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Akut iskemik inmede ilk 4,5 saat içinde uygulanan rekombinan doku plazminojen aktivatörü (rt-PA) etkinliği kanıtlanmış bir tedavi yöntemidir. Bu çalışmada 01.01.2018 - 01.12.2021 tarihleri arasında trombolitik tedavi uygulanan 71 akut iskemik inme hastasının verilerini analiz etmeyi ve merkezimizin deneyimlerini paylaşmayı amaçladık. Hastaların nörolojik durumları Ulusal Sağlık Enstitüleri İnme Skalası (NIHSS), engellilikleri ise Modifiye Rankin Skalası (mRS) ile değerlendirildi. Trombolitik tedavisinden 24 saat ve 7 gün sonraki NIHSS, geliş NIHSS’ye göre istatiksel olarak anlamlı düşük saptandı (her ikisi için p

Objective: There are a handful of studies investigating peri-ictal headache (PIH) and its clinical associations in patients with idiopathic/genetic epilepsies (I/GE). This multi-center study aimed to investigate PIH, which is an ignored comorbid condition in patients with I/GE, by headache experts and epileptologists working together. Methods: The data were collected from a cross-sectional large study, using two structured questionnaires for headache and epilepsy features, fulfilled by neurologists. Headaches were classified according to the International Classification of Headache Disorders, third edition, whereas seizure and syndrome types were diagnosed according to International League Against Epilepsy criteria. The patients with a headache starting 24 hours before the onset of the seizure (preictal) or within 3 hours after the seizure (postictal) were defined as patients with PIH. We compared demographic and clinical differences between two groups of patients with and without PIH statistically and used ROC curves to determine a threshold of the total number of seizure triggers associated with the occurrence of PIH. Results: Among 809 (531 females, 65.6%) consecutive patients with I/GE, 105 (13%) patients reported PIH (22 preictal, 82 postictal headaches, and one with both types). Peri-ictal headache was more frequently reported by females and those having a family history of migraine or epilepsy, and it was significantly associated with lower rates of seizure freedom for more than five years, drug resistance, and use of polytherapy, remarkably. Moreover, ROC curves showed that having more than 3 seizure triggers was associated with the presence of PIH. Conclusion: Our findings revealed that PIH may be linked to poor outcomes in I/GEs and seems to be related to a lower ictal threshold precipitated by multiple triggers. Future prospective studies will illuminate the unknown underlying mechanisms and appropriate management strategies for PIH to improve the prognosis.

Transient loss of consciousness (LOC) has an important place in emergency applications. Therefore, it is very important to define the etiology of LOC. In this study, we retrospectively analyzed our outpatient electroencephalography (EEG) records to evaluate whether the clinician ordering the test had a fulfilling result. EEG recordings between 01.07.2017 to 01.07.2018 in our outpatient clinic were reviewed. 1015 of EEGs were ordered by general neurologists (70.05%), 355 by epilepsy specialists (24.5%) and 79 by other departments (5.5%). The Department of Psychiatry was leading among other departments by one third. 281 out of 1449 EEGs were abnormal (19.4%). Only three patients had a seizure during EEG recording. Preliminary diagnosis for EEG record request were epilepsy in 829 patients (57.2%), syncope in 257 patients (17.8%), headache in 12 (0.8%), vertigo in 12 (0.8%), cognitive dysfunction in 71 (4.9%), sleep disorder in 16 (1.1%), intracranial mass lesion in 18 (1.0%), cerebrovascular diseases in 54 (3.7%), altered mental status in 26 (73.3%) and encephalitis in 15 patients (1.0%). Normal EEG recording results were 76.5% in the recordings with preliminary diagnosis of epilepsy. Abnormalities found in patients with preliminary diagnosis of epilepsy patients were sharp/spike in 45.1%, focal/generalied slowing in 41.5% and background slowing in 11.8%. Overall abnormality percentage was similar in EEGs requested by either general neurologists (76.0%) or epilepsy specialists (76.9%) but not by other departments (82.1%). As a result; EEG should not be interpreted as a screening test, patients’ details and clinical features during loss of consciousness episode have a priceless importance and preliminary diagnosis should be re- and reevaluated before EEG recording request.

One-and-a-half syndrome refers to a unilateral lesion involving the ipsilateral medial longitudinal fascicle and the 6th cranial nevre nucleus and/or the paramedian pontine reticular formation. Eight-and-a-half syndrome is a syndrome in which one-and-a-half syndrome and ipsilateral 7th cranial nevre palsy are seen together. These rare conditions result from limited lesions of the pontine tegmentum. We presented two cases with one-and-a-half and eight-and-a-half syndromes with ischemic infarction and hemorrhage in pons, respectively.

