Motor ünite sayısı tahmini yönteminde uygulayıcıdan kaynaklanabilecek farklılıkların incelenmesi

TEZ5363Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2005.viii, 50 s. : res. ; 29 cm.

Epilepsili Hastalarda Periferik Sinir Aksonal Eksitabilitesi

Giriş: Sodyum (Na ) kanalları hem santral sinir sistemi hem de periferik sinir sisteminde (PSS) aksiyon potansiyeli oluşumunda önemli bir role sahiptir. Persistan Na+ akımı, uzamış depolarizasyonun neden olduğu aksiyon potansiyellerinin repetetif ateşlenmesinde rol oynar ki bu epilepsiye neden olabilir. Sinir eksitabilite ölçümleri, insanların periferik aksonlarında impuls iletiminin biyofiziksel özellikleri ve bozukluklarını incelemek için yapılmaktadır. Metod: Bu çalışmada, PSS'de de benzer kanallar olmasından yola çıkılarak epilepsili hastaların periferik sinir duysal ve motor aksonlarında persistan Na+ akımında değişiklik olup olmadığını değerlendirmek için motor ve duysal aksonların güç-süre özelliklerini çalışmak amaçlanmıştır. Çalışmaya antikonvülzan tedavi almayan, yeni tanı almış parsiyel epilepsili 17 hasta ile primer jeneralize epilepsili 22 hasta ve 15 kontrol olgu alındı. Sonuçlar: Epilepsili olgularda motor liflerin reobazı ve 0.1 ms ve 1ms'deki stimulus gücü kontrol grubuna göre yüksek bulundu. Karar: Sonuçlarımız, epilepsili olguların periferik sinirlerinde aksonal eksitabilitede azalma ve dolayısıyla Na+ iletiminde olası azalmaya işaret etmektedir. Epilepside santral nöronlarda hipereksitabilite varken, periferik sinir eksitabilitesinde azalma söz konusu olabilir.Introduction: Sodium (Na+) channels have an important role for action potential formation in both central nervous system (CNS) and peripheral nervous system (PNS). The persistent Na+ current play a role in repetitive firing of action potentials caused by prolonged depolarization, thus could play a role in epilepsy. Nerve excitability measurements are made to investigate biophysical properties and disturbances of impulse conduction in peripheral axons in human subjects. Methods: In this study, it was aimed to study strength–duration properties of motor and sensory axons to evaluate whether there is a change in the current through persistent Na+ channels of sensory and motor axons in peripheral nerves of epileptic patients because of the presence of similiar channels in PNS. The study involved 17 patients newly diagnosed with partial epilepsy and 22 patients with primary generalized epilepsy who were not currently prescribed anticonvulsant therapy, and 15 control subjects. Results: Rheobase of motor fibres and stimulus strength at 0.1 ms and 1ms of motor fibres of total patients with epilepsy were higher than values of controls. Conclusions: Our results suggested a decreased axonal excitability and a possible decreased Na+ conductances in peripheral nerves in patients with epilepsy. While there is hyperexcitability of central neurons, reduced peripheral nerve excitability may be in question in epilepsy

Vascular compression of multiple cranial nerves - The clinical syndromes

WOS: 000253936000014Abnormal changes such as loops, tortuosity, and ectasia in vascular structures that form vertebrobasilar system can cause mechanical vascular-compression syndromes. Neurologic symptoms might be encountered by compression of one or more of these cranial nerves. The compression of 3 nerves together has not been reported in the literature. Here, we present a patient with facial pain, vertigo, and tinnitus associated with the vascular compression of 5, 7, and 8 cranial nerves. A 52-year-old man was admitted to the clinic with complaints of pain located in the left upper part of face, with tinnitus being prominent on the left, and positional vertigo developing occasionally. The physical and neurologic examinations were normal. Cerebral magnetic resonance imaging and magnetic resonance angiography showed tortuosity in both the vertebral arteries and in the basilar artery, as well as the external compression of trigeminal 5, 7, and 8 nerve complexes by the intradural segment of the left vertebral artery. Internal acoustic channel magnetic resonance imaging revealed the compression of the 7 and 8 nerve complexes by the left basilar artery

Peripheral Nerve Axonal Excitability in Epileptic Patients

WOS: 000318549800012Introduction: Sodium (Na+) channels have an important role for action potential formation in both central nervous system (CNS) and peripheral nervous system (PNS). The persistent Na+ current play a role in repetitive firing of action potentials caused by prolonged depolarization, thus could play a role in epilepsy. Nerve excitability measurements are made to investigate biophysical properties and disturbances of impulse conduction in peripheral axons in human subjects. Methods: In this study, it was aimed to study strength-duration properties of motor and sensory axons to evaluate whether there is a change in the current through persistent Na+ channels of sensory and motor axons in peripheral nerves of epileptic patients because of the presence of similiar channels in PNS. The study involved 17 patients newly diagnosed with partial epilepsy and 22 patients with primary generalized epilepsy who were not currently prescribed anticonvulsant therapy, and 15 control subjects. Results: Rheobase of motor fibres and stimulus strength at 0.1 ms and 1ms of motor fibres of total patients with epilepsy were higher than values of controls. Conclusions: Our results suggested a decreased axonal excitability and a possible decreased Na+ conductances in peripheral nerves in patients with epilepsy. While there is hyperexcitability of central neurons, reduced peripheral nerve excitability may be in question in epilepsy

Health related quality of life in patients admitted for video-electroencephalography monitoring diagnosed with epilepsy or psychogenic non-epileptic seizures

