Covid-19 ve Nörolojik Bozukluklar

Dünya Sağlık Örgütü tarafından 11 Mart 2019’da pandemi olarak kabul edilen COVID-19 hastalığının pandeminin ilk döneminde öncelikle solunum yollarını etkileyen ve ciddi akut solunum yetmezliğine (SARS) neden olan bir viral enfeksiyon olduğu kabul edilmiştir. Zaman içinde vasküler sistemler başta olmak üzere diğer organ sistemlerini ve en önemlisi de diğer sistemlerle beraber nörolojik sistemleri ve hatta bazen sadece nörolojik sistemleri etkilediği ortaya konmuştur. Ciddi semptomu olmayan hastalarda bile koku alma kaybı sık olarak görülmekte olup bazı hastalarda ilk veya tek belirti olabilmektedir. Viral enfeksiyonun iyileşmesine rağmen koku alma fonksiyonunun aynı hızla kazanılamaması yaşam kalitesini etkileyen önemli bir nörolojik tutulumdur. Dünyada pandemi sürecinde vaka bildirimleri ve klinik verilerin analizleri ile hızlı bilgi akışı devam etmektedir. Bu yazıda literatür incelemesi ile dünyada bildirilen nörolojik tutulumlar ışığında kranial sinir tutulumları, serebrovasküler hastalıklar ve inme, ansefalit, epilepsi, Guillain Barré sendromu, psikiyatrik bozukluklar ile ilgili güncel bilgilerin paylaşılması amaçlanmıştır

The Relationship Between Pituitary Gland Dimensions, Thyroid Functions, and Seizure Activity in Patients with Epilepsy

Objective:Morphological and functional changes in hormonal systems may present as the cause and/or result of epileptic seizures. The purpose of the present research is to evaluate the relationship between the structure of the pituitary gland, thyroid functions, and seizure activity in patients with epilepsy.Methods:It was designed as a hospital-based, retrospective, and case–control study. No secondary epilepsy patients (18-65 years) were included in the study. Disease duration, seizure frequency, and antiepileptic treatments were questioned. Electroencephalography findings were grouped as normal, nonspecific, slow wave activity, and epileptic activity. Seizure types were determined. The pituitary gland was measured with coronal T2-magnetic resonance imaging sequences. Pituitary gland width, height, and intercavernous distance were obtained. Thyroid-stimulating hormone, free triiodothyronine, and free thyroxine results were recorded.Results:There were 63 patients (mean age of 43.11 ± 12.38 years) and 44 healthy volunteers in the study. Pituitary gland width and intercavernous distance were lower in epilepsy patients compared to the control group (P = .012 and P = .006). Thyroid function test results were similar in the patient and control groups (P > .05). There was a negative correlation between the number of seizures in the last 1 month and the width of the pituitary gland (P = .008, r = −0.331). There was no relationship between other clinical features, antiepileptic therapy, and pituitary measurements and thyroid functions.Conclusion:The lower width of the pituitary gland and its relationship with the frequency of seizures support that seizure activity is associated with structural features of the hormonal system in patients with epilepsy