Hot Water Epilepsy in a Pregnant Woman: A Case Report

Hot water epilepsy is a unique form of reflex epilepsy precipitated by the stimulus of bathing with hot water poured over the head. It is mostly seen in infants and children, with a predominance in males. Unlikely, we present a 32-year-old pregnancy woman with the incipient of reflex seizures triggered by pouring hot water over the head while having a bath during the gestation period and treated successfully with carbamazepine 400 mg/day therapy. Hot water epilepsy is known as a benign and self-limited reflex epilepsy, by firstly avoiding hot water or long showers and secondly using intermittent benzodiazepines or conventional antiepileptic drugs, may be sufficient to be seizure-free

Clinical overlap of multiple sclerosis and autoimmune hepatitis: three cases

Multiple sclerosis (MS) is an autoimmune, inflammatory disease characterized by demyelination and axonal degeneration in the central nervous system. MS is the second major cause of disability following trauma, and is mostly seen between the ages of 20 - 40 years and in women. Autoimmune hepatitis (AH) is a chronic disease characterized by hypergammaglobulinemia, high levels of transaminases, presence of antibodies, and histologically by the necroinflammatory process with interface hepatitis. In AH, the etiological agent of the disease and the cause of liver injury remain unknown. MS may be associated with AH, autoimmune thyroiditis, and type 1 diabetes mellitus (DM). In literature, 8 cases with overlap of MS and AH have been reported. In this report, we present 3 cases which were detected with overlap of MS and AH, and are very rare condition in literature

Atipik baş ağrısı ile başvuran pnömosinüs dilatans olgusu

[No Abstract Available

Bir orbital ensefaloselin tesadüfi tanısı-kapak miyokimisinin ötesi

A 38-years-old woman presented to our hospital for routine eye examination. She had no complaints but it was learnt that she has been followed up with the diagnosis of a left upper eyelid myokymia for more than 10 years in various ophthalmological centers. Since her eyelid movement was atypical for a myokymia, but in form of an orbital pulsation instead she has undergone an orbital magnetic resonance imaging (MRI) scan. She was coincidentally diagnosed to have a left frontoorbital encephalocele detected by MRI. She had no trauma or chronic illness in history, so the condition was diagnosed as a ‘congenital encephalocele’ which is lately detected since due to the absence of obvious proptosis or an active clinical complaint

The case of Dermoid cyst causing Hydrocephalus

İntrakranial dermoid kistler nadir görülen, selim, yavaş büyüyen ektodermal hücrelerin inklüzyonlarından köken alan lezyonlardır. Genellikle asemptomatiktirler; semptomatik olduklarında rüptüre olurlar. Bu durumda kafaiçi basınç artışına, hidrosefaliye, aseptik menenjite ve epilepsiye yol açabilirler. Uzun zamandır olan ancak son 2 aydır sabahları daha belirgin olmak üzere günün her saatinde de devam eden sıkıştırıcı tarzda, bulantı-kusmanın ve otonom bulgularının eşlik etmediği, aura ve foto-fonofobinin olmadığı atipik baş ağrısı tarif eden 17 yaşında bayan hasta Nöroloji polikliniğine başvurdu. Yapılan nörolojik muayenede fundusta venöz dolgunluk dışında patoloji saptanmadı. Atipik baş ağrısı olan hastaya sekonder baş ağrısı nedeniyle beyin bilgisayarlı tomografisi çekildi ve dermoid kiste bağlı hidrosefali bulguları saptandı. Nadir olarak görülen ve görüldüğünde rüptürle sonuçlanan atipik baş ağrısıyla presente 17 yaşındaki bayan hastayı sunmayı değer bulduk

Relationship between apnea-hypopnea index and oxygen desaturation in REM-sleep period and morning headache in patients with obstructive sleep apnea syndrome

