Nocturnal groaning associated with REM sleep phenomenon

Bilimsel zemin: Nokturnal inleme, uyku sırasında respiratuvar disritminin eşlik ettiği ekspiryumda monoton ses çıkışının olduğu bir sendromdur. Günümüze kadar çok az nokturnal inlemeli olgu bildirilmiştir. Nokturnal inleme epizodlarının prevalansı özellikle REM uykusunda çok yüksektir. Bu nedenle REM uykusuyla ilişkili bir fenomen olduğu kabul edilmektedir. Bazı çalışmalarda, hastaların birkaçında bruksizm ve uykuda yürüme de vardır denmesine rağmen, REM uykusuyla ilişkili uyku fenomenleriyle birlikteliği açısından herhangi bir bilgi bulunmamaktadır. Amaç: 20 yaşında gündüz aşırı uykululuğu olan kadın hastada nokturnal inleme ve REM uyku fenomenlerinden uyku paralizisi ve hipnagojik halüsi-nasyonların birlikteliğini bildirmek ve bu birlikteliğin nedenlerini tartışmak. Gereç ve yöntemler: Nörolojik muayenesi ve kulak-burun-boğaz muayenesi, Epworth uykululuk skalası, tüm-gece polisomnografi tetkiki, multipl uyku latansı testi yapıldı. Sonuçlar: Nokturnal inlemeli olgularda diğer REM uykusuyla ilişkili fenomenlerin birlikte bulunabileceği akla gelmeli ve her nokturnal inlemeli olguda sorgulanmalıdır. Ancak bu sayede, bu birlikteliğin rastlantısal mı yoksa benzer patofizyolojiye mi bağlı geliştiği aydınlatabilecektir.Nocturnal Groaning Associated with REM Sleep Phenomenon Scientific background: Nocturnal groaning is described as a syndrome with expiratory monotonous vocalization associated with a respiratory dysrhythmia during sleep. To date, few cases have been reported. Nocturnal groaning is a predominantly REM sleep-related phenomenon, because a great prevalence for REM sleep-related episodes had been observed. Although in some literature it was told that nocturnal groan­ing was associated with some cases of bruxism and/or sleepwalking, there is no report of nocturnal groaning associated with any other REM related sleep phenomenon. Objective: To report the association of REM related sleep phenome-nons, such as sleep paralysis and hypnagogic hallucinations with noctur­nal groaning in a-twenty-year-old girl with excessive daytime sleepiness and to discuss the causes of this association. Material and methods: Neurological and ear-nose-throat examina­tions, Epworth sleepiness scale, full-night polysomnography and multi­ple latency test were done. Results: The association of nocturnal groaning with the other REM sleep related phenemenons had to be kept in mind and investigated in every patient with nocturnal groaning. By this means, whether the occurence of this association is due to a coincidence or same patho-physiological background could be enlightened

Hepatitis B Virus Infectıon Presenting As Chronıc Inflammatory Demyelinating Polyneuropathy

Periferik sinirlerin ilerleyici yada tekrarlayıcı, motor ve duyu kaybıyla karakterize olan kronik inflamatuar demiyelinizan polinöropati (KIDP); diabetes mellitus, kanser, sarkoidoz gibi nedenlerle gelişebilir. Hepatit B virus enfeksiyonu (HBVe) olan hastalarda KIDP gelişebilir, ancak HBVe’nin KIDP ile presentasyonu bildirilmemiştir. Olgumuz 60 yaşında erkek hasta, el ve ayaklarında ani gelişen güçsüzlük ve uyuşukluk şikayeti ile başvurdu. Hastada tetraparezi ile birlikte derin tendon reflekslerinde hipoaktivite, hipoestezi ve parestezi mevcuttu. Önce AST ve ALT yüksekliği, ardından da HBsAg ve HBV-DNA pozitifliği saptandı. Karaciğer biyopsisi kronik hepatit ve karaciğer fibrosisini göstermesine rağmen, hastada hepatit hikayesi yoktu. Sonuçta, KIDP etiyolojisi araştırılırken, hepatit öyküsü olmasa bile, HBVe düşünülmelidir.Chronic inflammatory demyelinating polyneuropathy (CIDP), which is characterized by a progressive or recurrent loss of motor and sensory peripheral nerves, could be due to many reasons such as diabetes mellitus, cancer, sarcoidosis. Although, CIDP could develop in patients with Hepatitis B virus infection (HBVi), HBVi wasnot found to present itself as CIDP. Our case is a 60 years old-man whom suddenly developed numbness and weakness in hands and feet. He was tetraparetic with hypoactive deep tendon reflexes, hypoesthesia and parestesia. Electroneuromyography (ENMG) revealed mixed type demyelinating and sensorial sensorimotor polyneuropathy. At the time of the diagnosis, high values of AST and ALT; later on, positivity of HBsAg and HBV-DNA were detected. Although liver biopsy showed chronic hepatitis and liver fibrosis, he didnot have any history of hepatitis. In conclusion, while investigating the etiology of CIDP, HBVi should be considered even if patients didnot mention or know any history of hepatitis

