Browsing by Author "Ak A.K."
Now showing 1 - 20 of 20
Results Per Page
Sort Options
Item An adverse event associated with antifungal therapy: Clinic-like posterior reversible encephalopathy syndrome; [Antifungal ilaca bağlı gelişen yan etki: Posterior reversible ensefalopati sendromu benzeri klinik?](AVES İbrahim KARA, 2018) Ak A.K.; Erbüyün S.; Heppekcan D.; Batum M.; Boyacı R.; Mavioğlu H.; Tok D.A.Posterior reversible encephalopathy syndrome (PRES) is a diagnosis characterized by headache, changes in consciousness, epileptic seizures, visual symptoms (decreased visual acuity and blurred vision), vasospasm, and perfusion abnormalities in the posterior systemic vessels of the brain. The most common clinical findings of PRES include headache, epileptic seizure, altered consciousness, motor deficits, and loss of vision. In the patient who presented with symptoms similar to those in PRES after the use of anidulafungin and had a history of trauma, other causes of PRES (like carotid and/or vertebral artery dissection, intra-abdominal trauma, and head trauma etc.) were excluded. In our case, visual disturbance was assessed as being secondary to central nervous system pathology. There are no similar cases in the literature that presented with clinical features of PRES and normal imaging findings. The primary aim of this study was to draw attention to the fact that anidulafungin may cause symptoms similar to those in PRES. © 2018 by Turkish Society of Medical and Surgical Intensive Care Medicine.Item Importance of Berlin, stop, and stop-bang questionnaires in evaluating obstructive sleep apnea syndrome in the bus drivers; [Otobüs şöförlerinde obstruktif uyku apne sendromunu değerlendirmede Berlin, stop, stop bang anketlerinin önemi](Nobelmedicus, 2020) Eşrefoğlu N.; Ak A.K.; Göktalay T.; Batum M.; Yılmaz H.Objective: To investigate the prevalence of obstructive sleep apnea syndrome (OSAS) symptoms in public transportation drivers, and the importance of the Berlin questionnaire (BQ), STOP questionnaire (SQ), and STOP-BANG questionnaire (SBQ) in OSAS screening, and the to evaluate correlations among these tests. Material and Method: This cross-sectional study was conducted after obtaining ethics committee approval. Demographic data and risk factors were categorized as high-risk and low-risk for snoring and OSAS. Results: All the drivers (n:392) were men and their mean age was 37.8±6.3(27-58). Even in the presence of any of the individual parameters of snoring, witnessed apnea, and increased daytime sleepiness in 392 drivers, a high risk was found in all for questionnaires developing OSAS (p<0.001). Body mass index ≥30 kg/m² and neck circumference ≥40 cm were associated with snoring (p<0.05) but not with age (p>0,05). The highest agreement was found between SQ and SBQ (p<0.001, kappa: 0.609, McNemar Test), a moderate agreement was present between BQ and ST (p=0.05, kappa: 0.607), and the weak correlation was found between BQ and SBQ questionnaires (p<0.001, kappa: 0.472, McNemar). Conclusion: It will be possible to eliminate a preventable cause of traffic accidents by evaluating OSAS risks in vehicle drivers with valid and easily-applicable tests such as the SBQ and SQ, and to direct drivers to appropriate units for polysomnography. © 2020, Nobelmedicus. All rights reserved.Item Evaluation of cognitive functions in idiopathic Parkinson’s disease and multiple system atrophy(ASEAN Neurological Association, 2021) Batum M.; Ak A.K.; Ari M.S.; Selçuki D.Background & Objective: Cognitive impairment is one of the non-motor symptoms impairing life quality in idiopathic Parkinson’s disease (PD) and multiple system atrophy (MSA). In our study, both groups’ possible cognitive impairments were evaluated and compared, and the relationship between cognitive profile and motor, non-motor scores, and disease duration was evaluated. Methods: Fifty two PD, 18 MSA, 30 healthy controls were included in the study. Demographic information, scores of Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Questionnaire (PDQ), Addenbrooke’s Cognitive Examination-Revised (ACE-R), and Frontal Assessment Battery (FAB) tests were recorded. In addition to the ACE-R test’s total scores, sub-scores measuring attention-orientation, memory, verbal fluency, language, and visual-spatial abilities were also evaluated. Results: There was no difference between the groups in age, gender, years of education, and levodopa dose in treatment (p> 0.05). In the inter-group comparison, FAB, ACE-R total, ACE-R sub-scores and PDQ values were significantly different (p <0.05). Significant impairment was found in FAB, ACE-R total, memory, verbal fluency, speaking, and PDQ scores in PD and in all tests in MSA compared to the control group (p <0.05). All tests except memory were more impaired in the