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Study Design: A case report. Objective: To present improvement of paraplegia due to spinal vascular malformation after delivery with no intervention. Summary Of Background Data: Pregnancy has been reported rarely in patients with Klippel-Trenaunay syndrome (KTS). A combined case of spinal arteriovenous malformations (AVMs) within KTS has not been reported before. Methods: A case report of KTS with paraplegia is presented and the pertinent literature is then reviewed. Results: A pregnant woman who was diagnosed with KTS in childhood presented with newly developed paraplegia due to spinal AVMs. Magnetic resonance image showed a vascular malformation at the T9-T12 levels without evidence of spinal cord hemorrhage. Diagnostic angiography that was performed after delivery revealed a high-flow arteriovenous fistula with AVM. Conclusion: Pregnancy complicated by paraplegia is thought to be secondary to venous engorgement and to the resulting spinal cord ischemia in this case. Her neurological symptoms and signs gradually improved over the few days after cesarean delivery. [ABSTRACT FROM AUTHOR]

The L Test has been developed to assess balance and gait disorders. Our aim in this study was to estimate the test-retest reliability and validity of the L Test when used with 82 persons with multiple sclerosis (PwMS). For these participants, we examined the degree of agreement between the results of a first and second administration of the L Test (separated by one day), using Bland-Altman analysis and intra-class correlation coefficients (ICCs). We computed minimal detectable change (MDC) and standard error of measurement (SEM) values for the L Test and evaluated concurrent validity by correlating L Test results with the Timed Up and Go test (TUG) and the 10-minute Walk Test (10MWT). Prior to administering these measurements, we randomized the sequence of the test administrations to our participants. The Bland-Altman analysis showed that L Test was reproducible, with upper and lower limits of agreement of 0.99 and -1.45 seconds, respectively. The L Test demonstrated excellent test-retest reliability, with an ICC value of 0.996 (95% CI: 0.994-0.998). Cronbach's alpha coefficient was 0.996. The performance of the L Test is measured by seconds required to complete the task, and we found the L Test SEM value to be 0.35 seconds, and its MDC value to be 0.97 seconds. The L Test showed a strong correlation with both the TUG test (rho = 0.936; p < .001) and the 10MWT (rho = 0.925; p < .001). We concluded that the L Test is a reliable and valid \ tool for assessing functional mobility and balance in PwMS., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The study aimed to evaluate the effect of high-intensity intermittent exercise (HIIE) on serum levels of MMP-9 and CHI3L1 in multiple sclerosis. Study group received HIIE twice a week for 12 weeks, while control group received no treatment. In intra-group comparison, study group showed a significant increase in MMP-9 and CHI3L1 levels, while control group showed no significant difference. In intergroup comparison, a significant difference was found only in CHI3L1 levels after treatment. The increase in MMP-9 and CH3L-1 concentrations in study group suggests that these biomarkers may play a role in regulating specific skeletal muscle adaptations due to HIIE., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The Expanded Disability Status Scale (EDSS) is the most popular method to assess disease progression and treatment effectiveness in patients with multiple sclerosis (PwMS). One of the main problems with the EDSS method is that different results can be determined by different physicians for the same patient. In this case, it is necessary to produce autonomous solutions that will increase the reliability of the EDSS, which has a decision-making role. This study proposes a machine learning approach to predict EDSS scores using aerobic capacity data from PwMS. The primary goal is to reduce potential complications resulting from incorrect scoring procedures. Cardiovascular and aerobic capacity parameters of individuals, including aerobic capacity, ventilation, respiratory frequency, heart rate, average oxygen density, load, and energy expenditure, were evaluated. These parameters were given as input to CatBoost, gradient boosting (GBM), extreme gradient boosting (XGBoost), and decision tree (DT) machine learning methods. The most significant EDSS results were determined with the XGBoost algorithm. Mean absolute error, root mean square error, mean square error, mean absolute percent error, and R square values were obtained as 0.26, 0.4, 0.26, 16, and 0.68, respectively. The XGBoost based machine learning technique was shown to be effective in predicting EDSS based on aerobic capacity and cardiovascular data in PwMS.

Background/aim: Multiple sclerosis (MS) is an inflammatory demyelinating central nervous system (CNS) disease. Among the paraclinical tests, brain and spinal Magnetic Resonance Imaging (MRI) is primarily involved in the diagnosis process, and cerebrospinal fluid (CSF) analysis is fundamental in diagnosing MS and the differential diagnosis. A positive relationship was demonstrated between oligoclonal band (OCB) positivity, CSF band number and immunoglobulin G(IgG) index. The study aimed to evaluate whether the number of OCB can predict disease activity and determine a correlation with the IgG index., Methods: Our study included 401 MS patients who had relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis (SPMS), clinic isolated syndrome (CIS), radiologic isolated syndrome (RIS), Neuromyelitis optica spectrum disorder (NMOSD) and Acute disseminated encephalomyelitis (ADEM) with OCB number groups of 2-4, 4-8, 8-12, and 12 and above., Results: No significant correlation was observed between IgG index, pre-and post-treatment EDSS (Expanded Disability Status Scale Scores) and disease-modifying therapies (DMT). Drug response was better in the patient group with band number between 2 and 8 and post-treatment EDSS scores were lower (1.62±0.44)., Conclusion: The study results suggested that band number may be as valuable as the IgG index and a predictive biomarker for disease activity., Competing Interests: Declaration of competing interest None., (Copyright © 2023. Published by Elsevier B.V.)

Background: During multiple sclerosis (MS) treatment different modes of action such as lateral (interferon beta to glatiramer acetate or glatiramer acetate to interferon beta) or vertical (interferon beta/glatiramer acetate to fingolimod) drug switch can be performed. This study aims to investigate the clinical effectiveness of switching from the first-line injectable disease modifying treatments (iDMTs) to fingolimod (FNG) compared to switching between first-line iDMTs., Methods: This is a multicenter, observational and retrospective study of patients with relapsing-remitting MS who had lateral and vertical switch. The observation period included three key assessment time points (before the switch, at switch, and after the switch). Data were collected from the MS patients' database by neurologists between January 2018 and June 2019. The longest follow-up period of the patients was determined as 24 months after the switch., Results: In 462 MS patients that were included in the study, both treatments significantly decreased the number of relapses during the postswitch 12 months versus preswitch one year while patients in the FNG group experienced significantly fewer relapses compared to iDMT cohort in the postswitch 12 months period. FNG cohort experienced fewer relapses than in the iDMT cohort within the postswitch 2 year. The mean time to first relapse after the switch was significantly longer in the FNG group., Discussion: The present study revealed superior effectiveness of vertical switch over lateral switch regarding the improvement in relapse outcomes. Patients in the FNG cohort experienced sustainably fewer relapses during the follow-up period after the switch compared the iDMT cohort. Importantly, switching to FNG was more effective in delaying time to first relapse when compared with iDMTs.

