Vedat Çilingir

Coping strategies and mood profiles in patients with multiple sclerosis

OBJECTIVE The aim of the present study was to investigate the coping strategies, mood characteristics and the association between these aspects in patients diagnosed with multiple sclerosis and healthy subjects. METHOD Fifty consecutive patients who were diagnosed with multiple sclerosis according to McDonald criteria and thirty-one healthy subjects were included in the study. In addition to the sociodemographic form, Expanded Disability Status Scale (EDSS), Coping Orientation for Problem Experiences Scale (COPE), and Profile of Mood States (POMS) tests were applied to the participants. RESULTS Non-functional coping strategies were significantly higher in the secondary-progressive type (p≤0.05). Depression-dejection, fatigue-inertia and total POMS scores were significantly higher in the secondary-progressive type (p≤0.05). CONCLUSION The results of our study demonstrate the importance of rehabilitation programs that encourage exercise among patients with multiple sclerosis to increase vigor-activity levels.

Dyke-davidoff-masson Syndrome With Cerebral Hypometabolism and Unique Crossed Cerebellar Diaschisis in 18f-fdg Pet/ct

A 23-year-old man with Dyke-Davidoff-Masson syndrome (DDMS) was admitted to the hospital with increasing frequency of epileptic seizures. Physical examination revealed mental retardation, left facial asymmetry, and left-sided spastic hemiparesis. Dysdiadochokinesia on the left upper limb was detected, and there was no dysmetria. MRI confirmed the well-known radiological features of DDMS. PET/CT demonstrated cerebral and contralateral cerebellar hypometabolism. We present DDMS with crossed cerebellar diaschisis, which was demonstrated by PET/CT.

Relations between mood characteristics, circadian preferences, and functionality in multiple sclerosis

Abstract Objective. Multiple sclerosis (MS) is a progressive disorder that results in demyelinization of the nerve fibers of the central nervous system. We aimed to determine chronobiological and mood features in patients with MS. Methods. The sample comprised 75 patients with MS (54 women and 21 men) and 50 healthy individuals (38 women and 12 men). Sixty-three patients were relapsing–remitting MS and twelve patients had secondary progressive-type MS. Mood characteristics were assessed using subscales of the Profile of Mood States (POMS). Chronotypical characteristics were determined by the Morningness–Eveningness Questionnaire (MEQ). Univariate and structural equation modeling was applied to untangle the possible connections between variables. Results. Both relapsing–remitting and secondary progressive patients scored higher on the depression–dejection and fatigue–inertia scales of the POMS than healthy individuals. Circadian preferences did not differ significantly between these groups. Patients using glatiramer acetate and other types of drugs had greater severity of functional impairment measured relative to interferon-beta treatment group. Glatiramer acetate had more negative effects on mood than interferon-beta therapy. This finding may be the result of significantly higher duration of disease and higher symptom severity scores in glatiramer acetate group. Conclusions. In the structural equation model, gender was found to be predictive for characteristics of mood.

Dissociative experiences in patients with epilepsy

A few studies have explored dissociative experiences in epilepsy patients. We investigated dissociative experiences in patients with epilepsy using the dissociative experiences scale (DES). Ninety-eight patients with epilepsy and sixty healthy controls were enrolled in this study. A sociodemographic questionnaire and the Dissociative Experiences Scale (DES), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered to the participants. The DES scores were significantly higher for the patients with epilepsy than the healthy individuals. The number of individuals with pathological dissociation (DES ≥ 30) was higher in the epilepsy group (n = 28) than in the control group (n = 8). Also, higher levels of dissociation were significantly associated with frequency of seizures, but were not associated with duration of epilepsy and age at onset of the disorder. These findings demonstrate that patients with epilepsy are more prone to dissociation than controls. The high rate of dissociative experiences among patients with epilepsy suggest that some epilepsy-related factors are present.

Effects of omalizumab therapy on peripheral nerve functions: short observational study

Introduction Peripheral neuropathy (PN) is a common neurological condition causing symmetrical and diffuse damage in nerves. The etiology of PN includes systemic diseases, toxic exposure, medications, infections, and hereditary diseases. Omalizumab is a humanized monoclonal anti-IgE antibody that exerts its activity by binding to free IgE in circulation. Aim To investigate the relationship between omalizumab and peripheral neuropathy. Material and methods The study included 30 patients who underwent omalizumab therapy (Xolair) due to the diagnosis of chronic urticaria. A detailed neurological and physical examination was performed in each patient both before and 3 months after the therapy. Electrophysiological examination was also performed using a Medelec Synergy instrument. Results The 30 patients included 8 (26.7%) men and 22 (73.3%) women with a mean age of 37.5 ±14.14 years. No serious side effect of the medication was detected in any patient although local wound irritation occurred in 3 (10%) patients. Moreover, no change occurred in the pre-treatment Neuropathy Symptom Score (NSS) or Neurological Disability Score (NDS) of the patients and no pathological values that could result in neuropathy were observed during motor/sensory nerve conduction. However, significant changes were detected in the sensory and motor components of the nerves with regards to pre- and post-treatment values. Conclusions Omalizumab therapy caused no peripheral neuropathy in any of our patients but altered the latency, amplitude, and velocity values of the peripheral nerves.