MSA group than the PD group. The motor scores in PD showed a strong correlation with FAB, ACE-R total, visual-spatial abilities, speaking, and PDQ scores, whereas motor scores in MSA only correlated poorly with PDQ scores. Conclusion: MSA progressing with multi-systemic involvement showed worse cognitive performance than PD in executive functions and visual-spatial functions, regardless of the disease duration. © 2021, ASEAN Neurological Association. All rights reserved.Item Ischemic chiasmal syndrome associated with posterior communicating artery (PCoA) and tuberothalamic artery (TA) infarction: a case report(Springer-Verlag Italia s.r.l., 2021) Ataç C.; Ak A.K.; Batum M.; Arı S.; Ovalı G.Y.; Çelebisoy N.Lesions affecting the body of the optic chiasm typically produce bitemporal hemianopia. The blood supply comes from the anterior communicating artery, anterior cerebral, posterior communicating, posterior cerebral, and basilar arteries. We herein report a young patient admitted to the emergency department with acute confusion, left-sided hemiparesis, hemihypoesthesia, and dysarthria. Bitemporal hemianopia was detected after resolution of confusion. On cranial magnetic resonance imaging (MRI), infarction in the right anterolateral thalamus in the territory of tuberothalamic artery (TA) and in posterior chiasma in the territory of the posterior communicating artery (PCoA) was revealed. Cerebral MR angiography showed luminal irregularity of the PCoA. The patient was presented to draw attention to the rare entity ischemic chiasmal syndrome. © 2020, Fondazione Società Italiana di Neurologia.Item Role of acetazolamide in treatment of patients with menstrual migraine(ASEAN Neurological Association, 2021) Çetin G.; Ak A.K.; Özyurt B.C.; Selçuki D.Objective: According to the ICHD-3 criteria, menstrual migraine (MM) is divided into two groups: pure menstrual migraine (PMM) and menstrually-related migraine (MRM). The present study aimed to evaluate and compare the severity of headache using a visual analog scale (VAS) and the effect on quality of life using the Headache Impact Test (HIT) and Migraine Disability Assessment (MIDAS) tests before and after 3 months of treatment in using short-term prophylaxis with acetazolamide. Methods: Patients who presented to the headache outpatient clinic of the neurology department with a diagnosis of MM were retrospectively reviewed. Acetazolamide was given at a dosage of 500 mg daily for 5 days starting two days before the predicted onset of the menstrual cycle as a short-term prophylactic treatment. VAS, MIDAS, and HIT assessments were performed before and after treatment. Results: A total of 26 patients with PMM and 26 patients with MRM were identified. After acetazolamide treatment, statistically significant improvement was found in MIDAS, VAS and HIT scores in both groups of patients. The post-treatment MIDAS score was significantly lower in the MRM group, but there was no significant difference in post-treatment VAS and HIT scores between the groups. Conclusion: Using acetazolamide for short-term prophylaxis in patients with MM leads to decreased severity and frequency of headache and improvement in quality of life. The study is the first in the literature to use acetazolamide for short-term prophylaxis in patients diagnosed with MM. © 2021, ASEAN Neurological Association. All rights reserved.Item Trigeminal neuralgia following Tolosa-Hunt syndrome(Springer Science and Business Media Deutschland GmbH, 2022) Durmaz G.S.; Ak A.K.; Gökçay F.; Çelebisoy N.[No abstract available]Item Vestibular migraine and persistent postural perceptual dizziness: Handicap, emotional comorbidities, quality of life and personality traits(Elsevier B.V., 2022) Ak A.K.; Çelebisoy N.; Özdemir H.N.; Gökçay F.Objective: To compare vestibular migraine (VM) and persistent postural-perceptual dizziness (PPPD) regarding dizziness associated handicap, emotional and somatic disorders, health-related quality of life (QoL) and personality traits. Methods: Thirty patients for each group [VM, PPPD and healthy volunteers (HC)] were studied. Dizziness Handicap Inventory (DHI), Beck depression and anxiety scales, Somatic Symptom Scale-8 (SSS-8), Short Form (36) Health Survey (SF 36) and the Big Five Inventory (BFI) were used. Results: DHI sub-scores were significantly high in both patient groups in comparison with the HC (p < 0.001 for all). Emotional (p = 0.001) and functional (p = 0.022) sub-scores of the PPPD patients were worse. Anxiety and somatic symptom scores of VM (p = 0.026 and p < 0.001 respectively) and PPPD (p < 0.001 for both) and depression scores of the PPPD (p = 0.003) were higher than the HC. Both anxiety (p = 0.009) and somatization (p = 0.005) scores of the PPPD patients were higher than the VM. SF-36subscales were affected