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Multiple sclerosis (MS) is an autoimmune and demyelinating disease of the central nervous system. It is a chronic disease, and in the evaluation of all other health and vital processes, decisions about vaccination should be made considering the disease process and the medications used by the patient. Since vaccination can be performed at any stage of life, immune system activity should be reviewed in patients with MS except where it is characteristic of the vaccine. In this review, the applications of different vaccines in patients with MS are discussed in two separate sections (part 1 was published in the previous issue).

Multiple sclerosis (MS) is an autoimmune and demyelinating disease of the central nervous system. It is a chronic disease, and in the evaluation of all other health and vital processes, decisions should be made by considering the disease process and the drugs used by the patient. Since vaccination can be performed at every stage of life, from childhood to adulthood, immune system activity, except where it is characteristic of the vaccine, should be reviewed in patients with MS. In this review, the applications of different vaccines in individuals with MS are discussed in two separate sections.

Objective: Coronavirus disease 2019 (COVID-19) may cause neurological impairments in addition to disorders of respiratory and gastrointestinal systems. We aimed to investigate the frequencies and clinical correlates of neurological symptoms in COVID-19. Materials and Methods: This cross-sectional study was conducted with 117 consecutive patients diagnosed as having COVID-19 in two designated centers assigned by the government to follow up the COVID-19 patients in Turkey. Results: The mean age was 53.08 ±15.63 years (range 18 to 89 years). Sixty-five (55.5%) mildly (non-complicated), 32 (27.4%) moderately (mild pneumonia), and 20 (17.1%) severely ill (severe pneumonia) patients are included. Seventy nine patients (67.5%) were detected to suffer from neurological complaints. The most common symptom was taste impairment seen in 36 (30.7%) patients. Other common complaints were smell impairment (25.6%), headache (24.7%), and dizziness (16.2%). Patients with neurological symptoms were younger, and more likely to have accompanying comorbidities. The patients with severe infection were also more likely to have coexisting comorbidities. Higher ferritin and LDH levels, and lower lymphocyte counts indicated the worse disease severity. Conclusion: Our results demonstrated that more than half of the non-critically ill COVID-19 patients experiences neurological complaints. Clinicians should be aware of the neuroinvasive spread of the coronaviruses, and neurological symptoms should be questioned in particular the young patients with accompanying comorbidities.

Fahr sendromu, simetrik ve bilateral intrakraniyal kalsifikasyon ile seyreden nadir bir hastalık tablosu olup psikiyatrik semptomlar, epileptik nöbetler, serebellar bulgular, ekstrapiramidal disfonksiyon ve demans gibi klinik belirtiler ile kendini gösterebilir. Hastalığın birçok farklı klinik tablosu olmasına rağmen etiyolojisi henüz net olarak bilinmemektedir. Bu yazıda epileptik nöbet ile başvuran ve psikiyatrik belirtileri olan Fahr sendromu olgusu sunmaktayız.Fahr syndrome is a rare disease with symmetrical and bilateral intracranial calcium accumulation and may present with clinical symptoms such as psychiatric symptoms, epileptic seizures, cerebellar findings, extrapyramidal dysfunction and dementia. Although the disease has many different clinical manifestations, its etiology is not yet clear. In this article, we present a case of Fahr syndrome with psychiatric symptoms presenting with epileptic seizures.

Batı Nil virüsü, asemptomatik bir klinik tablodan ağır ensefalit ve menenjite varan geniş bir klinik varyasyonla prezente olabilir. Akut demiyelinizan polinöropati birlikteliği çok nadir bildirilmiştir. 60 yaş erkek hasta bilinç bozukluğu, kol ve bacaklarda güçsüzlük şikayetleri ile başvurdu. Kliniği, laboratuvar, beyin omurilik sıvısı ve elektrofizyoloji bulguları ön planda Guillain Barre sendromu ile uyumlu idi. Ateş, bilinç bozukluğu ve spastisite gibi atipik bulguların eşlik etmesi nedeniyle detaylı araştırılan olguda serum BN virüsü IgM testi pozitif bulundu. Türkiye’den bildirilen ilk olgu olması nedeniyle sunulmaya değer görüldü.

Gerstmannn sendromu agrafi, parmak agnozisi, sağ-sol dezoryantasyonu ve akalkuli ile karakterize bir klinik tablodur. Saf vakaların hiçbirinde aleksi görülmemektedir. 62 yaşında erkek hasta sol pariyetotemporal alanda akut iskemik enfarkt ile başvurdu. Kliniğinde Gerstmann tetradının yanısıra aleksi tablosu mevcuttu. Nadir görülen bu tablonun klinik-nöroanatomik korelasyonu tartışmalıdır.

Objective: This study aimed to evaluate the R-R interval recording sensitivity in the early diagnosis of diabetic autonomic neuropathy (DAN).Methods: Sixty patients who applied to neurology outpatient clinics and were thought to have diabetic polyneuropathy were accepted to the study. The control group was formed by 31 healthy volunteers. The standard nerve conduction study and R-R interval measurements during resting and deep breathing were evaluated in the patient and control groups.Results: When R-R interval measurements of the patient and control groups during resting and deep breathing were compared, no statistically significant difference between the groups was determined.Conclusion: In the diagnosis of DAN, data about the recording of R-R interval measurements that show heart rate variability in resting and deep breathing as significant was not obtained. In larger patient groups, there is a need for broader studies in which Valsalva maneuver and tilt table test methods are also performed.