Browsing by Author "Kisabay A."
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Item Webino syndrome presented with pontine hematoma; [Ponti̇n hematomla bi̇rli̇kte görülen webi̇no sendromu](Turkish Society of Cerebrovascular Diseases, 2012) Kisabay A.; Çakiroǧlu E.; Selçuki D.Webino syndrome is considered a special form of bilateral internuclear ophthalmoplegia.It is characterized by bilateral absence of adduction, nystagmic abduction of both eyes, convergence deficiency and mostly with exotropia. Ischemic, demyelinating and infectious etiologies have been described. A 57 years old male patient is found worthy for presentation since there are eye findings compatible with very rarely encountered Webino syndrome secondary to pontine hematoma.Item A pre- and postoperative evaluation of multiple joint involvement as the initial finding of cervical syringomyelia and neuropathic arthropathy; [Servikal siringomiyelin ve nöropatik artropatinin ilk bulgusu olarak ortaya çi{dotless}kan çoklu eklem tutulumunun ameliyat öncesi ve sonrasi{dotless} deǧerlendirilmesi](2013) Kisabay A.; Zeybek S.; Sari S.; Tanyeli A.; Selçuki D.Syringomyelia is a progressive, degenerative disorder, in which a longitudinal cyst forms within the spinal cord. Neuropathic arthropathy can be seen in the late phases of the disease, with the most frequent involvement being in the shoulder. Herein, we present a 42-year-old female case who was diagnosed with syringomyelia as well as Arnold-Chiari Syndrome and neuropathic arthropathy. Her initial complaints were painless edema in the right shoulder and elbow, wounds on the tips of her fingers and amputations. She was evaluated both pre- and postoperative periods. It should be kept in mind that neuropathic arthropathy may develop as the initial symptom in spinal cord lesions which progress slowly. ©2013 Turkish League Against Rheumatism. All rights reserved.Item Micturition syncope: Report of two cases(Kare Publishing, 2013) Sari U.S.; Kisabay A.; Selcuki D.Micturition syncope: report of two cases Syncope is a symptom which is a transient loss of consciousness and very common in society and is one of the most important referral causes to emergency services. Micturition syncope (MS) appears as a rare cause of neurally-mediated syncope. MS is caused by reflex which results with vasodilatation and bradycardia, like defecation syncope. In the clinical setting, the MS is presented with transient loss of consciousness during supine position or micturition following after a sleep period mostly in otherwise healthy men. It is a reflex state in which standing triggers vasodilatation and bradicardia. MS covers 2-8% of all syncopes. There is still no consensus about treatment and outcome of MS. In this article two male patients with MS are presented. With these two cases, we aimed to give detailed information about micturition syncope which is a rare type of syncope.Item Recurrent painless ophthalmoplegic neuropathy with onset in advanced age - Case report(Elsevier B.V., 2015) Selcuki D.; Sari Ü.S.; Kisabay A.; Doʇan N.; Oktan B.; Batum M.Recurrent painless ophthalmoplegic neuropathy is a clinical condition characterized by attacks of recurrent migraine headaches accompanied by ophthalmoplegia. It is a type of migraine in which single or multiple cranial nerves, most commonly the cranial nerve III, are involved within 4 days following headache. It is rare and more common in men. There are patients with onset in childhood but cases have rarely been reported beginning in the adulthood. The subject being reported here was considered to deserve to be presented because of attacks of recurrent painless ophthalmoplegic neuropathy were seen in advanced age. © 2015 Elsevier GmbH.Item Association of myasthenia gravis and Behçet's disease: A case report(Urban and Partner, 2016) Kisabay A.; Sari U.S.; Boyaci R.; Batum M.; Yilmaz H.; Selcuki D.Myasthenia gravis is a disease of neuromuscular junction due to auto-immune destruction of the acetylcholine receptors. Behçet's disease, on the other hand, is a multisystemic vascular-inflammatory disease. Both conditions are not common in the general population although their association has not been reported in the literature. We wanted to present our patient who developed clinical course of myasthenia gravis following discontinuation of medications due to complications