Background: Although contactin-1 and contactin-2 are known as two proteins involved in axonal regeneration, it is unclear whether these proteins are induced by exercise in persons with multiple sclerosis (PwMS)., Objective: The aim of this study was to determine the serum levels of contactin-1 and contactin-2 in PwMS and to investigate the change of these markers with exercise., Methods: A total of 60 participants with relapsing-remitting MS were divided into groups by stratified randomization. The progressive functional exercise was applied to the intervention group. Participants in the control group continued the treatments and lives of the routines. Participants' contactin-1 and contactin-2, cognitive performance and aerobic capacities were evaluated., Results: The comparison of the pre-and post-study values of contactin-1 and contactin-2 showed significant differences only in the intervention group. The contactin-1 and contactin-2 values were similar between the groups before the exercise, whereas a significant difference was found in favor of the intervention group after the exercise. Paced Auditory Serial Addition Test-3 value increased significantly only in the intervention group., Conclusion: With this study, it was shown for the first time that contactin-1 and contactin-2, which play an important role in axonal regeneration and axonal organization, can be increased by exercise., Competing Interests: Declaration of Competing Interest The authors declare that there is no conflict of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Multiple sclerosis (MS) is a chronic progressive neurodegenerative disease of the central nervous system. Although there is increasing evidence that aerobic exercise has a positive effect on both cognitive and psychological functioning, there is limited evidence for Relapsing-Remitting MS (RRMS) patients. Moreover, it is unclear at what exercise modality and intensity the irisin, the cleaved and circulating form of the exercise-associated membrane protein Fibronectin Type III Domain Containing 5, is induced in patients with MS. This study aimed to investigate the effect of a regular aerobic exercise program on irisin serum level, depression, fatigue, and cognitive performance in patients with MS., Methods: Thirty-two individuals with RRMS were randomized into 2 groups as control and study groups (mean EDSS score 1.69 and 1.97, respectively). While the Study Group received a combined exercise training consisting of three sessions of aerobic exercise and Frenkel Coordination Exercises per week for 6 weeks, the Control Group received only Frenkel Coordination Exercise training. Before and after the study, the cognitive performance of the participants were evaluated with the Paced Auditory Serial Addition Test with 3-second stimulus (PASAT-3), their maximum aerobic capacity with the Fitmate Pro® (VO 2max ), their fatigue status with the Fatigue Impact Scale (FIS), and their depression status with the Beck Depression Inventory (BDI). Irisin serum levels were analyzed with Enzyme-Linked ImmunoSorbent Assay (ELISA) test from the serum samples of individuals., Results: Our results revealed that the irisin serum level significantly increased in the Study Group. Significant improvement in aerobic capacity, PASAT-3, FIS, and BDI values was observed in the Study Group compared to the Control Group. When the ΔIrisin, ΔVO 2max , ΔFIS, and ΔBDI values between the groups were compared, a significant difference was found in favor of the study group., Conclusion: The aerobic exercise revealed significant changes in depression, fatigue and irisin serum levels in MS patients. We think that this study, in which a significant increase in irisin serum level, significant improvement in depression, cognitive performance and fatigue states were obtained in the Study Group, will be a pioneering study for the future studies aiming to investigate the effects of irisin serum level on these symptoms in detail., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objective: Restless legs syndrome (RLS) is a well-established disease that has recently been shown to have variants affecting the arms, face, abdomen, and genital area. To our knowledge, there has been no study reporting on the RLS variant affecting the head region., Methods: The retrospective study reviewed a total of 460 patients who presented to Fırat University Medical School and were diagnosed as having RLS based on the International Restless Legs Syndrome Study Group (IRLSSG) criteria between June 2017 and January 2020. Of these, 18 patients that presented with head-related RLS symptoms (in addition to legs or arms) and four cases that presented with isolated head involvement were included in the study., Results: In 15 out of 18 (81.8%) patients, the restless head syndrome was accompanied by restless arm syndrome (RAS). In the remaining four (18.2%) patients, the disease involved the head region alone. The disease initially emerged in a single region in the body and gradually spread to one or multiple other regions in most patients and the symptoms were relieved by head rubbing. Serum iron level was low in 8 (36.4%) patients and normal in 14 (63.6%) patients. All the patients had normal cranial imaging and the symptoms were eliminated after dopaminergic therapy., Conclusions: Although RLS typically involves the legs alone, it may also affect other body parts such as upper extremities, abdomen, face, and genital area. We propose that the novel RLS variant described in the present study could be termed "restless head syndrome.", (© 2021. Fondazione Società Italiana di Neurologia.)

Background: During the pandemic, many neurological symptoms have been evaluated as complications of COVID-19 pneumonia., Objective: To investigate the frequency and characteristics of neurological findings, and their effects on the prognosis of patients with COVID-19 pneumonia who consulted with the Neurology department., Methods: Data on 2329 patients who were hospitalized with the diagnosis of COVID-19 pneumonia in our hospital were scanned. The clinical, laboratory and radiological findings relating to treatment of 154 patients who required neurological consultation were retrospectively evaluated by reviewing the clinical notes., Results: The number of COVID-19 pneumonia patients who required neurological consultations while hospitalized in the ICU was 94 (61.0%). The most common symptom among these patients was hyperactive delirium. Mean age, ferritin levels and CRP values ​​of those with delirium were higher, while the mean lymphocyte percentage were lower, than those of the patients without delirium. Epileptic seizures were observed in eight patients without an epilepsy diagnosis. Two patients were diagnosed with GBS and one patient with ICU neuropathy. The D-dimer levels of patients with acute hemorrhagic CVD and the thrombocyte levels of patients with acute ischemic CVD were found to be higher than in patients without acute ischemic CVD., Conclusion: The proportion of patients who required neurological consultations was higher in the ICUs. We observed neurological symptoms more frequently in the advanced age group. There were no significant increases in the incidence of other neurological conditions except delirium, in COVID-19 patients. We think that further studies are needed to support our data.

