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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.

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.

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.

The pseudoscalar current-delta transition form factors are calculated in the framework of relativistic baryon chiral perturbation theory including order $\mathcal{O} q^4 $. The complex-mass scheme, which is suitable and well-defined for unstable particles, is taken into account as a renormalization scheme. We discuss the low energy behavior of the pseudoscalar $\tilde{g} Q^2 $ and $\tilde{h} Q^2 $ form factors and note that the momentum dependence of the form factors is dominated by the pion pole contributions.

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)

Objective: The estrogen in women is a protective factor against the Parkinson’s disease (PD). It was aimed to investigate the frequency of total abdominal hysterectomy-bilateral salpingo-oophorectomy (TAH-BSO) history causing withdrawal estrogen in patients with PD in this study. Methods: The electronic records of the Movement Disorders Unit of the Neurology Department were reviewed. Female patients with PD were selected and compared with age-matched controls without movement disorders. The patients were divided into two groups (45 years (OR=1.58, 95% CI: 0.32-7.80, p=0.57). Conclusion: The frequency of TAH-BSO history in patients with PD is not common. Risk of PD may slightly increased in patients aged

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.

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.

WOS: 000435398900004 Objective: Restless Legs syndrome (RLS) is a frequent neurological disease. Levetiracetam (LEV) is an effective and broad-spectrum anticonvulsant drug. The aim of this study is to investigate the frequency of RLS in patients diagnosed with epilepsy who took LEV monotherapy. Materials and Methods: Two neurologists were reviewed the files of 1680 patients, who were followed in epilepsy outpatient clinic. One hundred seven patients under LEV monotherapy for at least six months and 120 healthy controls were included in the study. The criteria for the International Restless Legs Syndrome Study Group were taken into consideration for the assessment of RLS. Results: The mean age of patient group was 38.26 +/- 17.39 years, while the mean age of healthy controls was 39.17 +/- 16.12 years. There were no statistically significant differences in terms of age and sex between each two groups. The mean duration of LEV usage was 28.34 months. The LEV usage dose was between 500-3000 mg/day. RLS was seen in 7 (5.83%) healthy controls, whereas 4 patients (3.73%) had RLS in patient group before LEV treatment. The symptom of RLS in two patients disappeared after LEV treatment started and this rate decreased to 1.87%. The biochemical parameters were normal in all patient groups, after LEV treatment, peripheral neuropathy was detected in one patient whose symptoms were not relieved. Conclusion: LEV may have therapeutic effect on RLS. It may be preferred especially in comorbid situations where epilepsy and RLS are seen together. Longitudinal and prospective studies are needed to manifest better the therapeutic effects of LEV on RLS.

WOS: 000427323200003 Objective: Obstructive Sleep Apnea syndrome (OSAS) is a disease commonly seen in the community, causing labor loss and neuropsychiatric symptoms. The aim of the study is to compare the symptoms of depression and anxiety with those of healthy controls in patients with OSAS and to investigate the relationship between OSAS severity with anxiety and depression. Materials and Methods: Two hundred and thirteen patients with OSAS who underwent polysomnographic examination and 116 healthy controls were included in the study. The patient group was classified as mild, moderate and severe OSAS. Beck Anxiety and Beck Depression Scales were administered to the patients and healthy controls. Results: There was a significant difference between the patient group and the control group in the mean scores of Beck Depression and Beck Anxiety Scales. The mean scores of depression of the OSAS group were 11.16 +/- 8.87 (mild depression); 6.85 +/- 6.15 of the control group (p0.05). Conclusion: In our study; although there was a significant difference between depression and anxiety mean scores in patient and control group; there was no significant difference in anxiety and depression mean scores among mild, moderate and severe OSAS patients. Patients with OSAS were found to have mild anxiety and depressive symptoms. In these patients, there was no correlation between AHI values and depression and anxiety scores.

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.

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.

Bilateral thalamic infarction is a rare clinical condition. Thalamo-perforan arteries are arise from the same vascular territory in nearly one third of the cases and oclussion of it causes bilateral infacts. Clinical presentation can be altered mental status, decrease alertness, memory problems, mood disorders, cognitive problems and vertical gaze palsy. In this report we present two cases with different clinical status.

