Browsing by Author "Demir, Aylin Bican"
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Publication A rare cause of epilepsy: Ulegyria revisited in a series of 10 patients(Sage Publications, 2021-09-17) Demir, Aylin Bican; Eser, Pınar; Bekar, Ahmet; Hakyemez, Bahattin; Bora, İbrahim; BİCAN DEMİR, AYLİN; Eser, Pınar; BEKAR, AHMET; HAKYEMEZ, BAHATTİN; BORA, İBRAHİM HAKKI; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı/Epilepsi Merkezi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-6739-8605; 0000-0003-0132-9927; 0000-0002-3425-0740; ABX-9081-2022; AAI-2073-2021; V-7170-2017; AAI-2318-2021; ENI-7759-2022Introduction. Ulegyria results from perinatal hypoxic-ischemic brain injury in term infants. The specific mushroom-shaped configuration of ulegyria results from small atrophic circumvolutions at the bottom of a sulcus underlying an intact gyral apex. Clinically, ulegyria is generally associated with epilepsy. Here, we aimed to delineate the characteristics of patients with ulegyria and the epileptic seizures they experience. Material and methods. Medical records including radiology and pathology reports, video-electroencephalographic (EEG) analysis, operative notes, hospital progress and outpatient clinic notes were reviewed retrospectively in a total of 10 ulegyria patients. Results. Patients ages ranged between 24 and 58 years (mean, 32 +/- 9.8 years). Past medical history was confirmed for neonatal asphyxia in 2 (20%). Neurological examination was remarkable for spastic hemiparesis in 1 (10%) patient with perisylvian ulegyria and for visual field deficits in 2 patients (20%) with occipital ulegyria. Ulegyria most commonly involved the temporoparietal region (n = 5, 50%) followed by the perisylvian area (n = 2, 20%). Except the one with bilateral perisylvian ulegyria, all patients had unilateral lesions (n = 9, 90%). Hippocampal sclerosis accompanied ulegyria in 2 patients (20%). All patients experienced epileptic seizures. Mean age at seizure onset was 8.8 +/- 5.4 years (range, 2-20 years). Interictal scalp EEG and EEG-video monitoring records demonstrated temporoparietal and frontotemporal activities in 5 (50%) and 2 (20%) patients, respectively. The seizures were successfully controlled by antiepileptic medication in 8 patients (n = 8, 80%). The remaining 2 patients (%20) with concomitant hippocampal sclerosis required microsurgical resection of the seizure foci due to medically resistant seizures. Discussion. Ulegyria is easily recognized with its unique magnetic resonance imaging characteristics and clinical presentation in the majority of cases. It is highly associated with either medically resistant or medically controllable epileptic seizures. The treatment strategy depends on the age at onset and extends of the lesion that has a significant impact on the severity of the clinical picture.Publication Awareness of sleep and narcolepsy in children(Galenos, 2020-06-01) Demir, Aylin Bican; Okan, Mehmet Sait; Tütüncü, Rabia Toker; TÜTÜNCÜ TOKER, RABİA; Demir, Aylin Bican; BİCAN DEMİR, AYLİN; Okan, Mehmet Sait; OKAN, MEHMET SAİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-3129-334X; 0000-0001-6739-8605; 0000-0002-9303-5768; IZP-6290-2023; V-7170-2017; JCE-6657-2023Objective: This study aimed to increase the awareness of narcolepsy in children and emphasize the reduction of the socioeconomic burden caused by the delayed or incorrect diagnosis.Materials and Methods: Demographic characteristics, clinical features, and electrophysiological studies of children diagnosed with narcolepsy in the Bursa Uludag University, Health Practice and Research Hospital, Clinic of Pediatric Neurology, were obtained from medical records.Results: Six children were included in the study. The average age at which the initial symptoms were observed was 11.5 years, whereas the average age of diagnosis was 13.5 years. Daytime sleep was accompanied by cataplexy in five cases and hypnogogic hallucinations in one case. Notably, the seizure was primarily considered in the differential