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WOS: 000474456600002 Vaiproic acid (VPA) is one of the most frequently prescribed antiepileptic drugs for idiopathic generalized epilepsy, chronic or migraine headache, and bipolar disorder; however concerns about teratogenic effects have resulted in limited usage of the drug in women of childbearing potential. The aim of this review was to assess the current status of recommendations for the use of VPA according to international drug commissions and other recent reports.

WOS: 000438304900009 Women diagnosed with epilepsy must be followed by a neurologist as well as an obstetrician in the pre-pregnancy, pregnancy, birth, and puerperal periods. There are no indications for cesarean section or induced birth in epileptic patients, with the exception of some special cases, but in daily practice, cesarean section is routinely performed and these cases are referred to tertiary epilepsy centers. Likewise, with-drawal or unnecessary dose adjustment of antiepileptic drugs in breastfeeding mothers can cause adverse effects in the infant and the mother. The aim of this article is to minimize misjudgments that affect the quality of life of patients by increasing awareness of the genuine needs of pregnant women diagnosed with epilepsy during the birth and postpartum periods.

WOS: 000438303700004 Objectives: Sudden unexpected death in epilepsy (SUDEP) is attributed to peri-ictal cardiopulmonary abnormalities. In the present study, epilepsy patients on monotherapy (carbamazepine [CBZ], oxcarbazepine [OXZ], valproic acid [VPA]) were compared with a healthy control group to investigate the effects of epilepsy and various antiepileptic drugs on QTmax, QTmin, and QTd. Methods: Seventy eight (51.3% females) epilepsy patients with a mean age of 32.7 +/- 11.4 (range, 17-63) years and 71 (56.3% female) healthy subjects with a mean age of 36.3 +/- 13.6 (range, 18-64) years participated in the study. The shorter and longer QT were measured by electrocardiography (ECG) and then differences between them (QTd) were calculated. SPSS for Windows 21.0 package software was used to compare the findings between groups. Results: QTmin (p

WOS: 000426503600014 The color change in urine may result from various factors such as drugs, stains, foods, infections, metabolic diseases and structural abnormalities. When Status Epilepticus can not be controlled with the benzodiazepine and at least one antiepileptic drug treatments, it is defined as refractory status epilepticus. Propofol, which is a drug that may be used for the treatment of refractory status epilepticus. We present a 28-year-old male with refractory status epilepticus who experienced a color change in urine to green due to propofol infusion. Green urine discoloration is a benign and very rare side effect of propofol.

In this study, identification of epilepsy prevalence, epilepsypatients’ demographical data and epilepsy risk factors in the Adanacity centre is aimed. Methods: This is a community-basedcross-sectional study, and by using “proportional stratifiedsampling method”, target population of 7052 people was identifiedwith considering Adana city center population. Three districts,reflecting general socioeconomic status, are identified by usingrandom sampling method. One doctor and two pollsters filled surveyforms by face to face interviews. When the target population of 7052people was reached, the study was terminated. Pre-diagnosed epilepsypatients and participants who are more likely to be diagnosed withthe epilepsy in the future, because of their history features, areinvited to our clinic for further surveys and investigations.Results: Out of 7052 participants who were face to faceinterviewed, 3577 of them were male (50,7%) and 3475 were female(49,3%). 52 of the participants were epilepsy patients and activeprevalence of the epilepsy was found as 0,7%. 31 of the 52 patientswere male (59,6%), 21 of the 52 patients were female (40,4%).Prevalence of the epilepsy in the high, medium and low socioeconomicstatus districts were 0,3%, 0,7% and 1,4% respectively. As thesocioeconomic level decreased, the prevalence of epilepsy increasedand the results were statistically significant. (p, Bu çalışmada, Adana il merkezinde epilepsi prevalansı, hastalarındemografik verileri ve epilepsi gelişimindeki risk faktörlerininbelirlenmesi amaçlanmıştır. Gereç ve yöntem: Çalışma,toplum temelli kesitsel olarak planlandı ve Adana il merkezi nüfusuüzerinden ‘'orantılı tabakalı örneklem yöntemi'' kullanılarakhedef nüfus 7052 kişi olarak belirlendi. Toplumun, sosyoekonomikdüzeyini yansıtacak şekilde rastgele örneklem yöntemi ile üçmahalle belirlendi. Hazırlanan anket formları bir doktor ve ikianketör tarafından yüz yüze görüşme yöntemi ile dolduruldu.Hedef nüfus olan 7052 kişiye ulaşıldığında çalışmasonlandırıldı. Daha önceden epilepsi tanısı almış olan veyaöykü özellikleri ile epilepsi olabilecek olan grup, hazırlanandiğer anket formlarının doldurularak ileri tetkiklerin yapılmasıiçin kliniğimize davet edildi. Bulgular: Anket formudoldurulan 7052 kişinin, 3577'si erkek (%50,7), 3475'i (%49,3)kadındı. Taranan nüfus içerisinde 52 kişi epilepsi olaraktanındı ve aktif epilepsi prevalansı %0,7 olarak bulundu.Epilepsi tespit edilen grubun 31'i (%59,6) erkek 21'i (%40,4) isekadındı. Sosyoekonomik durumu yüksek olan mahallede prevalans %0,3sosyoekonomik durumu orta düzeyde olan mahallede %0,7 vesosyoekonomik durumu düşük olan mahallede ise prevalans %1,4olarak bulundu. Sosyoekonomik düzey düştükçe, epilepsiprevalansında artış saptandı ve bulgular istatiksel olarakanlamlı bulundu (p