Background: Multiple sclerosis is a disease that can reduce the quality of life with a physical disability, neuropsychiatric disorders, and cognitive dysfunctions. Therefore, multiple sclerosis treatment should include treatments for cognitive and neuropsychiatric disorders and pharmacological treatments. This study aimed to examine the effects of exercise on neuropsychiatric disorders, problem-solving skills, and emotional intelligence in multiple sclerosis patients., Methods: Thirty-six female relapsing-remitting multiple sclerosis patients aged between 18 and 45 years, with an Expanded Disability Status Scale between 1 and 3, who were diagnosed with definitive multiple sclerosis according to the revised McDonald criteria were included in the study. Participants completed outcome measures before and after the 12-week exercise program. Demographic/clinical information of the participants was obtained at baseline, neurological examinations were performed, and graded exercise testing on a bicycle ergometer was performed to determine aerobic capacity. Short Form-12 Version 2, Hospital Anxiety and Depression Scale, Modified Fatigue Impact Scale, Problem-Solving Inventory, Emotional Intelligence Scale were evaluated before and after the exercise program of the participants., Results: While a significant increase was observed in the HRpeak values ​​of the participants after the exercise (p < 0.05), the VO2 max values also showed a highly significant difference compared to the pre-treatment values. (p < 0.01). While a significant difference was detected in the mental subparameter of Short Form-12 (p < 0.05), a high level of significant difference was found in the physical subparameter (p < 0.01). While no significant difference was observed in the Hospital Anxiety and Depression Scale anxiety subparameter (p > 0.05), a significant difference was found in the depression subparameter (p < 0.01). There was a significant difference in Modified Fatigue Impact Scale physical and cognitive subparameters compared to pre-treatment (p < 0.01). A significant difference was observed in the Emotional Intelligence Scale total score after the treatment (p < 0.01)., Conclusions: The results of our study showed that exercise in relapsing-remitting multiple sclerosis patients provided significant improvements in emotional intelligence, improved neuropsychiatric parameters, and increased problem-solving skills. In addition, to the best of our knowledge, this study is the first study in the literature to investigate the effect of physical activity exercises on problem-solving skills in multiple sclerosis patients., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: One of the biggest problems for persons with Multiple Sclerosis (PwMS) is dizziness, poor posture, and balance problems that cause injury-causing falls. The aim of our study was to reveal the test-retest reliability and validity of the 3-Meter Backward Walk Test (3MBWT) in mildly disabled PwMS., Methods: This study included a total of 93 mildly disabled PwMS with mean EDSS of 1.89. 3MBWT, Functional Access Test (FRT), Dynamic Gait Index (DGI), Timed 25-Foot Walk (T25FW), and Timed-Up and Go (TUG) were applied to the patients. To measure test-retest reliability, a second evaluation was performed three days after the first evaluation., Results: Cronbach's alpha coefficient was found to be 0.998 (excellent). For intra-rater agreement, the ICC values in the individual test were 0.998. The SEM value was 0.18, the MDC value was found to be 0.50. A very strong correlation was revealed between the 3MBWT and FRT (r: -0.931, p: 0.001), TUG (r: 0.968, p: 0.001), T25FW (r: 0.879, p: 0.001), DGI (r: -0.871, p: 0.001) and falling history (r: 0.932, p: 0.001)., Conclusion: The 3MBWT was observed to be valid and reliable in mildly disabled PwMS. 3MBWT is an effective and reliable tool for measuring ability to walk backward in mildly disabled PwMS., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: This study aimed to detect ataxia in patients with multiple sclerosis (PwMS) with a deep learning-based approach based on images showing plantar pressure distribution of the patients. The secondary aim of the study was to investigate an alternative and objective method in the early diagnosis of ataxia in these patients., Methods: A total of 105 images showing plantar pressure distribution of 43 ataxic PwMS and 62 healthy individuals were analyzed. The images were resized for the models including VGG16, VGG19, ResNet, DenseNet, MobileNet, NasNetMobile, and NasNetLarge. Feature vectors were extracted from the resized images and then classified using Support Vector Machines (SVM), K-Nearest Neighbors (K-NN), and Artificial Neural Network (ANN). A 10-fold cross-validation was applied to increase the validity of the classifiers., Results: The VGG19-SVM hybrid model showed the highest accuracy, sensitivity, and specificity values (89.23%, 89.65%, and 88.88%, respectively)., Conclusion: The proposed method provided an automatic decision support system for detecting ataxia based on images showing plantar pressure distribution in patients with PwMS. The performance of the proposed method indicated that this method can be applied in clinical practice to establish a rapid diagnosis of ataxia that is asymptomatic or difficult to detect clinically and that it can be recommended as a useful aid for the physician in clinical practice., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background Multiple sclerosis (MS) is an autoimmune and neurodegenerative disease of the central nervous system in which disease activity can be monitored with some biomarkers. The aim of our study was to investigate serum Glial Fibrillary Acidic Protein (GFAP) and Neurofilament Light Chain (NFL) in relapsing-remitting MS (RRMS) patients after the aerobic exercise. Methods A total of 38 participants with RRMS (Expanded Disability Status Scale: 1.0 - 4.5) were randomized to a study group (3 × /week for 8 weeks at 60 - 70 % of maximal aerobic capacity (VO 2max ) + home exercises) and a control group (were given home exercises programme 3 times a week for 8 week). Serum NFL and GFAP levels were analyzed using enzyme-linked immunosorbent analysis method before and at the end of 8 weeks. Results: NFL and GFAP levels were statistically lower in the study group at the end of the study than before the study. In the control group, no significant changes were observed in serum NFL and GFAP levels. ΔNFL levels were significantly higher in the study group than control group. Conclusion It was shown, for the first time that serum GFAP and NFL levels (%10 and % 32, respectively) in RRMS patients decreased after aerobic exercise. Our study is important in terms of investigating the effects of aerobic exercise in individuals with RRMS and elucidating the underlying measurable biomarkers. The significant reduction of NFL and GFAP, which have an important role in the pathology associated with nervous system damage in MS, with aerobic exercise may be promising in understanding the regulation of disease activity in MS patients., (Copyright © 2021. Published by Elsevier B.V.)

Objectives: In recent years, radiological and biochemical data have emerged regarding the development of cellular damage in the brain of patients with migraine, calling into question what has traditionally been accepted as a benign disorder. In order to investigate whether cellular damage develops in the brain of episodic migraine patient, serum levels of neuron-specific enolase (NSE) and S100B have been evaluated in recent studies. However, contradictory results were obtained in these studies. Moreover, there is no study on NSE and S100B in cases of chronic migraine., Methods: Patients with episodic migraine with or without aura and chronic migraine were included. In addition, 27 healthy volunteers were included as a control group. Control group was selected from healthy volunteers of the same age and sex. We investigated serum NSE and S100B levels during the interictal period in 26 patients with episodic migraine and 27 patients with chronic migraine., Results: The serum NSE and S100B levels were significantly higher in both patients with episodic and chronic migraine than controls. Although there were no significant differences in the serum NSE and S100B levels between the two patients' groups, these markers were found to be higher in cases of chronic migraine., Conclusion: These results suggest that there is both neuronal and glial involvement in the two migraine groups. Elevations in these markers in cases of episodic migraine suggest that cellular damage not only results from headache episodes, but that there may be also an ongoing pathological process during the interictal period., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Elevated levels of chemerin can predict future ischemic cerebrovascular disease. Although chemerin is thought to play a role in atherosclerotic inflammation, whether circulating chemerin levels are associated with the severity of atherosclerosis remains to be determined., Objectives: Through the use of carotid Doppler ultrasonography, our aim in this study was to investigate the relationships of serum chemerin levels with carotid intima-media thickness (CIMT) as an indicator of generalized atherosclerosis., Methods: This study compared 40 patients with ischemic stroke and 40 healthy subjects. Measurements were made at end-diastole using color Doppler ultrasonography (CDUS) after a 5-min rest interval in a quiet and dark room. CIMT was defined as the distance between the innermost edge of the luminal echo to the innermost edge of the media/adventitia echo. CIMT was measured in the posterior wall of both common carotid arteries within 1 cm proximally to the bulbus. Three measurements were made on both sides and the average measurement was taken as the CIMT. Serum chemerin levels were determined in all patients and healthy subjects., Results: Serum chemerin levels were significantly higher in the patient group than in the control group (p=0.004). Serum chemerin levels were positively correlated with CIMT (p<0.05). There was a significant difference between the groups with regard to CIMT (p<0.001)., Conclusion: Elevated serum chemerin levels appear to be associated with CIMT, thus suggesting that a link exists between chemerin and atherosclerotic ischemic cerebrovascular disease.