Hemifasial Spazm sıklıkla tek taraflı olarak, fasial kasların periyodik klonik ya da tonik kasılmalarıyla seyreden, kronik bir hastalık olarak tanımlanmaktadır. Tedavisinde karbamazepin, klonazepam, sinir bloğu, miyektomi, fasial sinir nöroktomi, nöroşirurjik mikrovaskuler dekompresyon ve botulinum toksin uygulaması sık tercih edilen yöntem ve ajanlar olarak sıralanabilir. Botulinum toksin uygulaması; etki süresinin daha uzun olması, uygulanması kolay ve yan etki profilinin daha iyi olması sebebiyle medikal tedaviye göre daha fazla tercih edilmektedir. Botulinum toksini kaslarda paralizi meydana getirir. Bu etkisini doz bağımlı olarak terminal membrandan asetilkolin salınımını inhibe ederek gösterir. Botulinum toksin uygulamasının nadir görülen bir yan etkisi de uygulanan kaslarda meydana gelen atrofidir. Atrofi gelişim mekanizmaları hakkında kesin bir veri olmamakla birlikte bu etkinin kronik uygulamalar ile gerçekleştiği bilinmektedir. Bunun yanında kas lifi tipi, schwann ve satellit hücre sayısı, mitokondriyel mekanizmalar, kastaki kan perfüzyonu gibi faktörler atrofi gelişim riski açısından değerlendirilmiştir. Sunmuş olduğumuz bu olguda kronik botulinum toksin uygulamaları sonrasında yüz kaslarında atrofi gelişen bir hasta ele alınmıştır.

Objectives: It is important to know the range of normal vertebral artery (VA) flow volume. Diminished VA flow volume is associated with vertebrobasilar insufficiency. The study aim was to investigate the relationship between the posterior communicating artery (PCoA) calibration and the VA flow parameters, in patients with no underlying cerebrovascular disease, below 50 years of age. Materials and Methods: The study population consisted of 102 cases below 50 years of age. The basilar artery (BA), internal carotid artery (ICA), and the PCoA calibrations were measured with magnetic resonance angiography. The VA flow parameters (maximum systolic velocity, end-diastolic velocity, mean velocity, VA flow volume, and VA calibration) were measured with duplex sonography. Results: There was no statistically significant difference between these two imaging groups, in terms of VA Vmax, VA flow volumes, VA calibrations, and BA calibrations. However, the mean right ICA and mean left ICA calibrations were significantly higher in group 2 than group 1 ( P < .01). There was no significant correlation between mean PCoA calibration and mean Vmax, mean calibration, and the total flow volume of vertebral arteries. Conclusion: The findings indicate that the VA flow rate may be relatively maintained, regardless of PCoA measurements in this study.

© 2022 International League Against Epilepsy.Objective: The link between headache and epilepsy is more prominent in patients with idiopathic/genetic epilepsy (I/GE). We aimed to investigate the prevalence of headache and to cluster patients with regard to their headache and epilepsy features. Methods: Patients aged 6–40 years, with a definite diagnosis of I/GE, were consecutively enrolled. The patients were interviewed using standardized epilepsy and headache questionnaires, and their headache characteristics were investigated by experts in headache. Demographic and clinical variables were analyzed, and patients were clustered according to their epilepsy and headache characteristics using an unsupervised K-means algorithm. Results: Among 809 patients, 508 (62.8%) reported having any type of headache; 87.4% had interictal headache, and 41.2% had migraine. Cluster analysis revealed two distinct groups for both adults and children/adolescents. In adults, subjects having a family history of headache, ≥5 headache attacks, duration of headache ≥ 24 months, headaches lasting ≥1 h, and visual analog scale scores > 5 were grouped in one cluster, and subjects with juvenile myoclonic epilepsy (JME), myoclonic seizures, and generalized tonic–clonic seizures (GTCS) were clustered in this group (Cluster 1). Self-limited epilepsy with centrotemporal spikes and epilepsy with GTCS alone were clustered in Cluster 2 with the opposite characteristics. For children/adolescents, the same features as in adult Cluster 1 were clustered in a separate group, except for the presence of JME syndrome and GTCS alone as a seizure type. Focal seizures were clustered in another group with the opposite characteristics. In the entire group, the model revealed an additional cluster, including patients with the syndrome of GTCS alone (50.51%), with ≥5 attacks, headache lasting >4 h, and throbbing headache; 65.66% of patients had a family history of headache in this third cluster (n = 99). Significance: Patients with I/GE can be clustered into distinct groups according to headache features along with seizures. Our findings may help in management and planning for future studies.