Objective: To determine the health related quality of life (HRQOL) in patients with epilepsy or psychogenic non-epileptic seizures (PNES). Methods: This cross-sectional study was carried out between December 2010 and December 2014 in the Department of Neurology and Psychiatry, Faculty of Medicine, Baskent University, Adana, Turkey. Patients who were admitted for video-electroencephalography monitoring and diagnosed of epileptic seizures or PNES were asked to complete a questionnaire from the World Health Organization Quality of Life, and psychiatric comorbidities were diagnosed using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition. Results: Patients with epilepsy and PNES were found to have similar HRQOL in physical, psychological, social, and environmental domains. However, the percentage of comorbid psychiatric disorders were higher in patients with PNES than patients with epilepsy. Conclusion: Patients with epilepsy and PNES have similar HRQOL, and PNES are resistant to the standard medical therapies used for the treatment of epileptic seizures. The direct lifetime cost of undiagnosed PNES may be of equal with intractable epilepsy. A better understanding of the impact of PNES manifestations and epilepsy would help to provide appropriate clinical, psychological and social care

Parameters affecting F wave latency in normal population

Amaç: F dalga latansı, periferik sinirlerin proksimal bölümünün değerlendirilmesinde basit ve değerli bir metoddur. Çalışmanın amacı, normal sağlıklı bireylerde median, ulnar, tibial ve peroneal sinirlerde Fminimum dalga latansı kayıtlanmasıdır. Yöntem: Çalışmaya yaş ortalaması 44.2 ± 16.3 (17-73) olan 34 kadın ve 30 erkekten oluşan toplam 64 olgu alınmıştır. Median, ulnar, peroneal ve tibial sinirlerden yüzeyel elektrod ile F minimum latansı kayıtlaması yapılmıştır. Elde dilen veriler yaş, cins ve boya göre değerlendirilmiştir. Bulgular: Yaş ve boy uzunluğunun F minimum latansı üzerine istatistiksel olarak anlamlı etkisinin olduğu, cinsiyetin ise anlamlı etkide bulunmadığı belirlenmiştir. Sonuç: Fmin latansının değerlendirilmesinde yaş ve boy uzunluğu dikkate alınarak hastaların elektrofizyolojik verileri değerlendirilmelidir.Summary: Purpose: Determination of F-wave latency is a simple and valuable method in evaluating proximal part of the peripheral nerves. The aim of this study was to determine F-wave minimum latency of median, ulnar, tibial and peroneal nerves in normal healthy subjects. Methods: A total of 64 subjects including 34 female and 30 male at a mean age of 44.2 ± 16.3 (17-73) were studied. F-minimum latency was recorded from median, ulnar, peroneal and posterior tibial nerves using surface electrode. Collected data was evaluated according to the gender, age and height. Results: Age and height showed significant effect on F-wave minimum latency. However, gender showed nonsignificant effect on F-wave minimum latency. Conclusion: In evaluation of F latency, electrophysiological data of the cases should be interpreted after correcting for age and height

Hemifacial spasm and hypoacusia due to vascular loop compression - Case report and review

WOS: 000248998100013Vascular loop compression is the term used to classify a group of conditions thought to be caused by the compression of cranial nerve by vessel. The vascular abnormality is usually an atherosclerotic aberrant or ectatic intracranial artery, most commonly the anterior and posterior cerebellar artery or the vertebral artery. Hemifacial spasm is a well-recognized clinical feature of vascular compression of the facial nerve. Unilateral auditory symptoms due to eighth nerve involvement with vascular compression have also been reported. Involvement of both seventh and eighth nerves together is a rare condition and imaging features have not been established well. Here, we report a 50-year-old man with hemifacial spasm and unilateral hypoacusia associated with compression of left facial and auditory nerve complex by basilar vascular loop

Selective autonomic screening in Guillain-Barré syndrome

Background : Autonomic dysfunction is a common and important complication in Guillain-Barre syndrome (GBS) and may be the cause of significant morbidity or death. Objectives : To show the possible autonomic involvement in patients with GBS. Materials and Methods : The sympathetic skin response (SSR) and the parameters of heart rate variability gathered from a 24-h electrocardiogram recording were studied in 14 patients with GBS [13 with acute inflammatory demyelinating polyneuropathy (AIDP) and one with acute motor axonal neuropathy (AMAN)]. Results : In two of the patients, SSR couldn't be elicited. In the rest of the patients, amplitude of SSR was found to be decreased when compared with the control subjects. In the time domain analysis of the 24-h electrocardiogram, SDNN (the standard deviation of all R-R intervals), SDANN (the standard deviation of the averages of R-R intervals during all 5-min periods that constitute the 24-h day), SDNN index (mean of the standard deviations of all R-R intervals for all 5-min segments of the 24-h recording); in the frequency domain analysis HF(high frequency), LF(low frequency), VLF (very low frequency) and total power were found decreased in patients when compared with the control subjects. When the mean values with standard deviations of controls were compared with the patients' values one by one, the pregnant patient with AMAN had increased heart rate variability parameters. The remaining 13 patients had decreased values. Conclusions : These findings reflect an involvement of both the parasympathetic and sympathetic systems in GBS. Our results suggest that SSR and heart rate variability parameters may be used for early detection of any autonomic dysfunction in patients with GBS

Mitochondrial Diseases

The oxidative phosphorilasyon (OXPHOS) diseases are heterogeneous group of diseases that are caused by mutations in mitochondrial DNA (mtDNA) or nuclear DNA. These progressive diseases ,often present in early adult life, are characterised by multiorgan involvement and this condition can make diagnosis diffucult. [Archives Medical Review Journal 2003; 12(0.100): 32-80