Objectives: This study aims to evaluate the effects of ocrelizumab (OCZ) on familial Mediterranean fever (FMF) attacks in multiple sclerosis (MS) patients with FMF (MS+FMF patients)., Patients and Methods: This retrospective observational study included 11 patients (2 males, 9 females; mean age 46.6±9.2; range, 22 to 55 years) with MS+FMF hospitalized between January 2016 and July 2019. Demographic, clinical, and laboratory parameters and patient reported outcomes were analyzed in patients treated with OCZ for 18 months., Results: Combining OCZ with colchicine in MS+FMF patients significantly reduced the frequency of FMF attacks (p=0.003) and the frequency of joint attacks (p=0.002). Consistent with the clinical improvement, the maximum serum C-reactive protein levels were significantly decreased after combination therapy compared to before combination therapy (p=0.003). MS+FMF patients reported that FMF disease activity improved after OCZ therapy (Visual Analog Scale [VAS] 74±9.6 vs. VAS 46.5±8.1 mm, p=0.003)., Conclusion: Ocrelizumab therapy led to a prominent decrease in the frequency of FMF attacks, alleviated functional impairment, and improved quality of life in MS+FMF patients., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2021, Turkish League Against Rheumatism.)

Purpose: Diabetes mellitus (DM) is a metabolic disorder characterized by insulin deficiency or insulin resistance. Pregabalin (PGB) is an antiepileptic drug with proven efficacy in the treatment of epilepsy, generalized anxiety disorder, and neuropathic pain. In this study, we aimed to investigate the protective effects of PGB in brain tissue of rats with streptozotocin (STZ)-induced experimental diabetes., Materials and Methods: Twenty-eight Wistar albino male rats were randomly divided into four groups with seven rats each: (I) Control group, (II) PGB (50 mg/kg PBG), (III) DM, and (IV) DM + PGB (50 mg/kg/day PGB per orally for 8 weeks). Diabetes was induced with an intraperitoneal (i.p.) STZ injection (Sigma Chemical Co Louis Missour, USA) at a dose of 180 mg/kg. STZ was dissolved in 0.1 M phosphate-citrate tampon (pH 4.5). Paraffin sections were examined using histological and immunohistochemical analyses. To detect oxidative damage biochemically, malondialdehyde (MDA), the end product of lipid peroxidation; superoxide dismutase (SOD), catalase (CAT), glutathione (GSH) and glutathione peroxidase (GPx) which are antioxidant enzymes, levels were studied. In addition, bax, caspase-3 enzyme activities and TUNEL assay were studied to evaluate the apoptosis status., Results: In the DM group, MDA concentrations were significantly higher and GPx and SOD activities were significantly lower compared to the control group. MDA concentrations were significantly lower and SOD activity was significantly higher in the DM + PGB group than in the DM group. The GPx activity in the DM group decreased significantly compared to the control group. In immunohistochemical examinations (Bax, Caspase-3 and TUNEL), the apoptosis rate was significantly lower in the in DM + PGB group than in the DM group., Conclusion: Pregabalin may prevent harmful effects of oxidative damage by decreasing the MDA levels and increasing the SOD levels. In addition, it was thought that PGB may have antiapoptotic properties due to decreased bax and caspase-3 immunoreactivity and TUNEL positivity in PGB groups. Based on these findings, we think that PGB may be effective in reducing the risk of brain damage associated with DM., Competing Interests: Conflict of interestAll authors declare that there is no conflict of interest., (© The Japan Diabetes Society 2020.)

Background: This study reported on a variety of psychological reactions related to anxiety, sleep quality, depression, fatigue, and quality of life in individuals with multiple sclerosis (MS), related to the Covid-19 quarantine experience., Objective: The aim of this study was to investigate the neuropsychiatric effects of the COVID-19 pandemic in MS patients and to analyze the risk factors contributing to psychological stress., Methods: The study was designed as a prospective, cross-sectional survey study. Multiple assessment tools that are used in neurological practice, including Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Fatigue Impact Scale (FIS), Pittsburgh Sleep Quality Index (PSQI), and Multiple Sclerosis Quality of Life-54 (MSQOL-54) were administered prospectively both during the early and the peak stages of COVID-19 outbreak (ESO and PSO, respectively). The survey forms were designed using SurveyMonkey and the participants were participating in the survey via a web link and QR code., Results: Fifty patients were included in the study. BDI scores, PSQI and FSI measurements, cognitive and social subscale scores and total FIS score, MSQOL-54 measurements, physical and mental subscale scores, and total MSQOL-54 score at PSO were significantly different than those at ESO. The body mass index values of the patients increased significantly at PSO compared to those measured at ESO., Conclusions: The results provide a basis for the development of psychological interventions that could minimize the prevalence of sleep disorders and depression and could improve patients' quality of life during the outbreak.

Objective: Studies indicate that patients tend to develop chronic tension headache as a response to stress. The present study investigated the relationship between headache and the events that caused childhood traumas and defense styles, which could be considered as a significant source of stress in individuals with tension headache., Methods: Fifty patients between the ages of 18 and 65 years diagnosed with tension headache were included in the present study. The control group included 50 healthy participants. All study participants completed a sociodemographic data form prepared by the researchers and the Childhood Trauma Questionnaire and Defense Style Questionnaire., Results: Traumatic experiences (emotional abuse, physical abuse, emotional neglect, physical neglect, and sexual abuse) were significantly higher in the patient group compared to the control group. The total score of immature and neurotic defense styles was higher in the patient group than in the control group (P < .001, P < .001). The mature defense styles total score was significantly higher in the control group than in the patient group (P = .006). A positive correlation was found between the childhood trauma scores and immature and neurotic defense style scores., Conclusion: The findings indicate that traumatic experiences during childhood were more frequent in patients with tension headache compared to healthy individuals. Furthermore, these individuals had difficulty coping with stress, and inappropriate defense styles were employed as a response to stress., (© Copyright 2020 Physicians Postgraduate Press, Inc.)

