Browsing by Author "Tekgül H."

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    Miller Fisher syndrome: A case with pattern of pure sensory polyneuropathy concomitant with anti-GQ1B antibody
    (2007) Akinci G.; Polat M.; Tosun A.; Serdaroǧlu G.; Gökben S.; Tekgül H.
    Miller Fisher syndrome is characterized by the acute onset of ophthalmoplegia, ataxia, and areflexia. Anti-GQ1b antibodies are useful markers for the differential diagnosis of Miller Fisher syndrome. We describe the case of a seven-year-old male who presented with a four-day history of diplopia and ophthalmoplegia following a febrile flu-like illness with sore throat. On examination he was found to have ataxia, areflexia and ophthalmoplegia, and a diagnosis of Miller Fisher syndrome was made after the exclusion of other conditions and concomitant with electrophysiological findings on electromyography. Although this disorder has a rare incidence, it should still be considered in the differential diagnosis in our country.
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    Prediction of neurodevelopmental outcome in term neonates with hypoxic-ischemic encephalopathy
    (2013) Polat M.; Şimşek A.; Tansuǧ N.; Sezer R.G.; Özkol M.; Başpinar P.; Tekgül H.
    Background: Hypoxic ischemic encephalopathy may result in many neurological deficits. It is crucial to make early diagnosis and assess the prognosis correctly. Aims: We aimed to determine the factors to evaluate the prognosis of hypoxic ischemic encephalopathy. Methods: Electroencephalography, neuroimaging, periodic neurological exams and a developmental test at 44-48 months after discharge from the hospital were performed on twenty five term newborn infants with clinical evidence of hypoxic ischemic encephalopathy. Results: Normal/mildly abnormal neonatal electroencephalography correlated with favorable outcome, particularly if neuroimaging was normal. The cranial MRI sensitivity was 83.3%, while the specificity was 57.9%, the positive predictive value was 38.5%, and the negative predictive value was 91.6%. Moderate/severely abnormal electroencephalography and multifocal/diffuse cortical or deep gray matter lesions correlated with poor outcome. Conclusions: Newborn infants with hypoxic ischemic encephalopathy should be treated in neonatal intensive care units, assessed with periodic neurological examination, electroencephalogram and brain imaging. This would help to initiate early intervention and improve the outcome of patients. © 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
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    Changing views of cerebral palsy over 35 years: The experience of a center
    (2013) Tosun A.; Gökben S.; Serdaroǧlu G.; Polat M.; Tekgül H.
    In this study, it was aimed to evaluate the demographic and clinical characteristics of cerebral palsy (CP) cases over a 35-year period. Findings of 442 patients with CP followed from 1995 to 2006 (Group 2) were compared with 208 patients with CP followed between 1972 and 1994 (Group 1) in the same pediatric neurology division. Ratios of both prematurity (38% vs. 17.7%) and very low birth weight (VLBW) infants (13.8% vs. 1.5%) significantly increased in Group 2. There was also a four-fold increase in cesarean delivery in Group 2 (42.3% vs. 9.6%). A significant increase in the rate of early diagnosis during the first year was also found in this group (56.9% vs. 39.4%). The rate of spastic diparesis cases has significantly increased (33.7% vs. 7.7%), while the rate of spastic tetraparesis cases has significantly decreased (63.5% vs. 37.3%). It was seen that preventable risk factors continue today.
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    Shared Biological Pathways and Processes in Patients with Intellectual Disability: A Multicenter Study
    (Georg Thieme Verlag, 2022) Günay Ç.; Aykol D.; Özsoy Ö.; Sönmezler E.; Hanci Y.S.; Kara B.; Akkoyunlu Sünnetçi D.; Cine N.; Deniz A.; Özer T.; Ölçülü C.B.; Yilmaz Ö.; Kanmaz S.; Yilmaz S.; Tekgül H.; Yildiz N.; Acar Arslan E.; Cansu A.; Olgaç Dündar N.; Kusgoz F.; Didinmez E.; Gençpinar P.; Aksu Uzunhan T.; Ertürk B.; Gezdirici A.; Ayaz A.; Ölmez A.; Ayanoǧlu M.; Tosun A.; Topçu Y.; Kiliç B.; Aydin K.; Çaǧlar E.; Ersoy Kosvali Ö.; Okuyaz Ç.; Besen Ş.; Tekin Orgun L.; Erol İ.; Yüksel D.; Sezer A.; Atasoy E.; Toprak Ü.; Güngör S.; Ozgor B.; Karadaǧ M.; Dilber C.; Şahinoǧlu B.; Uyur Yalçin E.; Eldes Hacifazlioglu N.; Yaramiś A.; Edem P.; Gezici Tekin H.; Yilmaz Ü.; Ünalp A.; Turay S.; Biçer D.; Gül Mert G.; Dokurel Çetin İ.; Kirik S.; Öztürk G.; Karal Y.; Sanri A.; Aksoy A.; Polat M.; Özgün N.; Soydemir D.; Sarikaya Uzan G.; Ülker Üstebay D.; Gök A.; Yeśilmen M.C.; Yiś U.; Karakülah G.; Bursali A.; Oktay Y.; Hiz Kurul S.
