Neuropathic pain and mood disorders in earthquake survivors with peripheral nerve injuries = Neuropathiás fájdalom és hangulatzavar perifériás idegsérülést szenvedett földrengéstúlélőknél

Backround and purpose – Natural disas- ters, such as earthquakes, frequently result in mood disorders among affected individu- als. It is established that neuropathic pain arising from traumatic neuropathies is also linked to mood disorders. This study inves- tigates the influence of neuropathic pain on the development of mood disorders in earthquake survivors with peripheral nerve injuries, following the earthquake centered in Kahramanmaraş on February 6, 2023. Additionally, we aim to assess the electro physiological aspects of neuropathic injuries in these survivors. Methods – The study comprised 46 earth quake survivors with electrophysiologically confirmed peripheral nerve injuries, with 39 trauma free survivors serving as the control group. Neuropathic pain, anxiety and depression were assessed using the Douleur Neuropathique 4 (DN4) questionnaire and the Hospital Anxiety and Depression Scale (HADS). Results – Our findings revealed that the ulnar and peroneal nerves were the most commonly injured structures. Among the survivors with peripheral nerve injury, 31 out of 46 (67%) were found to experience neuropathic pain. Furthermore, plexopathy and multiple extremity injuries were associated with more severe neuropathic pain. However, there was no significant difference in anxiety and depression scores between the two groups and neuropathic pain was found to have no independent effect. Conclusion – The study indicates that the intensity of neuropathic pain varies based on the localization and distribution of peripheral nerve injuries. However, the presence of peripheral nerve damage or neuropathic pain was not directly associated with HADS scores, suggesting that mood disorders following disasters may have multifactorial causes beyond physical trauma. | Háttér és cél – A természeti katasztrófák, például a földrengések gyakran vezetnek hangulatzavarhoz az érintettek körében. Is- mert, hogy a traumás neuropathiákból eredő neuropathiás fájdalom is összefügg a hangu- latzavarokkal. Ez a tanulmány a neuropathiás fájdalom hatását vizsgálja a hangulatzavarok kialakulására a perifériás idegsérülést szen- vedett földrengéstúlélőknél, a 2023. február 6 i, Kahramanmaraş központú földrengést követően. Emellett célunk a neuropathiás sérülések elektrofiziológiai aspektusainak felmérése ezekben a túlélőkben. Módszerek – A vizsgálatban 46, elektro fiziológiailag igazolt perifériás idegsérüléssel rendelkező földrengéstúlélő vett részt, kont- rollcsoportként 39 traumamentes túlélő szol- gált. A neuropathiás fájdalmat, a szorongást és a depressziót a Douleur Neuropathique 4 (DN4) kérdőív és a Hospital Anxiety and Depression Scale (HADS) segítségével vizs- gáltuk. Eredmények – Az eredmények azt mutat- ják, hogy az ulnaris és a peronealis idegek voltak a leggyakrabban sérült struktúrák. A perifériás idegsérülést szenvedett túlélők közül 46 ból 31 (67%) esetében jelentkezett neuropathiás fájdalom. Továbbá, a plexo pathia és a többvégtag sérülés súlyosabb neuropathiás fájdalommal járt együtt. Mindazon által, a két csoport között nem volt szignifikáns különbség a szorongás és a de- presszió pontszámaiban, és a neuropathiás fájdalomnak nem volt független hatása. Következtetés – A vizsgálat azt jelzi, hogy a neuropathiás fájdalom intenzitása a perifriás idegsérülések lokalizációja és eloszlása alapján változik. A perifériás idegkárosodás vagy a neuropathiás fájdalom jelenléte azonban nem állt közvetlen kapcsolatban a HADS pontszámokkal, ami arra utal, hogy a katasztrófákat követő hangulatzavaroknak a fizikai traumán túl multifaktoriális oka van

Creutzfeldt-Jakob disease presented with dizziness, weakness and neuropsychiatric symptoms: 2 Case Reports