Amaç: Huzursuz bacaklar sendromu, özellikle bacaklarda ve ekstremitelerde uyuşma ve tanımlaması zor anormal bir his ile karakterizedir. Çalışmamızda kronik epilepsi hastalarında huzursuz bacaklar sendromu sıklığını saptamayı amaçladık.Yöntemler: Toplam 86 epilepsi hastası çalışmaya dahil edildi. Çalışma hastalarının epilepsi sınıflaması, 1981 International League Against Epilepsy sınıflamasına göre yapıldı. Hastaların demografik verileri toplandı ve diğer formlara ek olarak Uluslararası Huzursuz Bacaklar Sendromu Çalışma Grubu (IRLSSG) tarafından 2014 yılında yayınlanan 4 soruluk tanı kriterlerinden oluşan anketin Türkçe versiyonu hasta ile yüz yüze görüşülerek dolduruldu.Bulgular: Çalışmaya dahil edilen hastaların huzursuz bacaklar sendromu prevalansı % 5.81 (86 hasta üzerinden 5 hasta) bulundu. IRLSSG değerlendirme ölçeği ortalaması 17 ± 6,5 idi.Sonuç: Çalışmamızın sonuçları, yaygın nörolojik bir hastalık olan epilepsi hastalarında huzursuz bacaklar sendromunun prevalansının genel popülasyona göre daha düşük olduğunu gösterdi, Aim: Restless legs syndrome is characterized by an abnormal sensation, a difficult-to-define type of dysesthesia in the extremities, especially in the legs. In our study, we aimed to determine the frequency of restless legs syndrome in patients with chronic epilepsy.Methods: A total of 86 epilepsy patients were included in the study. Epilepsy grading of the study patients was performed based on the International League Against Epilepsy 1981 classification. Demographic data of the patients were collected and Turkish version of the questionnaire consisting of 4 questions of diagnostic criteria issued in 2014 by International Restless Legs Syndrome Study Group (IRLSSG), in addition to the other forms, were completed through face-to-face interviews.Results: Restless leg syndrome prevalence among the patients included in the study was found to be 5.81% (5 patients out of 86). Mean score of IRLSSG evaluation scale was 17±6.5.Conclusion: The results of our study showed that the prevalence of restless legs syndrome is lower in patients with epilepsy, a common neurologic disorder, compared to the general population.

WOS: 000438303700008 Sudden unexpected death in epilepsy (SUDEP) is a serious problem, and its importance has increased in recent years. It is responsible for the death of 17% of epilepsy patients. As the age of onset rises, the risk increases. Patients with refractory epilepsy are particularly at risk. Likewise, male gender, early age of onset, polytherapy, nocturnal seizures, generalized tonic-clonic seizures (GTCS) are also among the risk factors. Respiratory, cardiac, autonomic and brain stem related pathologies are held to be responsible for its pathophysiology.

WOS: 000377916300006 PubMed ID: 27303237 Epicardial fat, a metabolically active tissue, has emerged as a risk factor and active player in metabolic and cardiovascular diseases. We investigated epicardial fat thickness in patients who had sustained an acute ischemic stroke, and we evaluated the relationship of epicardial fat thickness with other prognostic factors. We enrolled 61 consecutive patients (age, >= 18 yr) who had sustained a first acute ischemic stroke and had been admitted to our hospital within 24 hours of the onset of stroke symptoms. The control group comprised 82 consecutive sex-and age-matched patients free of past or current stroke who had been admitted to our cardiology clinics. Blood samples were taken for measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at admission. Aortic stiffness indices and epicardial fat thickness were measured by means of transthoracic echocardiography within the first 48 hours. In comparison with the control group, the patients with acute ischemic stroke had significantly higher epicardial fat thickness (4.8 +/- 0.9 vs 3.8 +/- 0.7 mm; P < 0.001), lower aortic distensibility (2.5 +/- 0.8 vs 3.4 +/- 0.9 cm(2).dyn(-1); P < 0.001) and lower aortic strain (5.5% +/- 1.9% vs 6.4% +/- 1.8%; P=0.003). We found a significant association between epicardial fat thickness, NT-proBNP levels, and arterial dysfunction in patients who had sustained acute ischemic stroke. Increased epicardial fat thickness might be a novel risk factor and might enable evaluation of subclinical target-organ damage in these patients. department of Scientific Research Projects, Mugla Sitki Kocman University This research was financially supported by the department of Scientific Research Projects, Mugla Sitki Kocman University.