of corticosteroid for Behçet's disease. It was observed that clinical findings of myasthenia gravis recovered following restarting steroid treatment and he did not experience attacks of both conditions. Although Myasthenia gravis and Behçet's disease are distinct entities clinically as well as in terms of pathogenesis, they share common physiopathological features and their treatment is based on their common features. © 2016 Polish Neurological SocietyItem Manifestation of hashimoto's encephalopathy with psychotic signs: A case presentation(Yerkure Tanitim ve Yayincilik, 2016) Kisabay A.; Balikci K.; Sari S.; Selcuki D.Hashimoto's encephalopathy (HE) is a rare autoimmune disease with unclear pathophysiology, developing on the basis of Hashimoto's thyroiditis (HT), associated with antithyroid antibodies, that presents with autoimmune, neuroendocrine, and neuropsychiatric findings. The disease is characterized by generalized or focal slowing in the EEG, elevated antithyroid antibody titration in the serum, elevated cerebrospinal fluid protein level, and the presence of antithyroid antibodies. HE is known as an autoimmune disorder of the central nervous system. With this feature, it is differentiated from cognitive alterations observed in hypothyroidism or hyperthyroidism. The response to treatment with corticosteroids in line with the autoimmune nature of HE supports this diagnosis. This report shows a case presenting with neuropsychiatric symptoms, elevated antithyroid antibody titration in the serum, and complete response to steroid therapy. A clear indicator for the diagnosis of HE has not yet been found. Therefore, other potential causes need to be considered in the differential diagnosis of this clinical picture until they can be excluded after investigations. With this case report, we want to emphasize that in differential diagnosis of patients presenting with a variety of neuropsychiatric symptoms, Hashimoto's encephalopathy-though being seen quite rarely-should not be disregarded, given the dramatic improvement of patients receiving a correct diagnosis and appropriate treatment.Item Miller Fisher Syndrome/pharyngeal-cervical-brachial variant of GBS overlap and human herpes Virus-6 reinfection: May there BE a relationship?; [MFS/ Faringeal-Servikal-Brakial variant GBS Çakışması ile human herpes Virüs enfeksiyonu arasında bir ilişki var mı?](Ege University Press, 2016) Mavioğlu H.; Kisabay A.; Sari S.; Akçali S.; Oktan B.Miller Fisher Syndrome (MFS) is a rare variant of Gulliain Barre syndrome (GBS) characterized by external ophthalmoplegia, ataxia, areflexia, and usually by positive anti GQ1b antibody. It occurs through an autoimmune mechanism most frequently after Campylobacter jejuni, followed by Haemophilus influenzae infection. Although occurrence with other viruses and bacteria has been reported, the concurrence of MFS and Human Herpes Virus-6 (HHV-6) has not been reported so far. There are a few publications reporting association of GBS with HHV-6. In the present study, HHV-6 DNA with PCR was detected in the cerebrospinal fluid (CSF) of a 59 year-old female patient diagnosed with MFS/pharyngeal-cervical-brachial variant of GBS overlap from clinical findings and positive anti-GQ1b antibody in the serum. This article aims to create awareness of a possible relationship between MFS, GBS and HHV-6. © 2016, Ege University Press. All right reserved.Item Effects of CPAP (Continous positive airway pressure) treatment on oxidative stress and pro-inflammatory process; [CPAP (Continous positive airway pressure) tedavisinin oksidatif stres ve proinflamatuar sürece olan etkisi](Ege University Press, 2016) Kisabay A.; Sari U.S.; Çakiroğlu Aldemir E.; Oktan B.; Korkmaz T.; Dinç Horasan G.; Yilmaz H.Introduction: Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for development of atherosclerotic processes because it leads to hypertension, impaired glucose metabolism, obesity and metabolic syndrome, cardiac diseases, elevated blood pressure, and increased level of cholesterol, triglycerides, homocysteine, and coagulation. Materials and Methods: Our aim was to evaluate presence of subclinical atherosclerosis prior to CPAP treatment in the patients with OSAS without any history of previous diseases and any pathological finding in their investigations. After obtaining approval from the Ethics Board, we