterized by unilateral severe periorbital hemicranial pain. It is the most frequent form of trigemino-autonomic headaches. Diagnosis is straightforward after a thorough history taking and neurologic examination. Attack treatment and prophylactic therapy should be considered in all cases. Treatment might be challenging particularly in cluster headaches. In this study, treatment period and its results are presented in four cluster headache cases (52, 71, 48 and 28 years old) with drug resistant attacks. One gr of methylprednisolone was administered to all four cases for 3 days accompanied by prophylactic treatment. Attack severity and frequency subsided gradually after the treatment followed by a complete recovery. Remission periods were prolonged. Regarding these cases, we concluded that high dose steroid therapy might be efficient in chronic cluster headaches.

Acute confusional state is a change of mental status with sudden onset and fluctuating course. This study was aimed at determining the frequency of ACS that appears at early (acute) stage of stroke, its predisposing factors, and its impact on prognosis. Material and Method: 150 cases were included in this study which was performed prospectively. ACS was diagnosed on the basis of DSM-IV criteria and of Delirium Rating Scale. Pre-stroke cognitive functions were evaluated according to Informant Questionnaire on Cognitive Decline in Elderly scoring. White matter hyperintensities detected on cerebral magnetic resonance imaging were classified according to Cholinergic Hyperintensities Pathway Scale scoring. Results: The rate of ACS was determined as 28% in cases who experienced stroke. Advanced age, presence of cognitive decline, use of anticholinergic drugs during pre-stroke period and in acute stage, ischemic heart disease, hemorrhagic stroke, concomitant, infectious and metabolic problems, concurrent neglect and/or anosognosia phenomenon, advanced stage leukoaraiosis, high National Institute of Health Stroke Scale, Colinergic Hyperintensities Pathway Scale and Informant Questionnaire on Cognitive Decline in Elderly scores increase the possibility of entering acute confusional state. Functional and vital prognoses follow a poorer course in those who enter ACS than in those who do not. Conclusion: Cases who experienced stroke should be monitored closely, particularly in acute stage, with respect to cognitive changes. In the acute stage of stroke, diagnosing and treating metabolic and infectious problems that may cause ACS, and avoiding as much as possible anticholinergic medications is (are) important in terms of preventing the manifestation.

WOS: 000208791900398 …

14th Congress of European-Federation-of-Neurological-Societies -- SEP, 2010 -- Geneva, SWITZERLAND WOS: 000293331100329 … European Federat Neurol Soc

Objectives: To evaluate the effects of corrected QT dispersion (QTcd) on patients' prognosis with early stage non-lacunar ischemic stroke, regardless of location of the lesion. Methods: In this non-randomized prospective study, stroke patients were evaluated in the intensive care unit of Cukurova University Hospital, School of Medicine, Adana, Turkey, from 2002-2003. Neurologic symptoms of all subjects were recorded according to Glasgow Coma Scale (GCS) and Canadian Neurological Scale. Subtypes of stroke were defined according to the Oxfordshire Community Stroke Project classification. Patients with GCS between 7 and 11 were included in the study. Electrocardiograms of the patients were collected in the first 6 hours. Corrected QT (QTc) were calculated by the Bazzett formula. Corrected QT dispersion was defined as maximum minus minimum QT interval. Results: A total of 148 (74 male) consecutive acute stroke patients, aged between 36-90 years (mean 63.07 ± 12.55), were divided into 2 groups. Group I consisted of surviving patients (n=109) and Group II consisted of expired patients (n=39). There were no statistically significant differences in the mean age, gender distribution, frequency of hypertension, diabetes mellitus, and coronary artery disease between the groups. Group II (7.4 ± 3.7) had significantly higher QTcd (7.4 ± 3.7) compared to Group I (p=0.002). Conclusion: This study shows the value of QTcd in predicting patients' prognoses with early stage non-lacunar ischemic stroke, regardless of location of the lesion.

PubMedID: 18390026 Background: Headache in patients with systemic lupus eryhtematosus (SLE) is considered a common neurological finding, although the relationship is unclear. Another obscure point is the relationship between headache and neuroradiologic findings in these patients. Aim: In this study, we aimed to evaluate the correlation between headache characteristics and intracranial lesions in SLE patients. Methods and Results: Forty-eight SLE patients were chosen from those referred to our clinic depending on the American Collage of Rheumatology (ACR) criteria at the same time or after the diagnosis of SLE. Headache classification was done regarding the ICD-II criteria in the patients. Headache severity was assessed by visual analog scale (VAS), and subjects with VAS ?4 were included in the study. Patients were divided into two groups according to magnetic resonance imaging (MRI) findings: abnormal MRI (lesion positive) and normal MRI (lesion negative). On MRI, intracranial lesions were detected in 37.5 % (n=18) of the patients, and no lesion was found in 62.5% (n=30). Headache characteristics were as tension type in 54.1% (n=26) and migraine like in 39.6% (n=19) of all patients. Imaging findings were mostly as periventricular and subcortical focal lesions, ranging from 3-22 mm in diameter. A significant correlation was found between abnormal MRI findings with advanced age and prolonged disease duration (p=0.018, p=0.016). Conclusions: As a conclusion, a detailed neurologic evaluation and radiologic investigation, if necessary, should be performed in SLE patients with prolonged disease and advanced age, regardless of headache characteristics.

PubMedID: 17570919 [No abstract available]

PubMedID: 15389979 We report on the development of transient parkinsonism after progesterone injection in a pregnant patient with a risk of abortion. Etiological possibilities are discussed, including pregnancy itself, possible toxic effects of the dead fetus, and progesterone injection. Progesterone-induced parkinsonism seems the most likely diagnosis in this case. © 2004 Movement Disorder Society.

WOS: 000202992101322 …

11th Congress of the International-Headache-Society -- SEP 12-16, 2003 -- ROME, ITALY WOS: 000185115000648 … Int Headache Soc

Background Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p