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In addition to ocular neurodegeneration in multiple sclerosis (MS), accompanying microvascular changes in the retina are thought to occur. In this study we sought to compare retinal neurodegenerative changes using optical coherence tomography (OCT) and microvascular changes using OCT angiography (OCTA) of MS patients and healthy controls. This cross-sectional study included 164 eyes of 83 MS patients and 114 eyes of 57 healthy control subjects. There were significant differences in retinal nerve fibre layer (RNFL), ganglion cell complex (GCC), and radial peripapillary capillary (RPC) vessel density (VD) between the MS group and the control group, but no significant differences in superficial capillary plexus (SCP) VD and deep capillary plexus (DCP) VD, foveal avascular zone (FAZ), non-flow area (NFA), and choriocapillary flow (CCF) values. Comparing the eyes with and without previous optic neuritis showed no significant differences in the OCT and OCTA measurements. A negative correlation was found between the expanded disability status scale score and disease duration and the RNFL and GCC values. A positive correlation was found between the RNFL and GCC values and the SCP VD and RPC VD. In MS patients, RPC VD values decreased in correlation with decreases in RNFL and GCC. This reduction increased as the disease duration and disability criteria increased. OCT and OCTA may be important biomarkers in MS.

Background: Guillain-Barre syndrome is an acute immune-mediated polyneuropathy characterized by rapidly evolving symptoms and disability. Cerebrospinal fluid analysis and electrophysiological studies are crucial in the diagnosis of this syndrome. Objective: To evaluate the prognostic value of the type and number of demyelinating findings and cerebrospinal fluid protein levels in patients with acute inflammatory demyelinating polyneuropathy. Methods: We retrospectively analyzed electrophysiological data and cerebrospinal fluid of 67 consecutive patients with acute inflammatory demyelinating polyneuropathy from Istanbul, Turkey (2011-2019) studied ≤ 24 hours post-onset. Results: The patients who met a higher number of demyelinating criteria had increased disability scores in the first day and first month, and higher cerebrospinal fluid protein levels were correlated with worse prognosis both on the first day and the first month. However, the disability scores did not correlate with any single specific criterion, and no significant correlation was found between the number of satisfied criteria and cerebrospinal fluid protein levels. Conclusions: The number of demyelinating criteria that are met and high cerebrospinal fluid protein levels at the disease onset may be valuable prognostic markers. More systematic studies conducted with serial nerve conduction studies are required to highlight the roles of the suggested criteria in clinical practice. RESUMO Introdução: A síndrome de Guillain-Barré é uma polineuropatia imunomediada aguda caracterizada por sintomas e incapacidade em rápida evolução. A análise do líquido cefalorraquidiano e os estudos eletrofisiológicos são cruciais no diagnóstico dessa síndrome. Objetivo: Avaliar o valor prognóstico do tipo e número de achados desmielinizantes e dos níveis de proteínas do líquido cefalorraquidiano em pacientes com polineuropatia desmielinizante inflamatória aguda. Métodos: Analisamos retrospectivamente dados eletrofisiológicos e líquido cefalorraquidiano de 67 pacientes consecutivos com polineuropatia desmielinizante inflamatória aguda de Istambul, Turquia (2011-2019), estudados ≤24 horas após o início. Resultados: Os pacientes que atenderam a um número maior de critérios desmielinizantes apresentaram escores de incapacidade aumentados no primeiro dia e no primeiro mês, e níveis mais altos de proteína do líquido cefalorraquidiano foram correlacionados com pior prognóstico no primeiro dia e no primeiro mês. No entanto, os escores de incapacidade não se correlacionaram com nenhum critério específico e não foi encontrada correlação significativa entre o número de critérios satisfeitos e os níveis de proteína do líquido cefalorraquidiano. Conclusões: O número de critérios desmielinizantes atendidos e altos níveis de proteína no líquido cefalorraquidiano no início da doença podem ser marcadores prognósticos valiosos. Estudos mais sistemáticos conduzidos com estudos de condução nervosa em série são necessários para destacar os papéis dos critérios sugeridos na prática clínica.