Background: Suboccipital steroid injection can be used as a preventive treatment for episodic and chronic cluster headache (CH). In recent studies, prophylactic treatment has been used in addition to suboccipital steroid injection. In this study, we aimed to investigate the effectivity of the sole use of rapid- and long-acting steroid injections without prophylactic treatment in patients with episodic and chronic CH., Methods: The retrospective study included 51 patients with episodic and chronic CH that underwent greater occipital nerve (GON) blockade with a single dose of rapid- and long-acting steroid injection without additional prophylactic treatment. The frequency, severity, and duration of attacks after GON blockade as well as the side effects and long-term outcomes were reviewed., Results: In 28 (54.9%) patients, no attack occurred after GON blockade and cluster bouts were aborted. Mean duration of attacks was 86.67 ± 37.45 min before the treatment. However, in the 23 patients that had at least one attack after GON blockade, the mean duration of attacks was 31.73 ± 36.10 min between post-treatment days 0-3, 29.35 ± 40.49 min between post-treatment days 4-10, 28.48 ± 42.17 min between post-treatment days 11-28, and 35.65 ± 46.55 min after the post-treatment day 28 (p < 0.001). Moreover, 10 (37.04%) out of 27 patients with episodic CH who periodically had one or two cluster bouts in a year had no CH attack at the time of the expected subsequent cluster bout., Conclusion: GON blockade is a practical, reliable, and cost-effective treatment option for patients with episodic and chronic CH. Moreover, GON blockade is highly effective in reducing headache attacks and even aborting cluster bouts in CH patients without requiring additional prophylactic treatment., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objectives: Diabetic neuropathy is the most frequent chronic complication of diabetes. It may attack to sensory, motor or autonomous fibers. Varied mechanisms account for the development of diabetic neuropathy such as metabolic disorders, microvascular damages, neurotrophic support deficit, alternation in neuro-immune interactions, neural and glial cell apoptosis, and inflammation. Alpha lipoic acid (ALA) is a potent lipophilic antioxidant in vitro and in vivo conditions, which plays a main role as cofactor in many mitochondrial reactions, easily absorbed from gastointestinal tract and can easily cross the blood brain barrier (BBB). Apoptosis is an important mechanism of degenerative diseases, which is induced by some factors like hyperglycemia toxicity. In vivo and in vitro studies showed that hyperglycemia affected the cell survival and induced apoptotic changes in dorsal root ganglion neurons and Schwann cells., Methods: In this experiment we used a total of 28 rats. 14 rats were given 180mg/kg streptozotocin (STZ) dissolved by single intraperitoneally (i.p.) injection. Rats are divided into 4 groups; Control (group I), DM (group II), ALA (group III) and DM+ALA (group IV). Myelin sheaths of sciatic nerves were examined histologically for each group., Results: In the results of the histological examination, showed that loss of myelin sheath in sciatic nerves of rats while the group treated with ALA showed less myelin loss., Conclusion: This study might be suggested that ALA has a protective effect on peripheral neuronal cell damage generated with DM.

Introduction: Migraine, the most widespread cause of headache in young adults, is a frequent reason for presentation to emergency departments. The aim of this study was to determine the diagnostic value of serum galectin-3 and high-sensitivity C-reactive protein (hsCRP) levels in migraine patients., Material and Methods: Serum galectin-3 and hsCRP levels were measured using enzyme-linked immunosorbent assay in 70 migraine patients and 70 healthy control subjects., Results: The mean values of hsCRP and galectin-3 levels were significantly higher in the migraine group than those in the control group (1.67 ±0.49, 1.12 ±0.38 mg/l, p < 0.001; and 3.76 ±1.45, 2.05 ±0.29 ng/ml, p < 0.001, respectively). When the diagnostic values of the biomarkers were assessed in the migraine attack and control groups, the sensitivity and specificity of the test for hsCRP at the cut-off point of 1.32 mg/l were 70% and 73% (AUC = 0.805, 95% CI: 0.74-0.88, p < 0.001), and for galectin-3 at the cut-off point of 2.4 ng/ml, 89% and 90% (AUC = 0.97, 95% CI: 0.95-0.99, p < 0.001), respectively., Conclusions: This study showed the presence of a relation between high serum levels of hsCRP and galectin-3 in migraine patients. However, well-controlled, carefully executed longitudinal studies are required to confirm these findings.

Background: Headache is a leading disabler in adults worldwide. In children and adolescents, the same may be true but the evidence is much poorer. It is notable that published epidemiological studies of these age groups have largely ignored headaches not fulfilling any specific set of ICHD criteria, although such headaches appear to be common. A new approach to these is needed: here we introduce, and investigate, a diagnostic category termed "undifferentiated headache" (UdH), defined in young people as recurrent mild-intensity headache of < 1 h's duration., Methods: We conducted a nationwide cross-sectional survey in 31 schools in six regions of Turkey selected by mixed convenience-based and purposive modified cluster-sampling. A validated, standardised self-completed structured questionnaire was administered by a physician-investigator to entire classes of pupils aged 6-17 years., Results: Of the identified sample of 7889 pupils, 7088 (89.8%) participated. The 1-year prevalence of UdH was 29.2%, of migraine (definite and probable) 26.7%, and of tension-type headache (TTH) (definite and probable) 12.9%. UdH differed with respect to almost all headache features and associated symptoms from both migraine and TTH. Burden of headache and use of acute medication were lower in UdH than in migraine and TTH. Headache yesterday was less common in UdH than migraine (OR 0.32; 95% CI 0.28-0.37) and TTH (OR 0.64; 95% CI 0.56-0.77). Quality of life (QoL) was better in UdH (33.6 ± 5.2) than in migraine (30.3 ± 5.6; p < 0.001) and TTH (32.4 ± 5.3; p < 0.001), but worse than in pupils without headache (35.7 ± 4.7; p < 0.001)., Conclusions: This large nationwide study in Turkey of pupils aged 6-17 years has shown that many children and adolescents have a headache type that does not conform to existing accepted diagnostic criteria. This new diagnostic category of presumably still-evolving headache (undifferentiated headache) is common. UdH differs in almost all measurable respects from both migraine and TTH. Although characterised by mild headaches lasting < 1 h, UdH is associated with significant adverse impact on QoL. Longitudinal cohort studies are needed to evaluate the prognosis of UdH but, meanwhile, recognition of UdH and its distinction from migraine and TTH has implications for epidemiological studies, public-health policy and routine clinical practice.