0000-0001-6416-1442 WOS: 000576685800001 PubMed ID: 33033995 Purpose Obstructive sleep apnea (OSA) is a disorder characterized by recurrent episodes of obstruction of the upper respiratory tract during sleep often accompanied by oxygen desaturations. Antioxidant defense mechanisms are important to prevent OSA-associated diseases and decrease mortality. We aimed to determine the levels of selenium and vitamins A, C, and E in patients with OSA but without any comorbidities and compare the results with a control group, theorizing that the findings may be helpful to understand the antioxidant mechanisms in the pathogenesis of OSA and associated diseases. Methods We designed a case-control study with 146 subjects. Subjects were categorized into four groups by apnea-hypopnea index (AHI) scores: control (n = 32; AHI < 5), mild OSA (n = 32; 5 = 30) groups. Serum levels of selenium were measured by atomic absorption spectrometer. Vitamin A, C, and E levels were measured by high-performance liquid chromatography and ultraviolet (HPLC-UV) detector. Results After adjusting for age, BMI, and gender, serum selenium and vitamin A levels were found to be higher in patients with OSA compared with controls (ANCOVA,p < 0.008, andp = 0.014 respectively), and levels of these markers increased with the severity of the disease. AHI was positively correlated with selenium (r = 0.289; p < 0.001), and vitamin A levels (r = 0.276; p < 0.001). Conclusion These results demonstrated that antioxidant response with increased vitamin A, and selenium concentrations, may be important defense mechanisms in patients with OSA patients who do not have other comorbidities. Antioxidant nutrients or supplements may be implemented as a complementary treatment of OSA to support antioxidant defense. Mugla Sitki Kocman University Scientific Research Projects OfficeMugla Sitki Kocman University [19/087/06/3/4] Mugla Sitki Kocman University Scientific Research Projects Office supported this work under grant number 19/087/06/3/4.

An episode of temporary memory loss which is recovered within 24 hours is called transient global amnesia. The etiology and triggering factors are unclear but hippocampal lesions may contribute to this condition. Diffusion-weighted magnetic resonance imaging is used to detect these lesions. In this case report, two cases with transient global amnesia who had hippocampal lesions are presented. Geçici global amnezi, 24 saat içinde iyileşen geçici hafıza kaybı ataklarıdır. Etyolojisi ve tetikleyici faktörleri aydınlanmış değildir ancak hipokampal lezyonlar geçici global amneziye katkıda bu- lunabilir. Bu lezyonları saptamak için difüzyon ağırlıklı manyetik rezonans görüntüleme kullanılır. Bu olgu sunumunda hipokam-pal lezyonu olan geçici global amnezili iki olgu sunuldu.

0000-0001-6416-1442 WOS: 000574527400004 Context: This was an investigation of inflammation markers on the prediction and prognosis of patients with sleep apnea. Aims: Clinical detection of inflammatory markers is useful to assess systemic inflammation in patients with obstructive sleep apnea syndrome (OSAS). The aim of the study was to evaluate whether the lymphocyte-to-C-reactive protein (CRP) ratio (LCR) was a predictive marker in diagnosing and determining the severity of OSAS. Settings and Design: This was a retrospective clinical study. Subjects and Methods: One hundred and forty-one patients who had undergone polysomnography were included in the study. The sex, age, Apnea-Hypopnea Index (AHI), body mass index, and complete blood count parameters of the patients were recorded. AHI scores were used to classify the severity of OSAS. Statistical Analysis Used: Differences among the groups for each parameter were analyzed using Student's t-test and one-way analysis of variance with Tukey correction for normally distributed parameters and the Mann-Whitney U test and Kruskal-Wallis test for nonnormally distributed parameters. The correlation between LCR, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, CRP, and AHI scores was assessed using Pearson's correlation coefficient. Results: First, the patients were divided into four groups according to their AHI results, as control group, mild, moderate, and severe OSAS groups. The median LCR levels were 2.57 (1.59, 3.51) in the control group, 1.28 (0.74, 3.27) in Group 2, 1.63 (0.86, 2.6) in Group 3, and 1.05 (0.62, 2.31) in Group 4. In the comparison of all patients with OSAS and the control group, the median LCR level was 1.27 (0.7, 2.74) in patients with OSAS and 2.57 (1.59, 3.51) in the control group (P = 0.002). Conclusions: This study demonstrated that LCR is an important marker for systemic inflammation in patients with OSAS. LCR may be a new predictive marker in the diagnosis and prognosis of patients with OSAS.

