Suna Sarikaya

An evaluation of serum paraoxonase together with arylesterase activities and oxidative stress in children with intractable epilepsy: A cross-sectional study

Epilepsy is the most common chronic neurological illness in childhood and adolescence. The aim of this study was to investigate paraoxonase and arylesterase activities along with oxidative status parameters in children with intractable epilepsy. The study comprised 42 subjects with intractable epilepsy and a control group of 35 healthy subjects. Serum paraoxonase and arylesterase activities, and lipid hydroperoxide levels were determined. All paraoxonase and arylesterase activities were significantly lower in the intractable epilepsy subjects than in the controls (P<0.001), whereas lipid hydroperoxide levels were significantly higher (P<0.05). In conclusion, paraoxonase and arylesterase activities were decreased and the lipid hydroperoxide level was increased in patients with intractable epilepsy. These results showed that intractable epilepsy subjects may be more prone to the development of atherosclerosis.

The relationship of carpal tunnel syndrome and mean platelet volume in geriatric patients

The aim of this study was to examine the relationship between idiopathic carpal tunnel syndrome (CTS) and mean platelet volume (MPV) in patients older than 65 years old. The study included 48 patients, 92 hands (45 right/47 left) from 8225 patients who were consulted to electroneuromyography (ENMG) laboratory in January 2010 to December 2013. ENMG data, whole blood cell, erythrocyte sedimentation rate, C-reactive protein (CRP) levels of all patients were noted. In patient group MPV levels were significantly high (P=0.014). Although CRP levels were significantly elevated in patients, all CRP levels were in normal range. As a result, in patients older than 65 years increased MPV levels may be associated with CTS etiology and increased risk of cardiovascular disease.

Demansı olmayan Parkinson hastalarında işitsel olaya bağlı potansiyel (P300) ile kognitif fonksiyonların değerlendirilmesi

Evaluation of cognitive functions in Parkinson’s patients without dementia with auditory event related potential (P300) Objective: Idiopathic Parkinson’s disease is a clinical situation characterized by akinesia, rigidity, and tremor, and results from the degeneration of the dopaminergic nervous system. As the disease progresses over time, depression, cognitive dysfunction and alterations in cognitive functions are added to the movement disorder at varying rates. The P300 component is a useful parameter for cognitive processing studies on PD patients, as it is independent from motor skills. The current study aimed to show the effects of the PD on the cognitive functions by evaluating the cognitive functions of IPD patients without dementia with the help of an event related potential component, P300 test. Methods: Thirty-eight patients (25 males and 13 females), ranging in age between 40 and 80 years (mean: 58.8 years), were included to the study and the control group consisted of 39 volunteers (25 males and 14 females), ranging in age between 44 and 84 years (mean: 63.5 years), who did not have a history of cerebrovascular disease, dementia, or depression. The participants were informed about the content and the practice of the study, and informed consent forms were obtained. Neurological examination, standardized mini mental test, Unified Parkinson’s Disease Rating Scale (UPDRS), Hoehn and Yahr Scale, Hamilton Depression Rating Scale (HAM-D), and P300 tests were performed on the patients. Standardized mini mental test (SMMT), HAM-D, and P300 tests were performed in the control group. Results: P300 latencies in Parkinson’s patients were significantly prolonged compared to the control group. There was a decrease in P300 amplitude values with increasing HAM-D. Conclusion: P300 latency reflects the rate of stimuli classification by mental process, attention, and cognitive processing. Even if no dementia is present in PD patients, there is a dysfunction in these functions, and it can be demonstrated by the P300 test, which is independent from motor skills.

Brain metabolite values in children with breath-holding spells

Breath-holding spells are benign, paroxysmal events with apnea and postural tone changes after a crying episode in infants. The objective of this study was to investigate the pathologies in brain metabolite values in the absence of seizure in children with breath-holding spells by using magnetic resonance spectroscopy (MRS). Brain MRS examination was performed on 18 children with breath-holding spells and 13 neurologically normal children who were included as the control group. There was no significant difference in terms of N-acetyl aspartate (NAA), choline (Cho), creatine (Cr), and myoinositol (mI) levels and also in terms of NAA/Cr, Cho/Cr, and mI/Cr ratios between the patients and the control group (all P>0.05). Our study suggested that there is no permanent neuronal damage in patients with breath-holding spells. This result confirms the previous studies, which reported no permanent neuronal damage in patients with breath-holding spells.

Assessment of both serum S-100B protein and neuropeptide-Y levels in childhood breath-holding spells

OBJECTIVE Breath-holding spells are common paroxysmal events in children. Although the spells have a benign prognosis in the long term, they may be complicated by loss of consciousness, tonic-clonic movements, and occasionally seizures. Hence, this study aimed to measure the levels of serum S-100B proteins and neuropeptide-Y in the blood of children who experience breath-holding spells. METHODS The study groups consisted of 45 patients (13 females, 32 males) with breath-holding spells and a control group of 32 healthy individuals (12 females, 20 males). The serum S-100B levels were measured using commercially available ELISA kits. The neuropeptide-Y levels in the serum were measured with RayBio® Human/Mouse/Rat Neuropeptide Y ELISA kits. RESULTS The mean serum S-100B protein level of the breath-holding spells group was 56.38 ± 13.26 pg/mL, and of the control group, 48.53 ± 16.77 pg/mL. The mean neuropeptide-Y level was 62.29 ± 13.89 pg/mL in the breath-holding spells group and 58.24 ± 12.30 pg/mL in the control group. There were significant differences between the groups with respect to serum S-100B protein levels (p = 0.025), while there was no statistically significant difference in neuropeptide-Y levels between the breath-holding spells group and the control group (p = 0.192). CONCLUSIONS The findings of this study suggest that frequent and lengthy breath-holding may lead to the development of neuronal metabolic dysfunction or neuronal damage which is most likely related to hypoxia. In light of these findings, future studies should be conducted using biochemical and radiological imaging techniques to support these results.

