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Copyright of Ümraniye Pediatri Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ümraniye Pediatri Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ümraniye Pediatri Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Although ischemic stroke is known to be related to epilepsy, the relationship between epilepsy and microbleeds has not been fully described. In this study, we aimed to find out the relationship between the microbleeds and epilepsy after stroke. Methods: The patients diagnosed with epilepsy after stroke that were followed up as stroke and epilepsy clinic patients were retrospectively determined between March 2018-March 2020. The patients who underwent SWI scans in the MRI were included in this study. All the demographic information and the vascular risk factors were noted. Early onset epilepsy is defined to be in seven days after stroke and late onset epilepsy is defined to be after seven days according to International League Against Epilepsy. The microbleeds were divided into three groups by a radiologist who was blind to the patients: lobar, deep and posterior fossa localization. Also, the amount and the severity of the hemorrhages were noted. Results: In this study, 36 patients were included. The mean age was 68.3±1.4 (min: 26-max: 88). There were 16 female (44.4%) and 20 male (55.6%) patients. The most common risk factor was hypertension (n=28) and 18 patients had early onset epilepsy, whereas the other 18 patients had late onset epilepsy. The most common infarction was seen in the middle cerebral artery region (n=28 77.8%). Five patients had posterior cerebral artery infarcts (13.9%) and three patients had lenticulostriate artery territory infarcts (8.3%) and 22 patients had microbleeds. However, the type of epilepsy did not differ significantly between the microbleeds and non-microbleeds group (p=0.63). Conclusion: Although microhemorrhages were found in epilepsy patients (61.1%), there was no strong connection with epilepsy after stroke. To find out the effects of microhemorrhages on epilepsy after stroke, we need further multicenter studies. [ABSTRACT FROM AUTHOR]

Objectives: Corpus callosum (CC) is the largest commissural pathway that connects cerebral hemispheres. Structural changes have been reported in epilepsy. Therefore, in this study, the relationship between CC structure and blood parameters was evaluated in patients with epilepsy treated with monotherapy. Methods: In this study, 50 primary epilepsy patients treated with monotherapy and 40 healthy controls were included. Age, sex, antiepileptic drugs, duration of disease, type and frequency of seizures were questioned. Genu, truncus, splenium and anterior-posterior diameter of CC were measured in the TSE/T1 sagittal sequence of brain magnetic resonance imaging. The relationship between blood parameters, antiepileptic treatment and disease characteristics were evaluated. Results: Fifty patients (26 females, 24 males) were included in this study. The mean age was 34.46±13.02 years. Morphometric measurements of CC were genu was 11.12±1.69, truncus was 6.09±1.17, splenium was 10.39±1.93 and anterior-posterior was 69.08±5.19 millimeter (mm). Anterior-posterior diameter was smaller in patients with epilepsy (p=0.04). Female patients with epilepsy had smaller genu diameter (p=0.01). Splenium diameter was smaller in patients with longer disease duration (p=0.04). There was no difference between antiepileptic drug use and morphometric measurements (p>0.05). Urea and creatinine levels were higher in patients with epilepsy (p=0.00, 0.00). Vitamin D and ferritin levels were lower (p=0.01, 0.01). There was no correlation between blood values and morphometric measurements (p>0.05, r<0.25). Conclusion: Anterior-posterior diameter of CC is smaller in epilepsy. Especially in female patients, genu diameter is smaller. Splenium diameter is smaller in patients with a long duration of epilepsy. There is no correlation between blood parameters and CC diameters. [ABSTRACT FROM AUTHOR]

Objectives: Interictal electroencephalography (EEG) is an electrophysiological test used in daily practice and important in the diagnosis and treatment process for epileptic patients. Accurate assessment of the interictal epileptiform discharges (IEDs) and recognition of secondary bilateral synchrony (SBS) are important for the evaluation of appropriate treatment options. In this study, we investigated whether the presence of SBS is a risk factor for seizure frequency, treatment response, and localization. Methods: In this study, the data of 126 patients who were followed up with the diagnosis of epilepsy in the Neurology Outpatient Clinic of Namık Kemal University Education and Research Hospital were analyzed retrospectively. Demographic characteristics, seizure frequency, localization, treatment response and EEG characteristics of the patients were investigated and the results of 122 patients were obtained. Results: Fifty-eight (46%) of the patients were female, and 68 (54%) were male. The mean age was 36.5±16.4 (15-78) years. EEG of 15 patients (12.2%) was reported as SBS. Focal epileptiform abnormality was detected in 54 patients (44.2%) and focal irregular background activity (non-epileptic findings) was found in 12 patients (9.8%). When semiological features and EEG findings were evaluated together, 44 patients (34.9%) were classified as frontal lobe seizures, 66 patients (52.4%) as temporal lobe seizures, 16 patients (12.6%) as the others. Forty-six patients (36.5%) had no seizures, while 15 (11.9%) had one seizure per year, 46 (36.5%) had one seizure in one to six months, and 19 (15.1%) had daily or weekly seizures. Twenty-nine (23%) of the 46 seizure-free patients became seizure-free in an early stage, 17 patients (13.5%) became seizure-free after the sixth month of the treatment. Conclusion: Although the presence of IED and SBS in interictal EEG is not a risk factor for seizure frequency and treatment response, and the rate of SBS is higher in frontal lobe seizures. The presence of IED and SBS in the management of treatment may lead to false results. [ABSTRACT FROM AUTHOR]