Introduction: In patients with morning headache, REM sleep period decreases though little is known about its physiopathology. We evaluate the polysomnographic records of obstructive sleep apnea syndrome (OSAS) patients with the hypothesis that oxygen desaturations may be a better determinant in patients with morning headache, especially those in REM sleep periods. Methods: Patient group (group 1) with a total of 361 patients with OSAS and the controls (group 2) with 107 healthy individuals were evaluated. The presence of morning headache was compared between the groups, and sleep parameters were correlated with morning headache. Results: In group 1, patients with OSAS and morning headache, apneahypopnea index in the REM sleep period (26.7/hour, min-max: 0-108.4/hour) was higher than those in patients without morning headache (17.8/hour, min-max: 0-107.8/hour). The minimum oxygen saturation in REM sleep period and total sleep time (TST) was lower in patients with morning headache (REM sleep period: 82%, min-max: 50-94%; TST: 79%, min-max: 50-97%) in compared to patients without morning headache (REM sleep period: 84%, min-max: 50-93%; TST: 81%, min-max: 50-90%). Conclusion: Here we demonstrated that higher apnea-hypopnea index and lower oxygen saturation in REM sleep period were associated with morning headache in patients with obstructive sleep apnea syndrome

The impact of the COVID-19 lockdown on the quality of life in chronic neurological diseases: the results of a COVQoL-CND study

Background: Coronavirus disease 2019 (COVID-19) pandemic and lockdown period may induce an impairment in quality of life (QoL), disruption in treatment (DIT), and posttraumatic stress disorder (PTSD) in chronic neurological diseases (CNDs). To reach this information, a multicenter, cross-sectional study (COVQoL-CND) was planned. Parkinson's disease (PD), headache (HA), multiple sclerosis (MS), epilepsy (EP), polyneuropathy (PNP), and cerebrovascular disease (CVD) were selected as the CND. Methods: The COVQoL-CND study includes demographic data, the World Health Organization Quality of Life short form (WHOQOL-BREF), and Impact of Event Scale-Revised (IES-R) forms. Results: The mean age of a total of 577 patients was 49 +/- 17 (19-87 years), and the ratio of female/male was 352/225. The mean age of patients with PD, HA, MS, EP, PNP, and CVD were 65 +/- 11, 39 +/- 12, 38 +/- 10, 47 +/- 17, 61 +/- 12, and 60 +/- 15 years, respectively. The IES-R scores were found to be higher in the younger group, those with comorbid disease, contacted with CO-VID-19 patients, or diagnosed with COVID-19. In the group with a high IES-R score, the rate of DIT was found to be high. IES-R scores were negatively correlated with QoL. IES-R total scores were found highest in the CVD group and lowest in the PD group. The ratio of DIT was found highest in the PNP group and the lowest in the EP group. Contact with CO-VID-19 patients was high in the EP and HA group. Conclusions: The results of the COVQoL-CND study showed that lockdown causes posttraumatic stress and deterioration in the QoL in CND

The value of carotid intima-media measurements during the periods of attack and remission of migraine disease and tension-type headache in differential diagnosis

INTRODUCTION: In Turkey, 2% of emergency department admissions are migraine and there is no specific biomarker with differential diagnostic value in patients presenting with headache. There are studies showing that the blood-brain barrier deteriorates during migraine attacks, the risk of atherosclerosis is increased in migraine patients and it is associated with cardiovascular and cerebrovascular diseases. In light of this information, the value of carotid intima-media thickness (CIMT) measurements in the differential diagnosis of tension and migraine headache was investigated.  MATERIAL AND METHODS: The study group consisting of 20 tension headache, 23 migraine attacks, 20 remission migraine patients admitted to the emergency department and neurology outpatient clinic of Ridvan Ege Hospital between February and September 2017 and control group of 21 healthy volunteers were compared. Carotid intima-media thickness (CIMT) of all participants was measured by specialist radiologist. The data obtained were analysed using SPSS 15.0 statistical program.  RESULTS: There was no significant difference between the participants in terms of age and gender. When the carotid intima-media thickness was analysed between the four groups and according to the presence and type of migraine, no significant difference was found (p = 0.489).  CONCLUSIONS: This is the first study in the literature which evaluates the relationship between subclinical atherosclerosis and tension-type headache and migraine by examining patients with tension-type headache and migraine disease in both episode and remission period. According to the results obtained, migraine and tension headache is not associated with subclinical atherosclerosis. However, larger-scale studies are required in this sense

Evaluation of the vascular contacts of the facial nerve on three-dimensional fast imaging employing steady-state acquisition MRI in Bell's palsy