in both groups (p < 0.05). Vitality (p = 0.002), mental health (p = 0.045) and social role functioning (p = 0.006) of the PPPD group were worse than the VM. Higher scores for neuroticism (p < 0.001) was present for both groups. Scores for extraversion was low in PPPD patients (p = 0.010) in comparison with the HC. Conclusion: Dizziness associated handicap, anxiety and somatic symptom burden is high in both groups, even higher in PPPD with additional depression. Severe impairment in QoL is present with more severe impairment in emotional aspects in patients with PPPD. Neuroticism is a common personality trait for both groups with additional introversion in PPPD. © 2022Item Evaluation of the visual system with visual evoked potential and optical coherence tomography in patients with idiopathic Parkinson's disease and with multiple system atrophy(Springer Science and Business Media Deutschland GmbH, 2022) Batum M.; Ak A.K.; Arı M.S.; Mayali H.; Kurt E.; Selçuki D.Background: In addition to motor findings, non-motor findings including alterations in visual acuity, decrease in blink reflex, and pupil reactivity cause the impaired quality of life in idiopathic Parkinson’s disease (PD) and multiple system atrophy (MSA). Our study aimed to examine possible latency and amplitude changes in pattern visual evoked potentials (pVEP) along with retinal and macular changes in optical coherence tomography (OCT) in PD and MSA groups. We also intended to investigate whether any OCT parameters could be a biomarker for Parkinson's or MSA. Methods: Our study included 50 patients with PD, 15 with MSA, and 50 healthy control subjects. All patients in the study underwent neurological and ophthalmological examination and investigations of OCT to measure the retinal and macular thickness and pVEP to assess visual pathways. Results: When PD, MSA, and control groups were compared, a significant difference was found in all retinal thickness values in average, nasal, and superior retinal nerve fiber thickness (pRNFL), and in all macular thickness values except nasal outer and inferior outer quadrants and in ganglion cell complex (GCC) thicknesses (p < 0.05). Moreover, a significant difference was found in N75, P100, and N145 latencies and N75-P100 amplitude (p < 0.05). The thickness of both pRNFL, inner and outer macular quadrants, was thinner in the MSA group than in PD but GCC thickness was thinner in PD group. Conclusions: The present study compared pVEP and OCT parameters in PD and MSA groups. It was concluded that pVEP and OCT examinations were of importance in that they were easily accessible, affordable, noninvasive biomarkers that might be used in early periods and progression of the disease and in follow-up. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Item The REM-sleep-related characteristics of narcolepsy: a nation-wide multicenter study in Turkey, the REMCON study(Elsevier B.V., 2022) Akyildiz U.O.; Tezer F.I.; Koc G.; Ismailogullari S.; Demir A.B.; Ak A.K.; Sunter G.; Kara K.A.; Berktas D.T.; Sahin A.; Azman F.; Akcay B.D.; Gok D.K.; Yilmaz H.; Agan K.; Bekmezci Y.; Yetkin S.; Aksu M.; Karadeniz D.; Senel G.B.Introduction: Narcolepsy type 1 (NT1) is caused by hypocretin deficiency, the pathophysiology of narcolepsy type 2 (NT2) has not been delineated. Except for the hypocretin deficiency and cataplexy, all clinical and laboratory features used in the diagnosis of NT2 are identical to those used for NT1. The aim of this study was to assess the rapid eye movement (REM) sleep-related characteristics in the patients with narcolepsy; the characteristics of REM sleep in polysomnography (PSG) and multiple sleep latency test (MSLT) recordings, the quantification of REM sleep without atonia (RSWA) and atonia index, and the analysis of rapid eye movements (REMs) during REM sleep. Materials and methods: This study was planned by the Sleep Medicine Study Group of the Turkish Neurology Society, and conducted in 11 centers in eight cities in Turkey. The analysis of RSWA was analyzed by reviewing all REM sleep periods on nocturnal PSG and MSLT recordings per standard criteria. The total duration of the increased muscle tone during REM sleep in the chin and bilateral leg electromyography (EMG) recordings was calculated as RSWA index. The REMs index was also investigated the relation to the RSWA. Results: A total of 274 patients were involved; 147 patients (53.6%) were males and 127 patients (46.4%) were females; the mean age was 29.1 ± 12.0 years. The diagnosis of NT1 was made in 166 patients (60.6%), and 108 patients (39.4%) were diagnosed as having NT2. The mean Epworth sleepiness scale score was significantly higher in patients with NT1 than the patients with NT2 (P = 0.001). The diagnosis of REM sleep behavior disorder (RBD) was made in 19.3% of the