Objectives: EEG training can be provided during neurology residency and in PhD, observership or fellowship programmes after residency in Turkey. In this study, we aim to reveal the EEG profile of a reference epilepsy center which provides EEG training in Turkey, by evaluating our patients' clinical data and EEG findings within three months. Methods: The patients' clinical data and EEG findings were retrospectively assessed and categorized in groups. EEG recordings that have multiple EEG findings (both focal slowing and interictal epileptic abnormality) were added into each group. EEGs with NCSE, clinical or subclinical ictal recordings, PNES and arrhythmias were noted. Results: Most of the 867 EEGs (56.2%) were performed for epilepsy. Three hundred thirty-six of the EEG recordings (39%) had normal findings while the rest had minimum one abnormal findings. One hundred ninety of the EEG'S (22%) had interictal epileptic discharges, 198 EEGs (23%) had focal or hemispheric slowing, 358 EEGs (41%) had non-specific findings. Fifteen (2%) EEGs had ictal recordings and 19 (2%) had NCSE. NCSE was found in 26% of patients presenting with altered consciousness. Habitual seizures were present with verbal induction in 3/11 patients diagnosis with PNES. Arrhythmia was found 4%. Conclusion: The most common reason to perform a routine EEG is epilepsy. The NCSE, ictal recordings, PNES and arrhythmias are not rare in an outpatient EEG laboratory. NCSE can be observed in 1/4 of patients who underwent EEG recording due to altered consciousness. This study reveals a cross-sectional profile of the reference hospital. EEG training would be provided with experienced specialists by interpreting quantitatively and qualitatively adequate EEGs. [ABSTRACT FROM AUTHOR]

Objectives: Lacosamide is a third-generation antiepileptic agent that selectively enhances slow inactivation of sodium channels that take part in generation and propagation of action potentials and results in the diminution of neuronal excitability. Because of this new mechanism of action, it is expected to be efficacious in patients with drug-resistant epilepsy. In this study, we aimed to assess the efficacy and tolerability of lacosamide add-on treatment in refractory epilepsy patients by presenting our experience in a tertiary referral center. Methods: Medical records of refractory focal epilepsy patients who were followed in epilepsy outpatient clinic between October 2014 and May 2017 were retrospectively reviewed in this study. Patients who were treated with add-on lacosamide and completed minimum of six months follow-up period were included. ≥50% reduction in seizure frequency was defined as treatment response. Results: In this study, 88 patients were included. The percentage of seizure-free patients after six months follow-up was 4.6% and the treatment response rate was 55.6%. We also evaluated the effect of concomitant use of sodium channel blockers, the presence of abnormal findings on magnetic resonance imaging and the introduction stage of lacosamide. No significant difference was observed in the response rate regarding the mentioned parameters. 19% of the patients reported side effects, the majority of which were dizziness, vertigo and somnolence. None of them discontinued treatment because of side effects. Conclusion: Our findings suggest that lacosamide add-on therapy is effective in refractory focal epilepsy and has an appropriate tolerability and safety profile since none of the patients stopped treatment due to side effects. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to determine the prevalence of lateralized semiological findings in patients with temporal lobe epilepsy and to assess the contribution of relatively rare symptoms to lateralization, as well as classical lateralizing findings. Methods: The records of the 329 patients who were monitored by video-EEG for evaluation of epilepsy surgery were retrospectively reviewed in this study. The lateralization of the seizures was evaluated with ictal EEG and semiological findings. The records of 128 patients with unilateral temporal lobes were analyzed. Results: In our study, 343 seizures of the 128 patients were analyzed. Aura was identified on 241 patients (70.2%). The presence of aura was not associated with lateralization. Vertigo (p=0.02) and deja vu (p=0.04) indicated right temporal lobe in all seizures. One of the most frequently observed ictal clinical findings was oroalimenter automatism, but its presence was not significant for lateralization. Peri-ictal vegetative symptoms of ictal cough, vomiting, water drinking, hypersalivation and the urinary urge are rarely seen in the right temporal lobe-induced seizures were seen more frequently (p<0.05). Most of the ictal motor findings showed contralateral hemispheres. Clonic jerk ended the ipsilateral focus in all seizures (p=0.004). Conclusion: The presence of peri-ictal vegetative symptoms may help lateralize the epileptic focus to the right hemisphere when evaluated with other classical findings. Analysis of the seizure semiology that involves the phenomenon of lateralized seizures is a significant component of preoperative evaluation. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is to examine the characteristics of restraints applied in intensive care units and the neurovascular effects on patients to whom physical restraints are applied. Material and Methods: The cross-sectional observational study was conducted between April 2018 and September 2018 in the internal and surgical intensive care units of a state hospital. The study included 120 patients to whom physical restraints were applied. The data were collected using a data collection form developed in accordance with the literature through a review of patient records in addition to observation and interview methods. The patients under restraint were observed and the nurses responsible for patient care were interviewed. Approval for the study was granted by the Local Ethics Committee, permission was obtained from the institution and informed consent from the relatives of the intensive care units patients in the study. Data obtained in the study were analysed statistically using SPSS vn 22.0 software and descriptive statistics, the Cochran Q test, Chi-square test, Friedman test and the Kruskal Wallis test. Results: A statistically significant increase was observed in oedema and colour change in the region below the physical restraint in a 5-day observation period and pulse strength was determined to have decreased (p<0.05). No significant change was determined in the temperature and capillary filling time of the restrained area in the 5-day observation period (p>0.05). No significant difference was determined between the restraining materials used in respect of oedema and pulse strength. A statistically significant difference was determined between the restraining materials used in respect of colour change, capillary filling time and temperature parameters on the second and third days of the restricted area (p<0.05). Conclusion: The results of the study showed that in physical restraint, which is mostly preferred in intensive care units, an increase in the period of physical restraint increases the possibility of neurovascular complications and the use of special restraint equipment could reduce the potential development of neurovascular complications. [ABSTRACT FROM AUTHOR]