WOS: 000438988100007 Priapism is defined as a prolonged and persistent, painful erection of the penis without sexual stimulation. There have been a few case report of priapism resulting from the use of sodium valproate and topiramate. In our case, a 15-year-old male patient with partial seizures was treated with levetiracetam 1000 mg/day. Stuttering priapism was reported in the first week of treatment, which improved with drug withdrawal. To the best of our knowledge, there is no case report of a similar complication with levetiracetam.

Epileptik nöbet (EN) ve non epileptik psikojen nöbet (NEPN), nöroloji pratiği içerisinde tanı karmaşasının en sık yaşandığı klinik durumlardan biridir. Yanlış tanı, uzun yıllar sürebilen yanlış tedavi rejimlerine, ilaç yan etkilerine, ek mali yüklere ve sosyal yaşamda olumsuz etkilere yol açmaktadır. EN ve NEPN ayırıcı tanısı, nöroloji kliniklerinin yanı sıra aile sağlığı merkezlerinde de sıkça karşılaşılan problemlerin başında gelmektedir. Hasta ve yakınlarından alınan dikkatli öykü, ayrıntılı nörolojik muayene doğru tanı ve tedaviye ulaşmada oldukça önemlidir. Bu derlemede, aile sağlığı merkezlerinde EN ve NEPN ayırıcı tanısında kullanılabilecek semptom ve bulguların güncel literatür bilgisi ışığında gözden geçirilmesi amaçlanmıştır.

Reflex epilepsies are induced by specific stimulants. Stimulants could be simple or complex as well as from intrinsic or extrinsic sources. The prevelance of reflex epilepsies among epilepsy patients is 4-7%. The most common form is photosensitive epilepsy. The treatment is composed of primarily avoidance from the inducer and usage of antiepileptic drugs., Refleks epilepsiler, spesifik uyaranlarla tetiklenen nöbetlerdir. Uyaranlar basit ya da kompleks olabileceği gibi intrinsek veya ekstrensek kaynaklı olabilir. Epilepsili hastalar arasında refleks epilepsilerin prevalansı % 4-7 dir. En sık görülen tipini fotosensitif epilepsiler oluşturmaktadır. Tedavide öncelikle uyaranlardan kaçınmak yanı sıra antiepileptik ilaçların da kullanılması gerekebilir.

WOS: 000390945000007 Progressive myoclonic epilepsies are a devastating group of rare disorders. The case of a young man who presented with a late-diagnosed nephrotic syndrome, progressive myoclonic seizures with action myoclonus, is described in the present report. He was the fifth child of a consanguineous marriage, and there was no familial history of nephrotic syndrome or end-stage renal failure. Renal biopsy showed focal segmental glomerulosclerosis with collapsing glomerulopathy. The patient died at 25 years of age in a context of end-stage renal function consistent with nephrotic syndrome.

Syncope is defined as a transient loss of consciousness due to sudden temporary decline in cerebral perfusion. Cough syncope is classically seen in middle aged obese men with obstructive pulmonary disease. In patients that use Angiotensin converting enzyme (ACE) inhibitors, a dry persistent cough can emerge due to the side effects of this medication. Seventy years old male patient that use ACE inhibitor for hypertension accepted to the clinic with the complaint of syncope. A bout of coughing has developed during electroencephalography recording and 10 seconds in duration of subcortical like epileptiform discharges were viewed. The ACE inhibitor the patient was receiving was replaced with calcium channel blocker and no complaint was observed during the follow up period., Senkop, serebral perfüzyonun aniden geçici olarak düşmesiyle ortaya çıkan geçici bilinç kaybı olarak tanımlanır. Obstrüktif akciğer hastalığı olan orta yaşlı obez erkeklerde öksürüğe bağlı senkop klasik olarak görülmektedir. Anjiyotensin konverting enzim (ACE) inhibitörü kullanan hastalarda bu ilacın yan etkisi olarak kalıcı kuru öksürük görülebilmektedir. Hipertansiyon tedavisi için ACE inhibitörü kullanan yetmiş yaşındaki erkek hasta senkop şikayeti ile kliniğe kabul edildi. Elektroensefalografi kaydı sırasında bir öksürük nöbeti gelişti ve süresi 10 saniye olan subkortikal benzeri epileptiform deşarjlar görüldü. Hastanın kullandığı ACE inhibitörü kalsiyum kanal blokörleri ile değiştirildiğinde takip periyodunda herhangi bir komplikasyona rastlanmadı.

