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Aim:In our study, we aimed to analyze electroencephalography (EEG) findings in patients with hypocalcemia and to investigate possible relationship between calcium (Ca) level and EEG abnormalities and whether there was any change in EEG findings when serum Ca level returns to normal.Methods:Seventeen consecutive patients, who were admitted to the Endocrinology, Neurology and General Surgery Clinics at İstanbul Şişli Hamidiye Etfal Training and Research Hospital with a corrected serum Ca level of 8.5 mg/dL) in follow-up.Results:EEG abnormalities were detected in nine (53%) of 17 patients. EEG examination revealed slow background activity in seven patients (41%) and epileptiform abnormalities in two (12%) patients. In follow-up, normocalcemic period was observed in seven patients. EEG findings were improved in two of eight patients who had slow background activity and one of two patients with epileptiform activity in the normocalcemic period.Conclusion:Our study showed that various EEG findings, such as slowed background activity and epileptiform abnormalities, may be seen in isolated hypocalcemia patients even in the absence of clinical findings and these EEG findings may improve in normocalsemic period.

One of the most important reasons why the use of the intravenous (IV) tissue plasminogen activator (tPA), which is one of the key elements of acute ischemic stroke treatment, is not sufficiently widespread is the fact that many common questions have not been adequately answered. In this review, questions about systemic nonneurologic conditions, problems related with IV tPA treatment and complications of treatment, which were collected from our colleagues practicing in Turkey and which are more important in clinical practice, were answered on the basis of the current literature and clear recommendations are made

Use of intravenous tissue plasminogen activator (tPA) is one of the key elements of acute ischemic stroke management. Its use has not become widespread, and has faced significant problems in our country for more than a quarter of a century most probably due to many unanswered questions about issues related with daily practice. However, recent developments, which adequately focused and found solutions for most of these problems and questions, have led to a major change of point of view and understanding of the hyperacute management of stroke. This article, in the light of the relevant literature, discusses and provides clear recommendations for questions directed by neurologists practicing in Turkey mainly about typical neurologic issues faced in the setting of tPA use for acute stroke

OBJECTIVE: The objective of our study is to investigate the association between the infarcts in the cortical and deep posterior cerebral artery perfusion area and the mechanisms of stroke, clinical features and risk factors. METHODS: For this purpose, 57 patients included in this study who suffered strokes first time and have infarcts in the posterior cerebral artery perfusion area and admitted to our Neurology Clinics between January 2002 and August 2007. Subjects were divided in two groups as cortical branch infarct group and deep (thalamus) + cortical branch group. Patients were evaluated in four etiologic clusters; 1.Occlusion in the posterior cerebral artery or its branches. 2. Occlusion proximal to the posterior cerebral artery. 3. Cardio-embolic reasons. 4. Cryptogenic embolism group. All patients had cranial CT, MRI, neck Doppler USG, MRA or DSA, trans-esophageal or trans-thoracic echocardiography, hematologic and vasculytic investigations. Risk factors in all patients were recorded. RESULTS: Thirty-five (61%) patients had cortical branch infarct, 22 patients (39%) had infarcts in the cortical and deep PCA perfusion area. The cardio-embolism (n: 27; 47%) was the most frequently observed etiologic factor in both groups. This is followed by intrinsic PCA disease (n: 12; 21%), proximal artery disease (n: 10; 17%), cryptogenic embolism (n: 8, 15%), respectively. Headache was observed in 52% of the patients at the beginning of stroke. Seventy-eight of the patients had visual disturbances, 54% had motor symptoms, 24% had sensorial symptoms. CONCLUSION: It is concluded that cardiogenic embolism and intrinsic PCA disease are more frequent etiologic factors in infarcts observed in the cortical and deep posterior cerebral artery perfusion area. There was no statistical difference in etiology and risk factors between the patients who had PCA cortical branch infarct group and deep (thalamus) + cortical branch group.

OBJECTIVE: Cognitive dysfunction is currently recognized as a significant cause of disability in multiple sclerosis (MS). The Montreal Cognitive Assessment (MOCA) is screening device used to evaluate executive functions, visuo-spatial abilities, language, attention, and concentration, abstract thinking, memory, and orientation domain. The aim of this study is to compare cognitive functions of MS patients with age-matched controls using MOCA test. METHODS: Thirty nine subjects with a diagnosis of relapsing-remitting MS according to the 2010 revised McDonald criteria and 20 healthy volunteer controls participated in this study. Patients and controls underwent Turkish version of MOCA test. Total and subgroup scores were compared. RESULTS: Total MOCA score in MS patients and controls were 21,74±4,48 and 26,9±2,53 respectively. Total MOCA score of MS patients was significantly lower than controls. Significant deterioration was also found in language, attention, memory and executive functions domain. Disease duration and expanded disability status scale (EDSS) did not differ in patients with and without cognitive deficits. CONCLUSION: Patients with MS showed deterioration in language, attention, working and long term-memory and executive functions compared to controls. MOCA is a simple, stand-alone cognitive screening test with superior sensitivity. Our findings suggest that the MOCA test may be useful for screening cognitive impairment in MS patients early in the disease course

Aortic dissection can be fatal in case of underdiagnosis, and early treatment is essential for the survival. Although acute onset of chest or back pain is most common presenting symptoms, some patients might present with atypical findings such as acute stroke, mesenteric ischaemia, renal failure or myocardial infarction. Here, we report two cases presenting emergency room with atypical findings of aortic dissection which diagnosis is made during etiologic work up for ischemic stroke

Gait ignition failure (GIF) is clinically and pathologically a poorly defined term that has gone with many different names before. Coexistence with idiopathic Parkinson’s disease, progressive supranuclear palsy, multisystem atrophy, vascular parkinsonism, posthypoxic pallidal lesions and normal pressure hydrocephalus is common. Primary GIF is rare. Main problem is start hesitation and freezing. Here, we present a 69 year old woman whose chief complaint is difficulty of gait. She did not have any other extrapiramidal signs and her MRI did not reveal any abnormality. She was diagnosed as primary gait ignition failure