patients with NT1 versus in 2.8% of the patients with NT2 (P < 0.001). The percentage of SOREMP in PSG recordings was significantly higher in patients with NT1 (37.1%) than those with NT2 (18.9%, P = 0.001). MSLT showed that the mean sleep latency was shorter in patients with NT1 compared to those with NT2 (P < 0.001). The total duration of REMs on electrooculography recordings was also significantly higher in patients with RSWA in comparison with the patients without RSWA (P = 0.002). Total duration of REMs was significantly and positively correlated with the duration of RSWA on chin-EMG and leg-EMG recordings (P = 0.001). ROC analyses showed an RSWA index of ≥2% for the RSWA on chin-EMG with a sensitivity of 86.7% and a specificity of 71.3% (P < 0.001). The REMs index ≥20% was associated with the presence of RSWA with a sensitivity of 70.0% and a specificity of 57.1% (P = 0.008). Conclusions: In this nation-wide study, we identified for the first time that the increase in REMs density during REM sleep may be a major correlate of the RSWA. Significant positive correlations were demonstrated between the total duration of REMs on electrooculography recordings and the mean durations of RSWA in both chin and leg EMG recordings. A REMs index of >20% was demonstrated to have a moderate sensitivity and specificity in the diagnosis of RSWA. As observed in chin RSWA index, REMs index also showed a significantly high association with RBD, in comparison to RSWA per standard criteria. © 2022 Elsevier B.V.Item The impact of the COVID-19 pandemic on patients with tension-type headache: A multicenter survey(ASEAN Neurological Association, 2022) Fırat Y.E.; Karşıdağ S.; Neyal A.M.; Cengiz E.K.; Ergin N.; Ak A.K.; Sarıtaş A.Ş.; Gölen M.K.; Okuyan D.Y.; Bakar E.E.; Eren F.; Neyal A.; Çınar N.; Kendirli S.; Yılmaz B.Ö.; Şahin Ş.; Ateş M.F.; Bülbül N.G.; Demir A.; Doğan B.; Demirel E.A.; Erdemoğlu A.K.; Seven S.; Çomruk G.Background & Objective: Tension-type headache (TTH) is the most common primary headache. TTH worsens quality of life and is related to various psychosocial factors. We aimed to examine the severity of headache (intensity, frequency, and duration), analgesic use, quality of life (QoL), and the impact of COVID pandemic-induced stress in TTH patients. Methods: TTH cases seen at neurology outpatient clinics in 15 centers in Turkey were included in the study. A questionnaire incorporating sociodemographic and medical information, headache features, sleep quality, general quality of life, and impact of the pandemic event was administered to the subjects. Results: A total of 975 TTH patients were evaluated. Headache severity was higher in women as well as in patients with a history of COVID-19 contact. Women, those with chronic diseases, and cases with a COVID-19 contact history had worse perceptions of quality of life and were affected to a greater extent by the pandemic. The factors affecting the impact of the pandemic were female gender and difficulty in access to health services for headache. Co-existing chronic diseases and lost productive time due to headaches were negative determinants for both QoL and the impact of the pandemic. Conclusion: Our results show that the COVID pandemic severely worsened the headache burden, quality of life and mental health of TTH patients. These findings can guide us in the clinical approach to TTH cases. © 2022, ASEAN Neurological Association. All rights reserved.Item Can vestibular migraine development be predicted in patients with new onset migraine headaches?(ASEAN Neurological Association, 2022) Çelebisoy N.; Ak A.K.; Ataç C.; Özdemir H.N.; Gökçay F.; Durmaz G.S.; Kartı D.T.; Toydemir H.E.; Yayla V.; Işıkay A.İ.Ç.; Erkent İ.; Sarıtas A.S.; Özçelik P.; Akdal G.; Bıçakcı Ş.; Göksu E.O.; Uyaroğlu F.G.Objective: This study aims to determine the clinical features associated with the development of vestibular migraine (VM) in patients with migraine headaches. Methods: A cross-sectional, multicenter study was performed in nine tertiary neurology clinics. Patients with migraine without vestibular symptoms were classified as having migraine only (MO) and compared with patients with VM to determine any differences in clinical features, associated disorders, past medical history, and family history of migraine headaches. Moreover, we investigated the features that might predict the development of VM. Results: Two hundred forty-four patients with MO and 461 patients with VM were included. The age of onset of headache attacks was later in life for patients with VM (p<0.001). Migraine without aura (MwoA) was significantly more common than migraine with aura (MwA) in patients with VM (p=0.016). All associated features of migraine headaches were significantly more frequent in patients with MO than patients with VM (p<0.005). The same was true for all triggers, including fasting, sleep disturbances, menstruation, stress, flickering lights, and smartphones/computer games (p<0.005). A family history of migraine headaches was more common in MO patients (p=0.002). However, a previous history of motion sickness was significantly more common in patients with VM (p<0.001), as was aural fullness/tinnitus accompanying attacks (p<0.001). Logistic regression analysis indicated that aural fullness/tinnitus accompanying attacks and a previous history of motion sickness were risk factors for the development of VM. Conclusion: Patients with migraine reporting aural symptoms accompanying attacks and motion sickness in their past medical history are at increased risk of vestibular attacks fulfilling the diagnosis of VM later in life. © 2022, ASEAN Neurological Association. All rights reserved.Item Comparison of clinical features in patients with vestibular migraine and migraine(Springer Science and Business Media Deutschland GmbH, 2023) Çelebisoy N.; Ak A.K.; Ataç C.; Özdemir H.N.; Gökçay F.; Durmaz G.S.; Kartı D.T.; Toydemir H.E.; Yayla V.; Işıkay İ.Ç.; Erkent İ.; Sarıtaş A.Ş.; Özçelik P.; Akdal G.; Bıçakcı Ş.; Göksu E.O.; Uyaroğlu F.G.Vestibular migraine (VM) is accepted as the most common cause of spontaneous episodic vertigo. In most patients, vestibular symptoms follow migraine headaches that begin earlier in life. The aim of this multicenter retrospective study was to find out the differences between migraine patients without any vestibular symptoms (MwoV) and VM patients and to delineate the specific clinical features associated with VM. MwoV and VM patients were compared regarding demographic features, migraine headache years, headache attack frequency, intensity, symptoms associated with headache and vertigo attacks, presence of menopause, history of motion sickness and family history of migraine. Four-hundred and forty patients with MwoV and 408 patients with VM were included in the study. Migraine with aura was more frequent in patients with MwoV (p = 0.035). Migraine headache years was longer (p < 0.001) and headache intensity was higher in patients with VM (p = 0.020). Aural fullness/tinnitus was more common in patients with VM (p < 0.001) when all other associated symptoms were more frequent in patients with MwoV (p < 0.001) as well as attack triggers (p < 0.05). Presence of menopause and motion sickness history was reported more frequently by VM patients (p < 0.001). Logistic regression analysis indicated that longstanding history of migraine with severe headache attacks, aural fullness/tinnitus accompanying attacks, presence of menopause, previous motion sickness history were the differentiating clinical features of patients with VM. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.Item Prognostic predictors of remission in ocular myasthenia gravis(Springer Science and Business Media Deutschland GmbH, 2023) Çelebisoy N.; Orujov A.; Balayeva F.; Özdemir H.N.; Ak A.K.; Gökçay F.Background : Ocular myasthenia gravis (OMG) constitutes 15% of all myasthenia gravis patients. Methods: One hundred eight patients with OMG followed-up for over 36 months were retrospectively evaluated regarding factors associated with remission. Demographic features, neuro-ophthalmologic findings at onset, acetylcholine receptor (AChR Ab) and muscle-specifc tyrosine kinase antibodies (MuSK Ab), thymic status, single fiber electromyography (SFEMG) results were the variables considered. Results: Median age of disease onset was 57 years (range 18–82 years). Clinical features at onset was isolated ptosis in 55 (50.9%) and isolated diplopia in 33 (30.6%) patients. Combined ptosis and diplopia were present in 20 (18.5%) patients. Among 75 patients with ptosis, it was unilateral in 65 (86.7%) and bilateral in 10 (13.3%). AChR Abs were found in 66 (61.1%) and MuSK Abs in 2 (1.9%) patients. SFEMG abnormality was detected in 74 (68.5%) patients. Thymoma was present in 16 (14.8%) and thymic hyperplasia in 6 (5.6%) patients. Forty-one patients (37.9%) had been treated with pyridostigmine alone. Sixty-seven (62%) patients were given immunosupressive drugs. In 53 (49.1%) prednisone was used and in 14 (12.9%) patients it was combined with azathioprine. Thymectomy was performed in all 16 patients with thymoma. Complete stable remission (CSR) was achieved in 49 (45.4%) patients. Fifty-nine (54.6%) patients had reached minimal manifestation (MM) status; 32 (29.6%) having a status of MM-1 and 27 (25%) a status of MM-3. Conclusions: The presence of AchR Abs (p = 0.034) and an abnormal SFEMG (p = 0.006) at onset as increased risk factors for the presence of ongoing signs necessitating medical treatment. © 2022, The Author(s) under exclusive licence to Belgian Neurological Society.Item Prognostic factors in patients with cerebral sinus venous thrombosis presenting with hemorrhage and papilledema(Elsevier B.V., 2023) Sarıtaş A.