Is there any relationship between quality of life and polysomnographically detected sleep parameters/disorders in stable myasthenia gravis?

Ankarali, Handan Camdeviren/0000-0002-3613-0523; Tascilar, Nida/0000-0003-0780-0783WOS: 000427844400006PubMed: 28456888It is known that quality of life in myasthenia gravis is positively correlated with subjective sleep quality, still no data is available regarding the relationship between QOL and polysomnographically detected sleep parameters and disorders. In this study, we tried to highlighten this relationship, by performing polysomnography. Sleep-related complaints were evaluated in face-to-face interviews with 19 clinically stable MG patients and 26 healthy controls. During the interviews questionnaires assessing sleep quality, excessive daytime sleepiness, fatigue, depression, anxiety, and Turkish version of the MG-QOL 15-item scale [(MG-QOL15(T)] were administered and then an overnight polysomnography was performed. Sleep disorders, especially obstructive sleep apnea and fatigue were higher, whereas subjective sleep duration was significantly lower, in patients than controls. Excessive daytime sleepiness and poor sleep quality were not different between patients and controls. Other than percentage of sleep stage III, which was negatively correlated with MG-QOL15(T) scores, neither other sleep parameters nor sleep disorders were correlated with MG-QOL15(T) scores. MG composite, subjective sleep duration, fatigue severity and Hamilton depression rating scale scores were found to be positively correlated with MG-QOL15(T) scores. It was shown that decreasing disease severity and enhancing psychological well-being will improve patients' quality of life. We recommend that our findings should be repeated in a large prospective cohort of MG patients

Baş Ağrısı Hastalarında Tamamlayıcı ve Alternatif Tedavi Kullanımı

Objective: Complementary and alternative treatment methods (CAM) are used frequently for patient have primary headache patients and many studies investigate why it is used. Our aim is to determine reason of using CAM and application locations of CAM in our country. Methods: Two hundred patients who were diagnosed primary headache and accepted to participate in our study were enrolled. We investigate sociodemographic data, CAM usage frequency, preferred CAM, satisfaction rates, thought on CAM use, recommendation sources, whether medical treatment continues or not and reason of CAM usage. Results: The 26% of patients were using CAM and 55,7% of those using CAM were satisfied with the treatment. Patients using CAM were younger than those who did not use (p=0,033). Unemployed, students and all-day employees; single people and well-educated people were using CAM more often (p=0,042; p=0,026; p=0,009, respectively). The most frequent reason of CAM usage was 'effective treatment of headache of this treatment methods'. 85% of CAM users had also continued medical treatment. Conclusion: We found single and well-educated patients more likely candidate for CAM. High rates of CAM and medical treatment usage indicates that CAM only treatments are not generally accepted in our country.Giriş: Dünyada baş ağrısında tamamlayıcı ve alternatif tedavi (TAT) yöntemleri kullanımına yönelik çalışmalar artan sıklıkta yapılmakta ve hastaların bu tedaviye başvurma nedenleri araştırılmaktadır. Çalışmamızın amacı ülkemizdeki baş ağrısı hastalarında TAT yöntemlerinin yerini ve nedenlerini belirlemektir. Yöntem: Çalışmamıza nöroloji polikliniğinde primer baş ağrısı tanısı konulmuş çalışmaya katılmayı kabul eden 200 hasta dâhil edildi. Hastaların sosyodemografik verileri, TAT kullanım sıklığı, tercih edilen TAT yöntemi, memnuniyet oranları, TAT’a bakış açısı, tavsiye kaynakları, tıbbi tedaviye devam edip etmedikleri ve TAT’a başvuru sebepleri sorgulandı. Bulgular: Hastaların % 26’sı TAT kullanırken, TAT kullananlarda tedaviden memnuniyet oranı % 55,7 bulundu. TAT kullananlar kullanmayanlara göre daha gençti (p= 0,033). TAT kullanımı işsiz, öğrenci, tam gün çalışan gruplarında diğer meslek gruplarına göre (p= 0,042), bekârlarda evlilere oranla (p= 0,026) ve eğitim düzeyi yüksek olanlar da düşük olanlara göre (p= 0,009) daha fazlaydı. En sık TAT’a başvuru sebebinin ‘Bu tedavinin baş ağrısını etkili şekilde tedavi ettiğine inanma’ olduğu bulundu. TAT kullanan hastaların % 85’i önerilen tıbbi tedaviye de devam etmişti. Sonuç: Bekâr ve eğitim düzeyi yüksek bir hastanın TAT kullanımı için daha yüksek oranda aday olduğunu saptadık. Hastalarımızın önemli oranda TAT ile birlikte medikal tedaviye devam etmesi ülkemizde TAT’lerin tek başına kullanımının halen genel kabul görmediğini göstermektedir

