Hot Water Epilepsy: Presentation of Three Cases

Hot water epilepsy (HWE) is a reflex epilepsy that develops after pouring hot water on the head; seizures are induced through tactile and temperature-related stimuli. The number of cases reported worldwide is low, with most cases in Turkey and India. The exact pathophysiology of HWE is unknown but patients are thought to have abnormal thermoregulation systems with seizures that emerge due to the stimulation of a particular region in the brain cortex via contact of hot water on the skin of the head. We investigated the pathogenesis of this disorder through a literature review and by presenting the clinical and laboratory findings of three patients with HWE. Fortunately, HWE can largely be prevented; however, if non-reflexive seizures co-occur with HWE, proper medical treatment can be added to ensure seizure-free follow-up

Primer İzole Total Serebellar Agenezi: Yetişkin bir Hastanın Olgu Sunumu ve Literatür Taraması

Serebellar agenezi oldukça nadir görülür. Yenidoğan dönemde ölüme ve ciddi paraliziye sebep olabileceği gibi, yetişkin hayatta asemptomatik olarak da görülebilir. Radyolojik görüntüleme yöntemlerinin gelişmesiyle birlikte tanı olasılığı artmıştır. Serebellar agenezili hastalarda motor bozukluklar, mental durum bozukluğu serebellar koordinasyon bozukluğu bulunabildiği gibi, bunlardan hiçbiri de bulunmayabilir. Ek konjenital patolojilerin eşlik etmediği serebellar agenezide normal yaşam mümkündür. Serebellumdaki konjenital bozukluklar sıklıkla Dandy-Walker malformasyonu ve Chiari Malformasyonu şeklinde görülür. İleri tanı ve tedavilere gerek kalıp kalmayacağı açısından bu hastaların ayırıcı tanısının önemli olduğunu düşünmekteyiz. Radyolojik görüntüleme ile baş ağrısı yakınmasıyla başvuran 32 yaşındaki erkek hastamızda tespit ettiğimiz primer izole serebellar agenezi’yi literatür eşliğinde değerlendirdik

Paranasal Sinus Mucoceles with Intraorbital Extension

Objectives: The aim of this study was to report the clinical features, management, and outcome of patients with paranasal sinus mucocele with intraorbital extension. Materials and Methods: Eleven patients who were diagnosed and treated for paranasal sinus mucocele with intraorbital extension between 2005-2012 were included in this retrospective study. The clinical characteristics, treatment modalities, and complications were recorded and analyzed. Results: The records of 11 patients (aged 25 to 69, mean 47.6±15.6 years) with orbital mucocele were included in this study. The most frequent initial symptoms and findings were proptosis in 7 patients (63.6%), diplopia in 6 patients (54.5%), and ocular movement limitation in 6 patients (54.5%). The origin of the orbital mucocele was frontal sinus in 6 patients (54.5%), ethmoidal sinus in 3 patients (27.3%), and maxillary sinus in 2 patients (18.2%). Eight patients whose mucoceles were approachable with endoscopy (72.7%) were treated with functional endoscopic sinus surgery (ESS) and marsupialization of the sinus to the nasal cavity. Three patients’ mucoceles (27.3%) were located in the lateral side of the frontal sinus and were unapproachable with endoscopy. In these patients, the endoscopic approach was combined with the osteoplastic flap technique by external approach. After surgery, all the patients’ findings and symptoms improved; only one patient who had recurrent bilateral mucoceles required additional surgery. This recurrence was regressed by endoscopic surgery and no additional complications were observed. Conclusion: The frontal and ethmoidal sinuses were the most common origin of orbital mucoceles. Proptosis, limitation of eye movements, and diplopia were the most frequently detected signs in patients with orbital mucocele. Endoscopic sinus surgery produced favorable results in patients with an endoscopically approachable mucocele, and the osteoplastic flap technique with external approach led to successful results in patients with endoscopically unapproachable mucoceles. (Turk J Ophthalmol 2014; 44: 297-300