18th National Sleep Medicine Congress - OCT 26-29, 2017 - Bodrum, TURKEY Saruhan, Ercan/0000-0001-6416-1442 WOS: 000495454200003 Objective: Although the presence of a systemic inflammatory response is known in obstructive sleep apnea syndrome (OSAS), there have not been adequate investigations on the association of such a response with the predominance of apneas either in rapid eye movement (REM) or in the non-REM (NREM) phase. In this study, we compared interleukin-23 (IL-23) concentrations, a marker of systemic inflammatory process, in individuals with sleep apnea syndrome, whose apneas where predominant in the REM or NREM phase. Methods: Fifty-four patients aged over 18 years who were diagnosed as having OSAS based on polysomnography were included in the study. The apnea-hypopnea index (AHI) was used to divide patients into groups of AHI(REM)>AHI(NREM) and AHI(NREM)>AHI(REM). In the blood samples drawn from the patients, IL-23 concentrations were measured using enzyme-linked immunosorbent assay. Results:The study included patients with OSAS aged 28-65 years, of whom 29 were AHI(REM)>AHI(NREM) and 25 were AHI(NREM)> N-REM. The AHI(REM) >AHI(NREM) OSAS group had no sex-based variance (14 males, 15 females), but the AHI(NREM) >AHI(REM) group was substantially composed of males (21 males, 4 females). The average AHI( )of the AHI(NREM) >AHI(REM) group (43.34 +/- 21.40) was significantly higher than in the AHI(REM) >AHI(NREM) Nifm group (26.79 +/- 17.32). IL-23 concentrations were higher in patients with AHI(REM) >AHI(NREM) sleep apnea (225.38 +/- 77.29) compared patients with AHI(NREM) >AHI(REM), sleep apnea (183.68 +/- 78.49). Conclusion: In AHI(REM) >AHI(NREM )sleep apnea, the systemic inflammatory response may be more dramatic. Taking the AHI(REM) value into consideration along with the average AHI value seems to be important for treatment modalities.

WOS: 000496445800010 PubMed ID: 31280388 AimIn Parkinson's disease (PD), oxidative stress plays a substantial role in degeneration of dopaminergic neurons at the substantia nigra. Recent reports describe nesfatin-1 and glucagon-like peptide-1 (GLP-1) as molecules with neuroprotective property that relieve oxidative stress. In this study, we aimed to determine the blood levels of nesfatin-1, GLP-1 and oxidative stress status in patients with PD.Material and methodForty patients with PD, followed-up at the Department of Neurology of Mugla Sitki Kocman University Training and Research Hospital, were enrolled, as well as 40 age- and sex-matched participants as a control group. We determined and compared nesfatin-1, GLP-1, total antioxidant status (TAS), and total oxidant status (TOS) levels in patients with PD and control group.ResultsThe mean GLP-1 and nesfatin-1 values of patients with PD were lower than those of the control group, whereas their mean TOS value was higher. The mean TAS values, on the other hand, did not reveal any significant difference between the patient and the control groups.ConclusionThe lower nesfatin-1 and GLP-1 levels, in addition to higher TOS levels, in patients with PD compared to those of control group suggest that the neuroprotective effects of these molecules might be related to the oxidative processes. Further studies are required to search for the impact of abovenamed molecules on the treatment option and the likelihood that they may slow down disease progression. Mugla Sitki Kocman University Research Projects Coordination OfficeMugla Sitki Kocman University [15/237] Mugla Sitki Kocman University Research Projects Coordination Office through Project Grant. Number has granted this paper: (15/237)

Urticaria is a disease which progresses with itchy papules and plaques called urtica, obstructive sleep apnea syndrome (OSAS) is defined as daytime sleepiness and obstructive apnea and hypopnea attacks during sleep. In this study, we aimed to investigate the relationship between urticaria and OSAS. Thirty-one patients with chronic idiopathic urticaria were included in the study. Body mass indexes (BMIs) were calculated and polysomnography findings were recorded. Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were used to evaluate daytime sleepiness. The prevalence and severity of urticaria were calculated using the urticaria activity score (UAS). Chronic Urticaria Quality of Life Questionnaire was applied to patients. OSAS was detected in 13 (41.9%) of 31 patients. Then, 11 of the 13 patients had mild, 1 had moderate, and 1 had severe OSAS in the patient group. OSAS was not detected in the control group. A positive correlation was found between apnea-hypopnea index and BMI, the UAS scores in the patient group (respectively, r = .537, P = .002, r = .407, P = .023). In this study, we found that the frequency of OSAS in patients with urticaria was more than that in the normal population. Doctors treating urticaria should consider a comorbidity disease such as OSAS and regulate the treatment according to these two diseases.

