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Listeria monocytogenes is a gram positive microorganism that can cause multiorgan involvement. If brainstem involvement due to this microorganism occurs, it is called rhombencephalitis. There are nonspecific prodromal symptoms at the begining. Progressive brainstem symptoms and seizures can be added. 27 year old male patient presented with dizziness and ataxia for 15 days. It was learned that he had traveled to Saudi Arabia 2 months ago. Restricted abduction of left eye, left facial hemihypoesthesia, ataxia, dysmetria and bilateral Babinski sign positive were detected. In brain imaging, hyperintensity was detected at T2, DWI and FLAIR sequences in mesencephalon, pons and bulbus localization. Listeria monocytogenes in blood culture was detected. Immune deficit was not detected. Intravenous 150 mg/kg/day ampicillin was started. On the 12th day of admission, the patient died associated with respiratory deficit. Listeria monocytogenes should be considered in patients with resistant of classical antibiotic treatment cases who present with atypical brainstem symptoms. Typical brainstem involvement on brain imaging can be useful for diagnosis. Early recognition and treatment is the most important prognostic factor.

INTRODUCTION: About fifty million people have epilepsy in the world. This disease leads to concerns about occupational, social and marital in patients and their relatives. In addition, sleep disorders are more common in epileptic patients than normal. Disease-related concern and sleep disoder can affect negative the prognosis of disease. So, it is important to evaluate concern and sleep disorder. METHODS: Primary epilepsy patients were included between the ages of 18 and 85 who applied to the neurology clinic in 2016-2017. Demographic and clinical characteristics of the patients were evaluated. Epilepsy knowledge questionnaire and consisting of 16 questions, epilepsy concern scale consisting of 20 questions and Pittsburgh sleep quality tests were made. The results were evaluated with SPSS Windows 16 version. RESULTS: 49 (%48) female and 53 (%52) male patients included. The mean age was 31,86+-11,04. There were epileptic disease for 12,11+-12 years. 1,82+-1,02 different epilepsy medications were used. There were 2,06+-1,04 seizures in the last month. Epilepsy knowledge questionnaire was 10,56+-3,24; concern scale was 61,28+-6,82 and sleep quality test was 8,22+-3,27. Not relationship was found between disease-related concern and sleep quality (r: 0,12; p: 0,04). A low relation was found between the knowledge about the disease and concern (r: 0,35; p: 0,09). There was stronger relationship between seizure frequency and sleep disorder (r: 0,47; p: 0,04). DISCUSSION AND CONCLUSION: Patients had moderate knowledge but high level concern about epilepsy. Most of them had sleep disorder. So, disease-related concern and sleep disorder should also be evaluated during follow-up and treatment of patients.

Varicella zoster virus (VZV) is a virus belonging to the family of herpes virus that can remain latent in trigeminal nerve and dorsal root ganglia. Some neurological complications; encephalitis, myelitis, meningitis and central nervous system angiitis may occur with virus reactivation. These complications are very rare in people with normal immune response. A 70-year-old male patient presented with complaints of lower extremity weakness and incontinence for 2 days. Vesiculobullous lesions were observed in the area of the left lower extremity L5 dermatome and sacrum. Magnetic resonance imaging showed involvement of between T9 and T12 as transverse myelitis. Lymphocytic pleocytosis and protein elevation was detected in sample of the cerebrospinal fluid. VZV-DNA positivity determined in polymerase chain reaction (PCR). Patients with dermatomal lesions and myelitis findings should be considered transverse myelitis associated with VZV even if they have not immunodeficient. Rapid recognition and treatment are important for the prognosis.