Objectives: Epilepsy is a neurological disorder that can affect students' success and peer relations. Students with epilepsy sometimes have epileptic seizures at school. The aim of this study was to investigate the knowledge and behavior of guidance counselors regarding epilepsy. Methods: A descriptive survey model to assess a total of 73 guidance counselors working in schools in Istanbul. A total of 11 questions were prepared by the researcher based on the literature. In the analysis of the data, descriptive statistics, such as frequency, percentage, and arithmetic mean were used. Results: It was determined that the majority of guidance counselors had not received training about epilepsy and, that their primary sources of information about the disorder were newspapers and magaziness. They knew the students with epilepsy at school and had been advised of the condition by the family. While counselors have a responsibility to support epileptic students, they often do not feel qualified and do not accept the role at the time of a seizure. Serious errors in the appropriate behavior during a seizure were also noted. The qualifications of the guidance counselors were insufficient for neuropsychiatric intervention. Conclusion: Counselors have an important role in the care of epileptic students in the school environment. Training programs should be implemented to increase knowledge of epilepsy. Information about epilepsy should also be added to the university curriculum. [ABSTRACT FROM AUTHOR]

Objectives: Status epilepticus (SE) is a medical and neurological emergency with high morbidity and mortality. There are a variety of potential etiologies. The aim of this study was to evaluate the type of SE episode recorded in patients with brain tumors and to determine the effect of primary and metastatic brain tumors and SE type on response to treatment and mortality. Methods: An SE patient database was examined for individuals with brain tumors diagnosed clinically and electrophysiologically. Demographic features, SE subtype, response to treatment, and mortality rate were recorded. Results: There were 38 (14%) SE episodes in patients with intracranial tumors in the database. Convulsive SE (CSE) was the most common type, with 23 (60%) instances recorded. There was no statistically significant correlation between SE episodes and the intracranial tumor type (p=0.76). In all, 40% (n=15) remained refractory despite appropriate treatment. Six patients died in the hospital. No statistically significant relationship was found between refractoriness and mortality (p=0.737). Conclusion: The most common type of SE episode in patients with brain tumors was CSE. The higher mortality of patients with brain tumors and SE episodes may be a result of systemic complications that can accompany tumors. In addition, the changes in awareness of patients with brain tumors as they experience tumor progression or edema may be misdiagnosed, and if NCSE does not come to mind, the diagnosis is delayed, which can increase mortality. [ABSTRACT FROM AUTHOR]