Nonconvulsive status epilepticus (NCSE) is a heterogeneous, severe neurological disorder of different etiologies. In this study, the outcomes of NCSE episodes was assessed in a large series of adult patients. Our objective was to evaluate relationship between Status Epilepticus Severity Score (STESS) and etiology and the role of etiological factors on predicting the outcomes.In this retrospective study, the medical records of 95 patients over 18 years of age who were diagnosed with NCSE between June 2011 and December 2015 were reviewed. Their treatment and follow-up for NCSE was performed at the Epilepsy Unit in Department of Neurology, Antalya Research and Training Hospital. Etiological factors thought to be responsible for NCSE episodes as well as the prognostic data were retrieved. The etiological factors were classified into three groups as those with a known history of epilepsy (Group 1), primary neurological disorder (Group 2), or systemic/unknown etiology (Group 3). STESS was retrospectively applied to patients.There were 95 participants, 59 of whom were female. Group 1, Group 2, and Group 3 consisted of 11 (7 female), 54 (33 female), and 30 (19 female) patients, respectively. Of the 18 total deaths, 12 occurred in Group 2, and 6 in Group 3. The negative predictive value for a STESS score of ≤ 2 was 93.88% (+LR 2.05 95% CI: 1.44-2.9 and -LR 0.3 95% CI 0.10-0.84 ) in the overall study group. While the corresponding values for Group 1 (patients with epilepsy), Group 2 (patients with primary neurological disorder), and group 3 (patients with systemic or unknown etiology) were 100%, 92.59% (+LR 2.06 95%CI: 1.32-3.21 and -LR 0.28 95% CI 0.08-1.02 ) 83.33% (+LR 1.14 95%CI: 0.59-2.9 and -LR 0.80 95% CI 0.23-2.73).This study included the one of the largest patients series ever reported in whom STESS, a clinical scoring system proposed for use in patients with status epilepticus, has been implemented. Although STESS appeared to be quite useful for predicting a favorable outcome in NCSE patients with epilepsy and primary neurological disorders, its predictive value in patients with systemic or unknown etiology was lower. Further prospective studies including larger NCSE samples are warranted.A nonconvulsiv status epilepticus (NCSE) heterogén, különböző etiológiai faktorok következtében kialakuló, súlyos neurológiai betegség. A vizsgálat során NCSE-epizódok kimenetét elemeztük nagyszámú felnőtt beteg körében. A cél a Status Epilepticus Súlyossági Pontszám (STESS) és az etiológia közötti kapcsolat, valamint az etiológiai faktorok prediktív szerepének megállapítása volt.A retrospektív vizsgálat során áttekintettük annak a 95, 18 évesnél idősebb betegnek az orvosi dokumentációját, akiket 2011 júniusa és 2015 decembere között NCSE-vel diagnosztizáltak, majd az Antalya Kutatókórház Neurológiai Osztályának epilepsziarészlegén kezeltek. Összegyűjtöttük az NCSE-epizódok hátterében feltételezhető etiológiai faktorokat és a prognosztikus adatokat. Az etiológiai faktorokat három csoportba osztottuk: ismert epilepsziás kórtörténet (1. csoport), primer neurológiai betegség (2. csoport), szisztémás, illetve ismeretlen etiológia (3. csoport). A STESS megállapítása retrospektív módon történt.A 95 résztvevőből 59 volt nő. Az 1-es, 2-es és 3-as csoportokba 11 (7 nő), 54 (33 nő) és 30 (19 nő) beteg került. Összesen 18-an haltak meg, 12-en a 2-es, 6-an a 3-as csoportban. A ≤ 2 STESS-pontszám negatív prediktív értéke 93,88%-nak bizonyult a teljes betegpopulációban (+LR 2,05 95% CI: 1,44-2,9 és -LR 0,3 95% CI: 0,10-0,84), 100%-nak az 1-es, 92,59%-nak a 2-es és 83,33%-nak a 3-as betegcsoportban (+LR 2,06 95% CI: 1,32-3,21 és -LR 0,28 95% CI: 0,08-1,02; valamint +LR 1,14 95% CI: 0,59-2,9 és -LR 0,80 95% CI: 0,23-2,73).Az eddigi egyik legnagyobb NCSE-betegpopuláció esetében állapítottuk meg a STESS-pontszámokat. A STESS mint prediktív eszköz hasznosnak bizonyult a kedvező kimenet előrejelzésében az epilepsziás és a primer neurológiai betegcsoportban, míg kevésbé hasznosítható eredményt adott a szisztémás, illetve ismeretlen etiológiájú csoportban. További, nagyobb betegcsoporton végzett prospektív vizsgálatokra van szükség.

Purpose We aimed to study the relationship between the mentalizing ability and stigma in patients with epilepsy. Methods Patients with epilepsy were administered the following battery of tests: Mini-International Neuropsychiatric Interview (MINI) form, Reading the Mind in the Eyes Test (Eyes Test), Stigma Scale of Epilepsy (SSE), Internalized Stigma of Mental Illness (ISMI) Scale, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Results Assessment of an association between the Eyes Test score, ISMI Scale total score, and subscale scores revealed a negative significant correlation of Eyes Test scores with approval of stereotypes, perceived discrimination, stigma resistance, and total score. Eyes Test score and BDI scores appears to be significant predictor of internalized stigma among the clinical variables that were studied. A positive significant correlation was detected between BDI score and alienation, perceived discrimination, and total score. Conclusion The presence of a correlation between the mentalization and stigma perception in our study demonstrates that these two concepts are connected and that this connection needs further study. In particular, mentalization-based therapy can have an effect on the reduction of the stigma perceptions and in this way can improve the course of the disease, potentially improving the patients' quality of life.