Baş ağrısı hastalarında tamamlayıcı ve alternatif tedavi kullanımı

Objective: Complementary and alternative treatment methods (CAM) are used frequently for patient have primary headache patients and many studies investigate why it is used. Our aim is to determine reason of using CAM and application locations of CAM in our country. Methods: Two hundred patients who were diagnosed primary headache and accepted to participate in our study were enrolled. We investigate sociodemographic data, CAM usage frequency, preferred CAM, satisfaction rates, thought on CAM use, recommendation sources, whether medical treatment continues or not and reason of CAM usage. Results: The 26% of patients were using CAM and 55,7% of those using CAM were satisfied with the treatment. Patients using CAM were younger than those who did not use (p=0,033). Unemployed, students and all-day employees; single people and well-educated people were using CAM more often (p=0,042; p=0,026; p=0,009, respectively). The most frequent reason of CAM usage was 'effective treatment of headache of this treatment methods'. 85% of CAM users had also continued medical treatment. Conclusion: We found single and well-educated patients more likely candidate for CAM. High rates of CAM and medical treatment usage indicates that CAM only treatments are not generally accepted in our country.Giriş: Dünyada baş ağrısında tamamlayıcı ve alternatif tedavi (TAT) yöntemleri kullanımına yönelik çalışmalar artan sıklıkta yapılmakta ve hastaların bu tedaviye başvurma nedenleri araştırılmaktadır. Çalışmamızın amacı ülkemizdeki baş ağrısı hastalarında TAT yöntemlerinin yerini ve nedenlerini belirlemektir. Yöntem: Çalışmamıza nöroloji polikliniğinde primer baş ağrısı tanısı konulmuş çalışmaya katılmayı kabul eden 200 hasta dâhil edildi. Hastaların sosyodemografik verileri, TAT kullanım sıklığı, tercih edilen TAT yöntemi, memnuniyet oranları, TAT’a bakış açısı, tavsiye kaynakları, tıbbi tedaviye devam edip etmedikleri ve TAT’a başvuru sebepleri sorgulandı. Bulgular: Hastaların % 26’sı TAT kullanırken, TAT kullananlarda tedaviden memnuniyet oranı % 55,7 bulundu. TAT kullananlar kullanmayanlara göre daha gençti (p= 0,033). TAT kullanımı işsiz, öğrenci, tam gün çalışan gruplarında diğer meslek gruplarına göre (p= 0,042), bekârlarda evlilere oranla (p= 0,026) ve eğitim düzeyi yüksek olanlar da düşük olanlara göre (p= 0,009) daha fazlaydı. En sık TAT’a başvuru sebebinin ‘Bu tedavinin baş ağrısını etkili şekilde tedavi ettiğine inanma’ olduğu bulundu. TAT kullanan hastaların % 85’i önerilen tıbbi tedaviye de devam etmişti. Sonuç: Bekâr ve eğitim düzeyi yüksek bir hastanın TAT kullanımı için daha yüksek oranda aday olduğunu saptadık. Hastalarımızın önemli oranda TAT ile birlikte medikal tedaviye devam etmesi ülkemizde TAT’lerin tek başına kullanımının halen genel kabul görmediğini göstermektedir

Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study

Purpose: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST).Method: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients.Results: The mean age of the patients in the ES group was 39.73 +/- 12.64 and 40.17 +/- 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter.Conclusions: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST

Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study

Purpose: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). Method: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. Results: The mean age of the patients in the ES group was 39.73 +/- 12.64 and 40.17 +/- 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. Conclusions: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.WOS:0005375741000192-s2.0-85083703251PubMed: 3235381