Ş.; Batum M.; Ataç C.; Öztürk Ü.; Yılmaz H.; Mavioğlu H.; Selçuki D.; Ak A.K.Objective: The thromboinflammatory process is considered to play a role in the pathogenesis and prognosis of cerebral sinus vein thrombosis (CSVT). The purpose of the study was to compare the thromboinflammatory parameters between individuals with CSVT and healty controls. Additionally, the study sought to compare these parameters among CSVT subgroups with and without haemorrhage, as well as with and without papilledema. Furthermore, the investigation also aimed to identify which parameters had a more significant impact on the risk of hemorrhage and the development of papilledema in CSVT. Methods: Thromboinflammatory parameters were compared retrospectively between the CSVT group of 88 patients and 80 age- and sex-matched healthy controls, and in the CSVT subgroups with (n = 35) /without hemorrhage (n = 53) and with (n = 52) /without papilledema (n = 36) after ethics committee approval. In both groups, parameters contributing to the risk of hemorrhage and papilledema development were determined by univariate and multivariate analyses. Results: Regarding the risk of hemorrhage in CSVT patients, the most significant factors included hematocrit of <30.2 (%), mean platelet volume of ≤8.9 fL, neutrophil count of >5600, and hsCRP of >9 mg/L. Regarding the risk of papilledema development, the most important risk factors were age of ≤49, presence of vomiting, presence of blurred vision, HDL of >47 mg/dL, and D-dimer of >178 ng/mL. Conclusion: It was suggested that evaluating serum thromboinflammatory parameters, as well as demographic characteristics and neurological examination findings, had a critical role regarding prognosis and predictive factors in CSVT. © 2023Item Calcitonin gene-related peptide (CGRP) levels in peripheral blood in patients with idiopathic intracranial hypertension and migraine(Elsevier B.V., 2024) Ak A.K.; Gemici Y.I.; Batum M.; Karakaş B.; Özmen E.Y.; Gökçay F.; Çelebisoy N.Background: Calcitonin gene-related peptide (CGRP) plays a dominant role in migraine. This prospective study was designed to investigate CGRP levels in patients with idiopathic intracranial hypertension (IIH) and compare the results of migraine patients and healthy controls (HC). As a second objective, CGRP levels obtained from IIH patients defining sustained headache after the resolution of papilledema were compared with those not defining post-IIH headache. Methods: Thirty-six patients with IIH, 36 with episodic migraine (EM), 18 with chronic migraine (CM), and 36 HC were included in the study. CGRP levels were studied from blood samples obtained from the antecubital vein by using a commercial ELISA kit. Results: Serum CGRP levels of the patient groups were significantly higher than the HC (p < 0.001). As compared with controls, both CM (p Adj<0.001) and IIH (p Adj=0.039) had significantly increased levels of CGRP. Levels recorded from EM patients did not differ from the HC (p Adj=0.661). In 16 IIH patients, persistent headache was reported after the normalization of intracranial pressure (ICP). Twenty patients did not report post-IIH headaches. Comparison of serum CGRP levels of these two groups revealed significantly higher CGRP levels in patients with sustained headaches obtained from blood samples both at the initial and control visit (p Adj <0.001). Conclusions: CGRP levels of the patient groups were higher than the HC. High levels recorded in patients with IIH indicates the role of CGRP in IIH related headache and even higher levels in patients with sustained headache after normalization of ICP strengthens this finding. © 2024 Elsevier B.V.Item Cognıtıve functıons in idiopathic intracranial hypertensıon(Springer Science and Business Media Deutschland GmbH, 2024) Ak A.K.; Sarıtas A.S.; Batum M.; Gemici Y.I.; Karakaş B.; Çelebisoy N.Objective: Cognitive problems in idiopathic intracranial hypertension (IIH) is generally overlooked in the presence of disabling headache and threat to visual function. The aim of this study was to search for cognitive deficits in patients with IIH using neuropsychologic tests in addition to P300 potential recordings to assess cognition related brain activity. Methods: Fifty IIH patients were examined using Montreal Cognitive Assessment Test, Stroop Test and Visual Aural Digit Span Test to measure different domains of cognition at the time of diagnosis. P300 potentials were recorded by using an oddball paradigm. Hospital Anxiety and Depression Scale was used to determine anxiety and depression. Quality of life (QoL) was assessed by SF-36. The results were compared with fifty healthy controls with matching