WOS: 000468613100013 PubMed ID: 30238284 Purpose Obesity is among the known risk factors for obstructive sleep apnea syndrome (OSAS). In this study, our aim was to investigate the correlation of waist-to-height ratio, an indicator of central obesity, with presence and severity of OSAS; to compare the use of this ratio with the use of waist circumference and body mass index (BMI); and to determine OSAS-related cutoff values. Methods The patient records were retrospectively analyzed for whom a polysomnography was conducted at our sleep. Sex, age, Apnea-Hypopnea Index (AHI), waist circumference, height, and BMI values of those patients were recorded. AHI scores were used to classify severity of OSAS. Results The study included 437 OSAS patients and 72 control cases. Out of the patient group, OSAS was severe in 208 (47%) patients, moderate in 124 (28%), and mild in 105 (24%) of them. In the group of OSAS patients, waist-to-height ratio, waist circumference, and BMI were higher compared to the control group with a further difference of all three parameters among severe, moderate, mild OSAS, and controls both in males and females. Cutoff values for OSAS of females were 95.5cm for waist circumference, 0.595 for waist-to-height ratio, and 27.75 for BMI whereas the cutoff values of males were 100.5cm, 0.575, and 27.75, respectively. Conclusions A high value of waist circumference, waist-to-height ratio, and BMI is associated with the presence and severity of OSAS. We have determined the cutoff values of the studied anthropometric measurements in both sexes for OSAS and severe OSAS.

BACKGROUND Olfactory function deteriorates in patients with severe obstructive sleep apnea syndrome (OSAS). The effect of positive airway pressure (PAP) therapy on olfactory function has not been investigated before. In this study, we aimed to investigate the role of PAP therapy on olfactory impairment in patients with OSAS. METHODS Thirty patients who had OSAS and planned for PAP therapy were included in the study. All participants underwent a detailed otorhinolaryngological examination and polysomnography. The "Sniffin' Sticks" test was used for the analysis of olfactory function. The participants underwent the smell test before the PAP therapy, and about 3 months after the therapy. Pretreatment and posttreatment results were compared. RESULTS The pretreatment and the posttreatment apnea-hypopnea index (AHI) were 57.6 ± 29.8/hour and 9.5 ± 7.9/hour, respectively. Odor threshold (OT), odor discrimination (OD), odor identification (OI), and threshold-discrimination-identification (TDI) scores significantly increased after PAP therapy (p = 0.001, p = 0.002, p = 0.001, and p = 0.001, respectively). The pretreatment and posttreatment total TDI scores were 28.48 ± 4.71 and 32.50 ± 3.88, respectively (p = 0.001). CONCLUSION This study demonstrates olfactory dysfunction in patients with OSAS. We achieved a significant improvement in olfactory function of patients with OSAS after PAP therapy. Further studies are needed to illuminate the pathogenesis of olfactory dysfunction in OSAS, and the role of PAP therapy on olfactory improvement.