diagnosis before diagnosing narcolepsy.Conclusion: It is crucial to increase the awareness of narcolepsy by physicians. Although families and children cannot express sleep disorders, we believe that questioning of sleep patterns during anamnesis in routine neurology practice could prevent delayed diagnosis.Publication Covid-19 enfeksiyonu sonrası huzursuz bacaklar sendromunun araştırılması(Bursa Uludağ Üniversitesi, 2023-07-21) Uslu, Pınar Uzun; Mehdiyev, Duygu Arslan; Uncu, Gülgün; Ayas, Zeynep Özözen; Dinç, Yasemin; Demir, Aylin Bican; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı; 0000-0003-0342-5939; 0000-0001-6739-8605Huzursuz bacaklar sendromu (HBS) en sık görülen uyku ile ilişkili hareket bozukluğudur. HBS, yaşam kalitesini bozan önemli uyku sonuçları olan sensorimotor bir hastalık olup özellikle dinlenme sırasında ortaya çıkar. HBS semptomlarının sistemik inflamasyona sekonder oluşabileceği ya da kötüleşebileceği bilinmektedir. Covid 19 enfeksiyonu da sistemik inflamasyon yanıtına yol açabilen bir durumdur. Covid-19 enfeksiyonunun uyku bozuklukları ile ilişkisine ilişkin yapılmış birçok çalışma vardır. Ancak HBS ve covid-19 birlikteliğine ilişkin çalışmalar sınırlı olup bu araştırma ile literatüre katkıda bulunulmak istenmiştir.Publication Evaluation of coronavirus disease 2019-positive patients with febrile convulsions(Aves, 2022-12-01) Toker, Rabia Tütüncu; Demir, Aylin Bican; BİCAN DEMİR, AYLİN; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı; 0000-0001-6739-8605; KHB-9765-2024Objective: Febrile convulsion is a common seizure type in children between 6 months and 6 years of age and is seen in 2%-5% of children.1 Coronavirus disease 2019 spread rapidly and became a pandemic. As coronavirus disease 2019 can be seen in epilepsy patients, the relationship between coronavirus disease 2019 and seizures is not clear yet.2 This study aimed to evaluate the characteristics of coronavirus disease 2019-positive patients with febrile convulsions and compare them with coronavirus disease 2019-negative patients with febrile convulsions regarding their clinical features.Methods: Forty patients were included in the study. In our country, diagnosing, monitoring, and treating coronavirus disease 2019 are performed according to the Turkish Ministry of Health coronavirus disease 2019 Scientific Committee guidelines.Results: Twelve of the patients were coronavirus disease 2019 positive, whereas 28 were coronavirus disease 2019 negative. While the rate of complex febrile convulsion was 50% in the coronavirus disease 2019-positive group, this ratio was 25% in the coronavirus disease 2019-negative patient group.Conclusions: Seizures occur in the presence of higher-grade fever in coronavirus disease 2019-positive cases. On the other hand, the probability of seizures to occur focally and recur during the same disease period might be higher. Male gender and maternal history of febrile convulsions may be the risk factors.Publication Evaluation of ischemic stroke and risk factors of atrial fibrillation in patients with obstructive sleep apnea syndrome(Galenos Yayınevi, 2021-12-01) Dinç, Yasemin; Demir, Aylin Bican; DİNÇ, YASEMİN; BİCAN DEMİR, AYLİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; IWC-9957-2023; KHB-9765-2024Objective: Obstructive sleep apnea syndrome (OSAS), a sleep-related breathing disorder, is characterized by apnea and hypoapnea. In patients with OSAS, ischemic stroke may have various causes such as large-vessel atherosclerosis and cardioembolism. OSAS is one of the risk factors of atherosclerosis, and it is thought to increase the risk of ischemic stroke by triggering atherosclerosis. Many studies have shown the relationship between OSAS and cardioembolic stroke. Ischemic stroke is a heterogeneous group of diseases caused by many complex mechanisms and may show ethnic and racial differences. This study aimed to determine the etiology and risk factors of ischemic stroke in the patient group diagnosed with OSAS in our population.Materials and Methods: A total of 