age, gender and body mass index. Results: Neuropsychologic tests revealed wide cognitive impairment including attention, working memory, executive function, naming, language, delayed recall and orientation in IIH patients. In addition, quality of life was affected in the sub-parameters of general health perceptions, emotional role functioning, vitality, mental health and bodily pain. P300 potential latencies were long and the amplitudes were reduced indicating deficits in attention and working memory. Anxiety scores were high, and health-related QoL was low mainly involving vitality, emotional and mental health. Cognitive dysfunction was not correlated with the levels of anxiety and the correlation with headache severity was mild. Conclusion: A multidomain cognitive decline mainly involving attention and working memory was recorded in IIH patients. It was not correlated with anxiety and only a mild correlation with headache severity was present which may indicate a casual relationship between raised intracranial pressure and cognitive deficits. Screening is important as neuropsychological rehabilitation might be relevant in these patients. © The Author(s) under exclusive licence to Belgian Neurological Society 2024.Item Other primary headache disorders: Data from the HEAD-MENA-A study in Africa, Asia, and the Middle East(Elsevier B.V., 2024) Atalar A.Ç.; Genç H.; Ur Özçelik E.; Bolay H.; Uluduz D.; Unal-Cevik, I; Kissani N.; Luvsannorov O.; Togha M.; Ozge A.; Baykan B.; Cakan M.; Ak A.K.; Celik F.; Orun M.O.; Seker D.; Kucuk A.; Ozkan S.; Kiraz M.; Sirin T.C.; Ocal R.; Hakyemez H.A.; Yener M.O.; Serim V.A.; Cınar N.; Unal E.D.; Domac F.M.; Ates M.F.; Turkoglu B.G.; Gursoy G.; Cekic S.; Aslan S.K.; Agırcan D.; Oktar A.C.; Demirel E.A.; Gelener P.; Ibrahim E.A.A.E.; Evlice A.; Gorken G.; Sanlı Z.S.; Bayır B.R.H.; Tepe N.; Okluoglu T.; Demir T.G.; Badr M.Y.; Vurallı D.; Jafari E.; Polat B.; Ermis A.; Khanmammadov E.; Yolcu O.; Kul B.; Sakadi F.; Ulutas S.; Akturk T.; Ketema T.M.; Lala S.; Cedric A.P.S.A.; Velioglu S.K.; Kırbasoglu O.; Moustafa R.R.; Nowar A.G.; Kabay S.C.; Gumanovna V.K.; Yifru Y.M.; Nasergivehchi S.; Azizova I.; Kizek O.; Ekizoglu E.; Orhan E.K.; Melka D.; Alemayehu B.Objective: Other primary headache disorders (OPHD) are under-investigated compared to frequent primary headache types like migraine, tension-type headache, and trigeminal autonomic cephalalgias. Knowledge of the distribution and characteristics of OPHD subtypes is crucial for their recognition. We aimed to determine the prevalence at the hospital and headache clinics and clinical characteristics of OPHDs in patients from 13 countries. Methods: We analyzed a large dataset from the cross-sectional study Head-MENA-A (Middle East, North Africa, Asia). Consecutive patients over 10 years of age presenting with headaches were included from outpatient, inpatient, and emergency settings. A structured questionnaire addressing demographics, headache characteristics, accompanying symptoms, and triggers was administered. Headache subtypes were diagnosed according to the ICHD-3 criteria. Results: Among patients complaining of headaches (n = 3722), 106 (2.9%) were diagnosed with OPHD. Fifty-two patients (1.4% of all headache patients) had only OPHD, while 54 (1.5%) had both OPHD and a co-existing primary headache (mostly migraine). All OPHDs were more common in females. The most frequent subtypes were new daily persistent headache and primary stabbing headache (0.2% each among all admitted patients). Photophobia and phonophobia were the most frequent accompanying symptoms, while physical activity (28.8%), stress (15.4%), and the Valsalva maneuver (15.4%) were the most common triggering factors. The majority of triggering factors were more pronounced in patients with both migraine and OPHD. Conclusions: Other primary headaches are rare and heterogeneous. Their high co-existence with migraine suggests shared predisposing factors, hinting at a “headache continuum” concept for primary headaches. © 2024 Elsevier B.V.Item The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): Normative values with gender, age and education corrections in the Turkish population(Elsevier B.V., 2025) Batum M.; Sarıtaş A.