Objectives: Epilepsy is defined as a chronic neurological disease that results from increased excitability of nerve cells in the brain and requires prolonged or lifelong treatment. Epilepsy is the most common disease seen in neurology practice in childhood and adolescence, and is the second most common disease after cerebrovascular disease in the elderly. In recent years, quality of life for patients with many diseases has gained importance, to increase patient satisfaction and standard of living, but also to reduce costs, and a number of assessment scales have been developed. The aim of this study was to evaluate the quality of life of epilepsy patients and related factors in order to determine the appropriate treatment methods to improve psychosocial findings. Methods: Patients aged 18 to 65 years who had experienced a complex partial or generalized epileptic seizure in the previous year and had been definitively diagnosed with epilepsy were included in the study. Demographic data were noted and evaluated. The Quality of Life in Epilepsy-31 (QOLIE-31) inventory and the Hamilton Depression Rating Scale were administered to all of the patients, as well as the Arizona Sexual Experience Scale. The statistical analysis was performed using NCSS 2007 and PASS 2008 statistical software (NCSS, LLC, Kaysville, UT, USA). Results: A total of 72 patients were included in the study; 45 were female. The mean age was 28.93±10.72 years and the mean duration of treatment was 8.14± 8.40 years. In all, 34 patients (47.2%) had multiple seizures per year. The Hamilton Depression Rating Scale scores and QOLIE-31 measurement of anxiety related to seizures, total quality of life, emotional well-being, energy/fatigue, cognitive status, and social function were analyzed. There was a negative correlation between the total scores of 52.8% (p=0.005). Sexual dysfunction negatively affected all subscales of quality of life in female patients, while total quality of life subscores were negatively affected in males (p<0.005). Conclusion: pilepsy patients and their families should be well informed about the disease and trained extensively about living with seizures beginning at the diagnosis stage. A multidisciplinary approach to treatment that includes the various factors that can affect quality of life will lead to more effective treatment and follow-up. [ABSTRACT FROM AUTHOR]

Objectives: Sleep disorders are more common in patients with epilepsy than in healthy individuals. Epileptic syndromes and antiepileptic drugs can alter the structure of sleep. The aim of this study was to analyze differences in sleep patterns between patients with epilepsy and healthy individuals using subjective tests and polysomnographic evaluation. Methods: The determination of sleep characteristics and the presence of sleep disorders were evaluated using standard questionnaires and polysomnography in 29 patients with epilepsy and 25 controls. The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Insomnia Severity Index (ISI) were administered to assess the participants. Results: The mean PSQI, ESS, and ISI scores in adults with epilepsy were 12.76±8.93, 5.28±3.67, and 7.31±5.39, respectively. Lower sleep efficiency (p=0.046), decreased N1 sleep stage percentage (p=0.001), decreased rapid eye movement sleep stage percentage (p=0.001), and an increased N3 sleep stage percentage (p=0.012) were observed in patients with epilepsy. It was also noted that sleep latency was shorter in patients with epilepsy than in the control group (p=0.027). Conclusion: Sleep architecture has individual variability. Age, comorbidities, medications, and sleep recording methods are some of the factors that contribute to this variability. Both the disease itself and drugs used in the treatment of epilepsy can alter the structure of sleep. Our findings were similar to other studies investigating sleep macrostructure comparing adults with epilepsy and healthy individuals. However, knowledge of how epileptic mechanisms and antiepileptic drugs affect sleep is still insufficient. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to examine the effect of antiepileptic drugs on memory and executive functions in drug-responsive mesial temporal lobe epilepsy with unilateral hippocampal sclerosis (MTLE-HS). Methods: The patients were classified according to the 2017 International League Against Epilepsy classification of seizures. Thirty-four patients with the diagnosis of MTLE-HS and 30 matched controls were enrolled. Patients treated with a maximum 2 anti-epileptic drugs and experiencing no more than 2 instances of focal impaired awareness per month or 2 focal to bilateral tonic-clonic seizures in a year were accepted as drug-responsive. Patients receiving monotherapy (PRM) and polytherapy (PRP) were compared in terms of memory and executive functions. Results: There were 19 (55.8%) monotherapy patients in the group and 15 (44.2%) polytherapy patients. The maximum number of learned words recorded in a verbal memory test, the immediate and delayed recall score, and the logical memory score were all statistically significantly lower in the PRP group compared with the PRM group (p<0.05). The results of the verbal attention test and verbal fluency test were also significantly lower in the PRP group (p<0.01). Conclusion: Significantly greater impairment was observed in several aspects of cognitive function in the PRP group. These results indicate that antiepileptic drugs may have a negative impact on cognition. [ABSTRACT FROM AUTHOR]