343 patients were retrospectively screened to determine the prevalence and risk factors of ischemic stroke in patients with obstructive sleep apnea in the sleep laboratory of the Department of Neurology, Faculty of Medicine, Uludag University, between 2015 and 2020.Results: The study included 38 (11%) patients who were diagnosed with ischemic stroke. When patients with and without ischemic stroke were compared according to clinical, demographic, radiological, and polysomnographic data, a significant relationship was found in age, atrial fibrillation (AF), heart failure, hypertension, coronary artery disease, diabetes mellitus, smoking, and non-rapid eye movement 1. According to the binary logistic regression analysis, the variable most significantly related with ischemic stroke was AF. A significant relationship was found between OSAS severity and AF.Conclusion: OSAS is a treatable sleep disorder that causes cardiovascular morbidity. OSAS is an important risk factor for the development and recurrence of AF. In this study, AF is the most important variable related to ischemic stroke in patients with OSAS, and it is associated with the severity of OSAS. Thus, patients with OSAS must be evaluated for AF to prevent ischemic stroke.Publication Evaluation of obstructive sleep apnea syndrome in epilepsy patients with polysomnographic data(Kare Yayınevi, 2020-01-01) Leba, Leyla Köse; Demir, Aylin Bican; Bora, İbrahim; BİCAN DEMİR, AYLİN; BORA, İBRAHİM HAKKI; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; KHB-9765-2024; ENI-7759-2022Objectives: Sleep respiratory disorders, which are more common in epilepsy patients, are treatable diseases. We have discussed the diagnosis of sleep apnea syndrome after PSG of epileptic patients with visible apnea and snoring, in light of the findings in the literature.Methods: For this study, from 1120 patients with epilepsy, 32 of them who were diagnosed with OSA in the PSG test were selected. Thirty-two patients with epilepsy that snoring and apnea who consulted sleep center. Patients with simple snoring and upper airway resistance were not selected. Epworth Sleep Scales was applied to all patients and all patients were taken.Results: In this study, the findings showed that the ratio of OUAS in patients with epilepsy was 2.9%. 21 of the 32 cases were male and 11 were female. The mean age was 53 (42-69) years. 72% had partial epilepsies and 28% generalized. The Apne-hypopnea index was 28 (14-48). PAP treatment was performed after the diagnosis of sleep apnea syndrome.Conclusion: Sleep respiratory disorders are more common in patients with epilepsy than the rest of the population and they are treatable diseases. The other study revealed that the frequency of OSAS among epilepsy was 10,2%. In this study, the findings showed that the ratio of OSAS in patients with epilepsy was 2.9%. This a risk for OSAS and the medication used for the treatment should be selected appropriately. Clinical screening of OSAS in settings of epileptic patients may be needed to diagnose to find out it maybe a potential and modifiable risk factor for epilepsy.Publication Fluoxetine-associated sleep disorders-report of two cases and literature review(Galenos Yayıncılık, 2021-09-01) Leba, Leyla Köse; Demir, Aylin Bican; BİCAN DEMİR, AYLİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı; 0000-0001-6739-8605; V-7170-2017Narcolepsy is a condition characterised by excessive daytime sleepiness, cataplexy, hypnogogic hallucination and sleep paralysis. Sleep-related eating disorder (SRED) is a parasomnia that occurs while sleeping and manifests itself as paroxysmal episodes of involuntary eating and/or drinking. Both sleep disorders often occur as primary conditions. Sleep disorders secondary to medical treatment less often occur. This report presents the case of a patient with narcolepsy and another with SRED as a result of anamnesis and polysomnography. These sleep disorders are due to recently initiated fluoxetine treatment. Sleep disorder occurring as secondary to medication has