1
|
Şengüzel S, Cebeci AN, Ekici B, Gönen İ, Tatlı B. Impact of eating habits and nutritional status on children with autism spectrum disorder. J Taibah Univ Med Sci 2021; 16:413-421. [PMID: 34140869 PMCID: PMC8178636 DOI: 10.1016/j.jtumed.2020.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 01/11/2023] Open
Abstract
Objectives Obesity is common among children with Autism Spectrum Disorder (ASD). They suffer more feeding problems than children with normal developmental milestones. Several kinds of diet are recommended for children with ASD. This study determines the frequency of eating disorders and obesity among such children. We investigate the predisposing factors of eating disorders and examine the effects of consumed food on autism scores. Methods In this single-centre, cross-sectional study, 46 children with ASD aged between 2 and 10 years were included. Anthropometric measurements were recorded and Brief Autism Mealtime Behavior Inventory (BAMBI), Autism Behavior Checklist (ABC), and Food Frequency Questionnaire (FFQ) forms were filled in by their parents. Results The rates of being overweight and obese were 10.9% and 28.3%, respectively. Food selectivity was observed in 84.8% of the children, and BAMBI food refusal scores were significantly higher for those aged between 2 and 5 years (p = 0.03). Autism scores and consumption of milk, yoghurt, oily seeds, rice/pasta, and fruits (p < 0.05) were significantly correlated. There were also significant differences between these scores and the frequency of consuming eggs, legumes, and other cereals (p < 0.05). Conclusion Obesity was more common in children with ASD than typically developed children. Despite the high rate of food selectivity, our findings confirmed that food selectivity could be considered independent of obesity. Further, the diet of patients with ASD must include more fruits, yogurt, eggs, legumes, other cereals, less milk, and less rice/pasta.
Collapse
Affiliation(s)
| | - Ayşe N Cebeci
- Department of Pediatric Endocrinology, Istanbul Bilim University, Istanbul, Turkey
| | - Barış Ekici
- Pediatric Neurology Clinic, Istanbul, Turkey
| | - İsmail Gönen
- Department of Pediatrics, Private Liv Hospital, Istanbul, Turkey
| | - Burak Tatlı
- Pediatric Neurology Clinic, Istanbul, Turkey
| |
Collapse
|
2
|
Gürkan Tazegül EN, Kutlu Konuk F, Aksu ŞS, Unay ÖS, Yıldız Bıçakçı M, Ekici B, Tatlı B. Play interactions of parents toward children with autism spectrum disorder: NeuroPLAY parent play behavior assessment scale. J Child Adolesc Psychiatr Nurs 2021; 34:320-328. [PMID: 34124815 DOI: 10.1111/jcap.12338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/29/2021] [Accepted: 05/25/2021] [Indexed: 11/29/2022]
Abstract
PROBLEM The aim of this study is to analyze the changes that NeuroPLAY, which is an intensive early intervention method for children with autism spectrum disorder (ASD) and ages of 12-42 months, has created in the play skills of the parents of children with ASD by using method strategies. METHODS The study cohort includes 91 children ages ranging from 18 to 42 months old. The study is designed for repetitive measurements performed pre- and post-intervention. Within the scope of the study, children's ASD symptoms were evaluated with the Childhood Autism Rating Scale (CARS) and changes in the play skills of parents were evaluated using NeuroPLAY Parental Play Behavior Assessment Scale (NPPBAS). RESULTS The NPPBAS score at the beginning of the intervention was 12.55; repeated measurements (46.22 after 3 months, 45.95 after 6 months, and 48.53 after 12 months) were observed to increase core. The older age of the parents in the intervention program is associated with lower final NPPBAS scores. However, it was determined that the CARS score, which is an indicator of the autism spectrum, will decrease after intervention regardless of the parents' age. CONCLUSION The results showed that NeuroPLAY led to significant improvement in play behaviors of the parents.