Amaç: Bu çalışmada Bursa ilinde Alzheimer hastalarına bakım veren bireylerin hastalıkla ilgili farkındalık düzeyinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Orta veya ağır evre Alzheimer hastasına en az 6 aydır bire bir bakım veren 50 kişi çalışmaya dahil edildi. Hastaların ve bakım verenlerin demografik özellikleri kayıt altına alındı. Bakım verenlere hastalıkla ilgili basit temel bilgilerin sorgulandığı 10 soruluk bir anket uygulandı. Bulgular: Katılımcıların %56’sı hastalıkla karşılaşmadan önce hastalıkla ilgili bilgiye sahip değildi. %50’si yakını Alzheimer tanısı aldıktan sonra hastalıkla ilgili bilgi almak için herhangi bir yönteme başvurmamıştı. Katılımcıların %84’ü hastalığın kalıcı olduğunu, %80’i tedavisinin ilaçlarla yapıldığını bilmekteydi. %86’sı ilaçların şikayetleri sadece kısmen geriletmek için verildiğinin farkındaydı. %54’ü ağızdan alınan tabletler dışında başka tedavi seçeneklerinden haberdar değildi. %44’ü tedaviyle hastalığın düzelmediğini, %50’si ilaçları dönem dönem değiştirmek gerektiğini bilmekteydi. Hastalıkla ilgili sizi en çok sıkıntıya sokan şey nedir sorusuna sırasıyla gece uykusuzluğu, ajitasyonlar, inatçılık, hırçınlık, idrar ve gaita inkontinansı cevapları verildi. Sonuç: Hasta yakınlarının hastalıkla ilgili yeterli bilgiye sahip olması hastalığın erken tanınması, hastalığa bağlı gelişen problemlerin anlaşılabilmesi ve tedavi sürecinin düzgün yönetilmesine olanak sağlayacaktır., Objective: The aim of the study is to investigate the level of knowledge of Alzheimer Disease (AD) among caregivers in Bursa. Material and Methods: 50 caregivers who were taking care of medium or sever Alzheimer patient at least for six months one to one were included to the study. The demographic characteristics of patients and caregivers were reported. A survey consisted of 10 questions which question basic main data about the illness was applied to caregivers. Results: %56 of participants did not have knowledge about the illness before they met the disease. %50 of caregivers did not try any methods after the patients diagnosed with Alzheimer. %84 of the participants knew that the disease was persistent and %80 of them knew that the treatment was made by medicines. %86 of them realize that the medicines was given only to back space the disease. %54 of them was unposted about the treatment alternatives except oral tablets. %44 of them knew that the disease did not get better with medicine and %50 of them knew that they have to change the medicine time to time. When we asked the most thing that worry the caregivers the answers were sleeplessness, agitation, tenacity, irritability, urine and fecal incontinence. Conclusion: The enough knowledge of caregivers about the illness may provide facility to early diagnosis, understand problems about the illness, manage the treatment process.

Introduction: Various restrictions due to the coronavirus infection have affected working life globally. People with multiple sclerosis (pwMS) have several difficulties in social life, patient follow-up, and receiving treatments. In this study, we aimed to evaluate the experiences of pwMS during the COVID-19 pandemic. Method: We developed a 50-question survey aiming to determine fears, anxieties, and the problems experienced by patients regarding their diseases and social lives during the COVID-19 pandemic. The questionnaire was released online via the Turkish MS Society website, local MS societies websites, and social media accounts. Only the answers of the patients who filled out the questionnaire completely were evaluated. Results: In total, 6008 patients took the survey, and 3255 of them completed the questionnaire. Among all, 378 patients (11.6\%) were positive for COVID-19. The most common COVID-19-related symptom was fatigue (48.4\%). The routine medical follow-up was interrupted in 61.4\% and the medication was discontinued in 14\% of the patients. Approximately 25\% of the patients reported different symptoms related to relapse activity. The main concern of the patients related to the COVID-19 pandemic was the disruption of the health of the ones they loved. Among all the patients, 4.4\% lost their jobs. Conclusion: Our data showed that the COVID-19 pandemic strongly affected the working lives of pwMS. Also, the pandemic changed the attitudes of patients and neurologists. Therefore, the long-term effects of the COVID-19 pandemic on disease approach, patient follow-up, social conditions, and working life should be monitored.