been ignored because it has eluded the clinicians.Item Fokal Başlangıçlı Bilateral Tonik Klonik Nöbetlerde nöbet süresi ile demografik, klinik ve radyolojik özellikler arasındaki ilişkinin araştırılması(2024-04-16) Sarıdaş, Furkan; Mesut, Gizem; Demir, Aylin Bican; Bora, İbrahim; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı; 0000-0001-5945-2317; 0009-0006-2052-6335; 0000-0001-6739-8605; 0000-0002-9435-6037Video-elektroensefalografik izleme (VEM), nöbetlerin davranışsal ve elektroensefalografik (EEG) aktivite süresini objektif olarak değerlendirmek için altın standarttır. Bugüne kadar nöbet süreleri farklı hasta gruplarında klinik olarak veya EEG ile değerlendirilmiştir. Bu çalışma, VEM ile değerlendirilen fokal başlangıçlı bilateral tonik-klonik nöbet (FBTKN) tanısı olan epilepsi hastalarında, demografik, klinik ve nörogörüntüleme bulguları ile nöbet süresi arasındaki ilişkiyi ortaya koymayı amaçlamaktadır. Nisan 2005 ve Ocak 2024 tarihleri arasında merkezimizde FBTKN tanısı alan rastgele seçilmiş 58 hastanın tıbbi öyküleri, nörogörüntülemeler, VEM kayıtlarından elde edilen klinik ve iktal EEG bulguları retrospektif olarak analiz edildi. En kısa fokal aktivite frontal lob epilepsisinde ve en uzun jeneralize aktivite parietooksipital lob epilepsisindeydi. Fokal aktivite süresi frontal ve eksternal kapsül lokalizasyonlu lezyonlarda daha kısa, mezial temporal lokalizasyonda daha uzundu. Fokal aktivite süresi meziyal temporal sklerozda daha uzundu. Jeneralize aktivite süresi ensefalomalazi ve polimikrogiride daha uzun, kortikal displazide ise daha kısaydı. Lezyonlara kortikal atrofi eşlik ettiğinde fokal aktivite süresi daha kısaydı. Anti nöbet ilaç türü ile nöbet süreleri arasında herhangi bir korelasyon yoktu. Nöbet süreleri semiyolojik bulgulara, radyolojik özelliklere ve epilepsi sendromlarına göre değişebilir. Farklılıkları klinisyen için epilepsi sendromu türü, status olasığı, semiyolojik eşlik eden bulgular hakkında bilgi verici olabilir.Item Hairy cell leukemia presenting with Guillain-Barre syndrome(Taylor & Francis, 2007-01-31) Özkan, Hasan Atilla; Taşkapılıoğlu, Özlem; Demir, Aylin Bican; Özkocaman, Vildan; Öztürk, Hülya; Özkalemkaş, Fahir; Ali, Rıdvan; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 9250698600; 23037226400; 18036596400; 6603145040; 57197115377; 7201813027Publication Hypersomnia in gulllain-barre syndrome: A co-incidental or an aetiological association?(Galenos Publ House, 2021-06-01) Demir, Aylin Bican; Dinc, Yasemin; DİNÇ, YASEMİN; BİCAN DEMİR, AYLİN; Bakar, Mustafa; BAKAR, HACI MUSTAFA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605Increased daytime sleepiness, hypersomnia, is a very common symptom in the general population and may cause serious problems in their lives. Hypersomnia may be idiopathic or may occur secondary to other aetiologies. Infections and vaccinations may also be related to hypersomnias. A 74-year-old man complaining of muscle weakness after severe diarrhoea was admitted and diagnosed with Guillain-Barre syndrome (GBS). He also complained of increased daytime sleepiness since the emergence of his weakness, for which all metabolic and endocrine aetiologies were excluded. A full night polysomnography and multiple sleep latency test revealed objective daytime sleepiness and tree episodes of rapid eye movements during sleep periods. Because of the temporal association, the patient was diagnosed with secondary narcolepsy secondary to post-infectious GBS.Item Ictal kissing: Electroclinical features of an unusual ictal phenomenon(W B Saunders, 2016-09-23) Özkara, Çiğdem; Taşkıran, Emine; Çarpraz, İrem Yıldırım; Bilir, Erhan; Aydoğdu, İbrahim; Delil, Şakir; Chassoux, Francine; Demir, Aylin Bican; Bora, İbrahim; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; V-7170-2017; 18036596400; 6602914249Purpose: The study aimed to describe the electroclinical features of ictal kissing, an unusual behavior that may occur during focal seizures. Method: Twenty-five patients collected from four epilepsy centers and previously