Objective: Chronic inflammatory diseases are associated with altered body composition. Ghrelin has anti-inflammatory effects, and its level is altered in obesity and inflammatory diseases. The aim of the study was to evaluate the prevalence of obesity and ghrelin and obestatin levels in patients with Behçet's disease (BD)., Material and Methods: One hundred and forty-three (143) patients with BD and 112 healthy controls (HC) were enrolled. Participants were subdivided according to the body mass index (BMI) as lean (<18.5 kg/m 2 ), normal weight (18.5-24.9 kg/m 2 ), overweight (25-29.9 kg/m 2 ) and obese (≥30 kg/m 2 ). In addition to the routine evaluations (fasting blood glucose, lipid profile, and kidney and liver function tests), serum acylated-ghrelin (AG), unacylated-ghrelin (UAG), total ghrelin (TG) and obestatin levels were analyzed. Student's t-test and chi-square test were used for statistical analysis., Results: The prevalence of obesity was relatively lower in the BD group than in the HC group (12.6% vs. 20.5%, p=0.089). Serum ghrelin levels were similar in the BD and HC groups (p>0.05 for all) although the obestatin level was higher in the BD group compared to the HC group (p<0.001). Serum UAG, TG and obestatin levels were lower in obese BD patients (n=18) than non-obese BD patients (p=0.027, p=0.014 and p=0.001, respectively)., Conclusion: The obestatin level was high and the prevalence of obesity was low in the BD group. Moreover, obese BD patients had low obestatin levels. These results suggest that obestatin may protect BD patients from obesity., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Objective: The aim was to investigate the efficacy of cortexin and methylprednisolone on recovery in cases of traumatic facial nerve paralysis occurring after facial nerve trauma., Materials and Methods: The study was performed on 21 healthy rabbits. The buccal branches of the left facial nerves of all the rabbits were pressed, and facial nerve paralysis occurred. The rabbits were randomly divided into three equal groups: 3 mg/day cortexin intramuscularly, 1 mg/kg/day methylprednisolone intramuscularly, and 3 mg/day saline intramuscularly were administered for 10 days in Group I (cortexin group), Group II (methylprednisolone group), and Group III (control group), respectively. Electromyography was performed on the 7th, 14th, and 21st days to evaluate their improvement. Following this, the traumatic buccal branches of the facial nerves of rabbits were extracted and subjected to histopathological examination., Results: There was a significant difference between the cortexin and methylprednisolone groups and the control group in terms of neural fibrotic degeneration, myelin degeneration, axonal degeneration, normal myelin production, and edema. When the cortexin and methylprednisolone groups were compared with each other, there was no significant difference between them, except for an increase in collagen fibers. Cortexin significantly reduced the collagen fiber increase to a greater extent than methylprednisolone. The electromyography findings did not show any significant difference between the groups or within the groups., Conclusion: Our study suggests that cortexin and methylprednisolone are effective for healing traumatic facial nerve paralysis with intact nerve integrity; however, cortexin is unable to cause significant improvement, which is superior to that caused by methylprednisolone.

Introduction: Tinnitus is defined as a phantom auditory sensation, the perception of sound in the absence of external acoustic stimulation. Given that flufenamic acid (FFA) blocks TRPM2 cation channels, resulting in reduced neuronal excitability, we aimed to investigate whether FFA suppresses the behavioral manifestation of sodium salicylate (SSA)-induced tinnitus in rats., Material and Methods: Tinnitus was evaluated using a conditioned lick suppression model of behavioral testing. Thirty-one Wistar rats, randomly divided into four treatment groups, were trained and tested in the behavioral experiment: (1) control group: DMSO + saline (n = 6), (2) SSA group: DMSO + SSA (n = 6), (3) FFA group: FFA (66 mg/kg bw) + saline (n = 9), (4) FFA + SSA group: FFA (66 mg/kg bw) + SSA (400 mg/kg bw) (n = 10). Localization of TRPM2 to the plasma membrane of cochlear nucleus neurons was demonstrated by confocal microscopy., Results: Pavlovian training resulted in strong suppression of licking, having a mean value of 0.05 ±0.03 on extinction day 1, which is below the suppression training criterion level of 0.20 in control tinnitus animals. The suppression rate for rats having both FFA (66 mg/kg bw) and SSA (400 mg/kg bw) injections was significantly lower than that for the rats having SSA injections (p < 0.01)., Conclusions: We suggest that SSA-induced tinnitus could possibly be prevented by administration of a TRPM2 ion channel antagonist, FFA at 66 mg/kg bw.

Objective: Facial diplegia (FD) is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD., Method: The study was performed retrospectively and included 17 patients with a diagnosis of FD., Results: Patients were diagnosed with Guillain-Barré syndrome (GBS) (11), Bickerstaff's brainstem encephalitis (1), neurosarcoidosis (1), non-Hodgkin's Lymphoma (1), tuberculous meningitis (1) herpes simplex reactivation (1) and idiopathic (1). In addition, two patients had developed FD during pregnancy., Conclusion: Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

The authors evaluated neuron-specific enolase (NSE), S100 calcium-binding protein B (S100B), and heat shock protein 70 (HSP 70) levels and their relationships with in-hospital mortality, Glasgow Coma Scale (GCS) scores, and National Institute of Health Stroke Scale (NIHSS) scores. In total, 35 patients older than 18 years were presented to our emergency department and were diagnosed with non-traumatic intracranial hemorrhage (ICH) and 32 healthy controls were included. Blood samples were drawn on days 0 and 5. S100 calcium-binding protein B and HSP levels were significantly higher in patients than in controls on days 0 and 5. Neuron-specific enolase levels were higher in patients than in controls on day 0, but there was no significant difference on day 5. S100 calcium-binding protein B was negatively correlated with GCS, whereas it was positively correlated with NIHSS and bleeding volume. There was also a negative correlation between NSE and GCS, but it was not statistically significant. In addition, no significant correlation was found in terms of bleeding volume or NIHSS. Heat shock protein 70 was negatively correlated with GCS and positively correlated with bleeding volume and NIHSS, but these results were not statistically significant. S100 calcium-binding protein B and HSP 70 levels were significantly higher in those who died compared with survivors. The areas under the curve of S100 B, NSE, and HSP 70 for mortality were 0.635, 0.477, and 0.770, respectively. Neuron-specific enolase, S100B, and HSP 70 levels are simple, inexpensive, and objective measures in cases of ICH. These tests can be used to support an assessment for screening ICH patients with clinical scoring systems, such as GCS and NIHSS.