Creutzfeldt-Jakob disease (CJD) is among very rare, progressive, untreatable, neurodegenerative prion diseases. While the incidence is reported as 1/1000000 years in European countries, sporadic cases are rarely presented in Turkey. Clinical findings are in the form of rapid progressive dementia, myoclonus, cerebellar, pyramidal and extra pyramidal symptoms. Definitive diagnosis is established by histopathological examination. Our case is a 64-year-old male and 70-year-old female patients admitted with dizziness emerged as sub-acute weakness, nausea, vomiting, insomnia, imbalance and additional neuropsychiatric complaints. Focal activity slowness and common periodic sharp wave activities were observed in EEG. CJD was considered because bilateral symmetrical diffusion limitation was observed at both sides in the basal ganglia level in cranial diffusion MRI's and 14-3-3 protein was resulted as positive in CSF examinations. CJD, which is a very rare disease in patients presenting with progressive neuropsychiatric symptoms and seizure, is one of the diagnosis to be considered and we wanted to emphasize that there is no treatment for it and preventive measures should be taken

Predictors of a Good Outcome after Endovascular Stroke Treatment with Stent Retrievers

Background and Purpose. Successful recanalization after endovascular stroke therapy (EVT) did not translate into a good clinical outcome in randomized trials. The goal of the study was to identify the predictors of a good outcome after mechanical thrombectomy with stent retrievers. Methods. A retrospective analysis of a prospectively collected database included consecutive patients treated with stent retrievers. We evaluated the influence of risk factors for stroke, baseline NIHSS score, Alberta Stroke Program Early CT (ASPECT) score, recanalization rate, onset-to-recanalization and onset-to-groin puncture time, and glucose levels at admission on good outcomes. The number of stent passes during procedure and symptomatic hemorrhage rate were also recorded. A modified Rankin Scale (mRS) score of 0–2 at 90 days was considered as a good outcome. Results. From January 2011 to 2014, 70 consecutive patients with an acute ischemic stroke underwent EVT with stent retrievers. The absence of a medical history of diabetes was associated with good outcomes. Apart from diabetes, the baseline demographic and clinical characteristics of patients were similar between subjects with poor outcome versus those with good outcomes. Median time from onset to recanalization was significantly shorter in patients with good outcomes 245 (IQR: 216–313 min) compared with poor outcome patients (315 (IQR: 240–360 min); P=0.023). Symptomatic intracranial hemorrhage was observed in eight (21.6%) of 37 patients with poor outcomes and no symptomatic hemorrhage was seen in patients with good outcomes (P=0.006). In multivariate stepwise logistic regression analysis, a favorable ASPECT score (ASPECT > 7) and successful recanalization after EVT were predictors of good outcomes. Every 10-year increase was associated with a 3.60-fold decrease in the probability of a good outcome at 3 months. The probability of a good outcome decreases by 1.43-fold for each 20 mg/dL increase in the blood glucose at admission. Conclusion. To achieve a good outcome after EVT with stent retrievers, quick and complete recanalization and better strategies for patient selection are warranted. We need randomized trials to identify the significance of tight blood glucose control in clinical outcome during or after EVT

Fibrinogen to albumin ratio’s prognostic value in ischemic stroke patients who underwent mechanical thrombectomy

Background and purpose – Fibrinogen to albumin ratio (FAR) is thought to have a predictive effect in diseases such as cancer and myocardial infarction. We aimed to elucidate the prognostic value of FAR in ischemic stroke patients who underwent mechanical thrombectomy. Methods – A total of 103 patients hospitalized for acute stroke who underwent mechanical thrombectomy within 6 hours of symptoms’ outset have been analyzed retrospectively. Stroke severity was interpreted via the National Institutes of Health Stroke Scale (NIHSS) score during the neurological examination. Recanalization success after mechanical thrombectomy was evaluated with the TICI score (Thrombolysis in Cerebral Infarction scale), and 2b – 3 patients were recorded as those with recanalization. The patients’ modified Rankin scale (mRS) at discharge and at the end of the third month were recorded. Results – Statistically significant differences were observed in age, admission blood glucose, glomerular filtration rate and FAR according to the mRS scores of the patients in the third month (p<0.05). Significant variables in the risk factor analysis were re-evaluated in the multivariate model. The best model was determined using the backward Wald method in the multivariate model,and it was determined that differences in age, admission blood glucose, and FAR were significant. Conclusion – FAR can be used as a novel, effective, economical, and practical biomarker in patient with acute ischemic stroke who underwent mechanical thrombectomy