Objective: Hallucination is one of the non-motor symptoms inParkinson disease (PD). Several factors may affect the presence ofhallucination. In the present study, we aimed to compare PD patients presentingwith and without hallucinations, to determine risk factors, and to find outcommon hallucination types.Material and Methods: Idiopathic Parkinson patients regarding to UKParkinson Disease Society Brain Bank with and without hallucinations werecompared. The patients with psychotic symptoms due to metabolic, infectious, and structural causes wereexcluded. Disease severity was evaluated by Unified Parkinson Disease Rating Scale and Hoehn and Yahr staging.Cognitive status was assessed by Minimental State Examination test. Depressionwas diagnosed on the basis of DSM-V Tr. Description of hallucination,treatment, co-morbidity, sleep disturbances, REM sleep behavioral disorder,age, gender, scores of test and scale, stage of disease were recorded.Results: A total of 91 (59 female, 32 male) patients with idiopathic PD were enrolled. The group with hallucinations(Group 1) had 40 (43.9%) patients and the one without hallucinations (Group 2)had 51 (54.9%) patients. Total score of UnifiedParkinson Disease Rating Scale was significantly higher in Group 1 thanGroup 2 (37.83±16.65; 30.18±14.83; p=0.028). Sleepdisturbances were high in Group 1 (n=24, 60%) when compared to Group 2 (n=14,27.4%) (p=0.007). The mean duration ofhallucinations was 24.87±56.47 months in Group 1. Twenty-one patients (23.9%)had visual hallucinations; 15 (16.5%) patients had illusions (minorhallucinations); and four (4.4%) patients had auditory hallucinations.Conclusion: Disease severity in Parkinson's disease may be afactor in the presence of hallucinations. Hallucinations may also occur withsleep disorders. Minor hallucinations are frequently observed in early stages,with visual hallucinations being the most common hallucinations that may occurin every disease stage., Amaç: Halusinasyon Parkinsonhastalığındaki non-motor semptomlardan biridir. Halusinasyon varlığında birçok riskfaktörü rol oynayabilir. Bu çalışmada halusinasyonu olan ve olmayan Parkinsonhastalarının karşılaştırılması, risk faktörlerinin belirlenmesi, sık görülenhalusinasyon tiplerinin bulunması amaçlandı.Gereç ve Yöntemler: İngiltere Beyin Bankasıkriterlerine gore idiopatik Parkinson hastalığı tanısı olan hastalardahalusinasyonu olan ve olmayanlar karşılaştırıldı. Metabolik, enfeksiyöz veyapısal nedenlere bağlı psikotik semptomu olan hastalar çalışmaya dahiledilmedi. Hastalık şiddeti Birleşik Parkinson Hastalığı Değerlendirme Ölçeği veHoehn ve Yahr evrelemesine göre belirlendi. Kognitif durum Minimental DurumDeğerlendirme testi ile değerlendirildi. Depressif duygu durum tanısı DSM-5 ilekonuldu. Mevcut ise halusinasyon tanımlaması, tedavi, komorbidite, uykubozuklukları, REM uyku davranış bozukluğu, yaş, cinsiyet, ölçek ve testskorları ile hastalık evresi kayıt edildi.Bulgular: Çalışmaya toplam 91 (59 kadın,32 erkek) idiopatik Parkinson hastası alındı. Halusinasyonu olan grup (Grup 1)da 40 (%43.9), halusinasyonu olmayan grupta (Grup 2) 52 (%54.9) hasta vardı.Birleşik Parkinson Hastalığı Değerlendirme Ölçeği toplam skoru Grup 1 de Grup 2ye göre anlamlı oranda yüksekti (37.83±16.65; 30.18±14.83; p=0.028). Uykubozuklukları Grup 2 (n=14, %27.4) ile karşılaştırıldığında Grup 1’de (n=24, %60) anlamlı oranda yüksekti (p=0.007). Halusinasyon süresiGrup 1’de ortalama 24.87±56.47 aydı. 21 (%23.9) hasta görsel halusinasyon, 15 (%16.5)hasta illuzyon (minör halusinasyon) ve dört (%4.4) hasta işitsel halusinasyonasahipti.Sonuç: Parkinson hastalığında hastalık şiddetihalusinasyon varlığında etken olabilir. Halusinasyonlar uyku bozuklukları ilebirlikte görülebilir. Minör halusinasyonlar sıklıkla erken evrede izlenirken,en sık görülen görsel halusinasyon her evrede izlenebilir.

Multiple sclerosis is a chronic disease that usually occurs with exacerbations and remissions in young adults, affects the central nervous system white matter in multiple localization, and is thought to be the result of complex interactions of genetic and environmental factors, the most common form is relapsing-remitting MS. Forkhead transcription factors O class (FOXO) are responsible for the regulation of various cellular processes including cell cycle, apoptosis, DNA repair, cellular resistance and metabolism. DNA methylation is such an epigenetic change and has been shown to be associated with almost any biological process. The aim of our study to show the relation between the genetic variants of FOXO3a (rs2253310 rs4966936) and FOXO1 (rs3900833, rs4581585) and global DNA methylation in RRMS. We analyzed DNA obtained from 79 RRMS patients and 104 healthy individuals by PCR-RFLP method for the detection of genetic variants. For the determination of global DNA methylation, results were obtained using ELISA method. The data were evaluated statistically. As a result of our analysis; global DNA methylation is higher in RRMS patients compared to control individuals and it can be effective on the disease. In addition, it has been determined that variants of FOXO3a (rs2253310, rs4966936) and FOXO1 (rs3900833), which have been genotyped, may be effective in disease pathogenesis. These results suggest that DNAmethylation and FOXO gene variants may be effective in neuronal loss in RRMS.