Objectives: The social stigma associated with epilepsy can be a major cause of concealment of illness. This behavior is associated with many neuropsychiatric disorders. Sleep is an important factor affecting epilepsy and seizures. The aim of this study was to evaluate concealment of illness, sleep disorders, and related factors in epilepsy. Methods: A total of 95 primary epilepsy patients who were referred to the neurology outpatient clinic were included in the study. The demographic and clinical characteristics of the patients were recorded. Concealment of illness was measured using a scale consisting of 17 questions, and the Pittsburgh Sleep Quality Index (PSQI), consisting of 24 questions, was also administered to assess sleep disorders. Results: There were 44 (46.3%) female and 51 (53.7%) male epilepsy patients in the study. The mean concealment score was 57.09±8.96 and the mean PSQI score was 8.12±3.09. Sleep latency was significantly prolonged, and sleep efficiency and daytime functions were impaired. Indications of a sleep disorder were greater in young people (p<0.05; r=0.50). There was a negative correlation between age and concealment of illness (p<0.05; r=0.65) and a positive correlation between concealment of illness and a sleep disorder (p<0.05; r=0.54). Conclusion: The concealment of illness had a negative effects on sleep quality in patients with epilepsy. Concealment and sleep disorders increased as age decreased; therefore, it is especially important to evaluate young epilepsy patients carefully. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the incidence of epileptic seizures in the perioperative period in patients who were diagnosed with a glial tumor. Methods: This was a retrospective clinical study of the hospital files of 39 patients diagnosed with glial tumors in a single clinic between January 2016 and March 2018 as well as the data of the first 3 months of postoperative control. The glial tumor histopathological subgroup, presence of an isocitrate dehydrogenase mutation, radiological treatment feasibility of the site, deep or cortical location, and operative method were analyzed in relation to the incidence of epileptic seizures. Results: Of the 39 patients included in this study, the male/female ratio was 25/14. In all, 22 patients were diagnosed with a glial tumor after an epileptic seizure and 17 patients were initially examined for other complaints and subsequently diagnosed with a glial tumor. The functional field localization of the glial tumor in the preoperative period and the superficial location in the postoperative period were found to be statistically significant regarding epileptic seizure frequency. Conclusion: Functional level, superficial localization, World Health Organization grade II, and awake craniotomy were correlated with decreased incidence of postoperative seizures in glioma cases. However, despite the postoperative use of antiepileptic drugs in these subgroups, the incidence of epileptic seizures varied between 27% and 50%. [ABSTRACT FROM AUTHOR]

Objectives: Rho/Rho-kinase (ROCK) signaling has been shown to contribute to neuroinflammation, epileptogenesis, and seizures in convulsivetype epilepsy models. However, this pathway has not been investigated in the pathophysiology of absence epilepsy. The aim of this study was to investigate ROCK activity in brain regions involved in spike-and-wave discharge (SWD) generation and the effects of the Rho-kinase inhibitor, Y-27632, on ROCK activity in genetic absence epilepsy rats from Strasburg (GAERS). Methods: ROCK activity in the somatosensorial cortex, hippocampus, and thalamus was measured using an enzyme-linked immunosorbent assay (ELISA). An intracerebroventricular (i.c.v.) injection of Y-27632 was administered at a dose of 20 nmol/5 µl and changes in ROCK activity were assessed. To evaluate the effect of Y-27632 on SWDs, i.c.v. 20 nmol and 60 nmol doses of Y-27632 were administered to the GAERS subjects and electroencephalography was performed. Results: ROCK activity was elevated in the somatosensory cortex in the GAERS study subjects, and the Rho-kinase enzyme inhibitor, Y-27632, suppressed this increase. In addition, Y-27632 significantly reduced the total and mean duration of SWDs compared with the control group. Conclusion: The findings indicate that the Rho-kinase pathway may play a role in the generation of absence seizures, and that the suppressive effect of Y-27632 on SWDs may be a potential therapeutic target for this anti-absent effect. [ABSTRACT FROM AUTHOR]

Objectives: Status epilepticus (SE) is a neurological emergency with high mortality. As there are no data on the cost of treatment of SE in this country, the aim of this study was to investigate and analyze these costs. Methods: Patients who were hospitalized in the neurology intensive care unit between January and August 2018 were retrospectively evaluated. Demographic data, SE type, etiological factors, antiepileptic drugs used, duration of hospitalization, total cost of hospitalization, and the cost of medication(s) were recorded. Results: The records of 15 patients (male/female: 4/11) with a mean age of 46.73 years were examined. Seven patients had no previous history of epilepsy and their first seizure was SE-like. The seizures were classified as primary generalized convulsive (n=5), focal onset generalized convulsive (n=6), focal motor (n=1), and non-convulsive (n=3) SE. Medication mismatch (n=4), systemic infection (n=4), previous stroke (n=2), acute stroke (n=3), metabolic causes (n=1), and iatrogenic causes (n=1) were found in the seizure etiology. Two patients died during followup. The mean length of time of hospitalization in the neurology service and intensive care unit was 5.7 and 13.2 days, respectively. The mean total cost of the treatment per patient was TL 22,202.86 and the mean drug cost was TL 4,630.73. Conclusion: The presence of an acute central nervous system etiology and advanced age of the patient are 2 important factors that significantly increased the cost. More comprehensive data are needed to investigate the risk factors that contribute to the cost of larger patient numbers in our country. [ABSTRACT FROM AUTHOR]

