Browsing by Author "Saritas, AS"

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    Investigation of Sleep Breathing Disorders in Young Patients (Under 55 years) with Mild Stroke
    Kisabay, AKA; Saritas, AS; Batum, M; Göktalay, T; Horasan, GD; Selcuki, D; Yilmaz, H
    Introduction: Many patients with stroke also have sleep breathing disorders (SBD), most of which is obstructive sleep apnea (OSA). Methods: Sixty patients with a history of stroke aged under 55 years were included in our study. The demographic characteristics (age at stroke, sex, body mass index) of the patients and etiology of stroke was evaluated according to the Trial of Org 10712 in Acute Stroke (TOAST) classification. The National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) were used to evaluate functionality. All patients underwent polysomnography (PSG) investigations. Findings: Based on PSG investigations, seven patients were normal, 10 had primary snoring, and 14 had mild, 11 had moderate, and 18 had severe OSA. The demographic characteristics did not differ significantly between the groups. No significant correlation was found between disease severity and NIHSS, MRS or TOAST classifications. Large artery atherosclerosis in the etiology, facial paralysis and dysarthria in the neurological examination, and brain stem involvement in the stroke location were observed to accumulate in the severe OSA group. When the anterior system, posterior system, and association of both were compared for vessel location, no significant difference was found regarding circulatory systems. Conclusions: It is considered that SBD has also a role in the etiology of stroke in patients aged under 55 years, and it should be taken into consideration as much as other risk factors. This is the first study to emphasize the importance of this topic in the literature.
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    Cognıtıve functıons in idiopathic intracranial hypertensıon
    Ak, AK; Saritas, AS; Batum, M; Gemici, YI; Karakas, B; Celebisoy, N
    ObjectiveCognitive 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.MethodsFifty 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.ResultsNeuropsychologic 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.ConclusionA 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.
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    Oligoclonal Band Number Affect On Cognitive Function Of Multiple Sclerosis Patients
    Gemici, YI; Batum, M; Saritas, AS; Kisabay, A; Mavioglu, H
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    Clinical Approach Hypersomnia of Central Origin and Differential Diagnosis
    Ak, AK; Saritas, AS; Gemici, YI; Yilmaz, H
    Hypersomnia and excessive daytime sleepiness are commonly encountered by physicians dealing with sleep medicine. Although these are common symptoms associated with sleep disorders, they can be ignored. The tendency of excessive daytime sleepiness, which might be caused by sleep deprivation that continues for a while in our society, makes it difficult to diagnose diseases with hypersomnia. Hypersomnia is used as a comprehensive definition for excessive daytime sleepiness and/or excessive need for sleep or increased amount of sleep. Clinically, it presents with prolonged sleep times at night, falling asleep easily and everywhere, recurrent sleep attacks, and excessive daytime sleepiness. Hypersomnia can be either a symptom of neurological and metabolic diseases, especially sleep disorders, or develop due to substance, drug use, and trauma. Sleep attacks occurring during the day can affect individuals' academic or professional performance, disrupt their cognitive functions and social relations, and cause life-threatening traffic or work accidents. It is crucial to examine this symptom, which causes a significant deterioration in the quality of life of people, and to diagnose and treat the diseases causing it. This review article plans to address the epidemiological, pathophysiological, clinical aspects of sleep disorders that cause hypersomnia, treatment and emphasize the critical points in the differential diagnosis.
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    Evaluation of predictive factors of idiopathic intracranial hypertension in different clinics
    Karakas, B; Saritas, AS; Kisabay, AKA
    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/m(2) (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/m(2) 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.
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    Validity and reliability of the Turkish version of the Innsbruck RBD-9 diagnostic inventory (IRBD-9-TR)
    Aslan-Kara, K; Ak, AK; Saritas, AS; Yilmaz, H; Metin, KM; Çokal, BG; Agan, K; Aksu, M; Akyildiz, UO; Demir, AB; Çevik, B; Ertürk, AY; Karadeniz, D; Öztura, I; Sünter, G; Tekin, S; Tezer, I; Berktas, DT; Totik, N; Senel, GB
    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 alpha 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.
