Optical Coherence Tomography-A New Diagnostic Tool to Evaluate Axonal Degeneration in Multiple Sclerosis: A Review

Multiple sclerosis is an inflammatory demyelinating disorder of the central nervous system with a wide spectrum of clinical signs and symptoms. Multiple sclerosis lesions have a predilection for the optic nerves, periventricular white matter, brainstem, spinal cord, and cerebellum. The mechanisms responsible for multiple sclerosis are complex and heterogeneous across patients and disease stages. No specific markers exist for the definite diagnosis and prognosis of multiple sclerosis. The afferent visual pathway, which extends from the retina to the primary visual cortex including the optic nerve, is one of the most commonly affected sites in multiple sclerosis (94-99%). Pathology of affected optic nerves exhibits inflammation, demyelination, gliosis, axonal injury, and thinning of the retinal nerve fiber layer (RNFL). The RNFL is composed of unmyelinated axons, and measuring RNFL thickness is a viable method to monitor axonal loss reflecting disease progression. Optical coherence tomography is a noninvasive and reproducible tool in assessing the impact of multiple sclerosis on the thickness of the RNFL. Assessment of the afferent visual pathway using clinical, imaging and electrophysiological methods provides insights into the pathophysiology of multiple sclerosis and may also serve a prognostic role in multiple sclerosis

Optical Coherence Tomography-A New Diagnostic Tool to Evaluate Axonal Degeneration in Multiple Sclerosis: A Review

Multiple sclerosis is an inflammatory demyelinating disorder of the central nervous system with a wide spectrum of clinical signs and symptoms. Multiple sclerosis lesions have a predilection for the optic nerves, periventricular white matter, brainstem, spinal cord, and cerebellum. The mechanisms responsible for multiple sclerosis are complex and heterogeneous across patients and disease stages. No specific markers exist for the definite diagnosis and prognosis of multiple sclerosis. The afferent visual pathway, which extends from the retina to the primary visual cortex including the optic nerve, is one of the most commonly affected sites in multiple sclerosis (94-99%). Pathology of affected optic nerves exhibits inflammation, demyelination, gliosis, axonal injury, and thinning of the retinal nerve fiber layer (RNFL). The RNFL is composed of unmyelinated axons, and measuring RNFL thickness is a viable method to monitor axonal loss reflecting disease progression. Optical coherence tomography is a noninvasive and reproducible tool in assessing the impact of multiple sclerosis on the thickness of the RNFL. Assessment of the afferent visual pathway using clinical, imaging and electrophysiological methods provides insights into the pathophysiology of multiple sclerosis and may also serve a prognostic role in multiple sclerosi

An internal cerebral artery dissection presented with anterior choroidal artery infarction

Anterior choroidal artery (AchA) is a branch of internal carotid artery. AchA infarcts are frequently presented by lacunar syndromes. Hemiparesis is the most common presenting symptom. Horner syndrome and cranial nerve palsies are unusual findings for AChA infarcts. In case of presentation with these, etiopathogenesis should be reconsidered and reevaluated. A 42 year old man was admitted to our neurology clinic with right hemiparesis. He had Horner syndrom and hypoglossal nerve palsy. An acute AChA infarction was seen in cranial and diffusion-weighted magnetic resonance imaging (MRI). As there was a suspicious sign of carotid dissection in extracranial MR angiography, digital substraction angiography was performed and dissection of left carotid artery in the subpetrosal region was observed. The patient was diagnosed with left carotid artery dissection and was started on oral anticoagulan therapy. Presentation of an acute AChA infarction due to the dissection of ICA is rarely observed. ICA dissections can sometimes be presented by Horner syndrome and/or cranial nerve palsies. Especially in young stroke patients, dissection should be considered even if the patient does not mention headache

Mild Encephalitis/Encephalopathy with a Reversible Lesion in The Splenium

Mild encephalitis/encephalopathy with a reversible lesion in the splenium (MERS) is a clinico-radiological syndrome with mild central nervous system symptoms and a reversible lesion in the splenium of the corpus callosum. It is mainly associated with a number of viral and bacterial infections, including Coronavirus disease 2019 (COVID-19). In this paper, we report four MERS patients. One had a mumps infection, the second had aseptic meningitis, the third had Marchiafava-Bignami disease, and the fourth had atypical pneumonia associated with COVID-19 infection