published reports were reviewed for their demographic, clinical, and electrophysiological features. Results: Sixteen of 25 patients were female. The mean age was 32.9 years (9.9-51 years) and the average age at seizure onset was 14.5 years. All seizures were localized to the temporal lobe (TL) and lateralized to right side in 17 patients, left side in 2 patients, and unclear in 6 patients. A total of 55 ictal video electroencephalograms (EEGs) were analyzed. There were other symptoms such as speaking, spitting, hugging, and oral and upper-extremity automatisms along with different types of ictal kissing behavior during the seizures. The median duration of all seizures was 106.7 +/- 73.73 s. Kissing occurred at a median time of 71 s (1-95 s) after the onset of seizure, and ictal epileptiform discharges usually involved TL during kissing episode. Conclusion: Ictal kissing is mainly associated with right TL and female gender, although association with left TL may also occurs, possibly related to the circuits involving temporo-insular structures.Publication Investigating the impact of sleep stage of the patients at which they wake up on the stanford sleepiness scale after polysomnography(Galenos, 2022-06-01) Demir, Aylin Bican; Leba, Leyla Köse; Uslu, Pınar Uzun; Demir, Aylin Bican; BİCAN DEMİR, AYLİN; 0000-0001-6739-8605; V-7170-2017Objective: Sleep inertia is a period that cognitive performance and wakefulness are lower in the transition phase from sleep to wakefulness than during the daytime. The sleep inertia period is reported to extend from 1 minute to 4 hours. In our study, we aimed to investigate the impact of the sleep stage of the patients at which they wake up on the sleep inertia and the Stanford sleepiness scale (SSS) as well.Materials and Methods: Patients who applied to Bursa Uludag University Faculty of Medicine, Department of Neurology between the dates of March and September 2016, with such complaints about sleep disorders and with indications for admission to polysomnography were involved in the study. The patients were informed and their consent was received after PSG to complete the SSS.Results: One hundred patients were involved in the study. There were 55 patients waken up in the 2nd stage of NREM, 35 patients in REM sleep, and 10 patients in the 3rd stage of NREM. The points given by the patients and the number of these patients were as follows: 1-3 points for 37, 28, and 8 patients; 4 points for 1, 1, and 1 patient; and 5-7 points for 17, 6, and 1 patient, respectively.Conclusion: The arousal threshold differs in REM sleep and at the 1st, 2nd, and 3rd stages of NREM. The impact of waking up at any stages on the sleep inertia and/or the performance of the patients during the day is not known. For this reason, revealing the impacts of waking up at different sleep stages on the SSS was aimed in this study.Item Let's do the induction of psychogenic seizures nonepileptic?(Wiley, 2016-10) Bora, İbrahim; Demir, Aylin Bican; Ceylan, Dursun; Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0001-6739-8605; ENI-7759-2022; V-7170-2017; CIF-1703-2022Item Mezial temporal sklerozlu hastalarda entorinal korteks ve hipokampal volüm ölçümlerinin karşılaştırılması(Journal Neurological Sciences, 2011) Bora, İbrahim Hakkı; Canbulat, Nazan; Demir, Aylin Bican; Hakyemez, Bahattin; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; 6602914249; 19933685600; 18036596400; 6602527239The aim of this study is to evaluate the frequency of EC (Entorhinal cortex) atrophy in patients with TLE (Temporal Lobe Epilepsy) demostrate the diagnostic value in patients with or without hippocampal sclerosis. Metod: 23 patients, with TLE who were observed and recording in the Video-EEG monitorization and a control group of 17 patients were involved in the study. In both goups differences between video recordings of seizures with syncronized EEG recording were evaluated and lateralization of the seizure focus or the relation with the dominant hemisphere were recorded. 