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    Understanding Pain Patterns in Medication Overuse Headache: Insights from Turkiye's Real-Life Experience
    Tepe, N; Bolay, H; Akgör, MC; Vuralli, D; Ari, BC; Eliaçik, S; Ak, AK; Uzunkaya, O; Ergin, N; Saritas, AS; Öcal, R; Sahbaz, FG; Demir, TG; Uludüz, D; Uluduz, E; Aciman, E; Atalay, AC; Oguz, K; Özbenli, T; Yilmaz, GG; Öksüz, N; Genç, H; Örün, MO; Can, AI; Özge, A
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    The impact of the COVID-19 pandemic on patients with tension-type headache: A multicenter survey
    Firat, YE; Karsidag, S; Neyal, AM; Cengiz, EK; Ergin, N; Ak, AK; Saritas, AS; Gölen, MK; Okuyan, DY; Bakar, EE; Eren, F; Neyal, A; Çinar, N; Kendirli, S; Yilmaz, BO; Sahin, S; Ates, MF; Bülbül, NG; Demir, A; Dogan, B; Demirel, EA; Erdemoglu, AK; 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.
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    Comparison of clinical features in patients with vestibular migraine and migraine
    Çelebisoy, N; Ak, AK; Ataç, C; Özdemir, HN; Gökçay, F; Durmaz, GS; Karti, DT; Toydemir, HE; Yayla, V; Isikay, IÇ; Erkent, I; Saritas, AS; Özçelik, P; Akdal, G; Biçakci, S; Göksu, EO; Uyaroglu, FG
    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.
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    Can vestibular migraine development be predicted in patients with new onset migraine headaches?
    Çelebisoy, N; Ak, AK; Ataç, C; Özdemir, HN; Gökcay, F; Durmaz, GS; Karti, DT; Toydemir, HE; Yayla, V; Isikay, AIÇ; Erkent, I; Saritas, AS; Özçelik, P; Akdal, G; Biçakci, S; Göksu, EO; Uyaroglu, FG
    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.
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    Distinctive sleep complaints and polysomnographic findings in antibody subgroups of autoimmune limbic encephalitis
    Küçükali, CI; Yilmaz, V; Karadeniz, D; Akyildiz, UO; Algin, DI; Saritas, AS; Ak, AK; Demir, AB; Yilmaz, H; Domaç, FM; Elmali, AD; Hos, ÜD; Gözübatik-Çelik, RG; Kabeloglu, V; Bilgin, B; Berktas, DT; Türk, BG; Delil, S; Dilber, C; Öztürk, ST; Yeni, SN; Özkara,Ç; Aksu, M; Tüzün, E; Senel, GB
    Introduction Sleep disturbances are being increasingly recognized in association with autoimmune encephalitis (AIE). We investigated the prevalence of sleep-related symptoms and polysomnographic features of patients with AIE and the long-term outcomes in these patients in a multi-center, prospective study from Turkey.Methods We prospectively evaluated patients with definite AIE in a common database including demographics, AIE-related and sleep-related symptomatology. Maximum and latest modified Rankin scores (mRS) and Liverpool Outcome Score (LOS) were noted.Results Of 142 patients, 87 patients (61.3%) fulfilled the criteria for definite AIE (mean age, 46.8+18.8 years; 51.7% women; mean disease duration, 21.0+38.4 months). 78.9% of patients had at least one or more new onset or worsened sleep-related symptomatology: insomnia (55.3%), excessive daytime sleepiness (EDS, 28.0%), sleep apnea (18.7%), REM sleep behavior disorder (RBD, 17.3%), restless legs syndrome (10.7%) and oneiric stupor (9.3%). Sleep efficiency, N3 and REM sleep were decreased and N1 sleep was increased in patients with Ab[+] AIE. LOS points were highest in those with insomnia and sleep apnea, and lowest in those with EDS, RBD and oneiric stupor. RBD and sleep apnea were more common in anti-LG1 Ab[+] group than anti-NMDAR Ab[+] group. Index of periodic leg movements was highest in anti-LG1 Ab[+] group. Patients with EDS and oneiric stupor had more common memory problems. Maximum and latest mRS scores were positively correlated with EDS and oneiric stupor. EDS, RBD and oneiric stupor were negatively correlated with LOS points.Conclusion Our study emphasizes the presence and importance of early diagnosis of sleep disturbances in AIE in regard to their deteriorative influences on disease prognosis.