Ş.; Erdoğan B.; Çelebi N.; Ak A.K.; Mavioğlu H.Cognitive impairment is common in multiple sclerosis (MS) and can be demonstrated in all stages and subtypes of the disease. The most recently created battery to evaluate information processing speed, verbal and visual memory to evaluate cognitive functions in MS is the Brief International Cognitive Assessment for MS (BICAMS). The aim of this study is to predict the normal values of BICAMS for our society according to age, gender, and education duration. Two hundred ninety-four healthy volunteers, grouped by age, gender, and education duration, were included in the study. Symbol Digit Modalities Test (SDMT), California Verbal Learning Test II (CVLT-II), and Brief Visuospatial Memory Test-Revised (BVMTR) tests included in the BICAMS battery were applied to all patients. Linear regression analysis method was used to estimate the expected BICAMS test scores of the study participants according to their age, gender and education period. There was no difference between SDMT, CVLT-II, and BVMT-R results in men and women (p = 0.354, p = 0.110, p = 0.410, respectively). SDMT, CVLT-II, and BVMT-R results differed significantly in all age and education level groups (p < 0.001). It was determined that the most effective factor that effects the BICAMS results was the education level. It is thought that normal values for age, gender, and education level can facilitate the use of the battery in clinical practice, as well as for longitudinal patient assessments. © 2025Item Evaluation of predictive factors of idiopathic intracranial hypertension in different clinics(Elsevier B.V., 2025) Karakaş B.; Sarıtaş A.Ş.; Ak A.K.Purpose: Idiopathic Intracranial Hypertension (IIH) is marked by elevated intracranial pressure without an identifiable cause. This study aimed to compare predictive factors between two IIH groups: those experiencing remission (single attack) and those developing migrainous headaches, in order to identify factors influencing the disease's progression. Methods: This retrospective study was conducted after obtaining ethics committee approval. It involved 118 patients diagnosed with IIH who were followed up in the Neuro-ophthalmology outpatient clinic between 2011 and 2023. Data on demographics, clinical history, comorbidities, habits, neurologic and neuro-ophthalmologic findings, cranial imaging features, lumbar puncture opening pressure, and current medical treatments were collected to assess the clinical course and predictive factors. The analyzed parameters were compared between two subgroups: one experiencing remission (single attack) and the other developing migrainous headaches. Statistically significant parameters were subjected to univariate and multivariate analysis. Results: Of the 118 patients, 87 (73.7 %) were in the single-attack group, while 31 (26.3 %) were in the migrainous headache group. Key predictive factors identified between the groups were the presence of allodynia (p < 0.001), neck and back pain (p = 0.042), BMI > 27.8 kg/m² (p = 0.002), and a history of migraine (p < 0.001). Conclusions: Allodynia, neck and back pain, a history of migraine, and a BMI > 27.8 kg/m² were found to be predictive factors for the development of migrainous headaches in IIH patients. This is the first study in the literature to compare these two patient groups and identify the factors that contribute to the development of migrainous headaches. © 2025 Elsevier B.V.Item Validity and reliability of the Turkish version of the Innsbruck RBD-9 diagnostic inventory (IRBD-9-TR)(2025) Aslan-Kara K.; Ak A.K.; Sarıtaş A.Ş.; Yılmaz H.; Metin K.M.; Çokal B.G.; Ağan K.; Aksu M.; Akyıldız U.O.; Demir A.B.; Çevik B.; Ertürk A.Y.; Karadeniz D.; Öztura İ.; Sünter G.; Tekin S.; Tezer İ.; Berktaş D.T.; Totik N.; Şenel G.B.BACKGROUND: Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is characterized by loss of the normal atonia of REM sleep accompanied by repetitive motor and behavior phenomena of dream content. OBJECTIVE: To evaluate the reliability and validity of the Turkish version of the original form of the Innsbruck Rapid Eye Movement Sleep Behavior Disorder Diagnostic Inventory (IRBD-9) scale (IRBD-9-TR) and ensure that this screening test can be easily used in the Turkish language. METHODS: The present is a multicenter and prospective study involving 184 patients: 51 with iRBD and 133 healthy controls. The iRBD patients were not diagnosed before submitted to video polysomnography (vPSG) and filling out the IRBD-9-TR. RESULTS: The optimal cut-off value for the IRBD-9-TR symptom score was of 0.28, with a sensitivity of 0.941 and a specificity of 0.947, and 94.4% of the patients were correctly diagnosed. The rotated factor loadings for the diagnostic accuracy of each individual question showed that the short version of the IRBD-9-TR (questions 1, 2, 3, 6, and 8) presented higher specificity and excellent discrimination of iRBD patients from healthy controls. The Cronbach's α coefficient for the symptom section of the IRBD-9-TR was of 0.857, and the Kappa coefficient, of 0.885. CONCLUSION: The short version of the IRBD-9-TR presents good validity and reliability to be used as a screening test to assess iRBD patients. It is convenient and potentially useful in both outpatient clinical and epidemiologic research settings. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).