The prevalence and perinatal results of gestational diabetes mellitus in pregnant women who were admitted to Derince Teaching and Research Hospital Obstetric and Gynecology Department

Amaç: Çalışmamızın amacı hastanemiz kadın hastalıkları ve doğum polikliniklerine rutin gebelik takibi için başvuran hastalarda gestasyonel diyabetes mellitus (GDM) sıklığını araştırmak ve bu olguların perinatal sonuçlarını analiz etmektir. Gereç ve Yöntem: Bu çalışmada Kocaeli Derince Eğitim ve Araştırma Hastanesine, Temmuz 2012-Mart 2013 yılları arasında kadın hastalıkları ve doğum polikliniğine başvuran, rutin diyabet taraması uygulanmış 526 hastanın perinatal sonuçları retrospektif olarak incelenmiştir. Hastaların hepsine 50 gram glukoz tolerans testi (GTT) uygulanmış ve sonuçları anormal olanlarda 100 gram oral glukoz tolerans testi (100 gr OGTT) yapılmıştır. Hastalar ACOG kriterlerine göre GDM olmayan (Grup 1) ve GDM olan (Grup 2) iki gruba ayrılmış ve hastalar yaş, gravida, parite, abortus, doğum haftası, bebek kilosu, bebek boyu, 1. ve 5. dakika Apgar skorları açısından karşılaştırılmıştır. Bulgular: Çalışmaya dahil edilen 526 hastanın 46 (% 8,7) sında GDM saptanmıştır. 145 hastada (%27.5) ise 50 gr tarama testi yüksek bulunmuştur. İstatistiksel analizde yaş, abort sayısı ve bebek kiloları ve doğum şekillerinde farklılık saptanmıştır. Anne yaşı, abort sayıları, bebek kiloları ve sezaryen oranları grup 2 de daha yüksek bulunmuştur. Sonuç: Kliniğimize başvuran gebelerin GDM prevalansı %8,7 dir. Bizim çalışmamızda, anne yaşının GDM için önemli bir risk faktörü olduğunu, bebek doğum kilolarının ve sezaryen oranlarının diyabetik annelerde daha yüksek olduğunu tespit ettik.Objective: The aim of this study was to determine gestational diabetes mellitus (GDM) frequency and perinatal results of these patients whom referred to our hospital’s antepartum clinic for routine follow-up. Material and Methods: In this study perinatal results of 526 pregnant women who attended to our antepartum clinic for routine follow-up between July 2012 and March 2013 were analyzed retrospectively. A 50-g glucose challenge test (GCT) applied at 24-28 weeks’ gestation. The patients who had a value of blood glucose ≥ 140 mg/ dl undergone 100-g oral glucose tolerance test (OGTT). Patients were divided in two groups according to ACOG GDM criteria. Group 1 was not GDM and group 2 was that diagnosed as GDM. These groups were compared according to maternal age, gravidity, parity, abortus ,gestational weeks at birth, rates of cesarean section, cesarean indications, birth weight, birth height and 1. and 5. minute Apgar scores. Results: Of the 526 pregnant women 46 patients di¬agnosed as GDM (8,7%). One hundred forty five patients had abnormal 50 gr GTT results (27,5%). Maternal age, abortus, birth weight and cesarean rates were found different in statistically analysis. These parameters were detected higher in group 2 patients. Conclusion: The prevalence of GDM in pregnant women who were admitted to our clinic was 8,7 %. In our study we found that maternal age was an important risc factor for GDM and birth weight, cesarean rates were higher in diabetic patients

The prevalence and perinatal results of gestational diabetes mellitus in pregnant women who were admitted to Derince Teaching and Research Hospital Obstetric and Gynecology Department