Demographic Characteristics of Strokes Types in Sanliurfa

Aim: Sanliurfa training and research hospital for diagnosis and treatment of patients with stroke admitted demographic features planned. We aimed to study demographic feature of stroke patient who admitted to Sanliurfa training and research hospital for diagnosis and treatment. Material and Method: 01/10/2011 and 01/9/2012, ischemic and hemorrhagic brain training and research hospital in Sanliurfa vascular disease diagnosis and treatment without any exclusion criteria, patient sequential 454 retrospectively. Results: 366'si 88 were ischemic, hemorrhagic stroke. 54.6% by sex male,% 45.4 were women. Average age: 67.86 di.56.3% radiologically roaming the front circulation infarct brain infarct% found the rear 23.2. Hospital stay duration: 9.27 day.. Hemorrhagic stroke was longer this Sura in the group. Mortality rate 4.6% in all in packaging (21 patients), ischemic in boots in 1.9% (7 patients), hemorrhagic of boots were found at 15.9% (14 patients). Discussion: our study of Sanliurfa province stroke data in terms of the region together, although a portion of their valuable results. In the summer, the ischemic stroke incidence is higher

Four Novel SCN1A Mutations in Turkish Patients With Severe Myoclonic Epilepsy of Infancy (SMEI)

Severe myoclonic epilepsy of infancy (SMEI) (OMIM #607208), also known as Dravet syndrome, is a rare genetic disorder characterized by frequent generalized, unilateral clonic or tonic-clonic seizures that begin during the first year of life. Heterozygous de novo mutations in the SCN1A gene, which encodes the neuronal voltage-gated sodium channel alpha subunit type 1 (Nav1.1), are responsible for Dravet syndrome, with a broad spectrum of mutations and rearrangements having been reported. In this study, the authors present 4 novel mutations and confirm 2 previously identified mutations in the SCN1A gene found in a cohort of Turkish patients with Dravet syndrome. Mutational analysis of other responsible genes, GABRG2 and PCDH19, were unrevealing. The authors' findings add to the known spectrum of mutations responsible for this disease phenotype and once again reinforce our understanding of the allelic heterogeneity of this disease

Novel VLDLR microdeletion identified in two Turkish siblings with pachygyria and pontocerebellar atrophy

Congenital ataxia with cerebellar hypoplasia is a heterogeneous group of disorders that presents with motor disability, hypotonia, incoordination, and impaired motor development. Among these, disequilibrium syndrome describes a constellation of findings including non-progressive cerebellar ataxia, mental retardation, and cerebellar hypoplasia following an autosomal recessive pattern of inheritance and can be caused by mutations in the Very Low Density Lipoprotein Receptor (VLDLR). Interestingly, while the majority of patients with VLDL-associated cerebellar hypoplasia in the literature use bipedal gait, the previously reported patients of Turkish decent have demonstrated similar neurological sequelae, but rely on quadrupedal gait. We present a consanguinous Turkish family with two siblings with cerebellar atrophy, predominantly frontal pachygyria and ataxic bipedal gait, who were found to have a novel homozygous deletion in the VLDLR gene identified by using high-density single nucleotide polymorphism microarrays for homozygosity mapping and identification of CNVs within these regions. Discovery of disease causing homozygous deletions in the present Turkish family capable of maintaining bipedal movement exemplifies the phenotypic heterogeneity of VLDLR-associated cerebellar hypoplasia and ataxia