The Relationship of Stroke and Sleep-A Review

Ischemic stroke appears the third leading cause of mortality and the first cause of disability in developing countries. The relationship between sleep disorders and cerebrovascular risk factors is well defined and there are different mechanisms in pathophysiology. Ischemic stroke affects many pathways, such as hypoxia, increased wakefulness reactions, decreased sleep quality, increased free oxygen radicals, inflammatory mechanisms activation, endothelial dysfunction, atherosclerosis, hypertension, and insulin resistance. Sleep disturbances contribute to stroke pathology through multiple direct or indirect mechanisms. Due to the fact that sleep disorders are among the changeable cerebrovascular risk factors, it is very important to raise awareness about the diagnosis, management and prevention of sleep disorders

Evaluation of the Severity of Sleep Complaints According to the Stages of Chronic Obstructive Pulmonary Disease

Objective: Impairment of continuity of the sleep due to arousals and stage changes commonly experienced by the patients with chronic obstructive pulmonary disease (COPD) cause sleep problems associated with insomnia or hypersomnia. These resultant sleep problems lead to impaired quality of life in the patients with COPD. The aim of this study was to evaluate complaints related to sleep-alertness in the patients with COPD in the setting in which subjective sleep tests and polysomnography investigation using scales of quality of life are unavailable. Materials and Methods: The present study included 70 patients with COPD (33 were men and 37 were women). First, the patients with symptoms of COPD were evaluated clinically and COPD was staged based on degree of restriction of airflow (GOLD 2011). Sleep-alertness situation of all patients was evaluated using Epworth Sleepiness Scale (ESS) and Pittsburgh Scale of Seep Quality (PSSQ). Results: No statistically significant relationship was observed between stage of COPD and results of subjective sleep tests. Conclusion: Although these results indicate that stage of disease does not impact sleepiness and quality of sleep in the patients with COPD, they support the fact that presence of COPD alone negatively affected quality of sleep

Association of myasthenia gravis and Behçet's disease: A case report

Myasthenia gravis is a disease of neuromuscular junction due to auto-immune destruction of the acetylcholine receptors. Behçet's disease, on the other hand, is a multisystemic vascular-inflammatory disease. Both conditions are not common in the general population although their association has not been reported in the literature. We wanted to present our patient who developed clinical course of myasthenia gravis following discontinuation of medications due to complications of corticosteroid for Behçet's disease. It was observed that clinical findings of myasthenia gravis recovered following restarting steroid treatment and he did not experience attacks of both conditions. Although Myasthenia gravis and Behçet's disease are distinct entities clinically as well as in terms of pathogenesis, they share common physiopathological features and their treatment is based on their common features

How Should Antiepileptic Drugs Be Selected During Pregnancy

Antiepileptik ilaç kullanan annelerin bebeklerinde prematüre, gelişme geriliği ve major malformasyon riski; ilaç almayanlara göre daha yük-sek oranda olmasına rağmen, konvülsif nöbetlerin anne ve bebek sağlığına olan zararlı etkileri çok daha fazladır. Bu yüzden antiepileptik ilaçların fetüse getirdiği riskler ile gebelik sırasında oluşan nöbetlerin anne ve bebek sağlığına etkisi dikkatlice değerlendirilmelidir. Hem antiepileptik ilaçlar, hem de nöbetler fetüsü olumsuz yönde etkileyebilir. Son zamanlarda yeni çıkan antiepileptik ilaçların yan etkilerinin az olması ve toleransın yüksek olması özelliklerinden dolayı yaygın kullanılmaya başlanmış olması, bu ilaçların gebelerde olan etkinliğinin araştırılmasına neden olmuştur. Bununla birlikte eski kuşak antiepileptiklerin bilinen teratojenik etkileri yanında kognisyon üzerine etkilerinin olumsuz olması da bu ilaçların daha dikkatli kullanılmasını gerektirmektedir. Gebelikte antiepileptik seçiminde birincil amaç; nöbetleri kont-rol altına almak, bebeğin hem fiziksel hem de kognitif malformasyon gelişme riskini en aza indirmektir.Although the risk of prematurity, growth retardation, and major malformations is higher in infants of mothers using antiepileptic medications than in those of the mothers not using them, the harmful effects of the convulsive seizures on the maternal and fetal health are much more. Thus, the risks introduced by the antiepileptic medications to the fetus as well as the effects of the seizures occurring during gestation on ma-ternal and fetal health should be evaluated carefully. Both antiepileptic medications and seizures may negatively impact the fetus. Given that recently introduced antiepileptic medications have fewer side effects they are used widely and due to their high tolerability rates, several inves-tigations regarding their efficacy have been prompted in pregnant women. On the contrary, the teratogenic effects of the old-generation anti-epileptics and their negative effects on cognition warrant more careful use of these medications. The primary objective in choosing antiepilep-tic medications for pregnant women is to control the seizures and minimize the risk of developing both physical and cognitive malformations

How Should Antiepileptic Drugs Be Selected During Pregnancy

Although the risk of prematurity, growth retardation, and major malformations is higher in infants of mothers using antiepileptic medications than in those of the mothers not using them, the harmful effects of the convulsive seizures on the maternal and fetal health are much more. Thus, the risks introduced by the antiepileptic medications to the fetus as well as the effects of the seizures occurring during gestation on maternal and fetal health should be evaluated carefully. Both antiepileptic medications and seizures may negatively impact the fetus. Given that recently introduced antiepileptic medications have fewer side effects they are used widely and due to their high tolerability rates, several investigations regarding their efficacy have been prompted in pregnant women. On the contrary, the teratogenic effects of the oldgeneration antiepileptics and their negative effects on cognition warrant more careful use of these medications. The primary objective in choosing antiepileptic medications for pregnant women is to control the seizures and minimize the risk of developing both physical and cognitive malformations

Airplane headache: An atypical case with autonomic symptoms and long duration

WOS:000616431700026Airplane Headache (AH) which is classified under headache attributed to disorder of homeostasis in International Classification of Headache Disorders (ICHD)-3 is a severe, unilateral, orbitofrontal headache that occurs during and caused by airplane travel. It remits after landing. AH cases with autonomic symptoms had rarely been reported. We present a 35-year-old male complained of five attacks of right-sided, unilateral, orbitofrontal headache accompanied with lacrimation, conjunctival injection and eye redness ipsilaterally, starting 20-30 minutes prior to landing. The headache duration varied between 30-90 minutes. AH diagnosis was made in the light of anamnesis and neurological examination. The secondary causes and primary headaches with autonomic symptoms were ruled out. As far as we know this is the first reported longer duration AH case with autonomic symptoms in the literature. AH is an underdiagnosed headache. We report this atypical AH case to call attention to this rare but treatable headache