Ultrasonic Elastography Evaluation in Optic Neuritis.

ABSTRACT Purpose: In the present study, we attempted to determine whether ultrasonic elastography (USE) evaluation can be used in a diagnosis of optic neuritis (ON). Materials and Methods: Thirteen patients who each had one normal eye and one eye with a diagnosis of ON were included in the study. Ultrasonography (US) and USE examinations were performed on the affected and non-affected eyes of all participants. Optic nerve and adjacent fat tissue regions at the same depth were selected, and USE measurements were obtained. The optic nerve diameter was measured in both normal and affected eyes. Results: The mean USE values for the optic nerve were 2.58 ± 0.50 m/s in ON eyes and 1.91 ± 0.39 m/s in normal eyes (p = 0.001). The mean USE values for the optic-nerve adjacent tissue were 2.26 ± 0.45 m/s in ON eyes and 1.77 ± 0.22 m/s in normal eyes (p = 0.001). The mean optic-nerve diameter was 3.80 ± 1.09 mm in ON eyes and 3.28 ± 0.98 mm in normal eyes (p = 0.005). Conclusions: USE may be considered an accessible, safe technique for the detection of significant optic-nerve tissue stiffness in ON and may be used an adjunctive tool for confirming this diagnosis.

White matter lesions in patient with treatment resistant obsessive compulsive disorder: a case report

Neurobiological models of Obsessive compulsive disorder (OCD) suggest that there are structural and functional abnormalities in frontal-striatal-thalamic-cortical circuits. These cortical and subcortical microcircuits are physically and functionally connected through the white matter. Therefore, the disrupted white matter microstructure may be implicated in the pathophysiology of OCD. Neuroanatomical studies have reported various regional white matter abnormalities in patients with OCD. In this case, we present subcortical WMHs in a patient with treatment resistant OCD.

Psychotic Attacks Due to Toxic Neurobrucellosis in Two Adolescent Patients

Psychotic attacks due to toxic neurobrucellosis in two adolescent patients Brucellosis is a multisystem disease which can present with a broad spectrum of clinical manifestations and complications and affect the central nervous system directly or indirectly. Immunopathologic mechanisms like T-cell mediated cytotoxicity and microglia activation are suggested to play a role in neurobrucellosis. The diagnosis of toxic neurobrucellosis is confirmed by isolation of Brucella organism from blood cultures and/or positive Coombs Wright test and the Standard agglutination test (SAT) in serum when there are no cerebrospinal fluid (CSF) findings. The magnetic resonance imaging (MRI) of brain in patients with neurobrusellosis may show different findings mimicking such neurological diseases as inflammation, white matter changes and vascular involvements and other infectious and inflammatory conditions. Different clinical manifestations of neurobrucellosis have been described including meningitis, meningoencephalitis, myelitis, and psychiatric disorders. It has been indicated in case studies that neurobrucellosis may lead to psychotic disorders. In this study, we present two adolescents who presented with psychotic symptoms due to toxic neurobrucellosis.

White matter abnormalities and Virchow Robin spaces in patients with psychotic disorders

In this study, we aimed to present white matter abnormalities and Virchow Robin spaces in patients with psychotic disorders and to discuss possible underlying mechanisms. The patient sample comprised 24 patients with psychotic disorders who had white matter abnormalities on MRI. Magnetic resonance imaging (MRI) appeared periventricular white matter changes in twelve patients (%50,0), frontal lesions in six patients (%25,0), parietal lesions in six patients (%25,0), temporal lesions in one patients (%4,2), infratentorial lesions in two patients (%8,3), and Virchow Robin spaces in eight patients (%33,3) This study suggested that there is a relationship between white matter abnormalities and psychotic disorders.

ISCHEMIC STROKE IN A YOUNG MAN WITH MTHFR A1298C AND ACE I/D POLYMORPHISM

Ischemic stroke is a leading cause of death and disability worldwide. Mutations in several candidate genes involving angiotensin-converting enzyme (ACE) and methylenetetrahydrofolate reductase (MTHFR) gene have been found to be associated with ischemic stroke. This report describes the case of a 29 year-old man who presented with sudden onset left hemiparesis and hemihipoestesia. Magnetic resonance imaging investigations showed acute ischemic infarct in the right parietal region. Mutation analysis revealed homozygout MTHFR A1298C and ACE I/D polymorphisms and laboratory invastigations showed mild hyperhomocysteinemia. No other risk factor was detected for ischemic stroke etiology.