Bell felcinde kararlı-durum eldeli MRG ile hızlı üç boyutlu görüntülemede fasiyal sinire vasküler basının değerlendirilmesi Amaç: Bu çalıflmanın amacı, üç boyutlu kararlı-durum eldeli hızlımanyetik rezonans görüntülemede (3D-FIESTA) fasiyal sinirin vasküler bası kalıplarını göstermek, bunun yanı sıra bu kalıplar, HouseBrackmann (HB) derecelendirmeleri ve Bell felcindeki (BP) sonuçlararasındaki korelasyonu değerlendirmektir.Yöntem:Çalıflmaya 52 BP hastası ve 25 sağlıklı kontrol dahil edildi.Ayrıca 52 hasta da sağlıklı (asemptomatik) taraf üçüncü grubu oluflturdu. Vasküler temasın varlığı, sayısı ve anatomik yerleflimine görefasiyal sinirin vasküler temas kalıpları 3D-FIESTA MRG'de sınıflandırıldı. Bulgular:Yüz sinirinin vasküler bası kalıpları bakımından gruplararasında anlamlı bir farklılık saptandı (p<0.001). Hastaların semptomatik taraflarında çoklu vasküler basılar daha belirgindi. Hasta geldiğinde, 3. hafta ve 3. aydaki kontrollerde vasküler bası kalıplarıyla HBdereceleri arasında pozitif istatistiksel korelasyon mevcuttu (r=0.335;p=0.015, r=0.587; p<0.001 ve r=0.493; p<0.001). Sonuç:3D-FIESTA MRG'de fasiyal sinirin çoklu vasküler basısınınçok daha sık olduğu ve BP'de düflük iyileflme oranlarıyla iliflkili olduğu saptanmıfltır. Bu nedenle, 3D-FIESTA MRG BP'de prognostikbilgi sağlayabilirObjective:The purpose of this study was to demonstrate the vascularcontact patterns of the facial nerve (FN) on three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) magnetic resonance imaging (MRI) and evaluate the correlation between these patterns, House-Brackmann (HB) grades and outcomes in Bell's palsy (BP). Methods:Fifty-two patients with BP and 25 healthy controls wereincluded in the study. Besides, a third group was formed by theasymptomatic sides of 52 patients. The vascular contact patterns ofthe FN on 3D-FIESTA MRI were classified with regard to the presence, number and anatomic location of the contact. Results: A significant difference was found between the groups in termsof vascular contact patterns of the FN (p&lt;0.001). Multiple vascular contacts were more prominent in the symptomatic sides of the patients.There was a positive statistical correlation between vascular contact patterns and HB grades at presentation and at the 3rd week and 3rd monthfollow-ups (r=0.335; p=0.015, r=0.587; p&lt;0.001 and r=0.493; p&lt;0.001). Conclusion:Multiple vascular contacts of the FN on 3D-FIESTAMRI were found to be more common and associated with poor recovery in BP. Thus, 3D-FIESTA MRI may provide prognostic information in BP

Evaluation of the vascular contacts of the facial nerve on three-dimensional fast imaging employing steady-state acquisition MRI in Bell’s palsy

Objective: The purpose of this study was to demonstrate the vascular contact patterns of the facial nerve (FN) on three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) magnetic resonance imaging (MRI) and evaluate the correlation between these patterns, House-Brackmann (HB) grades and outcomes in Bell’s palsy (BP). Methods: Fifty-two patients with BP and 25 healthy controls were included in the study. Besides, a third group was formed by the asymptomatic sides of 52 patients. The vascular contact patterns of the FN on 3D-FIESTA MRI were classified with regard to the presence, number and anatomic location of the contact. Results: A significant difference was found between the groups in terms of vascular contact patterns of the FN (p<0.001). Multiple vascular contacts were more prominent in the symptomatic sides of the patients. There was a positive statistical correlation between vascular contact patterns and HB grades at presentation and at the 3rd week and 3rd month follow-ups (r=0.335; p=0.015, r=0.587; p<0.001 and r=0.493; p<0.001). Conclusion: Multiple vascular contacts of the FN on 3D-FIESTA MRI were found to be more common and associated with poor recovery in BP. Thus, 3D-FIESTA MRI may provide prognostic information in BP