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Objectives: We aimed to investigate the effects of the coronavirus disease 2019 (COVID-19) outbreak on the quality of life (QOL) of patients with epilepsy. Methods: A total of 104 epilepsy patients admitted to our hospital during October and November of 2019 were evaluated for their QOL using the QOL in Epilepsy-31 questionnaire. These assessments were repeated in July 2020 and August 2020 to evaluate the impact of the epidemic on the QOL of epilepsy patients in the same group. The data of the patients were analyzed in SPSS. Results: During the pandemic period, overall score values decreased significantly compared to the pre-pandemic period (p=0.049). Although most of the subscores worsened with the pandemic, the most significant deterioration was observed in emotional well-being (p=0.021). There were six patients (5.8%) whose seizure frequency increased during the pandemic period. In the multivariate analysis, the only parameter that predicted an increase in seizure frequency during COVID-19 was the overall score. Overall score had a positive correlation with educational level. Disease duration, age, marital status, and number of drugs used were found to be negatively correlated with the overall score of the patients. Conclusion: The COVID-19 epidemic causes a significant deterioration in QOL in patients with epilepsy. During epidemics such as COVID-19, clinicians should consider psychosocial factors. In patients with epilepsy, measures should be taken not only to control seizures but also to prevent deterioration in mental health and QOL.

Objective: To evaluate the effect of continuous positive airway pressure (CPAP) treatment on metabolic syndrome and insuline resistance in patients with obstructive sleep apnea syndrome (OSAS). Materials and Methods: This study evaluated retrospectively with 30 patients who received OSAS diagnosis following polysomnography between the years January 2016 - January 2017, whose Respiratory Disturbance Index were above 15, and who were between the ages of 18-78, having no diabetes, chronic liver and kidney disease, malignancy and mental retardation. The anthropometric measures and blood values of these patients before the CPAP treatment and 3 months afterwards were evaluated in their controls. The effect of CPAP treatment on metabolic syndrome and insulin resistance assessed by homeostatic model assessment index was investigated. Results: It has been observed that the body mass index (BMI) decreases significantly following the CPAP treatment. No significant changes were found in the anthropometric measurements including the neck circumference, waist circumference, hip circumference, and waist/hip ratios as well as insulin resistance and metabolic syndrome parameters (before of treatment BMI: 31.33±5.58, post treatment BMI: 30.83±7.13, p=0.03). The ESS evaluating the subjective daytime sleepiness following the CPAP treatment has decreased significantly. Conclusion: Although this study didn’t improve insulin resistance with assessed homeostatic model assessment, and metabolic syndrome, a significant improvement in BMI and ESS was demonstrated in post treatment. Long-term studies with more cases and with high compliance are needed to demonstrate the effects of CPAP treatment on metabolic syndrome in OSAS patients.

Idiopathic generalized epilepsy (IGE) is a type of epilepsy with a monogenic or polygenic inheritance pattern representing 47% of all epilepsies. Idiopathic epilepsies have a complex genetic structure and the genetic factors involved in the development of epilepsy are still unclear. Dog models are often used in researching the complex genetic basis of epilepsy. A study of Rhodesian Ridgeback (RR) dogs with generalized myoclonic epilepsy found a 4-bp-deletion in the second exon of the DIRAS1 gene. In the literature, there is no study on the presence of a relationship between DIRAS1 gene and epilepsy in human population. We aimed to analyze whether there is a relationship between human epilepsy and DIRAS1 gene. For genomic analysis, peripheral blood samples were taken from 109 patients diagnosed with IGE and 51 healthy volunteers in the Turkish population. Genomic DNA isolation was performed from blood samples and the DIRAS1 gene region of the genomic DNA was amplified by Polymerase Chain Reaction (PCR). PCR products were purified and sequenced. DNA sequencing results were analyzed by chi-squared test. In the patient and control groups, G/C change was found in nucleotide 549 of DIRAS1 gene. No significant correlation was found between the distribution of DIRAS1-549-G/C genotypes and allele frequencies (p = 0.8 and p = 0.7, respectively). In this study, DIRAS1-549-G/C polymorphism has been shown not to play an important role in the development of epilepsy in the Turkish population. As a result, new data on IGEs whose molecular mechanism is still not fully elucidated has been revealed.

Spinal dural arteriovenous fistula, which is caused by the low flow shunts between dural arteries and the perimedullary venous system shows progressive myelopathy signs. It is usually found in the thoracic region. It is vital to accurately make differential diagnosis since the disease may cause irreversible injury. In this case report we aimed to discuss four cases of spinal arteriovenous fistula that showed different outcomes.

Psoriasis (Ps) is a chronic skin disease that can lead to negative impacts on quality of life (QoL) because of diseaserelated comorbidities. We aimed to investigate the risk of obstructive sleep apnea syndrome (OSAS) in patients with Ps.Fifty-seven patients with Ps were included in this study. The patients were evaluated for their demographics, Psoriasis Area Severity Index (PASI), duration of disease, Psoriasis Quality of Life Index (PQLI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and also Berlin questionnaire (BQ), in terms of the risk groups of OSAS. High and low risk groups were compared with above-mentioned parameters.Of the patients studied, 35 (61.40%) were at high-risk according to BQ. In the high-risk group, body mass index (BMI) was significantly high (P = 0.009), and they were all obese. The mean values of PASI, disease duration, PQLI and PSQI were significantly higher in the high-risk group compared to the low-risk group (each P0.05). PASI (P = 0.013), BMI (P = 0.014), PLQI (P = 0.012) and hypertension (HT) (P = 0.030) had significance in prediction of OSAS development, whereas only PASI and BMI showed significant impacts. It was seen that increase in BMI values was slightly more effective than increase in PASI values (1.25- fold against 1.07-fold) in development of OSAS.We suggest patients with severe and long-term Ps should be evaluated in terms of OSAS, and OSAS may be accepted as a comorbidity for Ps in the future.

Summary Objectives: In this study, we aimed to show any effect of different types of cognitive activities on the electroencephalography (EEG) of patients with juvenile myoclonic epilepsy (JME). Methods: 30 patients with JME who stated that their seizures are not effected by any mental activity were submitted to a 30-minute standard awake video EEG. A neuropsychological activation battery (NPA) was performed during the ongoing video EEG. Results: The provocative effect of at least one test of NPA was observed in seven of 30 patients (23.3%) and the inhibitory effect of NPA was observed in nine of 30 patients (30.0%). Conclusion: We demonstrated that increased attention, concentration, and the tests associated generally with the frontal lobe functions were crucial for provocating the EEG discharges. This may support the studies with neuropsychological tests and structural neuroimaging techniques showing focal cortical abnormalities mainly associated with frontal lobe in JME.