planned to compare the results of investigations for risk factors for atherosclerosis (fasting blood glucose [FBG], total cholesterol, Triglycerides, HDL- and LDL-cholesterol, thyroid function test, homocysteine, fibrinogen, high sensitivity C-reactive protein [hsCRP]) before and after CPAP treatment and to examine the effect of CPAP treatment on these parameters between July 2013 and July 2015. Findings: Findings obtained before CPAP treatment (homocysteine, hsCRP, HbA1c, subclinical hypothyroidism) suggested subclinical atherosclerosis. In comparative evaluation between the findings before and after CPAP treatment, no statistically significant difference was found in levels of triglycerides, HDL-cholesterol and fT4 (P = 0.346, 0.540, 0.060, respectively) whereas significant differences were found in leukocyte and platelet counts, hemoglobin level, fasting blood glucose, LDL-cholesterol, homocysteine, fibrinogen, fT3, TSH, CRP, and HbA1c (P = 0,003,-0,010,-0,000,-0,001,-0,008-0,004-0,000-0,000-0,025-0,000-0,000-0,000, respectively). Subclinical hypothyroidism was present in 12 (20%) patients before CPAP and in 5 (7%) patients after CPAP treatment. Conclusions: Improvement has been seen even in early markers of atherosclerosis with effective CPAP. © 2016, Ege University Press. All Rights Reserved.Item Association of PRES with SVT in the presence of pre-eclampsia: A case report; [Preeklampsi varliǧinda PRES-SVT birlikteliǧi: Bir olgu sunumu](Turkish Society of Cerebrovascular Diseases, 2016) Kisabay A.; Atilgan D.; Selçuki D.Clinical findings during the postpartum period include headache, seizures, focal neurological deficits, fluctuation in conscious, and visual complaints (blurred vision, reduced visual acuity, visual field defects, and cortical blindness). A 31 years old woman was pregnant at 37th gestational week and evaluated for her findings of headache, nausea, vomiting, seizure, tendency to sleep and hypertension. Cranial magnetic resonance imaging (MRI) was found to be consistent with posterior reversible encephalopathy syndrome as well as venous sinus thrombosis. In conclusion, since their treatment are distinct, possibility of presence of both clinical diagnoses should be kept in mind in the case of headache and/or focal deficits and seizure occurring during the post-partum period. Copyright © 2012 TBDHD.Item Evaluation of the effect of botulinum neurotoxin type A (BoNT/A) on daily activity performance in chronic migraine patients using VAS, MIDAS AND HIT-6 tests(ASEAN Neurological Association, 2018) Zeybek S.; Kisabay A.; Sari U.S.; Selcuki D.Background & Objectives: According to ICHD-III beta 2013 criteria, chronic migraine is defined as having headaches more than 15 times a month, for a period of more than 3 months, at least 8 must have migrainous features or good response to migraine-specific treatment; there must also be a history of 5 or more migraine attacks. The aim of the present study was to evaluate the effect of Botulinum Neurotoxin A (BONT/A) on headache and daily activities in chronic migraine patients using VAS, MIDAS and HIT-6 tests. Methods: Twenty five patients admitted to Hospital Department of Neurology were reviewed retrospectively. In order to evaluate the severity of headache and effects on daily performance, MIDAS (Migraine Disability Assessment Test), VAS (Visual Analogue Scale for Pain) and HIT-6 results after the baseline assessment, first and second administration of (BONT/A) were examined retrospectively from patients’ records. Results: VAS, MIDAS and HIT-6 scores were compared after baseline assessment and the first and second administrations. Results showed that VAS, MIDAS and HIT-6 scores decreased. This difference was statistically significant (p<0.05). Correlation analysis was conducted and significant correlations between scores on these three tests were found. Conclusions: The results showed that BoNT/A is an important and effective treatment option for chronic migraine patients not responding to migraine-specific prophylactic treatment and having alterations in daily life due to frequency and severity of pain. © 2018, ASEAN Neurological Association. All rights reserved.Item Evaluation of visual pathways using visual evoked potentials in the patients with impaired fasting glucose and impaired glucose tolerance(Taylor and Francis Ltd, 2019) Korkmaz