Fatih Özdağ

Auditory event-related brain potentials in fibromyalgia syndrome

ObjectiveThe aim of this study was to investigate cognitive functions using auditory event-related brain potentials (ERP) in fibromyalgia syndrome (FMS).MethodsThe P300 component of ERP was studied in 36 female FMS patients and 22 control subjects. The short form 36 (SF-36) medical outcome study was used to determine quality of life. Number of tender points and disease duration were noted. Cognitive functions were evaluated with P300.ResultsThe symptoms were discrepant in FMS (P<0.001). The scores of the eight SF-36 subgroups in FMS patients were significantly lower than in the control group (P<0.001). Fibromyalgia syndrome patients had prolonged latency and reduced amplitude of P300 (P<0.001). No correlation was found between the subgroups of SF-36, tender point count, disease duration, and P300.ConclusionThe results of our study reveal that FMS affects quality of life and dysfunction in cognitive abilities can be determined by brain event-related potentials.

The effect of obstructive sleep apnea on olfactory functions.

The aim of this study was to investigate the effect of obstructive sleep apnea (OSA) on the parameters of olfactory functions (odor threshold, odor discrimination, and odor identification tests) for orthonasal olfaction, retronasal olfactory testing, and olfactory bulb (OB) volumes.

A Sledgehammer on the Brachial Plexus: Thoracic Outlet Syndrome, Subclavius Posticus Muscle, and Traction in Aggregate

Reported here is a 30-year-old man who was seen because of pain and weakness in the upper extremities after a tractional injury. Physical examination revealed significant atrophy in the left deltoid and right intrinsic hand muscles, generalized hypoesthesia, decreased deep tendon reflexes bilaterally, and decreased strength in various muscle groups. Roos (right) and hyperabduction (bilateral) tests were positive. Electrodiagnostic studies were consistent with bilateral brachial plexopathy. Cervical radiographs showed long transverse process of C7 on the right side and a small rudimentary rib articulating with C7 on the left side. Brachial plexus magnetic resonance imaging demonstrated an aberrant muscle and compressive brachial plexus injury on the left side. Surgery via transaxillary approach was performed on the left side. The occurrence of traumatic brachial plexopathy in the presence of underlying thoracic outlet syndrome and subclavius posticus muscle is discussed for the first time in the literature.

Serum asymmetric dimethylarginine levels in diabetic patients with neuropathy

OBJECTIVE The goal of our study was to evaluate the role of asymmetric dimethylarginine (ADMA) in patients with diabetic neuropathy. MATERIALS AND METHODS In this study, 58 diabetic patients and 26 healthy volunteers were included. In both groups ADMA measurements were performed together with other biochemical examinations. Nerve conduction studies and Neuropathy Symptom Score (NSS) were administered to the diabetic patients. RESULTS ADMA levels were found significantly higher in diabetic patients compared to the control group (p = 0.0001). However, ADMA levels were not statistically significant between diabetic patients with neuropathy and without neuropathy (p = 0.86 and p = 0.47). CONCLUSION These results demonstrate that there is not any significant relationship between ADMA and diabetic neuropathy.

Plasma apelin levels in diabetic patients with and without neuropathy

The aim of this study was to investigate the plasma apelin levels in diabetic patients with and without neuropathy. All consecutive diabetic patients who presented for routine follow-up at our outpatient clinic were invited to participate in this clinical study. Forty diabetic patients (20 female and 20 male) and twenty-two non-diabetic control subjects (9 female and 13 male) were included in the study. Neurological evaluations in diabetic subjects were done by nerve conduction studies and evaluated with the Neuropathy Symptom Score. Fasting plasma glucose, HbA1c, lipid and apelin levels were measured in each subject. The mean plasma apelin level was significantly higher in the diabetic patients than in the control subjects (p = 0.026). Apelin levels were statistically similar between diabetic patients with and without neuropathy (p = 0.43). Further, plasma apelin levels were found to be higher in diabetic patients with neuropathy when compared with those of healthy control subjects (p = 0.02). In diabetic patients with neuropathy, plasma apelin levels correlated significantly with diabetes duration (r = 0.5, p = 0.02). We propose that apelin levels in diabetic patients are higher in the presence of neuropathy and longer disease duration, although this might not solely suffice as an indicator for the presence of neuropathy in diabetic patients. Drawing attention to the possible association between the apelinergic system and diabetes mellitus, we believe that further studies with larger samples should be carried out also to investigate the presence of retinopathy and nephropathy.