WOS: 000389053000033 PubMed ID: 27966319 Background/aim: This study aimed to define the frequency of a primitive reflex, the buccopalpebral reflex (BPR), and its association with the clinical situation in patients with Parkinson disease. Materials and methods: Between May 2010 and May 2011, 222 patients, 115 with Parkinson disease and 107 patients without any sign of neurodegenerative disease, were included in the study. All included patients were examined for BPR and snout reflex and were also evaluated with the Mini Mental State Examination. All patients with Parkinson disease were classified with the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr Score to determine their clinical severity. Results: Sixteen patients with Parkinson disease (13.9%) had a BPR (+) and 4 patients in the control group (3.7%) (P < 0.001). The UPDRS score, UPDRS daily life activities score, and UPDRS motor system score were all higher in the group with BPR (+). All patients with a BPR also had a positive snout reflex. Conclusion: BPR is more frequent in patients with Parkinson disease than in patients without a neurodegenerative disease.

23rd World Congress of Neurology (WCN) - SEP 16-21, 2017 - Kyoto, JAPAN WOS: 000427450302038 Parkinson's disease (PD) is a neurodegenerative disorder characterized by bradykinesia, tremor, rigidity, and postural instability which progress through the loss of dopaminergic neurons (1). Progressive loss of dopaminergic neurons at the substantia nigra pars compacta is responsible for the pathophysiology (2). Postmortem studies have shown the essential role of oxidative stress in neuronal degeneration of the dopaminergic nigral neurons (3). Recent reports describe nesfatin-1 and glucagon-like peptide-1 (GLP-1) as molecules with neuroprotective property that relieve oxidative stress. Here we aimed to determine the blood levels of nesfatin-1 and GLP-1 in PD and their effect on oxidative processes. World Federat Neurol

WOS: 000410870800004 PubMed ID: 29042878 Objective Stroke is the second most common cause of death and the leading cause of adult disability. Both stroke patients and their family can therefore experience increased traumatic stress level. Methods The participants are close relatives of patients (n=65) who had a first time stroke (CRPWS) hospitalized. A control group (CG) (n=61), who had no history of chronic illness in their family and had at least one traumatic life event experience. The National Institutes of Health Stroke Scale, Modified Rankin Scale, Personal Information Form, Life Events Checklist, Traumatic Stress Symptom Scale, and Multidimensional Scale of Perceived Social Support, were used in the study. Results We found no significant association between NIHSS and MRS of patients and traumatic stress level of the family member. The traumatic stress level was significantly higher in the CRPWS group than in the CG group. Traumatic stress level was higher in women than men and was not associated with perceived social support in the CRPWS group. Conclusion The traumatic stress level of the relatives was not associated with the clinical features of the stroke patients. In the early phase, after the diagnosis of stroke, psychological support may be important to prevent CRPWS from PTSD.

Stroke is the most common cause of seizures in the elderly. Antiepileptic drugs are used to treat most patients with late poststroke seizures. The aim of this study was to evaluate the efficacy and tolerability of levetiracetam (LEV) in patients aged 60 or older with late-onset poststroke seizures. This prospective study evaluated patients 60 years of age or older, who had at least two late-onset poststroke seizures and were given LEV monotherapy. Demographic data and seizure and stroke characteristics were recorded. Outpatient visits were made after 2, 4, 6, 9, and 12 months and every 3 months thereafter, and the effectiveness and tolerability of LEV were investigated. Thirty–four patients with a mean age of 69.76 ± 6.41 were included in this study. Average seizure frequency before treatment was 3.61 ± 3.02/month. Mean follow-up time was 17.68 ± 3.24 months. At daily doses of 1000–2000 mg, 82.4% of the patients were seizure free, and 7 patients (20.6%) had side effects. LEV was discontinued in one patient because of severe somnolence. Two patients were switched to another antiepileptic drug because of uncontrolled seizures despite an increase in dose up to 3000 mg/day. LEV monotherapy can be effective and well tolerated in elderly patients with late-onset poststroke seizures.