Methylation is a key epigenetic modification of DNA and regarding its impact on epilepsy, it is argued that "DNA methylation may play an important role in seizure susceptibility and maintenance of the disorder". DNA methylation status of KCC2 (SCL12A5) and NKCC1 (SCL12A2) associated with refractory temporal lobe epilepsy was investigated in our study.Thirty-eight patients with temporal lobe epilepsy (TLE) who were diagnosed by video EEG monitoring and 32 healthy control subjects were included in the study. Twenty-three patients in TLE group were men and the remaining 15 were women. Among them, 27 had unilateral temporal focus (9 with right; 18 with left) and 11 patients had bilateral TLE. We analyzed promoter region methylation status of the KCC2 (SCL12A5) and NKCC1 (SCL12A2) genes in the case and control groups. Gene regions of interest were amplified through PCR and sequencing was accomplished with pyro-sequencing.We found a significant relationship between TLE and methylation on the NKCC1. However, there was no association between TLE and methylation on the KCC2 gene. Also, we found no association between right or left and unilateral or bilateral foci of TLE. There was no relationship between TLE and methylation on the NKCC1and KCC2 genes in terms of mesial temporal sclerosis in cranial MRI, head trauma or febrile convulsions.The methylation of NKCC1 can be a mecha-nism of refractory temporal lobe epilepsy. There are limited findings about DNA methylation in TLE. Therefore, further studies with large sample sizes are necessary.A metiláció kulcsfontosságú a DNS epigenetikai módosítása során. Az epilepsziában fontos a metiláció szerepe, olyannyira, hogy az is felmerül: a DNS-metiláció közreműködik a rohamokra való fogékonyság kialakulásában, továbbá a betegség fenntartásában is. Vizsgálatunkban elemeztük a refrakter temporalis epilepsziával asszociált KCC2 (SCL12A5) és NKCC1 (SCL12A2) gének metilációs státuszát.38, video-EEG-monitorral diagnosztizált temporalis epilepsziában szenvedő beteget és 32 egészséges kontrollszemélyt vontunk be a vizsgálatba. A 38 betegből 23 volt férfi, 15 nő; 27-en unilaterális temporalis epilepsziában (9 jobb oldali, 18 bal oldali), 11-en kétoldali temporalis epilepsziában szenvedtek. A vizsgálati és a kontrollcsoportban egyaránt elemeztük a KCC2 (SCL12A5) és NKCC1 (SCL12A2) gének promoter régióinak metilációs státuszát. A kérdéses régiókat PCR-rel amplifikáltuk és piroszekvenálással elemeztük.Szignifikáns kapcsolat mutatkozott a temporalis epilepszia és az NKCC1 metilációja között. Mind­azonáltal, nem volt kapcsolat a temporalis epilepszia és a KCC2 gén metilációja között, továbbá nem találtunk össze­függést az epilepto­gén fókusz elhelyezkedése (jobb vagy bal oldali unilaterális, il­let­ve kétoldali temporalis epilepszia), valamint a metilációs státusz között sem. Nem mutatkozott kapcsolat a temporalis epi­lep­szia, a KCC2, NKCC1 gének metilációs státusza, valamint a koponya-MRI-n ábrázolódó mesialis halántéki sclerosis, a fejet ért trauma vagy a lázgörcs között sem.A refrakter temporalis epilepszia hátterében az NKCC1 metilációja állhat. További nagy esetszámú vizsgálatokra van szükség, mivel korlátozott adattal rendelkezünk a DNS metilációjával kapcsolatosan refrakter temporalis epilepszia esetében.

World Congress of Neurology (WCN) - OCT 27-31, 2019 - Emirates Neurol Soc, Dubai, U ARAB EMIRATES WOS: 000516770702255 World Federat Neurol

WOS: 000465507100013 PubMed ID: 30759289 The etiology of juvenile myoclonic epilepsy (JME) is still unknown and the process of elaboration of multiple genetic mechanisms is ongoing. The aim of this study was to investigate the potential role of NKCC1 (SCL12A2) and KCC2 (SCL12A5) in JME by comparing their DNA methylation status in patients with JME versus healthy controls. Forty-nine patients with JME and 39 healthy individuals were compared for DNA methylation at the 5CpG islands. A total of 71 (81%) samples were found to have methylation in the NKCC1 gene, 36 (73%) from patients and 35 (90%) from healthy individuals. Out of the KCC2 samples, 50 (57%) were found to have methylation, 33 (67%) from patients and 17 (44%) from healthy individuals. In patients with JME, methylation of NKCC1 (73%) was lower than its methylation in the controls (90%) (p=0.047). On the other hand, methylation of KCC2 in patients with JME (67%) was greater than the methylation in the controls (44%) (p=0.022). Twenty-eight patients were treated with VPA and ongoing medications were not found to be associated with methylation (p>0.05). In the present study, we determined significantly lower NKCC1 DNA methylation and significantly higher KCC2 DNA methylation levels in patients with JME compared with the healthy controls. This implies that NKCC1 expression can be higher and KCC2 expression can be reduced in affected people. Further studies that investigate the potential effect of DNA methylation mechanisms regulating gene expression on seizure activity and how they change JME network activity will be helpful.

World Congress of Neurology (WCN) - OCT 27-31, 2019 - Emirates Neurol Soc, Dubai, U ARAB EMIRATES WOS: 000516770701373 [No abstract available] World Federat Neurol