    Background  Although the underlying genetic causes of intellectual disability (ID) continue to be rapidly identified, the biological pathways and processes that could be targets for a potential molecular therapy are not yet known. This study aimed to identify ID-related shared pathways and processes utilizing enrichment analyses. Methods  In this multicenter study, causative genes of patients with ID were used as input for Disease Ontology (DO), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes enrichment analysis. Results  Genetic test results of 720 patients from 27 centers were obtained. Patients with chromosomal deletion/duplication, non-ID genes, novel genes, and results with changes in more than one gene were excluded. A total of 558 patients with 341 different causative genes were included in the study. Pathway-based enrichment analysis of the ID-related genes via ClusterProfiler revealed 18 shared pathways, with lysine degradation and nicotine addiction being the most common. The most common of the 25 overrepresented DO terms was ID. The most frequently overrepresented GO biological process, cellular component, and molecular function terms were regulation of membrane potential, ion channel complex, and voltage-gated ion channel activity/voltage-gated channel activity, respectively. Conclusion  Lysine degradation, nicotine addiction, and thyroid hormone signaling pathways are well-suited to be research areas for the discovery of new targeted therapies in ID patients. © 2022 Hippokrates Verlag GmbH. All rights reserved.
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    Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes
    (W.B. Saunders Ltd, 2022) Yılmaz Ü.; Gücüyener K.; Yavuz M.; Öncel İ.; Canpolat M.; Saltık S.; Ünver O.; Çıtak Kurt A.N.; Tosun A.; Yılmaz S.; Özgör B.; Erol İ.; Öztoprak Ü.; Elitez D.A.; Direk M.Ç.; Bodur M.; Teber S.; Anlar B.; Aykol D.; Yıldız E.P.; Yarar C.; Kara B.; Haspolat; İncecik F.; Kutluk G.; Dilber C.; Dundar N.O.; Tan H.; Demir E.; Dursun B.D.; Dilek T.D.; Türkdoğan D.; Yalnızoğlu D.; Akbaş S.; Güleç A.; Yılmaz D.; Ayanoğlu M.; Kanmaz S.; Güngör S.; Öztürk G.; Besen; Haliloğlu G.; Karaca N.B.; Öztürk S.; Yüksel D.; Gürkaş E.; Oktay S.; Serin H.M.; Karadağ M.; Hakkı Akbeyaz İ.; Yiş U.; Polat B.G.; Okan M.S.; Bektaş Ö.; Orgun L.T.; Günbey C.; Per H.; Gültutan P.; Öztürk S.B.; Aksoy E.; Akyüz G.; Tekgül H.; Kürekçi F.; Kurul A.S.H.; Çarman K.B.; Alikılıç D.; Duman Ö.; Kömür M.; Yıldırım M.; Alıcı N.; Gümüş H.; Polat M.; Konuşkan B.; Güngör O.; Mert G.G.; Edizer S.; Mıhçı F.; Öztürk S.T.; Toker R.T.; Arslan M.; Şahin S.; Gencpinar P.; Yıldırım E.; Yüksel E.; Ekici A.; Deniz A.; Yayici Köken Ö.; Okuyaz Ç.; Süt N.Y.; Atasoy E.; Solmaz İ.; Yetkin M.F.; Bilgin N.; Atasever A.K.; Tekin H.G.; Dokurel İ.; Özçelik A.; Aksoy A.; Türköz A.N.; Cavusoglu D.; Özkan M.; Tekin E.; Şahin T.U.; Ünalp A.; Koç H.; Sarıgeçili E.; Sarıtaş S.; Ayça S.; Kayılıoğlu H.; Şenoğlu M.Ç.; Kamaşak T.; Asadova N.; Keskin F.; Karaoğlu P.; İpek R.; Acer H.
    Background: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Türkiye. Clinical and paraclinical features were compared between patients with disease onset before 12 years (earlier onset) and ≥12 years (later onset) as well as between our current (2015–2021) and previous (<2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset <12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought. © 2022 European Paediatric Neurology Society
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    A multicenter study of radiologically isolated syndrome in children and adolescents: Can we predict the course?
