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Limb-shaking transient ischemic attack (TIA); is an uncontrolled rhythmic or dysrhythmic, temporary, and generally coarse tremor movement of the upper or lower extremities. Since Miller Fisher's first report of limb-shaking TIA associated with internal carotid artery (ICA) stenosis in 1962, this condition has been described regularly. These are characterized by brief, arrhythmic, jagged, or jerky movements of the extremities and are generally misdiagnosed as focal seizures or movement disorders. TIA is usually correlated with negative neurological symptoms; thus, the diagnosis of TIA is typically not considered in patients presenting with episodic abnormal movement disorder. We presented three cases, one of these cases was one with ICA stenosis who benefits from revascularizatıon treatment (internal carotid artery stenting), the second case with ICA stenosis and who does not benefit from revascularization treatment (carotid endarterectomy operation), and the last patient wıthout ICA stenosis. The common feature of all three patients was hypotension. These patients are not as rare as thought, and the etiology of cerebral hypoperfusion should be urgently evaluated. [ABSTRACT FROM AUTHOR]

Objective: The study retrospectively evaluated the effects of quetiapine on sleep in primary insomnia and neurodegenerative diseases using polysomnographic data. Materials and Methods: Between January 1, 2010, and June 1, 2023, the records of 49 patients who were followed up in the sleep outpatient clinic of the neurology department of our hospital and who underwent polysomnography examination were retrospectively reviewed. Patients aged between 18 and 65 years with primary insomnia and neurodegenerative diseases were included in the study. Results: The mean age of 49 patients (26 females and 23 males) were 56.67 years. The mean quetiapine dose was 59.37. Sleep latency, stage 1 (N1) duration, stage 2 (N2) duration, mean and minimum SO2 and apnea-hypopnea index were similar. Total sleep duration, stage 3 (N3) duration and rapid eye movement (REM) sleep duration were higher in neurodegenerative patients. N3 duration was shorter in patients with primary insomnia on quetiapine. Sleep duration and REM duration were longer in the neurodegenerative group and sleep latency was longer in primary insomnia in quetiapine users. Among quetiapine users, the N2 sleep percentage was higher and the nonREM 3 sleep percentage was lower in primary insomnia, whereas there was no difference in sleep percentages in neurodegenerative patients. Conclusion: Quetiapine is an atypical antipsychotic agent. It shortens sleep latency and decreases the percentage of REM sleep and wake time. It increases total sleep time, sleep efficiency, and N2 sleep. In this study, in primary insomnia patients using quetiapine, N3 sleep duration was shorter and sleep percentage was lower, whereas N2 sleep percentage was longer. There has been no placebo-controlled study of any antipsychotic drug for treating insomnia. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Uludag University Medical Faculty / Uludağ Üniversitesi Tıp Fakültesi Dergisi is the property of Journal of Uludag University Medical Faculty 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.)

Aim: Sleep is an essential part of a healthy life. Many people experience insomnia due to their living conditions. Matrix metalloproteinases (MMPs) play an essential role in remodeling the microenvironment. Tissue inhibitors of MMPs (TIMPs) maintain a balance with MMPs. Disruption of the balance causes various pathologies. The aim of the study is to elucidate the effects of sleep disturbance on matrix metalloproteinases and inhibitors by comparing MMP-2/TIMP-2 and MMP-9/TIMP-1 ratio in the serum of patients with chronic insomnia to healthy controls. Materials and Methods: This study included 40 adult males diagnosed with chronic insomnia and 40 healthy individuals as a control group. Blood samples were obtained from the brachial vein and subsequently centrifuged at 2,000 rpm for 15 minutes to collect serum samples. MMP-2, MMP-9, TIMP-1, and TIMP-2 levels were analyzed using commercial Enzyme-linked immunosorbent assay (ELISA) kit protocols with the obtained serum samples. Results: Consequently, in this study it was demonstrated a higher MMP-2/TIMP-2 ratio in chronic insomnia patients when compared to healthy controls, whereas the MMP-9/TIMP-1 ratio remained unchanged. Conclusion: These results suggest that higher MMP2/TIMP2 ratio may potentially contribute to the pathogenesis of diseases associated with sleep deprivation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Objective: Status epilepticus (SE) is a serious neurological emergency that can has high morbidity and mortality rates and requires prompt diagnosis and treatment. There are different etiologies and the prognosis varies multifactorially. The aim of this study was to reveal the etiological causes, clinical features and mortality rates of patients diagnosed with SE at our center. Methods: The records of 234 patients with a diagnosis of SE over the age of 18 who were followed up and treated at our center between 01.01.2015-01.01.2022 were evaluated retrospectively. Using the hospital information operating system database, we identified people hospitalized with an International Classification of Diseases 10th Revision code G41 for SE as the primary diagnosis. Demographic information, clinical characteristics, and discharge results were obtained from medical records. Results: One hundred-twenty (51.3%) female and 114 (48.7%) male patients were evaluated. The top 3 most common etiologic causes were: discontinuation of anti-seizure treatments without advice (n=82), cerebrovascular events (n=50), and meningitis or encephalitis (n=39). Motor seizures were detected in 183 (78.2%) patients, and non-motor seizures were detected in 51 (21.8%) patients. Seizures were suppressed by first-line treatment in 24 patients and by secondline treatments in 135 patients. Seventy-five patients whose seizures could not be suppressed were accepted as refractory SE and 9 died. The mean age of all patients was 55, and 63 of the patients died. Conclusion: In this study, clinical and demographic features, the etiological causes and in the hospital mortality rates of SE followed in a single center in the Turkish population were determined. The most common causes of patients diagnosed with SE were discontinuation of anti-seizure treatments without our recommendation, cerebrovascular diseases and central nervous system infections, respectively. In our center, no relationship was found between age and mortality. The in-hospital mortality rate was 3.9% for all patients (n=234) and 12% for patients with refractory SE (n=75). [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea syndrome (OSAS) is a common disorder that results from the collapse of the upper airways during sleep and causes temporary hypoxia. OSAS and hypertension are common and multifactorial diseases. aim This study aimed to determine the clinical, demographic, polysomnographic and prognostic features of OSAS patients with hypertension. Materials and Methods: In this study, 364 patients diagnosed with OSAS in the sleep laboratory of the Department of Neurology, Bursa Uludağ University Faculty of Medicine between 2016 and 2021 were retrospectively scanned and included. The patients were analyzed by comparing them with and without hypertension. Results: When patients with and without hypertension were compared according to clinical, demographic and polysomnography data, age (p<0.001), sex (p=0.009), presence of diabetes mellitus (DM) (p<0.001), presence of coronary artery disease (p<0.001), presence of heart failure (p=0.020), presence of atrial fibrillation (p=0.004), ischemic stroke (p<0.001), minimum oxygen saturation (p=0.015), oxygen desaturation index (p=0.034) and body mass index (BMI) (p<0.001) were statistically significantly correlated. When the significant variables were analyzed with binary logistic regression, the most significant variables were age [p<0.001, odds ratio (OR): 1.07], DM (p<0.001, OR: 7.58), coronary artery disease (p=0.003, OR: 4.92), heart failure (p=0.041, OR: 5.53), ischemic stroke (p=0.042, OR: 3.38) and BMI (p<0.001, OR: 1.28). Conclusion: In this study, we found that cardiovascular diseases such as coronary artery disease, heart failure and ischemic stroke are more common in OSAS patients with hypertension, and this is independent of risk factors such as age, DM and BMI. OSAS and cardiovascular diseases may show ethnic and racial differences. For this reason, we suggest conducting multicenter prospective studies examining the effects on blood pressure regulation and cardiovascular diseases in our own population. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Giriş: Epileptik olmayan psikojen nöbetler (EOPN) epilepsi başta olmak üzere senkop, panik atak, anksiyete bozuklukları, hiperventilasyon atakları, parasomniler, auralı migren ve geçici iskemik ataklar ile sıklıkla karışabildiğinden dolayı klinisyenler tarafınca poliklinik şartlarında tanı sürecinde oldukça zorlanılan bir durumdur. Bu nedenle hastalarda birçok farklı tetkik ve tedaviler uygulanmaktadır. Ayrıca stres veya duygusal tetikleyiciler gibi faktörlerin olması EOPN'i düşündürebilir. Bu durumların temelinde veya primer uyku bozuklukları sonucu hastada EOPN gelişebilir. Amaç: Epileptik olmayan psikojen nöbetler ile uyku bozuklukları arasındaki ilişkiyi araştırmaktır. Yöntem: Çalışmamıza 154 hasta VEM ünitesinde ortalama 2,72 gün yatırılarak değerlendirildi. Yatış süresince ortalama 3,31 EOPN gözlemlendi. Hastalarımıza Epworth uykululuk ölçeği, RLS şiddet değerlendirmesi, pittsburgh uyku kalitesi indeksi ve uykusuzluk şiddeti indeksi uygulandı. Sonuçlar: Hastaların ortlama yaşı 38,38 ve çoğunluğu kadın cinsiyeti oluşturmaktaydı. Hastaların epworth uykululuk ölçeği ortalama 13,23 olarak sonuçlandı. Hastaların %42'sinde insomni şikayeti, %23'ünde ise huzursuz bacaklar semptomlarının varlığı dikkati çekti. Tartışma: EOPN'li hastalarda epilepsi hastalarına göre daha sık uyku sorunlarından bahsedilmekte olup yaklaşık üçte birinde uyku bozukluğu öyküsü olduğu görülmüştür. Toplam 68 hastayı kapsayan 4 ayrı polisomnografi çalışması yapılmıştır. Uykuda solunum bozukluğu hastaların %14-29'unda, periyodik hareket bozukluğu hastaların %27'sinde tespit edilmiş ve ortalama uyku latansı 45 dakikalık gecikme göstermiş olup uykuya ilk dalıştan sonra ortalama 1-2 saat uyanıklık ile genel uyku kalitesindeki bozukluk gösterilmiştir. Bu çalışmalar hastaların büyük bölümünün uyku ilacı kullanmasının nedenini ortaya koymaktadır. Uyku bozuklukları, depresyon ve anksiyete bozukluklarında yaygın görülen semptomlardan biridir, ancak EOPN ile ilişkisinin basit bir komorbiditeden fazlası olduğu düşünülmektedir. Sonuç olarak EOPN hastalarında tedavide ve tetikleyici nedenler açısından mutlaka uyku bozukluğunun değerlendirilmesi ve gerekli koşullarda polisomnografi ile tedavisinin planlanması da gerektiğini düşünmekteyiz. [ABSTRACT FROM AUTHOR]