Introduction: Thrombocyte indexes (TIN) are biological markers of thrombocyte morphology and function. In critical patients, few studies evaluated TIN relation with disease severity and prognosis. Aim: In this study, we objected to evaluate TIN as a routine feasible parameter at respect of clinical significance to predicting mortality, even though thrombocyte count and functions were prone to alter by variable conditions of critical care unit patients. Materials and methods: Data of 314 patients those with objected parameters out of 347 retrospectively evaluated for TIN relation with clinical surveillance and demographics, in a ten bed capacity mixed-type tertiary CCU in between Jan 1st -- 31st Dec 2016. Results: Patients', 194 male (62%), mean age was 62.7 ± 16.9 (19-86) and APACHE II score was 18.9 ± 8.5, mean length of stay (LOS) was 9.1 (1-182) days and with 43% mortality. The mean thrombocyte volume (MPV) and dispersion width (PDW) indexes were both correlated each other and positively with disease severity, on the other hand negatively with thrombocyte count. The higher plateletcrit (PCT) levels otherwise lower MPV and PDW were found in males, and also showed relatively lower mortality rates (37.6%<44.1%) (p<0.01). Increrased PDW levels and lower thrombocyte counts were related to higher mortality, in addition to this, PCT<0.17 levels showed 2x higher mortality risk compared to PCT>0.32. Both PDW/PLT and PDW/ PCT ratios related to mortality too (p<0.001, p<0.001), otherwise with relatively lower coefficients (r: 0,11, r: 0,10). Conclusion: TIN in mixed type CCUs was assumed as PDW and PCT could be included to disease severity scoring system prognostic biomarkers, like thrombocyte counts. [ABSTRACT FROM AUTHOR]

Amaç: Epilepsi tanılı gebe hastaların yönetimi zordur. Yüksek oranda sağlıklı (%92-96) çocuk doğurmalarına rağmen, prematüre doğum, fetal ve neonatal ölüm riski, konjenital malformasyonlar ve gelişme geriliği oranları normal populasyona göre artış göstermektedir. Epilepsi tanılı kadın hastaların büyük kısmında gebelik döneminde nöbet sıklıkları değişmemektedir. Bu çalışmada amaç epilepsi tanılı gebelerin, gebelik dönemindeki nöbet sıklıkları ve bu nöbetlerin yenidoğan bebeğin gelişim parametrelerine etkisinin ve yenidoğan bebekte karşılaşılabilecek malformasyonların belirlenmesidir. Gereç ve Yöntem: On dört Şubat 2014-14 Şubat 2016 tarihleri arasında doğumu gerçekleşen 55 epilepsi tanılı gebe hasta çalışmaya alındı. Nöbet tipi, sıklıkları, kullandıkları anti epileptik ilaçlar, bebeklerin ölçüleri, bebeklerdeki malformasyonlar kaydedildi. Bulgular: Gebelik süresince; hastaların %56,4 (n=31)'ünün nöbet sıklığının değişmediği, %21.8'inin (n=12) nöbet sıklığının arttığı, %21.8'inin (n=12) nöbet sıklığının azaldığı belirlendi. Bebeklerden %3.6'sı intrauterin eksitus oldu. Bebeklerin %7.3'ünde malformasyon saptandı. Sonuç: Gebelerin sadece %21.8'inde nöbet sıklığının arttığı saptanmıştır. Jeneralize nöbeti olan hastaların bebeklerinde malformasyon ve mortalite oranı daha yüksek bulundu. Monoterapi kullanan hastaların, politerapi kullananlara göre daha yüksek oranda sağlıklı bebek doğurdukları gözlendi. Objectives: Management of pregnant patients with epilepsy is difficult. Despite the high healthy birth rate (92-96%); prematurity, fetal or neonatal death, congenital malformations and developmental failure rates are higher than the average population. The seizure rates of the majority of the patients with epilepsy do not change during pregnancy. The purpose of this study is to determine the frequency of epileptic seizures of the patients during pregnancy and rate of malformations that may be encountered in newborn babies. Methods: 55 pregnant patients with epilepsy who were born between February 2014 and February 2016 were included in the study. Types of seizures, frequency, anti-epileptic drugs used, measures of infants, malformations in infants were recorded. Results: During pregnancy; it was determined that the frequency of seizure was 56.4% (n=31), and 21.8% of patients (n=12) had increased seizure frequency whereas 21.8% (n=12) had lower seizure frequency. 3.6% of infants were lost in intrauterine. 7.3% of infants had a malformation. Conclusion: Only 21.8% of the pregnant women had an increase in seizure frequency. Malformation and mortality rates were higher in infants of patients with generalised seizures. It was observed that patients who used monotherapy gave birth to more healthy babies than those using polytherapy. [ABSTRACT FROM AUTHOR]