Background and aim: In this study, the frequency of subclinical hepatic encephalopathy in cirrhotic patients was investigated. Methods: Seventy five cirrhotic patients and 75 healthy controls of the same age, sex and education level were included. In order to diagnose subclinical hepatic encephalopathy, the number connection test-A as a psychometric test, and somatosensory evoked potential, visual evoked potential and Brain-stem auditory-evoked potential as electrophsiological tests were used. Electroencephalography and magnetic resonance imaging procedures were performed on each patient. Results: Abnormal results for number connection test-A, somatosensory evoked potential, brainstem auditory-evoked potantial and visual evoked potential were 23%, 44%, 2.7% and 2.7% respectively. The frequency of abnormality as diagnosed by electroencepholography and magnetic resonance imaging were 5.3% and 32% respectively. The results indicated that subclinical hepatic encephalopathy was potentially present in some cirrhotic patients and that some of them might progress to overt hepatic coma. Conclusions: Periodic follow-up of these patients is necessary due to the negative effects that subclinical hepatic encephalopathy may have on physical tasks such as driving and manual work., Giriş ve amaç: Bu çalışmada sirozlu hastalarda subklinik hepatik ensefalopati sıklığı araştırıldı. Gereç ve yöntem: Çalışma 75 sirozlu olgu ile bu olgularla benzer yaş, cinsiyet ve eğitim düzeyinde olan sağlıklı 75 olguda yapıldı. Subklinik hepatik ensefalopati sıklığını saptamak için psikometrik testlerden Number Connection Test ile elekrofizyolojik testlerden somatosensoriel uyarılmış potansiyel, görsel uyarılmış potansiyel ve beyinsapı uyarılmış potansiyel testleri uygulandı. Ayrıca bu hastalara görüntüleme yöntemlerden elektroensefalografi ve “magnetic rezonans imaging” incelemeleri yapıldı. Bulgular: Psikometrik testlerden Number Connection Test %22, elektrofizyolojik testlerden somatosensoriel uyarılmış potansiyel % 44, beyinsapı uyarılmış potansiyel % 2.7 ve görsel uyarılmış potansiyel % 2.7 olguda anormal bulgu verdi. Görüntüleme yöntemlerinden elektroensefalografi % 5.3 ve magnetic rezonans imaging % 32 olguda anormal bulundu. Bu sonuçlar aşikar ensefalopati olmaksızın sirozlu hastaların bir kısmında subklinik hepatik ensefalopatinin mevcut olduğunu ve bu olguların kolaylıkla karaciğer komasına girebileceklerini düşündürmektedir. Sonuç: Kanımızca özellikle motorlu araç kullanımı, makina işletme gibi ağır sorumluluk gerektiren işlerde çalışan sirozlu hastalarda subklinik hepatik ensefalopatinin araştırılması, tedavi edilmesi ve bu olguların daha yakından izlenmesi gerekmektedir.

29th International Epilepsy Congress -- AUG 28-SEP 01, 2011 -- Rome, ITALY WOS: 000294217200070 …

Fibromuscular dysplasia (FMD), which usually affects middle-aged and older women, is a non-atheromatous and non-inflammatory angiopathy. Definitive diagnosis is made only by angiography showing classic string-of-beads appearance. In this article, we present a patient with acute ischemic stroke due to FMD who was successfully treated with thrombolytic therapy as well as to revise the approach to FMD in the light of the literature.

We prospectively reviewed the healing period of 29 patients with carpal tunnel syndrome treated surgically between 1990-1994. We compared both preoperative and postoperative clinical and electrodiagnostic findings. Of these patients, 27 (92%) were female and 2 (8%) male. The mean age was 46.9 years. We performed carpal tunnel decompression for 33 hands of 29 patients. The mean follow up time was 12.2 months (3 to 41 months). In conclusion: the subjective signs of the carpal tunnel syndrome improved in a short time, but the improvement of the electrophysiological changes took more time exceeding 6 months after the carpal tunnel release., Bu çalışmada 1990-1994 tarihleri arasında Karpal Tünel Sendromu (KTS) tanısı konularak cerrahi tedavi yapılan hastalarda postoperatif iyileşme hızı prospektif olarak incelendi. Bu amaçla olgularımızın preoperatif ve postoperatif klinik muayene ve elektronörografik (ENG) bulguları karşılaştınldı. Çalışmaya alınan 29 hastanın 33 eline KTS dekompresyon ameliyatı yapıldı. Hastalarımızın 27 (%93)'si kadın, 2 (%7)'si erkek olup ortaIama yaş 46.9 olarak bulundu. Ortalama takip süresi 12.2 (3-41 ) aydı. Olguların tamamına yakınında dekompresyon sonrası subjektif bulguların kısa sürede iyileşmesine karşın, elektrofizyolojik iyileşmenin daha geç ve özellikle 6. ay dolayında belirginleştiği görüldü.

WOS: 000318549800004 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.