3D-T1 secands hippocampus and EC layers were calculated and mean volume were calculated. Results: The lateralization signs; versiv head deviation, concurrency of ipsilateral automatism with contralateral dystonic posture and the 4 sign were found to lateralize the contralateral of the seizure focus, while speech arrest lateralize the dominant hemisphere. There were no differences in the frequency of lateralization sign between the group of patients with hippocampal sclerosis and the other group without hippocampal screlosis. In both of the patient groups, frequency of EC atrophy was statistically significant. Although reduction of EC volumes were frequently bilateral in both groups, EC volumes were found to be smaller at the ipsilateral seizure focus. Conclusion: The present study demostrated that most of the patients with TLE had EC atrophy. EC volume measurements with Video-EEG monitoring and neuropsychometric tests can be useful in some circumstanses where it's difficult to distinguish between TLE and Extra Temporal Lobe Epilepsy and especially to distinguish frontal and temporal seizures.Publication Mri findings in children with migraine or tension-type headache(Bmc, 2023-08-30) Toker, Rabia Tütüncü; Mutlucan, İlknur Özdeniz; Tanrıverdi, Çiğdem; Demir, Aylin Bican; BİCAN DEMİR, AYLİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; V-7170-2017Purpose Migraine and tension-type headache are common primary headaches in children. There is a risk of developing secondary headache in children. The current study was aimed to evaluate magnetic resonance imaging findings (MRI) in children with migraine or tension-type headache.Methods The study was planned in children with migraine or tension-type headaches who have been followed up in the pediatric neurology outpatient clinic with regular office visits for at least two years and had neuroimaging in the last year.Results 280 patients (187 female patients) datas were studied. 91 (61 female patients) were followed up with the diagnosis of migraine and 189 (126 female patients) with the diagnosis of tension-type headaches. The age of patients was found to be 13.1 +/- 3.4 years. Brain tumor was found in one child with tension-type headache who had papilledema. Incidental MRI findings found 7.7% and 12.7% in migraine and tension-type headache, respectively. MRI findings in the study were arachnoid cyst (14), pituitary adenoma (6), mega cisterna magna (6), pineal cyst (3), non-specific gliosis (2) and tumor (1).Conclusion Arachnoid cysts were found incidental as the most common MRI finding in children with migraine or tension-type headache. The rare life-threatening secondary headache may develop in children. The fundus examination as a complement to the neurological examination can be useful for requesting MRI.Publication Neuro-behcet is a rare disease but should be considered in all kinds of neurological findings, even in childhood(Clinical & Exper Rheumatology, 2022-08-01) Toker, Rabia Tütüncü; Bodur, Muhittin; Demir, Aylin Bican; Okan, Mehmet Sait; TÜTÜNCÜ TOKER, RABİA; BODUR, MUHİTTİN; BİCAN DEMİR, AYLİN; OKAN, MEHMET SAİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Nörolojisi Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0002-3129-334X; 0000-0002-2588-8195; 0000-0001-6739-8605; 0000-0002-9303-5768; IZP-6290-2023; JAN-9435-2023; KHB-9765-2024; DKC-6496-2022Objective: Behfet's disease (BD) is a vasculitis characterised by eye, musculoskeletal, neurological and gastrointestinal involvement, in addition to recurrent oral ulcers. Neuro-Behvet is the term used to define the nervous system involvement in BD and is very rarely seen in childhood. This study aims to show that neuro-Behret can manifest a clinical course involving all kinds of neurologic findings in the paediatric population.MethodsThe Clinic of Paediatric Neurology at Uludag University provides tertiary treatment for children up to eighteen years of age in Bursa, Turkey. Five patients who were clinically diagnosed with Neuro-Beket in the last 5 years were included in the study. Results: Seizure, myopathy, transverse myelitis, polyneuropathy, venous thrombosis and facial nerve paralysis were respectively seen in the patients. ConclusionNeuro-Behfet is rare in children, but it is important to know that it can cause various neurological findings, and also systemic findings should be taken into consideration in the diagnosis of neurological diseases. Studies on the neurological involvement of BD in children are inadequate. We believe that paediatric neurologists should be more aware of the neuro-Behfet condition.Publication Obstructive sleep apnea syndrome and cardiovascular diseases; the role of hypertension(Galenos Yayınevi, 2022-09-01) Dinç, Yasemin; Demir, Aylin Bican; DİNÇ, YASEMİN; BİCAN DEMİR, AYLİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0003-0342-5939; IUQ-6999-2023; JZV-0986-2024Objective: Obstructive sleep apnea syndrome (OSAS) is a common disorder that results from the collapse of the upper airways during sleep and causes temporary hypoxia. OSAS and hypertension are common and multifactorial diseases. aim This study aimed to determine the clinical, demographic, polysomnographic and prognostic features of OSAS patients with hypertension.Materials and Methods: In this study, 364 patients diagnosed with OSAS in the sleep laboratory of the Department of Neurology, Bursa Uludag University Faculty of Medicine between 2016 and 2021 were retrospectively scanned and included. The patients were analyzed by comparing them with and without hypertension.Results: When patients with and without hypertension were compared according to clinical, demographic and polysomnography data, age (p<0.001), sex (p=0.009), presence of diabetes mellitus (DM) (p<0.001), presence of coronary artery disease (p<0.001), presence of heart failure (p=0.020), presence of atrial fibrillation (p=0.004), ischemic stroke (p<0.001), minimum oxygen saturation (p=0.015), oxygen desaturation index (p=0.034) and body mass index (BMI) (p<0.001) were statistically significantly correlated. When the significant variables were analyzed with binary logistic regression, the most significant variables were age [p<0.001, odds ratio (OR): 1.07], DM (p<0.001, OR: 7.58), coronary artery disease (p=0.003, OR: 4.92), heart failure (p=0.041, OR: 5.53), ischemic stroke (p=0.042, OR: 3.38) and BMI (p<0.001, OR: 1.28).Conclusion: In this study, we found that cardiovascular diseases such as coronary artery disease, heart failure and ischemic stroke are more common in OSAS patients with hypertension, and this is independent of risk factors such as age, DM and BMI. OSAS and cardiovascular diseases may show ethnic and racial differences. For this reason, we suggest conducting multicenter prospective studies examining the effects on blood pressure regulation and cardiovascular diseases in our own population.Item Pain, daytime sleepiness, anxiety and depression levels of patients with chronic neuropathic pain syndromes(Ege Üniversitesi Tıp Fakültesi, 2015-12-08) Kotan, Zeynep; Kotan, Vahap Ozan; Demir, Aylin Bican; Bora, İbrahim; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; 0000-0001-6739-8605; A-4421-2016; V-7170-2017; 18036596400; 6602914249; 16316866500Objective: The current study aims to determine pain, daytime sleepiness, anxietyand depression levels of patients with chronic neuropathic pain and compare different clinical conditions causing neuropathic pain in terms of these variables. Method: 241 patients (105 patients with diabetic neuropathy, 39 patients with fibromyalgia, 27 patients with carpal tunnel syndrome, 27 patients with radiculopathy, 22 patients with trigeminal neuralgia and 21 patients with postherpetic neuralgia) were included in the study. The assessments were performed using socio-demographic data form, Visual Analog Scale (VAS), Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scale (HAD). Results: Evaluation of pain with VAS and LANSS showed no statistical difference among subgroups. Scores of LANSS and VAS were positively correlated with each other. ESS scores were found to be above the