T.; Kisabay A.; Hekimsoy Z.; Senol E.; Selçuki D.Purpose: There are many studies on degeneration of the ganglion cells using visual evoked potential (VEP) in Diabetes mellitus (DM). The present study intended to investigate whether the retinopathy findings would be helpful for detecting the degeneration to develop or not in retinal ganglion cells with the VEP test before being detectable in ophthalmoscopic examination on prediabetic patients. Materials and methods: The present study was conducted prospectively after obtaining approval from the Ethics Committee. In our study, the subjects were divided into three groups as impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and normal patients. They also underwent physical, ophthalmological and VEP examination. Three main components of VEP obtained from these groups were N75, P100, and N145 latency and N75-P100 amplitude. Results: The study participants consisted of the IFG group (n: 30, female/male ratio: 21/9; mean age: 49.17 ± 10.52 years), the IGT group (n: 30, female/male ratio: 23/7; mean age: 47.00 ± 11.09 years), and the Control Group (n: 40, female/male ratio: 30/10; mean age: 48.03 ± 10.96 years). Difference in sex and age between the study groups (p > 0.05). P100 latency was found to increase significantly in comparison between the IGT and Control Group for both eyes (p right: 0.003, p left: 0.001) whereas it did not increase significantly in the comparison between the IFG and the Control Group (p right: 0.065, p left: 0.116). Conclusion: It was observed that VEP may be a parameter of predictive value that might be used in evaluating prediabetic cases in terms of retinopathies similar to DM. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.Item CADASIL with Atypical Clinical Symptoms, Magnetic Resonance Imaging, and Novel Mutations: Two Case Reports and a Review of the Literature(Springer New York LLC, 2019) Sari U.S.; Kisabay A.; Batum M.; Tarhan S.; Dogan N.; Coskunoglu A.; Cam S.; Yilmaz H.; Selcuki D.Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary microangiopathy with adult onset caused by a missense mutation in the NOTCH3 gene in chromosome 19p13. It presents with autosomal dominant arteriopathy, subcortical infarctions, and leukoencephalopathy. Its common clinical presentations are seen as recurrent strokes, migraine or migraine-like headaches, progressive dementia, pseudobulbar paralysis, and psychiatric conditions. Two patients with CADASIL syndrome, whose diagnosis was made based on clinical course, age of onset, imaging findings, and genetic assays in the patients and family members, are presented here because of new familial polymorphisms. The first patient, with cerebellar and psychotic findings, had widespread non-confluent hyperintense lesions as well as moderate cerebellar atrophy in cranial magnetic resonance scanning. The other patient, with headache, dizziness, and forgetfulness, had gliotic lesions in both cerebral hemispheres. CADASIL gene studies revealed a new polymorphism in exon 33 in the first patient. In the other patient, the NOTCH3 gene was identified as a new variant of p.H243P (c.728A > C heterozygous). By reporting a family presenting with various clinical symptoms in the presence of new polymorphisms, we emphasize that CADASIL syndrome may present with various clinical courses and should be considered in differential diagnoses. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.Item Idiopathic intracranial hypertension: Are there predictors for visual outcome or recurrences?(Elsevier B.V., 2019) Tata G.; Kisabay A.; Gokcay F.; Celebisoy N.Objective: To find out the predictors of final visual outcome and recurrences in idiopathic intracranial hypertension (IIH). Patients and methods: Medical records of 75 patients with IIH were analyzed retrospectively. Gender, age of disease onset (AODO), body mass index (BMI), lumbar puncture opening pressure (LP-OP), visual acuity (VA) in logMAR, optical disc appearance (ODA), visual field (VF) mean deviation (MD), treatment results and recurrence rates were considered. Results: Mean age at onset age was 32.4 years, BMI was 311 kg/m² and median LP-OP was 380 mm H2O. All patients were treated with acetazolamide with a median dose of 1500 mg. The mean follow-up period was 44.8 months. AODO, BMI, LP-OP were not correlated with any of the examination parameters (VA, ODA, VF) at the first or last visit. The correlation between the VA and VF both at the first and last visit was not very powerful. VA of the last visit was fairly correlated with the VA of the first visit. However, the correlation between the last and first visit VF was very good. A very significant improvement in both VA and VF was recorded after treatment. Recurrences were noted in 23%. Demographic and clinical features of the recurring and non-recurring patients were not significantly different in terms of AODO, BMI, LP-OP, VA, VF or ODA. Conclusions: The patients with IIH respond to treatment with acetazolamide. First visit VF is the main determinant of the final visual outcome. Recurrences cannot be predicted by the demographic or clinical features at presentation. © 2019Item Visual evoked potentials and our studies(Nova Science Publishers, Inc., 2020) Korkmaz T.; Kisabay A.Evoked potentials are electrical responses of the brain to light, sound, or electrical stimuli. Depending on the type of stimulus, they emerge as visual, auditory, or somatosensorial evoked potentials. Visual evoked potentials (VEPs) are electrophysiological signals taken from the electroencephalographic activity of the visual cortex and recorded the scalp over the cortex. VEPs depend on the functional integrity of the visual pathways at any level including optic components of the eyes, retina, optic nerve, optic chiasm, optic radiations, and the visual cortex. On the pattern VEP recordings, 3 main components are observed which are called N75, P100 and N145. There are two types of recordings, known as pattern VEP and flash VEP. The presence of dopamine in the inner plexiform layer of the retina in mammals including humans and the fact that dopamine is not known to be an important transmitter anywhere in the visual system except for the retina, suggests that VEP abnormality is of retinal origin. Factors affecting VEP latency and amplitude include inflammation, hypoxia, and atherosclerosis. We have several publications on this topic on different groups of patients. This chapter of the book was intended to be written in order to explain and comment on our studies as well as the others on the definitions, types, recordings, waves, commenting normal and abnormal responses. Physiology and the pathophysiological mechanisms underlying abnormal VEPs will also be discussed. © 2020 Nova Science Publishers, Inc..Item Evaluation of the patients diagnosed as idiopathic intracranial hypertension with and without papilledema visual pathways by analysis of visual evoked potential(Taylor and Francis Ltd., 2021) Kisabay A.; Selcuki D.; Zeybek S.; Batum M.Background Idiopathic intracranial hypertension (IIH) is a clinical syndrome characterized by increased intracranial pressure in the absence of clinical, laboratory, or radiological findings of space-occupying lesion in the cranium. Papilledema is found in majority of the patients with IIH while it is absent in only about 5–6% of the patients. Methods Our primary objective was to evaluate the patients with IIH with (n: 45) and without (n: 15) papilledema using cranial MRI and VEP analyses and to compare the obtained results. Diagnosis of IIH according to ICHD-3 criteria admitted to and followed in our clinic before receiving any treatment between 2008 and 2018 were reviewed retrospectively after obtaining approval from the Ethics Committee. Results There was no statistically significant difference between both groups’ ages (P: 0.494) while differences in lumbar puncture (LP) opening pressure and VAS were found to be statistically significant (p = 0.034, 0.001, respectively). In our VEP investigation, it was seen that latencies in the group without papilledema were seen to be closer to those in the control group (P latency: 0.706, P amplitude: 0.080). Increase in latency and decrease in amplitude were seen in the group with papilledema compared to the group without papilledema (p < 0.001). Conclusion In conclusion, alterations in the optic nerve may be detected with VEP investigation before the detection of papilledema through ophthalmoscopic examination in these patients. Thus, VEP investigation may be considered to have predictive value. VEP examination may be recommended in diagnosis and treatment and during follow-up periods. © 2020 Informa UK Limited, trading as Taylor & Francis Group.