    (Elsevier B.V., 2023) Yılmaz D.; Teber S.; Gültutan P.; Yıldırım M.; Bektaş Ö.; Alikılıç D.; Güngör M.; Kara B.; Öncel İ.; Dilek T.D.; Saltık S.; Kanmaz S.; Yılmaz S.; Tekgül H.; Çavuşoğlu D.; Karaoğlu P.; Yılmaz Ü.; Orak S.A.; Güngör O.; Anlar B.
    Objectives: To evaluate clinical characteristics, imaging features and etiological profile of Radiologically Isolated Syndrome (RIS) along with clinical and radiological follow-up. Methods: Demographic, clinical and radiological data of patients younger than 18 years fulfilling the criteria for RIS were retrospectively analyzed. RIS was defined by the detection of lesions meeting the revised 2010 McDonald Criteria for dissemination in space on magnetic resonance imaging (MRI) in the absence of any symptoms of demyelinating disease or an alternative cause for the MRI findings. Results: There were total 69 patients (38 girls, 31 boys). The median age at index MRI was 15.7 years, and median follow-up time was 28 months. The most common reason for neuroimaging was headache (60.9%). A first clinical event occurred with median 11 months in 14/69 (20%) of cases. Those with oligoclonal bands (OCB) in cerebrospinal fluid (CSF) and follow-up longer than 3 years were more likely to experience a clinical event (p<0.05): 25% of those with OCB manifested clinical symptoms within the first year and 33.3% within the first two years compared to 6.3% and 9.4%, respectively in those without OCB. Radiological evolution was not associated with any variables: age, sex, reason for neuroimaging, serum 25-hydroxyvitamin D level, elevated IgG index, OCB positivity, total number and localization of lesions, presence of gadolinium enhancement, achievement of 2005 criteria for DIS and duration of follow-up. Conclusion: Children and adolescents with RIS and CSF OCB should be followed-up for at least 3 years in order to detect any clinical symptoms suggestive of a demyelinating event. Because disease-modifying treatments are not approved in RIS and no consensus report justifies their use especially in pediatric RIS, close follow-up of OCB-positive patients is needed for early recognition of any clinical event and timely initiation of specific treatment. © 2023 Elsevier B.V.
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    Corrigendum to “Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes” [Europ. J. Paediatr. Neurol. 41 (2022) 8–18 doi.org/10.1016/j.ejpn.2022.08.006, (S1090379822001246), (10.1016/j.ejpn.2022.08.006)]
    (W.B. Saunders Ltd, 2024) Yılmaz Ü.; Gücüyener K.; Yavuz M.; Ibrahim Oncel; Canpolat M.; Saltık S.; Ünver O.; Çıtak Kurt A.N.; Tosun A.; Yılmaz S.; Özgör B.; Ilknur Erol; Öztoprak Ü.; Elitez D.A.; Çobanoğulları Direk M.; Bodur M.; Teber S.; Anlar B.; Erol İ.; Aykol D.; Direk M.Ç.; Yıldız E.P.; Yarar C.; Kara B.; Haspolat; İncecik F.; Kutluk G.; Dilber C.; Dundar N.O.; Tan H.; Öncel İ.; Demir E.; Dursun B.D.; Dilek T.D.; Türkdoğan D.; Yalnızoğlu D.; Akbaş S.; Güleç A.; Yılmaz D.; Ayanoğlu M.; Kanmaz S.; Güngör S.; Öztürk G.; Besen; Haliloğlu G.; Karaca N.B.; Öztürk S.; Yüksel D.; Gürkaş E.; Oktay S.; Serin H.M.; Karadağ M.; Akbeyaz İ.H.; Yiş U.; Polat B.G.; Okan M.S.; Bektaş Ö.; Orgun L.T.; Günbey C.; Per H.; Gültutan P.; Öztürk S.B.; Aksoy E.; Akyüz G.; Tekgül H.; Kürekçi F.; Hız Kurul A.S.; Çarman K.B.; Alikılıç D.; Duman Ö.; Kömür M.; Yıldırım M.; Alıcı N.; Gümüş H.; Polat M.; Konuşkan B.; Güngör O.; Mert G.G.; Edizer S.; Mıhçı F.; Öztürk S.T.; Toker R.T.; Arslan M.; Şahin S.; Gencpinar P.; Yıldırım E.; Yüksel E.; Ekici A.; Deniz A.; Köken Ö.Y.; Okuyaz Ç.; Süt N.Y.; Atasoy E.; Solmaz İ.; Yetkin M.F.; Bilgin N.; Atasever A.K.; Tekin H.G.; Dokurel İ.; Özçelik A.; Aksoy A.; Türköz A.N.; Cavusoglu D.; Özkan M.; Tekin E.; Şahin T.U.; Ünalp A.; Koç H.; Sarıgeçili E.; Sarıtaş S.; Ayça S.; Kayılıoğlu H.; Şenoğlu M.Ç.; Kamaşak T.; Asadova N.; Keskin F.; Karaoğlu P.; İpek R.; Acer H.