Amaç: Çalışmamızın amacı hastanemiz kadın hastalıkları ve doğum polikliniklerine rutin gebelik takibi için başvuran hastalarda gestasyonel diyabetes mellitus (GDM) sıklığını araştırmak ve bu olguların perinatal sonuçlarını analiz etmektir. Gereç ve Yöntem: Bu çalışmada Kocaeli Derince Eğitim ve Araştırma Hastanesine, Temmuz 2012-Mart 2013 yılları arasında kadın hastalıkları ve doğum polikliniğine başvuran, rutin diyabet taraması uygulanmış 526 hastanın perinatal sonuçları retrospektif olarak incelenmiştir. Hastaların hepsine 50 gram glukoz tolerans testi (GTT) uygulanmış ve sonuçları anormal olanlarda 100 gram oral glukoz tolerans testi (100 gr OGTT) yapılmıştır. Hastalar ACOG kriterlerine göre GDM olmayan (Grup 1) ve GDM olan (Grup 2) iki gruba ayrılmış ve hastalar yaş, gravida, parite, abortus, doğum haftası, bebek kilosu, bebek boyu, 1. ve 5. dakika Apgar skorları açısından karşılaştırılmıştır. Bulgular: Çalışmaya dahil edilen 526 hastanın 46 (% 8,7) sında GDM saptanmıştır. 145 hastada (%27.5) ise 50 gr tarama testi yüksek bulunmuştur. İstatistiksel analizde yaş, abort sayısı ve bebek kiloları ve doğum şekillerinde farklılık saptanmıştır. Anne yaşı, abort sayıları, bebek kiloları ve sezaryen oranları grup 2 de daha yüksek bulunmuştur. Sonuç: Kliniğimize başvuran gebelerin GDM prevalansı %8,7 dir. Bizim çalışmamızda, anne yaşının GDM için önemli bir risk faktörü olduğunu, bebek doğum kilolarının ve sezaryen oranlarının diyabetik annelerde daha yüksek olduğunu tespit ettik.Objective: The aim of this study was to determine gestational diabetes mellitus (GDM) frequency and perinatal results of these patients whom referred to our hospital’s antepartum clinic for routine follow-up. Material and Methods: In this study perinatal results of 526 pregnant women who attended to our antepartum clinic for routine follow-up between July 2012 and March 2013 were analyzed retrospectively. A 50-g glucose challenge test (GCT) applied at 24-28 weeks’ gestation. The patients who had a value of blood glucose ≥ 140 mg/ dl undergone 100-g oral glucose tolerance test (OGTT). Patients were divided in two groups according to ACOG GDM criteria. Group 1 was not GDM and group 2 was that diagnosed as GDM. These groups were compared according to maternal age, gravidity, parity, abortus ,gestational weeks at birth, rates of cesarean section, cesarean indications, birth weight, birth height and 1. and 5. minute Apgar scores. Results: Of the 526 pregnant women 46 patients di¬agnosed as GDM (8,7%). One hundred forty five patients had abnormal 50 gr GTT results (27,5%). Maternal age, abortus, birth weight and cesarean rates were found different in statistically analysis. These parameters were detected higher in group 2 patients. Conclusion: The prevalence of GDM in pregnant women who were admitted to our clinic was 8,7 %. In our study we found that maternal age was an important risc factor for GDM and birth weight, cesarean rates were higher in diabetic patients

The role of genetics in stroke risk factors; the discussion of two rare genetic syndroms associated with stroke and review of the literature

Stroke is defined as a focal or at times global neurological impairment of sudden onset, that lasts more than 24 hours or that leads to death. The nonmodifiable risk factors for stroke include age, race, gender and acquired risk factors include smoking, hypertension, diabetes and obesity. Previous studies have shown that these mentioned risk factors might be responsible for approximately 50% of patients presenting stroke. However for the remaining half of the stroke patients no risk factors could be detected and genetics might be responsible for this group. In this manuscript we would like to present 2 cases who were being followed-up with the rare genetic syndromes as Marfan syndrome and Robinow syndrome respectively. These patients presented to our clinic with stroke and no identifiable risk factors other than these genetic syndromes could be detected. By this case-series we would like to further discuss the relationship between genetic syndromes and stroke

A Case of Neurosyphilis Presenting with Multiple Cranial Neuropathy

Syphilis is a sexually-transmitted disease caused by the spirochete bacterium Treponema pallidum. Central nervous system involvement can occur in every stage of the disease. It is classified into: acute syphilitic meningitis, meningovascular syphilis, and parenchymatous neurosyphilis. Acute basilar syphilitic meningitis is characterized primarily by the presence of cranial nerve involvement. As cranial nerve enhancement may be seen in a broad range of diseases, it can be the only clinical feature of neurosyphilis

Susac syndrome: Clinical features, laboratory testing and treatment responses of 20 cases

Bu çalışma, 25-28, Ekim 2017 tarihlerinde Paris[Fransa]’da düzenlenen 7. Joint European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ECTRIMS)-Americas-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ACTRIMS) Kongresi‘nde bildiri olarak sunulmuştur.European Comm Treatment & Res Multiple SclerosisAmericas Comm Treatment & Res Multiple Sclerosi