Collapse
Affiliation(s)
| | | | | | - Öykü S Unay
- Istanbul Pediatric Neurology Clinic, Istanbul, Turkey
| | | | - Barış Ekici
- Istanbul Pediatric Neurology Clinic, Istanbul, Turkey
| | - Burak Tatlı
- Istanbul Pediatric Neurology Clinic, Istanbul, Turkey
| |
Collapse
|
3
|
Doenyas C, Ekici B, Unay ÖS, Gönen İ, Tatlı B. Autism in Turkey: demographics, behavior problems, and accompanying medical conditions in a sample of Turkish youth with autism spectrum disorder. Int J Dev Disabil 2021; 69:179-189. [PMID: 37025343 PMCID: PMC10071939 DOI: 10.1080/20473869.2021.1937001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/27/2021] [Accepted: 05/27/2021] [Indexed: 06/19/2023]
Abstract
Autism spectrum disorder (ASD) is an etiologically heterogeneous neurodevelopmental condition that eludes a single explanation or cure. Epidemiological studies reveal risk factors, relevant comorbidities, and behavioral correlates to reach a better understanding of ASD. To contribute such data from an understudied ASD population, this paper presents epidemiological data from a Turkish sample of individuals with ASD (n = 911, 748 boys (82.1%) and 163 girls (17.9%) between 1 and 18 years of age). Average age at diagnosis was 31.06 ± 11.88 months, and the male-to-female ratio was 4.6:1. Three in 4 individuals with ASD had obsessive behaviors, and 1 in 4 had allergic conditions, inappropriate sexual behaviors, self-harming behaviors, and harmful behaviors towards others. One in 3 received a dietary treatment for at least 3 months; almost half received vitamin supplements; the majority (70%) did not experience constipation; and 2 in 3 were picky eaters. This paper presents data on the age of diagnosis, gender ratios, accompanying behaviors, and dietary interventions in Turkish individuals with ASD, which are topics of current research interest about ASD. Such data from non-Western populations may supplement epidemiological knowledge gained from Western populations to help reach a more comprehensive understanding of this condition with many unknowns.
Collapse
Affiliation(s)
- Ceymi Doenyas
- Koç University Research Center for Translational Medicine, Istanbul, Turkey
| | - Barış Ekici
- Pediatric Neurologist, Istanbul Special Child Neurology Clinic, Istanbul, Turkey
| | - Öykü Su Unay
- Occupational Therapist, Istanbul Special Child Neurology Clinic, Istanbul, Turkey
| | - İsmail Gönen
- Department of Pediatrics, İstinye University, Istanbul, Turkey
| | - Burak Tatlı
- Pediatric Neurologist, Istanbul Special Child Neurology Clinic, Istanbul, Turkey
| |
Collapse
|
4
|
Pembegul Yıldız E, Tatlı B, Ulak Ozkan M, Erarslan E, Aydınlı N, Çalışkan M, Özmen M. Evaluation of the prognostic factors in school age children who experienced neonatal seizures. Epilepsy Behav 2020; 102:106673. [PMID: 31770716 DOI: 10.1016/j.yebeh.2019.106673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/17/2019] [Accepted: 10/17/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND This prospective study aimed to evaluate long-term neurodevelopmental outcomes and risk factors of the previously reported cohort, at their school age. METHOD We included neonates whose seizures were directly observed by the child neurologist or neonatologist based on clinical observations. They were assessed for cognitive and neurological outcomes at the age of 9-11 years. The test battery included a neurological examination, the Wechsler Intelligence Scale for Children-Revised (WISC-R) test, and patients with the diagnosis of cerebral palsy (CP) were graded according to the Gross Motor Function Classification System (GMFCS). The primary outcome of this study was to determine risk factors for the long-term prognosis of neonatal seizures. RESULTS For the long-term follow-up, 97 out of 112 patients of the initial cohort were available (86.6%). We found that 40 patients (41%) have the normal prognosis, 22 patients (22.7%) have the diagnosis of CP, and 30 patients (30.9%) were diagnosed as having epilepsy. Twelve out of 22 patients with CP had the diagnosis of epilepsy. The WISC-R full-scale IQ scores were <55 points in 27 patients (27.8%) and were >85 points in 40 patients (41.2%). According to GMFCS, 10 patients were classified as levels 1-2, and 12 patients were classified as levels 3-5. In multivariate regression analyses, 5-min APGAR score <6 was found to be an independent risk factor for CP, and 5-min APGAR score <6 and neonatal status epilepticus were independent risk factors for epilepsy. CONCLUSIONS This prospective cohort study reveals that abnormal school age outcome after neonatal seizures are significantly related to 5-min APGAR score <6 and neonatal status epilepticus.