Migren hastalarında atak olmayan dönemde koku tanımlama testi ile koku fonksiyonunun değerlendirilmesi

Objective: Despite the fact that there are many studies about the osmo- phobia and migraine, we have very little knowledge about the olfactory abilities of migraineurs during the period between the attacks. So, the aim of this study was to evaluate the olfactory function of migraineurs during the period without headaches with odor identification test. Methods: Two hundred and ninety healthy people aged 16 to 65 years (152 female, 138 male) and 84 migraine patients aged 18 to 55 years (47 female, 37 male) were studied. The participants with migraine were selected from the patients who applied to headache outpatient clinic for assessment. Participants, appropriate to the study, were physically and neurologically examined in detail and then they were taken to the test room in order to be screened with Short Smell Test Battery of GATA Haydarpafla (GULTEST). Results: The mean GULTEST score of the migraine group was less than the healthy group and the difference was significant. The effect of gender, cigarette smoking and disease status (migraine) on GULTEST scores was evaluated by linear regression model. It was found that females had higher odor identification scores than males in both migraineurs and controls. On the other hand, cigarette smoking had a significant negative effect on GULTEST scores. Furthermore, migraine had a significant negative effect on GULTEST scores. Conclusion: Our study showed that even during the headache-free peri- od, migraineurs might have reduced olfactory abilities.

Simultaneous posterior and middle cerebral artery infarct

On the follow-up, the patient developed painful, erythematous skin lesion of 15 cm in diameter, located on the lateral malleolus and dorsum of the foot [Figure 2]. MEFV gene investigation revealed homozygote mutation for M694V gene. Five pyrin gene mutations (E148Q, M680I, M694V, M694I and V726A) were detected by using the PRONTOTM FMF Basic Kit according to the manufacturer’s instructions. Biopsy specimens from the duedonum and rectum were negative for amyloidosis. A diagnosis of FMF with CNS demyelination was considered and colchicine therapy was started. With colchicine therapy, her symptoms regressed and no further progression of the disease was observed during two years follow-up.

How long does denervation take in poliomyelitis? Or is it a lifetime?”

Background and Objective: This study aims to determine the period of reinnervation in patients with poliomyelitis. This research was conducted to identify the appearance of denervation potentials in patients with poliomyelitis as indicators for reinnervation. Materials and Methods: A total of 246 male patients with poliomyelitis were assessed electrophysiologically between 1988 and 2007. The mean age was 22.8 (18–42). It has been an average of 19.9 ± 4.9 years since the beginning of complaints from the patients. Results: The patients had no complaints of newly developing muscle weakness, fatigue, muscle and joint pain, and difficulties in breathing and swallowing. Neurological examinations revealed the absence of myotomal pain and sensory loss. Upon assessment of the patients’ limbs, the following findings were revealed: two patients had left upper and lower limb involvement, two patients had left upper and right lower limb involvement, 6 patients had left upper limb involvement, 12 patients had both lower limb involvement, 105 patients had left lower limb involvement, 1 patient had both upper limb involvement, 2 patients had right lower and upper limb involvement, 12 patients had right upper limb involvement, 6 patients had both lower limb involvement, 95 patients had right lower limb involvement, and 3 had all the three extremities affected. The needle electromyography revealed the presence of denervation potentials in 25.2% (62) of the patients. Conclusion: When poliovirus attacks the motor neuron, this neuron may be completely destroyed, damaged, or unaffected. Reinnervation occurs when nearby functioning motor units send out terminal axon sprouts to reinnervate the damaged muscle fibers. As a consequence of poliomyelitis, several muscle fibers become atrophic and fibrotic, but others continue to survive. This study showed that patients with a history of poliomyelitis experienced denervation with subsequent reinnervation for many years.

Segmental vitiligo in a patient with thoracic outlet syndrome

Reported here is a 35-year-old man with findings of thoracic outlet syndrome and bilateral segmental vitiligo on C8–T1 dermatomes. The possible causal relationship between the two disorders under the common denominator of cervical sympathetic involvement is discussed for the first time in the literature.