Which Markers Play a Role in Diabetic Polyneuropathy and Neuropathic Pain?

Objective:In diabetes mellitus (DM) patients, in the development of neuropathy and pain, uric acid (UA), C-reactive protein (CRP), γ-glutamyltransferase (GGT), erythrocyte sedimentation rate (ESR), and fibrinogen increased levels may affect the being of neuropathy by increasing oxidative stress through mechanisms related to inflammation and vascular impairment. In the study, we intended to compare serum UA, GGT, CRP, ESR, and fibrinogen levels in type 2 DM patients, with and without polyneuropathy.Method:Ninety-six type 2 DM patients and 24 participants were included in the study. Physical examinations, neuropathic pain scales, laboratory tests (UA, GGT, CRP, ESR, and fibrinogen levels), and electroneuromyography were evaluated.Results:Ninety-six type 2 DM patients and 24 healthy persons were included in the study as the study and control groups. Diabetic polyneuropathy (DPN) patients with neuropathic pain showed that CRP and low-density lipoprotein cholesterol levels were statistically significantly higher. No statistically significant difference was found between the groups in terms of UA, GGT, CRP, and fibrinogen levels.Conclusion:Increased CRP levels in DPN patients with neuropathic pain may reflect the inflammatory mechanisms involved in the pathogenesis of pain associated with DPN

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (<4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs

Catathrenia; Sleep-related Respiratory Disorder Which May Mimic Central Sleep Apnea in Polysomnography: A Case Report

Catathrenia is a sleep-related respiratory disorder characterized by groaning during sleep. This situation is usually not noticed by the affected individuals themselves but is often indicated by family members or bed partners. This disorder, the cause of which is not completely known, is extremely rare. In this case report, a patient who admitted with a complaint of groaning and diagnosed with catahtrenia by polysomnography was presented with its clinical and electrophysiological features. In addition to drawing attention to the fact that catathrenia may be confused with the central sleep apnea pattern in polysomnography, it was emphasized that it should be considered in the differential diagnosis because of a limited number of cases reported in the literature

Physical Activity, Anxiety, and Seizure Frequency in Epilepsy: The Results of the First 3 Months of the Coronavirus Disease 2019 Pandemic

Objectives: The coronavirus disease 2019 (COVID-19) pandemic is an extraordinary experience around the world; however, its effect on physical activity, anxiety, and seizure frequency remains unknown among epilepsy patients in the time of the national lockdown. We aimed to investigate whether the physical activity, anxiety, and seizure frequency were affected during the national lockdown of the first 3 months in patients with epilepsy

Ictal religious speech in non-dominant temporal lobe epilepsy: three cases

Ictal religious speech and gestures, rare ictal semiological findings, sign the epileptic focus at the non-dominant temporal lobe in the literature. Therefore, we aim to present non-dominant temporal lobe semiological findings, including ictal praying and religious gestures in three cases