Search

Psychogenicnonepileptic seizures (PNES) may be evaluated as epileptic seizures (ES).Moreover, PNES may be accompanied by ES and might be the cause of resistance toantiepileptic drug (AED) in patients with ES which can be defined aspseudoresistance. We aimed to evaluate the rate of PNES and comorbidity of PNESand ES in our database as well as evaluating the prognosis in these patients.We retrospectively evaluated the records of all patients who were admitted tothe epilepsy center between January 1, 2007, and March 31, 2015. Medical recordreview included outpatient clinic notes, neurological findings, video-EEGmonitorization reports, home videos of patients, routine EEG reports, brainimages, and follow-up of patients. A total of 4247 patients were evaluated and114 of these patients had PNES. There were 65 patients with PNES only and 49 patients with PNES/ES. Patients withPNES/ES had a longer duration of diagnosis than patients with PNES(p, Psikojeniknonepileptik nöbetler (PNEN), epileptik nöbetler (EN) olarakdeğerlendirilebilir. Bundan da fazla olarak PNEN, EN’ye eşlik edebilir veepilepsi hastalarında psödodirenç olarak tanımlayabileceğimiz antiepileptikilaca (AEİ) direncin nedeni olabilir. Bu çalışmada PNEN ve PNEN ile ENbirlikteliğini ve bu hastalarda prognozu değerlendirmeyi amaçladık. 1 Ocak 2007ve 1 Mart 2016 tarihleri arasında epilepsi merkezine gelen hastalarındosyalarını retrospektif olarak inceledik. Hastaların poliklinik notlarını,nörolojik bulguları, video-EEG monitörizasyonu raporlarını, hastaların evvideolarını, rutin EEG kayıtlarını ve takiplerini değerlendirdik. Toplamda 4247hasta incelendi ve 114 hastada PNEN saptandı. Sadece PNEN olan 65 hasta,PNEN/EN birlikteliği olan 49 hasta vardı. PNEN/EN birlikteliği olan hastalardatanı koyma süresi, sadece PNEN olanlara göre daha uzundu (p

Valproic acid is a branched-chain carboxylic acid construct used as anantiepileptic agent. Side effects can be listed as nausea, vomiting, alopecia,weight gain, asymptomatic increase in liver function tests, fulminant hepatitis,sedation, ataxia, tremor, pancreatitis, cardiac arrhythmia, thrombocytopenia,hyperammonemia and encephalopathy. Valproate-associated encephalopathy is oftencharacterized by impairment in change of consciousness, apathy, irritability,confusion, and impaired liver function. This table is accompanied with a highlevel of ammonia in the blood. Rarely, encephalopathy may occur withouthyperammonemia and irrespective of serum valproate level. Typical clinicalfindings in this case report were supported by EEG records and serum ammonialevel was found to be normal in our patient. Valproate Encephalopathy withoutHyperammonemia was diagnosed. Clinical improvement after cessation of valproatetreatment was also demonstrated by EEG findings and the diagnosis wassupported., Valproik asit antiepileptik ajan olarakkullanılan dallı zincirli karboksilik asit yapısında bir ajandır. Yan etkileri; bulantı, kusma, alopesi, kiloalımı, asemptomatik olarak karaciğer fonksiyon testlerinde artış, fulminanhepatit, sedasyon, ataksi, tremor, pankreatit, kardiyak aritmi, trombositopeni,hiperammonemi ve ensefalopati tablosu olarak sıralanabilir. Valproat ileilişkili ensefalopati sıklıkla bilinç durumunda bozulma, apati, sinirlilik,konfüzyon, karaciğer fonksiyonlarında bozulma ile karakterize bir tablodur. Butabloya kan amonyak düzeyinde yükseklik sıklıkla eşlik eder. Daha nadir olarakise hiperammonemi görülmeden ve serum valproat düzeyine bağlı olmaksızın daensefalopati tablosu ortaya çıkabilir. Bildirmiş olduğumuz bu olguda tipikklinik bulgular; EEG kayıtları ile desteklenmiş, hastamızda serum amonyakdüzeyi normal bulunmuştur ve Hiperammonemi olmaksızın Valproat Ensefalopatisitanısına ulaşılmıştır. Sonrasında valproat tedavisinin kesilmesinin ardındangörülen klinik iyileşme, yine EEG bulgularıyla da ortaya konmuş, tanıdesteklenmiştir.

WOS: 000452643700001 Determination of the health qualifications of personnel, students, and their candidates, who are members of the Turkish Armed Forces, the General Command of Gendarmerie and the Coast Guard Command has been transferred to Ministry of Health hospitals. One hundred sixty-two hospitals affiliated to the Ministry of Health were authorized to report in this context. The magnitude of this uncertain patient volume, and most importantly, the lack of awareness of the legislation has made the job particularly challenging for neurology specialists. In order to minimize the problems faced by our colleagues after the transfer of military health services and health board processes to the Ministry of Health, which has been performed for about a century in the military system, the most common features of neurologic diseases are presented with report samples.