Melatonin Can Be Used to Treat Childhood Breath-Holding Spells

Dear Sir, We read with great interest the article by Saad et al, ‘‘Selenium and Antioxidant Levels Decreased in Blood of Children With Breath-Holding Spells.’’ Breath-holding spells are the most common form of nonepileptic paroxysmal events in infancy. Although the pathophysiology of breath-holding spells is still unknown, several studies have indicated the presence of an underlying dysfunctional autonomic nervous system in children with breath-holding spells. In recent studies, increased oxidative stress was reported in children with breath-holding spells. Various medical treatments are in current use to treat childhood breath-holding spells. Iron therapy, piracetam, levetiracetam, fluoxetine, glycopyrrolate, theophylline and atropine are considered as medical treatment and have shown varying rates of efficacy. Melatonin is a serotonin derivative hormone which is a highly effective antioxidant, free radical scavenger, and a primary circadian regulator. Previous reports have shown that tryptophan depletion and low production of melatonin is involved in the pathogenesis of central nervous system dysfunctions. It has been used with patients in attention-deficit hyperactivity disorder (ADHD), autism spectrum disorders, epilepsy, febrile seizure, and all sleep disturbances associated with mental, neurologic, or other medical disorders. To our knowledge, no studies have evaluated melatonin treatment in children with breath-holding spells. A 12-month-old male infant was recently admitted to the pediatric neurology department with a 3-month history of breath-holding spells. His spells were mixed type, and there were about 5 attacks of breath-holding spells per week. The physical examination of the patient, the hemogram, biochemical tests, brain magnetic resonance imaging, electroencephalography, and echocardiography findings were found to be normal. Treatment of melatonin 0.08 mg/kg (1 mg/d) was started, and this medication resulted in a significant improvement in the patient’s spells. He received this medical treatment for 8 weeks and, ssubsequently, a reduction of the frequency of breath-holding spells (1 attack/week) was observed. In conclusion, we have shown that melatonin, which is a serotonin derivative hormone synthesized by neurons in the pineal gland, can be used to treat childhood breath-holding spells. It was hypothesized that the supplement of exogenous melatonin may be a new treatment for breath-holding spells in children. However, it is clear that there is a need for further studies with a large patient population. Mustafa Calik, MD Department of Pediatric Neurology, Harran University School of Medicine, Sanliurfa, Turkey

PP14.6 – 2304: Assessment of both the serum S-100B protein and neuropeptide Y levels in childhood breath-holding spells

Objective Breath-holding spells are common paroxysmal events in children. Although the spells have a benign prognosis in the long term, they may be complicated by loss of consciousness, tonic-clonic movements, and occasionally, seizures. To the best of our knowledge, there have been no studies investigating whether attacks of breath-holding spells may lead to neuronal damage. In addition, the neurotransmitters and neuropeptides related to seizures have not been previously measured in breath-holding spells. This study aimed to measure the levels of serum S-100B proteins and neuropeptide-Y in the blood of children who experience breath-holding spells. Methods This prospective study was performed at the Department of Pediatric Neurology, Harran University School of Medicine, Sanliurfa, in Turkey. The study groups consisted of 45 patients (13 females, 32 males) with breath-holding spells and a control group of 32 healthy individuals (12 females, 20 males). The serum S-100B levels were measured by using commercially available ELISA kits and The neuropeptide-Y levels in the serum was measured with RayBio® Human/Mouse/Rat Neuropeptide Y ELISA kits. Results There were significant differences between the groups regarding to serum S-100B protein levels (P=0.025), while there was no statistically significant difference in neuropeptide-Y levels between the breath-holding spells group and control group (P=0.192). Conclusions In conclusion, frequent or lengthy breath-holding spells may lead to the development of neuronal damage which s most likely secondary to hypoxia. Therefore, breath-holding spells should be taken under the control as soon as possible.

A Case Report of Moyamoya Disease Presenting with Seizure

Moyamoya disease is characterised by idiopathic steno-occlusion at the intracranial carotid arteries with concomitant abnormal vascular networks. In this case report, a 34 year old man presented to the emergency room with a complaint of seizure and was diagnosed with Moyamoya disease by history, examination, cranial computed tomography (CCT) and digital subtraction angiography (DSA). This case was reported as it is the first known example of a patient presenting initially with seizure, as well as the rarity of the disease.

Peculiar MRI findings of intracranial hypotension in patients with abducens nerve palsy

A 26-year-old female patient was admitted to our department with headache and diplopia. Her medical history revealed a caesarean section with epidural anaesthesia a week before the admission. Ophthalmological examination revealed right abducens paralysis with normal visual acuity, normal biomicroscopic findings, and normal fundi on funduscopic examination, and normal intraocular tension in both eyes. A contrast-enhanced cranial MRI revealed bilateral subdural fluid collection, engorgement of venous structures, enlargement of the pituitary gland and diffuse tentorial thickening. All of these findings are consistent with early intracranial hypotension (figures 1 and 2). On MRI, enhancement of the …