INTRODUCTION: In this study, we aimed to discuss the data of patients with acute ischemic stroke with intravenous thrombolytic therapy (IV-tPA) in our clinic in the light of the literature. METHODS: Seventy patients with acute ischemic stroke diagnosed between April 2016 and 2017 who received IV-tPA were included in the study. Demographic, radiological and clinical data of the patients were recorded. The intracranial hemorrhages and neurological status at the end of the third month were evaluated with the modified MRS score and the National Stroke Health Scale (NIHSS) scores within 3 months after discharge. The values of the symptom-needle time, the Alberta stroke program, the early computerized tomography score (ASPECT) and the NIHSS scores at the first application and follow-up were analyzed. RESULTS: 28 of the patients were female and 42 were male and the mean age was 66.44 ± 13.47. Thirty-nine (55.7%) of the patients were referred to emergency services and 31 (44.3%) were directed to thrombolytic therapy from the emergency department of other hospitals. The initial NIHSS scores at the time of admission were 14.27 ± 4.26, while the NIHSS scores at the 24th hour were 11.47 ± 5.85. The ASPECT score at the time of admission was 9.61 ± 0.81. The median symptom-to-needle time was 89.5 minutes (0-245). The median door-to-needle time was 77 minutes (20-187). During thrombolytic application, edema occurred in 4 patients and intrahepatic hemorrhage occurred in 1 patient. At the end of the third month, 20 patients (28.5%) had complete recovery of neurological disability and 9 (12.9%) were exiting. DISCUSSION AND CONCLUSION: The results of this study show that IV-tPA treatment is a safe and effective treatment for acute ischemic stroke, similar to past studies, and that this treatment reduces the disability at the end of the third month.

Objective:We aimed to evaluate the frequency and severity of restless legs syndrome in patients with asthma and the effect of the disease on sleep quality.Materials and Methods:Forty-three patients followed by asthma and 30 healthy people were included in the study. The diagnosis of Restless Legs Syndrome was made according to the criteria of the International Restless Legs Syndrome Study Group. Excessive daytime sleepiness scores were determined according to the Epworth Sleepiness Scale (ESS). According to the Pittsburgh Sleep Quality Index (PSQI) the sleep quality and according to the Insomnia Severity Index (ISI) the insomnia was determined.Results:Male/female rate in the asthmatic group was 1/8, and the mean age was 48.88 years. The healthy control group was selected to be gender and age-matched. Restless Legs syndrome was found 25.58% (n=11) in the asthmatic group and 16.7% (n=5) in the control group, and it was also not statistically significant. The number of asthmatic patients with ESS ≥10 was six, while there was one person in the control group, and it was not statistically significant. According to the PSQI values, there was a significant difference between the asthmatic group and the control group (p

WOS: 000449522300015, Malignancy, immunosuppressive drug use, and diabetes mellitus (DM) are defined as risk factors for herpes zoster. A 58-year-old male patient with the diagnosis of DM was admitted to the emergency room with the complaints of double vision. His neurological examination revealed under activity of the right lateral rectus muscle and hypoactive deep tendon reflexes. In this report, we discuss a rare case of isolated abducens nerve palsy that occurred after postviral infection in the patient.

Objectives We investigate the relationship between the severity of vascular disease and epicardial adipose tissue thickness(EAT-t) and the neutrophil/lymphocyte (NEU/LY) ratio in acute stroke patients. Methods Seventy-six patients and 38 healthy controls were included in the study. Strokes were divided into three groups: lacunar infarction, middle cerebral artery infarction (MCA), and other arterial infarcts. Patients were assessed using the GCS (Glasgow coma scale) and NIHSS (National Institutes of Health Stroke Scale) scales. In addition to laboratory measurements, EAT-t was evaluated in all patients by using echocardiography. Results The EAT-t value and NEU/LY ratio were higher in the patient group than in the control group. The MCA group was found to have a significantly higher NEU/LY ratio than the lacuna group (p = 0.017) as well as the other patient (p = 0.025) group. There was a positive correlation of NIHSS score with EAT-t (r = 0.291; p = 0.013), and NEU/LY ratio (r = 0.289; p = 0.014). Conclusion The EAT-t and NEU/LY ratio were high in patients with acute ischemic stroke patients. The higher ratio of NEU/LY compared to other infarcts in the MCA group. These findings support the relationship between acute ischemic stroke severity and inflammation .