Notalgia parestetika (NP) dorsal vertebral veskapular alanda nöropatik karakterde ağrı, kaşıntı ve pigmentasyon artışı ilekarakterize cilt lezyonu ile seyreden klinik bir durumdur. Etiyolojisi veprevelansı tam olarak bilinmeyen bu klinik sıklıkla göz ardı edilebilmekte vetanı konulmasının gecikilmesiyle süreç içerisinde kronikleşmektedir. Poliklinikpratiğimizde nadir görülen bu olgu üzerinden NP kliniği, etyopatogenezi vetedavi seçenekleri tartışılmak istenmiştir., Notalgia Paresthetica(NP) is a clinical condition associated with skin lesion which charecterized byneuropathic pain, pruritus and and hyperpigmentation by dorsal vertebral andscapular area. Etiology and prevalence of clinic is unknow exactly so thisclinic ignore mostly and due to delayed diagnosis became chronic diseases intime. This rare phenomenon was discussed with the pathogenesis and treatmentoptions in our practise.

INTRODUCTION: To evaluate the ef?cacy and safety of lacosamide (200-300-400 mg/day) as adjunctive treatment in patients with uncontrolled focal-onset seizures taking two or more antiepileptic drugs (AED) retrospectively. METHODS: We performed a retrospective medical record review of patients with uncontrolled focal epilepsy who received lacosamide as add-on therapy for at least six months. Data included demographics, lacosamide dosing, concomitant AED therapy and seizure activity in first and sixth months. RESULTS: A total of 83 patients were evaluated. Mean percent reductions in seizure frequency per month were 38.98% in first month and 33.22% in sixth month as well as 50% responder rate were 53% in first month and 47% in sixth month. The percentage of AED which has an effect on sodium channel and concomitantly administered with lacosamide was found 97.6%. Dose-related adverse events included dizziness, nausea, diplopia, gastroenterological side effects,headache, itchy skin and blurred vision. It was determined that all patients with drug side effect used AED which has an effect on sodium channel and concomitantly administered with lacosamide. DISCUSSION AND CONCLUSION: Adjunctive treatment with lacosamide reduced seizure frequency for patients with uncontrolled focal-onset seizures., GİRİŞ ve AMAÇ: İki veya daha fazla antiepileptik ilaç (AEİ) kullanan ve nöbetleri durmayan fokal başlangıçlı epilepsi hastalarında lakozamidin 200-300-400 mg/gün dozlarda ek tedavi olarak kullanılmasının etkinliği ve güvenilirliğini retrospektif olarak incelenmesi amaçlandı. YÖNTEM ve GEREÇLER: Nöbetleri durmayan ve ek tedavi olarak en az altı ay boyunca lakozamid kullanan fokal başlangıçlı nöbetleri olan hastaların medikal kayıtları retrospektif olarak incelendi. Demografik veriler, lakozamid dozu, birlikte kullandığı AEİ tedavisi ve birinci ve altıncı aylardaki nöbet aktivitesi incelendi. BULGULAR: Toplam 83 hasta değerlendirildi. Nöbet sıklığındaki ortalama azalma birinci ayda %38.88, altıncı ayda %33.22 ve tedaviye % 50 yanıt oranı birinci ayda %53, altıncı ayda % 47 olarak bulundu. Lakozamid ile birlikte kullanılan ve sodyum kanalı üzerinden etki eden AEİ oranı % 97.6 olarak bulundu. Doza bağımlı yan etkiler sersemlik, bulantı, diplopi, gastrointestinal yan etkiler, baş ağrısı, kaşıntı ve görme bulanıklığı olarak bulundu. İlaç yan etkisi tespit edilen hastaların hepsinin lakozamid ile birlikte sodyum kanalı üzerinden etki eden AEİ kullandığı tespit edildi. TARTIŞMA ve SONUÇ: Kontrol altına alınamayan fokal başlangıçlı nöbetleri olan hastalarda ek lakozamid tedavisi nöbet sıklığını azaltmaktadır.

Objective The prognostic value of electrophysiology and its significance in the prediction facial function outcome in facial palsy patients remains unclear because of the different methodologies used in previous studies. We aimed to establish the prognostic value of electrophysiological testing in a group of patients with facial palsy. Methods We prospectively analyzed facial nerve electrophysiology results and compared them with the House–Brackmann scale in 65 patients. The treatment consisted of a standard corticosteroid plus antiviral regimen. Clinical evaluation comprised the House–Brackmann grading system and electrophysiological tests (nerve excitability, nerve conduction study (NCS), needle electromyography (EMG), and blink reflex) conducted on the 5th, 20th, and 90th days after paralysis onset. Results In predicting the prognosis, the nerve excitability test in the acute phase, NCS in the subacute phase, blink reflex in the acute and subacute phases and needle EMG in the subacute phase provided statistically significant results. Conclusion Prognosis can be determined, and excessive tests can be eliminated with proper timing and electrophysiological testing. Significance In determining the prognosis of facial paralysis, the nerve excitability test should be used in the acute phase, and NCS and needle EMG should be used in the subacute phase. Blink reflex studies are helpful in both the acute and subacute phases.