The potential toxic effects of several pesticides, including imidacloprid on non-target organisms have not been clearly established. Also, the chronic effects of non-toxic doses on cognitive function in mammals are unknown. In this study, the effects of different doses of imidacloprid on learning and memory of infant and adult rats were evaluated, and the expressions of genes synthesizing proteins known to be associated with learning in brain tissues were also documented. 0.5, 2 and 8 mg/kg doses of imidacloprid were administered to newborn infant and adult Wistar albino rats by gavage. Their learning activities were evaluated, and the expression levels of the inotropic glutamate receptor GRIN1, synoptophysin, growth-associated protein 43 and the muscarinic receptor M1 in hippocampus were determined by real-time PCR method. Learning activities were diminished significantly at 2 and 8 mg/kg doses in the infant model groups and at 8 mg/kg dose in adult rats. Also, expression levels of GRIN1, SYP and GAP-43 were found to be insignificantly altered. Only the expression of M1 were significantly changed in high doses of adult group. Thus imidacloprid in high doses causes deterioration in cognitive functions particularly in infant rats, and this deterioration may be associated with changes in the expressions of related genes., (© 2015 The Authors. International Journal of Experimental Pathology © 2015 International Journal of Experimental Pathology.)

Objective: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP., Materials and Methods: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP., Results: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1° and 5° occurred in 43 (37.3%) of the needles and deflection ≥ 5.1° occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent., Conclusion: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH.

Behçet's disease (BD) is a chronic inflammatory disease. Increased productions of cytokines including interleukin (IL)-1β and IL-18 are documented, and IL-1α and β gene polymorphisms are associated with susceptibility to the disease. IL-33 is a recently discovered member of IL-1 cytokine family. The aim of the study was to detect serum IL-33 level and IL-33 gene polymorphisms in a cohort of BD. Unrelated 117 patients with BD and 149 healthy controls (HC) were enrolled. Serum IL-33 levels were analyzed by enzyme-linked immunosorbent assay method. DNA samples were harvested using an appropriate commercial DNA isolation kit. Four single nucleotide polymorphisms of IL-33 gene (rs7044343, rs1157505, rs11792633 and rs1929992) were genotyped using the appropriate commercial primer/probe sets on real-time PCR. Serum IL-33 level was not significantly different in the BD and HC groups (p > 0.05). However, its level was lower in the active BD patients compared to the inactive ones and HC group (p = 0.044 and p = 0.037, respectively). There was no significant difference in terms of the genotypic and allelic distributions of rs1157505 and rs1929992 polymorphisms (p > 0.05 for all). However, the TT variants of rs7044343 and rs11792633 polymorphisms were very rare, and the T allele frequencies of these polymorphisms were lower, in the BD group compared to the HC group (p < 0.0001 for all). The rs7044343 and rs11792633 variants of IL-33 gene are associated with the decreased risk of BD in our cohort. Therefore, it may be concluded that IL-33 acts a protective role on the pathogenesis of BD.

Our goal was to evaluate the clinical patterns, additional risk factors, treatment and outcome of cerebral venous thrombosis (CVT) related to adolescent oral contraceptive pill (OCP) usage. We evaluated 22 patients with CVT related to OCPs admitted to Firat and Dicle University Hospitals from January 2008 to January 2013. We assessed the clinical features, risk factors, imaging results and prognosis. Magnetic resonance imaging (MRI) and magnetic resonance were the preferred procedures for the diagnosis of CVT. MRI revealed parenchymal lesions in 11 (50 %) patients, and the remaining patients had normal MRIs. The sinuses most frequently affected by thrombosis were the superior sagittal sinus and the transverse sinus. The additional risk factors identified for CVT were antiphospholipid syndrome, protein C deficiency, protein C and S deficiency, factor V Leiden associated with heterozygous antithrombin III deficiency, methylenetetrahydrofolate reductase and prothrombin gene mutations. CVT may be overlooked in adolescents because it is more common among middle-aged and elderly adults. CVT should be suspected in the presence of neurological symptoms in adolescents, especially in those using OCPs.

Clothianidin (CLO) is one of the pesticides used to protect against insects, and its potential toxic effects on cognitive functions are not clearly known. This study aims to evaluate the possible effects of dose-dependent CLO on learning and memory in infant and adult male rats and the expression of related genes in the hippocampus. Doses of 2, 8 and 24 mg/kg of CLO were administered to newborn infant and adult albino Winstar rats in the form of gavage and dissolved in vehicle matter. Their cognitive and learning functions were evaluated by the Morris water maze and probe tests. Expression levels of N-methyl D-aspartate 1 (GRIN1), muscuranic receptor M1, synoptophysin (SYP) and growth-associated protein 43 (GAP-43) of tissues isolated from the hippocampus were determined using the real-time PCR method. In the Morris water maze test, no change (p > 0.05) was exhibited in the adult and infant rats after CLO was applied, although there was a significant difference (p < 0.05) in performance between infants and the control group after 24 mg/kg was applied in the probe test. Also, expression levels GRIN1, M1, SYP, GAP-43 did not change when compared to the control (p > 0.05). Our study shows that exposure to high doses of CLO causes deterioration of cognitive functions in infant rats.

Unlabelled: P300 event-related potentials (ERPs), objective measures related to cognitive processing, have not been studied in Sydenham's chorea (SC) patients., Purpose: To assess cognitive impairment with P300 ERPs., Method: Seventeen patients with SC and 20 unaffected healthy children were included. Stanford-Binet test was used for psychometric assessment, and odd-ball paradigm was used for auditory ERPs., Results: There was no significant difference in P300 latencies between the SC-pretreatment group, SC-posttreatment group and control group (p>0.05). Mean interpeak latencies in SC-pretreatment group and SC-posttreatment group showed significant prolongation compared with the control group (p<0.05). Mean interpeak latencies in SC-posttreatment group were significantly decreased compared with SC-pretreatment group (p<0.05). Compared to controls, patients did not show significant difference in Stanford-Binet intelligence examination., Conclusion: This report suggests that interpeak latencies and amplitudes of P300 ERPs could be useful for detecting and monitoring cognitive impairment in SC patients.