cut-off point (> 10) in all subgroups. LANSS, but not VAS scores were positively correlated with ESS scores. Depression scores were above the cut-off point (> 7) in diabetic neuropathy, fibromyalgia and trigeminal neuralgia groups and anxiety scores were above the cut-off point (> 10) in diabetic neuropathy, fibromyalgia, trigeminal neuralgia and carpal tunnel syndromegroups. No correlation was found between scores of both VAS and LANSS and scores of HADS. Depression scores correlated positively with ESS scores (r=0.153, p<0.05). Conclusions: Daytime sleepiness, depression and anxiety are associated comorbidities with different neuropathic pain syndromes. Neuropathic character, but not the intensity of pain is associated with daytime sleepiness. Pain intensity does not predict anxiety and depression levels. Depression, but not anxiety shows a positive correlation with daytime sleepiness. These results might have implications for the better understanding of comorbidities in different neuropathic pain syndromes.Item Relapsing remitting multipl skleroz hastalarında ekstrakraniyal ve intrakraniyal venöz yapıların doopler sonografi, kraniyal mr venografi ve selektif venografi ile değerlendirilmesi ve sağlıklı kontroller ile karşılaştırılması(Bursa Uludağ Üniversitesi, 2020-07-08) Öksüz, Emine Kaygılı; Taşkapılıoğlu, Özlem; Turan, Ömer Faruk; Hakyemez, Bahattin; Demir, Aylin Bican; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0002-6752-1519; 0000-0002-3425-0740; 0000-0001-6739-8605Son yıllarda Multipl skleroz (MS) etyolojisinde, internal juguler ven (IJV) ve/veya azigos venlerde venöz drenaj bozukluğu olarak tanımlanan kronik serebrospinal venöz yetmezliğin (KSSVY) etkili olduğu ileri sürülmektedir. Bu teori, MS etyopatogenezinde etkili olduğu düşünülen otoimmün teoriyi toptan yadsıması nedeni ile ciddi tartışmalar başlatmıştır. Bu teori ile, MS etyopatogenezine farklı açılardan bakılması nedeniyle ilgi çekmiş ve bununla ilgili birçok çalışma başlatılmıştır. Çalışmamızda Doppler sonografi (DS), kranial MR venografi (MRV) ve selektif venografi (SV) ile MS hastalarında KSSVY’nin varlığının tespiti, ekstrakraniyal-intrakraniyal venöz yapıların yapısal- fonksiyonel açıdan incelenmesi, sağlıklı kişilerle karşılaştırılması amaçlanmıştır. 25 Relapsing Remitting MS hastasına DS, SV ve kraniyal MRV yapılırken, 20 sağlıklı kişiye kraniyal MR venografi ve Doppler sonografi yapıldı. Hastalarda DS’ de reflü varlığı açısından kontrol grubuna göre istatistiksel olarak anlamlı idi (p<0,05 P=0,001). Kraniyal MRV’ de intrakraniyal venlerde morfolojik açıdan hasta ve sağlıklı grup arasında istatistiksel olarak anlamlı fark yoktu. Selektif venografide hastaların %72’sinde sağ IJV’de, %76’sında sol IJV’de, %12’sinde azigos vende %50 ve üzeri darlık saptanırken; hastaların %60 da sağ IJV de, %48 inde sol IJV de ve %16 sında ise azigos vende %75 ve üzeri darlık izlendi. Hastaların %44’ünde azigos vende anomali izlendi. Çalışmamızdaki MS hastalarında KSSVY görülme oranı %76 idi. Saptamış olduğumuz yüksek orandaki kolateral dolaşım varlığı, hastalarda saptadığımız reflünün bir göstergesi olabilir. Kontrol grubuna etik kurul selekktif selektif venografiye izin vermediği için normalde nasıl olduğunu bilmiyoruz. Bu çalışmada sınırlı sayıda hasta grubunda bu teoriyi destekleyecek darlık bazı hastalarda gösterilmiştir. KSSVY’liğin MS hastasına özgü bir patoloji mi yoksa herkeste olabilecek fizyolojik bir varyasyon olup olmadığını söylemek mümkün değildir. Buna karar vermek için incelemeleri ilerletmek MS ve KSSVY arasındaki ilişkiyi ve/veya bunun MS belirtileri üzerindeki etkilerini saptamak için daha çok sayıda hastada yapılacak geniş çalışmalara ihtiyaç olduğu düşüncesindeyiz. Bu konuda daha ileri çalışmalara ihtiyaç vardır.Item The retrospective evaluation of effectiveness of teriflunomide treatments in multiple sclerosis patients(Sage Publications Ltd, 2018-03) Turan, Ömer Faruk; Ertaş, Ahmet Candost; Demir, Aylin Bican; Sıvacı, Ali Özhan; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; V-7170-2017