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    Eating attitudes of migraine patients in Turkey: a prospective multi-center study
    Ocal, R; Karakurum-Goksel, B; Van, M; Coskun, O; Karaaslan, C; Ucler, S; Gokcay, F; Celebisoy, N; Sirin, H; Ak, AK; Saritas, AS; Sirin, TC; Bayir, BRH; Ekizoglu, E; Orhan, EK; Bayram, D; Tanik, N; Bicakci, S; Ozturk, V; Inan, LE; Metin, KM; Eren, Y; Dora, B; Oguz-Akarsu, E; Karli, N; Celik, EU; Atalar, AC; Celik, RGG; Mutluay, B; Aydinlar, EI; Dikmen, PY; Semercioglu, S; Emre, U; Buldukoglu, OC; Er, B; Kilboz, BB; Ibis, S; Yagiz, S; Koklu, H; Kamaci, I; Aliyeva, G; Ates, BE; Kara, MM; Altunc, FZ; Kaya, I; Sisman, C
    Background Migraine is a disease characterized by headache attacks. The disease is multifactorial in etiology and genetic and environmental factors play role in pathogenesis. Migraine can also be accompanied by psychiatric disorders like neurotism and obsessive compulsive disorder. Stress, hormonal changes and certain food intake can trigger attacks in migraine. Previous studies showed that eating attitudes and disorders are prevalant in patients with migraine. Eating disorders are psychiatric disorders related to abnormal eating habits. Both migraine and eating disorders are common in young women and personality profiles of these patient groups are also similar. A possible relationship which shows that migraine and eating habits are related can lead to a better understanding of disease pathogenesis and subsequently new therapeutic options on both entities. Association of migraine in relation to severity, depression and anxiety and eating habits and disorders were aimed to be investigated in this study.Methods The study was designed as a prospective, multi-center, case control study. Twenty-one centers from Turkey was involved in the study. The gathered data was collected and evaluated at a single designated center. From a pool of 1200 migraine patients and 958 healthy control group, two groups as patient group and study group was created with PS matching method in relation to age, body-mass index, marital status and employment status. Eating Attitudes Test-26 (EAT-26), Beck's Depression Inventory (BDI) and Beck's Anxiety Inventory (BAI) were applied to both study groups. The data gathered was compared between two groups.Results EAT-26 scores and the requirement for referral to a psychiatrist due to symptoms related to eating disorder were both statistically significantly higher in patient group compared to control group (p = 0.034 and p = 0.0001 respectively). Patients with migraine had higher scores in both BDI and BAI compared to control group (p = 0.0001 and p = 0.0001 respectively). Severity of pain or frequency of attacks were not found to be related to eating attitudes (r:0.09, p = 0.055).Conclusions Migraine patients were found to have higher EAT-26, BDI and BAI scores along with a higher rate of referral to a psychiatrist due to symptoms. Results of the study showed that eating habits are altered in migraine patients with higher risk of eating disorders. Depression and anxiety are also found to be common amongst migraine patients.
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    Cognitive functions in idiopathic intracranial hypertension
    Ak, AK; Saritas, AS; Batum, M; Gemici, YI; Karakas, 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.
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    Prognostic factors in patients with cerebral sinus venous thrombosis presenting with hemorrhage and papilledema
    Saritas, AS; Batum, M; Ataç, C; Öztürk, U; Yilmaz, H; Mavioglu, H; Selçuki, D; Ak, AK
    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.