Background: Cerebrovascular event is a clinical condition characterized by symptoms and findings pertaining to loss of focal cerebral function because of the vascular causes. Atherosclerosis has a forefront role in the pathogenesis of stroke. Inflammation has an important place in the formation of atherogenesis and atherosclerosis. Visceral adipose tissue-derived serpin (vaspin) is a new adipokine, which is identified recently, associated with obesity and diabetes and also has a proinflammatory characteristic. This study was intended to investigate the relation between vaspin and stroke and stroke and other risk factors., Methods: A total of 50 patients with stroke, as 28 men (56%) and 22 women (44%), and a total of 50 healthy individuals, as 25 men (50%) and 25 women (50%), were enrolled in the study. Blood samples were taken in the acute period (first 48 hours) in the patient group, and serum vaspin levels were measured. Vaspin level was also measured in the control group. The association of vaspin with the lipid parameters, gender, and the severity of internal carotid artery (ICA) stenosis in the patient group was evaluated. Stenotic plaques in ICA were classified as normal, mild (stenosis under 50%), moderate (stenosis 50%-69%), severe (stenosis 70%-99% to preocclusion), and occlusion., Results: No statistically significant difference was found between 2 groups in terms of age and gender (P > .05). Vaspin levels were found to be significantly higher in the patient group (164.73 ± 153.76 ng/mL) compared with the control group (116.21 ± 34.60 ng/mL) (P < .05). However, no relation was established between vaspin level and the severity of ICA stenosis., Conclusions: Vaspin levels have been shown to increase in acute ischemic stroke patients. The increased vaspin levels may vary depending on several factors in acute period of ischemic stroke., (Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.)

Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent, stereotypic episodes of nausea, vomiting, and other symptoms, separated by intervals of comparative wellness. These episodes carry on for hours or days. The patient is healthy between the episodes and has no clinical finding. For the treatment of the CVS, antiemetic, antimigraine and sedative medications were used. However, in some cases CVS treatment is very difficult. We report about a young patient, who did not respond to many agents, but was succesfully treated with chlorpomazine.

Background: We sought to determine the risk factors and clinical outcomes of pregnant women with cerebral venous thrombosis (CVT)., Methods: Nineteen pregnant patients with a diagnosis of CVT were followed in the neurology unit between 2009 and 2012. Patients with central nervous system infection and with CVT secondary to invasive procedures were excluded. Magnetic resonance imaging and magnetic resonance venography were performed for all patients., Results: There were 19 pregnant women ranging in age from 18 to 38 years (mean 27.5 years). The follow-up period ranged from 11 to 24 months (mean 19 months). Symptoms and signs that suggested a rise in intracranial pressure were present nearly in all cases, including headache, vomiting with or without nausea, disturbances of consciousness, and papilledema. Seizures and status epilepticus (with or without preeclampsia) were present in 8 cases. The rate of CVT was higher in the third trimester. The superior sagittal and transverse sinuses were the most commonly affected cerebral sinuses in our patients, and parenchymal involvement was present in 7 patients. There was no maternal mortality, and 20 infants were still alive and healthy., Conclusions: If magnetic resonance imaging is available, it should be used for the detection of CVT in all pregnant patients instead of computed tomography. Patients with parenchymal lesions, thrombophilia, and antiphospholipid syndrome had a greater risk of being left with neurologic sequelae. For pregnant patients with CVT, low molecular weight heparin in full anticoagulant doses should be continued throughout the pregnancy. Anticoagulant therapy did not appear to predispose patients to further intracranial hemorrhage., (Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

We examined the effect of bosentan, an ETA and ETB receptor antagonist, on EEG, an indicator of neuronal activity, in rats with experimentally induced cerebral ischemia-reperfusion. The rats were divided into three groups with seven rats in each group. Before the procedures, the EEGs of all rats were recorded for ten minutes. 30 mg/kg bosentan in 2 cc physiological serum was administered to the first group, and the second and third groups were injected with 2 cc physiological serum intraperitoneally. After the administration, the right and the left common carotid arteries of the animals in Groups 1 and 2 were clipped for 10 minutes using aneurysm clippings. The rats in the third group received only a subcutaneous incision. Ten minutes after the clips were removed in the first and second groups and after the incision in the third group, EEG recordings were repeated for 10 minutes. All the rats were decapitated and MDA values in the brain tissue were measured for evaluation of the efficiency of induced cerebral ischemia. Induced cerebral ischemia was performed effectively because the MDA levels in Groups 1 and 2 were elevated, compared to the levels in Group 3 (p<0.05). After the application of the Cerebral Ischemia-Reperfusion Technique, the EEG showed minimal slowing in the rats in Group 1, and generalized diffuse slowing in the rats in Group 2 compared to pre-ischemic findings. Bosentan may reduce the damage induced by ischemia on neuronal electrophysiology, likely through its vasodilation effect on cerebral vessels.

Multiple sclerosis lesions or plaques are considered to be the result of an inflammatory process in the brain that leads to attack myelin. Inflammation causes disruption of blood-brain barrier in acute, active plaque areas. This process may lead to increase blood supply that causes increase in temperature in these associated areas. These plaques can be seen by examining the brain using magnetic resonance imaging (MRI). Presence of these plaques plays an important role in indicating dissemination in time within the new diagnostic criteria and in treatment of active MS. Gadolinium-based contrast agents help for quantitative assessment of inflammatory activity and lesion load. However, these agents have serious risks such as anaphylaxis and kidney damage. We wanted to open up a discussion for the feasibility of using noninvasive MR thermometer technique instead of conventional MRI techniques, for evaluating the temperature and the extent of temperature changes of white matter and plaques in MS patients. After successful using of MR thermometer technique with upgraded applications, the time needed to perform the studies in a routine setting can be significantly shortened. With eliminating usage of contrast agent, considerable influx money can be provided along with preventing the adverse effects and risks of contrast agent usage., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The present article describes two unrelated cases of progressive myoclonic epilepsy (PME) of the Lafora's disease and Unverricht-Lundborg types who were treated with topiramate (TPM) as add-on therapy for their myoclonus. After the initiation of topiramate therapy both cases responded with marked decrease in myoclonic seizure frequency and improvement of quality of life. Topiramate appears to be a useful alternative agent in cases of PME and could be consider for adjunctive therapy.

Craniopharyngiomas are the most frequently encountered suprasellar tumours in children. Owing to the slow growth rate of these tumours, they are often quite large before becoming symptomatic. They are more common among children and older adults (55-74 years). Depending upon the direction of growth and tumour size, craniopharyngiomas can affect the hypothalamus, pituitary stalk, optic nerves and chiasm and carotid arteries. Compression of these neural and vascular structures frequently precipitates endocrine disorders, visual loss and an increased intracranial pressure. Hypopituitarism leading to a delayed puberty is a rare presentation of craniopharyngioma. The diagnosis of craniopharyngioma is usually made with the classic radiological imaging features based on CT and MRI.

We planned this study to investigate the frequency of epilepsy in paralytic polio survivors. We analyzed the clinical data of 91 paralytic polio survivors. Patients who had been diagnosed with epilepsy were examined by electroencephalography and brain magnetic resonance imaging. 11 of the 91 patients had epilepsy (12%). The mean age at which the patients were exposed to acute poliomyelitis was 5.3±3.8 years (age range: 1-13). The mean age of epilepsy onset was 17±5.6 (age range: 4-25) in the epileptic patients. Our findings suggest that paralytic polio survivors may be at a higher risk for epilepsy compared to normal subjects., (Copyright © 2011 Elsevier B.V. All rights reserved.)