Introduction: Parkinson-s disease is the second leading neurodegenerative disease worldwide; however, its pathogenesis remains unclear. Recently, the neuroinflammation theory, one of the theories explaining the pathogenesis of Parkinson-s disease, has become prominent. We investigated the relationship between Parkinson-s disease and inflammatory markers including epicardial adipose tissue thickness, neutrophil-lymphocyte ratio, and thrombocyte-lymphocyte ratio.

Aim/Background: Restless legs syndrome (RLS) is a frequent neurological and sleep disorder. Metabolic disorders are known to be related to sleep disorders. We prospectively evaluated whether obesity and its possible cofactors were related to the presence of RLS. Materials and Methods: The study included 143 obese and 94 non-obese individuals. Obese patients had a BMI of 30 and over, while non-obese patients had a BMI lower than 30. Patients with arthritis and pregnancy were excluded but not those with diabetes mellitus. Participants who met diagnostic criteria recommended by the International RLS Study Group were diagnosed as having RLS. Depression, anxiety, daytime sleepiness, insomnia and sleep quality were evaluated in detail. Results: The mean age of obese patients was 40.52years and that of non-obese patients was 39.76years. The mean body mass index was 36.77 in the obese group and 25.71 in the non-obese group. The occurrence of depression, anxiety, sleep quality, and insomnia scores were significantly higher in obese individuals. The evaluations of daytime sleepiness, sleep efficiency and sleep latency were not significantly different between the groups. Discussion: Although the presence of RLS was correlated with obesity and vascular risk factors at a significant level, it was also shown that depression, anxiety and insomnia were significantly frequent in obese patients (although not daytime sleepiness). Further studies are needed.

Objective Attitude of healthcare providers toward older people is very important in the aging world. Neurologists contact older adults very frequently. We aimed to investigate the attitudes of neurologists toward older adults. Measurements We recorded participants age; sex; duration of clinical practice in neurology; existence of older adult relatives; and history of geriatrics education, nursing home visits, older adult patient density in their clinical practice, and participation in voluntary public activities. UCLA Geriatrics Attitude Scale was used to evaluate participants' attitudes. Results A total of 100 neurologists participated in this study. Seventy-seven percent had positive, 3 % had neutral, and 20 % had negative attitudes. Twenty-seven percent of the participants had history of geriatrics education, and these participants tended to have a higher rate of positive attitudes. Neurologists with positive attitudes tended to be older than those with negative attitudes. Participants with history of living with older adult relatives had lower rates of positive attitudes. The most common diagnoses of the patients the participants encountered were stroke and dementia. Independent factors associated with positive attitudes were history of geriatrics education and older age. History of living with older relatives tended to have a negative effect. Most of the negative items of the attitude scale were associated with the natural course and behavior of the common diseases in neurology practice. Conclusions Generalization of geriatrics education may translate into a better understanding and improved care for older patients. Development of instruments and implementation of qualitative studies to assess attitudes of neurologists toward older adults are needed.

Aim/background: Restless legs syndrome (RLS) is a common neurological movement disorder which is commonly seen in hemodialysis (HD) patients. Insomnia, depression, and anxiety disorders frequently show concurrence. In this study, we aimed to investigate RLS and insomnia prevalence and related factors in HD patients. Subjects and methods: Patients who were under HD treatment and healthy controls with similar mean age, sex ratio, and hypertension and diabetes mellitus frequency were included in this study. Depression, insomnia, and daytime sleepiness assessments were performed by using Beck Depression Inventory, Insomnia Severity Index, and Epworth Sleepiness Scale. The diagnosis of RLS was made using the International RLS Study Group consensus criteria. Results: About 156 HD patients and 35 controls were enrolled. The mean age was 50.6 in the HD group and 49.7 in the control group. Female sex was 43.9% in the HD group and 57.1% in the control group. RLS was significantly more frequent in HD patients compared with controls. The rate of sub-threshold insomnia and insomnia with moderate severity was higher in HD patients. While insomnia severity score and diabetes mellitus were significantly associated with the presence of RLS, depression, RLS, older age, and being under HD treatment were independently associated with insomnia severity. Conclusions: HD patients commonly have RLS and insomnia. Insomnia and diabetes mellitus seem to be major factors underlying RLS in HD patients. Furthermore, depression and RLS seem to be closely related to insomnia in these patients. Treatment of depression, insomnia, and RLS may be beneficial to improve quality of life in HD patients.