    The authors would like to apologise for any inconvenience caused. © 2024 European Paediatric Neurology Society
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    Optic neuritis in Turkish children and adolescents: A multicenter retrospective study
    (Elsevier B.V., 2024) Direk M.Ç.; Besen Ş.; Öncel İ.; Günbey C.; Özdoğan O.; Orgun L.T.; Sahin S.; Cansu A.; Yıldız N.; Kanmaz S.; Yılmaz S.; Tekgül H.; Türkdoğan D.; Ünver O.; Thomas G.Ö.; Başıbüyük S.; Yılmaz D.; Kurt A.N.; Gültutan P.; Özsoy Ö.; Yiş U.; Kurul S.H.; Güngör S.; Özgör B.; Karadağ M.; Dündar N.O.; Gençpınar P.; Bildik O.; Orak S.A.; Kabur Ç.Ç.; Kara B.; Karaca Ö.; Canpolat M.; Gümüş H.; Per H.; Yılmaz Ü.; Karaoğlu P.; Ersoy Ö.; Tosun A.; Öztürk S.B.; Yüksel D.; Atasoy E.; Gücüyener K.; Yıldırım M.; Bektaş Ö.; Çavuşoğlu D.; Yarar Ç.; Güngör O.; Mert G.G.; Sarıgeçili E.; Edizer S.; Çetin İ.D.; Aydın S.; Diler B.; Özdemir A.A.; Erol İ.; Okuyaz Ç.; Anlar B.
    Background: Various etiologies may underlie optic neuritis, including autoantibody-mediated disorders described in the last decade. We re-examined demographic, clinical, laboratory features and prognostic factors in pediatric patients with autoimmune optic neuritis according to current knowledge. Methods: Cases of pediatric ON from 27 centers in Türkiye diagnosed between 2009 and 2022 were included for retrospective evaluation. Results: The study included 279 patients, 174 females and 105 males, with a female-to-male ratio of 1.65. The average age at onset was 12.8 ± 3.4 years, and mean follow-up, 2.1 years (range: 1–12.1 years). Patients <10 years old were grouped as "prepubertal" and those ≥10 years old as "others”. The diagnoses made at the end of follow-up were multiple sclerosis associated optic neuritis (n = 90, 32.3 %), single isolated optic neuritis (n = 86, 31 %), clinically isolated syndrome (n = 41, 14.7 %), myelin oligodendrocyte glycoprotein antibody associated optic neuritis (n = 22, 7.9 %), and relapsing isolated optic neuritis (n = 18, 6.5 %). Predominant diagnoses were myelin oligodendrocyte glycoprotein antibody associated optic neuritis and acute disseminated encephalomyelitis associated optic neuritis in the prepubertal group and multiple sclerosis associated optic neuritis in the older group. Recurrences were observed in 67 (24 %) patients, including 28 with multiple sclerosis associated optic neuritis, 18 with relapsing isolated optic neuritis, 11 with myelin oligodendrocyte glycoprotein antibody associated optic neuritis, 8 with aquaporin-4 antibody related optic neuritis, and 2 with chronic relapsing inflammatory optic neuropathy. Recurrences were more common among female patients. Findings supporting the diagnosis of multiple sclerosis included age of onset ≥ 10 years (OR=1.24, p = 0.027), the presence of cranial MRI lesions (OR=26.92, p<0.001), and oligoclonal bands (OR=9.7, p = 0.001). Treatment in the acute phase consisted of intravenous pulse methylprednisolone (n = 46, 16.5 %), pulse methylprednisolone with an oral taper (n = 212, 76 %), and combinations of pulse methylprednisolone, plasmapheresis, or intravenous immunoglobulin (n = 21, 7.5 %). Outcome at 12 months was satisfactory, with 247 out of 279 patients (88.5 %) demonstrating complete recovery. Thirty-two patients exhibited incomplete recovery and further combination treatments were applied. Specifically, patients with relapsing isolated optic neuritis and aquaporin-4 antibody related optic neuritis displayed a less favorable prognosis. Conclusion: Our results suggest optic neuritis is frequently bilateral in prepubertal and unilateral in peri‑ or postpubertal patients. Age of onset 10 or older, presence of oligoclonal bands, and brain MRI findings reliably predict the development of multiple sclerosis. The risk of developing multiple sclerosis increases mostly during the second and third years of follow-up. Relapsing isolated optic neuritis remains a separate group where the pathogenesis and outcome remain unclear. Investigation of predisposing and diagnostic biomarkers and long follow-up could help to define this group. © 2023 Elsevier B.V.