Objectives: Long-term video-electroencephalogram (EEG) monitoring (VEM) is a diagnostic system used for many purposes, including the precise categorization of epileptic seizures, excluding non-epileptic seizures, and finding the seizure onset zone. The aim of this study was to demonstrate the importance of the use of VEM in the diagnosis and differential diagnosis of epilepsy. Methods: Data of patients who were hospitalized in the video-EEG unit of Dicle University Neurology Department between 2012 and 2016 were retrospectively evaluated. The records of 245 patients that were of at least 24-hours duration were included in the study. Results: The mean duration of recording was 3.3±1.3 days. Clinically observed seizures were detected in 37.5% (n=92) of the patients. Of those, 21.2% (n=52) were evaluated as epileptic seizures and 16.3% (n=40) were defined as non-epileptic seizures. The proportion of psychogenic non-epileptic seizures was 14% (n=36). The mean length of the recording of the first seizure attack was 1.6 days. Interictal EEG abnormalities were found in 13.4% (n=33) of the patients. The mean duration of the disorder was 7.3 years. Conclusion: Medical history, physical examination, and routine EEG procedures can be misleading factors in the diagnosis of epilepsy. VEM is a crucial technique to differentiate diagnoses in patients with treatment-resistant epilepsy and to precisely diagnose the seizure type and the epileptic syndrome. [ABSTRACT FROM AUTHOR]

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Objectives: Reflex seizures are proven epileptic seizures that accompany focal or generalized epilepsy syndromes and are precipitated by sensory/cognitive stimuli or motor activity. As there isn't much knowledge about reflex seizures, in daily practice at most epilepsy clinics, inquiries about reflex seizure precipitants are often not made. The aim of the present study was to determine number and type of reflex seizure precipitants identified by patients with epilepsy. Methods: A survey was prepared that consisted of 12 questions and a total of 299 patients followed by our epilepsy clinic provided responses. Results: When queried in detailed, 73.9% of 299 patients, reported at least one reflex precipitant. The most frequently reported precipitant was stress, respectively. Conclusion: Knowledge of reflex seizure precipitants plays an important role in correct diagnosis of epilepsy, as well as management and control of seizures. Thorough questioning about reflex seizure precipitants should take place during evaluation of epilepsy patients. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present descriptive study was to determine the effect of patient compliance with antiepileptic drug therapy on quality of life. Methods: The study population comprised 115 patients with epilepsy who applied to the neurology clinic of a state hospital in western Turkey between February and December 2011. Ethics committee approval and informed consent were obtained. Data were collected using a personal information form and the Quality of Life in Epilepsy Inventory-89 (QOLIE-89) in face-to-face interviews. Descriptive statistics, parametric tests, and non-parametric tests were used to evaluate data. Results: Mean age of the population was 36.10±14.95 years, and mean age at onset was 21.35±17.00. Males comprised 50.4% of the population, and 59.1% of patients took medication regularly. Patients received the highest scores on the subscales of language, social isolation, and physical function, and the lowest on the subscales of health perception, energy/fatigue, and seizure concerns. Total QOLIE-89 scores were found to be slightly above average, while subscale scores were generally below. There were significant differences between QOLIE-89 subscale scores and rates of regular medication use (p<0.05); subscale scores were higher, as were indications of quality of life. Conclusion: Quality of life was found to be low. Patients and their relatives should be better informed of the benefits of treatment compliance on quality of life. [ABSTRACT FROM AUTHOR]

Objectives: Neurocutaneous syndromes are genetic diseases that affect the nervous system and the skin. Epileptic seizures are seen with variable frequency. In the present study, data of 29 patients from 5 centers were analyzed in an effort to draw attention to the disease group. Methods: Data of 29 patients diagnosed with neurocutaneous syndrome were retrospectively evaluated. Results: Study population was composed of 15 women (51.7%) and 14 men (48.3%), with a mean age of 31 (72±2.16). Ten patients (34.5%) were diagnosed with tuberous sclerosis, 9 (31%) with Sturge-Weber syndrome, 3 (10.3%) with neurofibromatosis type 1, 3 (10.3%) with neurofibromatosis type 2, 1 (3.4%) with neurocutaneous melanosis, 1 (3.4%) with hypomelanosis of Ito, 1 (3.4%) with probable Sturge-Weber syndrome, and 1 patient was diagnosed with unclassified neurocutaneous syndrome. One patient did not receive antiepileptic treatment, 9 (31%) received monotherapy, and 19 (65.5%) received polytherapy. Carbamazepine was the most commonly used medication. Conclusion: Attention is drawn to the prevalence of neurocutaneous syndrome in epileptic adults, with seizure frequency depending on syndrome type. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to evaluate demographic and clinical findings of patients who underwent follow-up at the newly established epilepsy outpatient clinic of the Muğla University Faculty of Medicine. Methods: Included were 208 patients who underwent follow-up at the clinic between March 2014 and September 2015. Results: Mean age was 29.42±15.86, with a range of 5-84 years. Eighty-three patients were men (39.9%); 125 were women (60.1%). The most common risk factors included head trauma, febrile convulsion, and family history of epilepsy. Seizures of 155 patients (75.5%) were partialonset, those of 22 (10.6%) were generalized, and those of 9 (4.3%) were unclassified. Sixty-seven patients (37.2%) had normal electroencephalogram, 96 patients (53.3%) had partial, and 10 patients (5.6%) had generalized epileptiform abnormalities. Of the 172 patients (28.5%) to whom antiepileptic drugs had been administered, 49 were resistant to medical treatment. Of the patients with modified therapy, 22 (41.5%) were seizure-free, 7 (13.2%) experienced >50% reduction in seizure frequency, and 8 experienced <50% reduction. Seizure frequency of 16 patients (30.2%) did not change. Conclusion: Regular monitoring of patients in certain centers significantly increases compliance, success of treatment, seizure-free rate, and the monitoring of side effects. [ABSTRACT FROM AUTHOR]

Objective: The present study was planned to determine workload of intensive care unit nurses who were working in intensive care units of general, coronary, and cardio - vascular surgery departments of a private health group hospital. Material and Methods: The design of the present study was planned as a descriptive study. The study population comprised of 150 nurses working in the intensive care units of general, coronary, and cardiovascular surgery departments of five hospitals of a private health group between January 02, 2012 and February 06, 2012. The sample of the present study consisted of 38 nurses selected by disproportionate cluster sampling. The nurses in intensive care units were working in two shifts a day, the duration of first shift was 10 hours (between 08:00-18:00 pm) and the duration of second shift was 14 hours (between 18:00 pm-08:00 am). The mean working duration of nurses was 56±6 hour per week. Among the intensive care units, general and coronary surgery intensive care units were third generation and cardiovascular surgery intensive care unit was second generation. The mean number of patients was 2.69 in every shift. The data was collected by the researcher using the “General Information Form”, ”Cheltenham Patient Classification Scale”, and “List of Nursing Practice”. The “List of Nursing Practice” was filled by the nurses working during the day and night shifts. During the shift, every procedure performed for the patients was recorded in the list every 10 minutes. The Cheltenham Patient Classification Scale was applied to the patients hospitalized in intensive care units during the study period. The study was carried out within one week in which the nurses participated in every shift. Nurses participating in the study were informed about how to fill the Cheltenham Patient Classification Scale and List of Nursing Practice. The Ethics Committee approval was obtained for the study. Statistical analysis of the data was performed using the SPSS (Statistical Packages for the Social Sciences) version 16.0. Results: Of the participants, 79% were female. The mean age was 25±2 years. Ac - cording to the educational level of the participants, high school graduates ranked first with a rate of 55.2%. Of the participants, 86.6% were working in general surgery intensive care unit. Of the patients evaluated by the Cheltenham Patient Classification Scale, 2.6% was classified as Type 2, 34.2% was classified as Type 3, and 63.2% was classified as Type 4. According to the List of Nursing Practice, the nurses allocated their times as follows: direct care practices (37% for day shift, 34% for night shift), recording (12% for day shift, 12.5% for night shift), diagnosing (19% for day shift, 18.5% for night shift), extra-duty works (15% for day shift,19% for night shift), patient-related indirect care activities (11% for day shift, 12% for night shift), and individual activities (6% for day shift, 4% for night shift). It was remarkable that the times allocated for extra-duty works and patient-related indirect activities were high.Conclusion: While the percentages of time allocated for direct care practices were 37% for day shift and 34% for night shift, the percentages of time allocated for extra- duty works were high as 15% for day shift and 19% for night shift. In order to allow nurses more time for direct care practices, employment of assistant health-care workers is suggested. (Yoğun Bakım Derg 2013; 4: 21-4) [ABSTRACT FROM AUTHOR]