Collapse
Affiliation(s)
| | - Burak Tatlı
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey
| | - Melis Ulak Ozkan
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey
| | - Emine Erarslan
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey
| | - Nur Aydınlı
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey
| | - Mine Çalışkan
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey
| | - Meral Özmen
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey
| |
Collapse
|
5
|
Turkyilmaz G, Sarac Sivrikoz T, Erturk E, Ozcan N, Tatlı B, Karaman B, Toksoy G, Kalelioglu İH, Has R, Yuksel A. Utilization of neurosonography for evaluation of the corpus callosum malformations in the era of fetal magnetic resonance imaging. J Obstet Gynaecol Res 2019; 45:1472-1478. [PMID: 31155818 DOI: 10.1111/jog.13995] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 04/14/2019] [Indexed: 01/26/2023]
Abstract
AIM We evaluated the ability of fetal neurosonography and magnetic resonance imaging (MRI) to asses callosal anomalies (CA) and associated cranial malformations. We also aimed to determine the long-term prognosis of the cases. METHODS Thirty-six cases of CA diagnosed combined with neurosonography and MRI between January 2012 and October 2017 were retrospectively reviewed. RESULTS Seventeen of 36 fetuses were diagnosed complete agenesis of corpus callosum (CACC) (47.2%), 9 had partial agenesis of corpus callosum (PACC) (25%) and 10 was dysgenesis of the corpus callosum (DCC) (27.2%) at ultrasonography (US) examination. Fetal MRI reported 16 of cases as CACC (44.4%), 11 PACC (30.5%) and nine (25%) DCC. The overall consistency between neurosonography and MRI in the definition of CA were 91% of cases. Sulcation anomalies were present in 9 cases in the US (25%) and 11 cases in MRI (30.4%). Seven of cases showed posterior fossa abnormalities in the US (19.4%) and eight cases in MRI (22.1%). Neonatal MRI added new findings to fetal MRI and neurosonography including grade-1 intraventricular hemorrhage and periventricular leukomalacia in two cases (12.5%). Eighteen cases were terminated (50%), 17 cases were followed up and mean follow up interval was 39 ± 5.1 months. The neurologic outcome was abnormal in seven (41.7%) patients. Presence of associated brain anomalies worsened the prognosis. CONCLUSION Fetal neurosonography has a comparable performance with MRI in the diagnosis of CA and associated anomalies. It should be used in collaboration with MRI to achieve accurate diagnosis which is crucial for counseling.
Collapse
Affiliation(s)
- Gurcan Turkyilmaz
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tugba Sarac Sivrikoz
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Emircan Erturk
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Nahit Ozcan
- Department of Radiology, Sonomed Radiology Center, Istanbul, Turkey
| | - Burak Tatlı
- Department of Pediatric Neurology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Birsen Karaman
- Department of Medical Genetics, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Güven Toksoy
- Department of Medical Genetics, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - İbrahim H Kalelioglu
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Recep Has
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Atil Yuksel
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
6
|
Abstract
Dravet syndrome is a rare and progressive epileptic encephalopathy of infancy. Stiripentol reduces the seizure frequency in patients with Dravet syndrome. We evaluated the clinical characteristics of patients with Dravet syndrome and their response to stiripentol. We retrospectively collected the data of 21 patients (11 females; mean age, 8.2 years, range: 5.4-15 years) with Dravet syndrome who were treated with stiripentol in our outpatient clinic between June 2016 and June 2017. Patients with seizure reduction ≥50% were considered responders. Most of our patients had severe (47%) or moderate (33%) cognitive disabilities, although 14% had mild cognitive disability. There was a significant difference in both status epilepticus and age between the groups with normal/mild versus severe/moderate neurocognitive prognoses. Of the patients, 85.7% were using stiripentol. The mean duration of stiripentol use was 41.2 months (range: 24-64 months). In 12 patients (57%), the seizure frequency decreased by more than 50%, and 2 of them were seizure-free. Status epilepticus was not recorded after stiripentol treatment in 8 of 11 patients with status epilepticus. Despite the small sample size, our results suggest that stiripentol has a favorable efficacy. In addition, considering the absence of status epilepticus after treatment and the negative effects of status epilepticus on cognitive development, early treatment should be initiated in SD patients, for whom disease control is difficult.
Collapse
Affiliation(s)
- Edibe Pembegul Yıldız
- 1 Division of Pediatric Neurology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Melis Ulak Ozkan
- 2 Division of Pediatric Neurology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Tugce Aksu Uzunhan
- 2 Division of Pediatric Neurology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Gonca Bektaş
- 2 Division of Pediatric Neurology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Burak Tatlı
- 2 Division of Pediatric Neurology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Nur Aydınlı
- 2 Division of Pediatric Neurology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Mine Çalışkan
- 2 Division of Pediatric Neurology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| | - Meral Özmen
- 2 Division of Pediatric Neurology, Department of Pediatrics, Istanbul Medical Faculty, Istanbul, Turkey
| |
Collapse
|
7
|
Yıldız EP, Hızlı Z, Bektaş G, Ulak-Özkan M, Tatlı B, Aydınlı N, Çalışkan M, Özmen M. Efficacy of rufinamide in childhood refractory epilepsy. TurkJPediatr 2018; 60:238-243. [DOI: 10.24953/turkjped.2018.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
8
|
Yildiz EP, Yesil G, Bektas G, Caliskan M, Tatlı B, Aydinli N, Ozmen M. Spinal muscular atrophy with progressive myoclonic epilepsy linked to mutations in ASAH1. Clin Neurol Neurosurg 2017; 164:47-49. [PMID: 29169047 DOI: 10.1016/j.clineuro.2017.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 11/08/2017] [Accepted: 11/13/2017] [Indexed: 11/26/2022]
Abstract
Spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME), a rare disorder caused by mutation in the ASAH1 gene, is characterized by progressive muscle weakness and intractable epilepsy. The literature about SMA-PME is very rare and most of the time limited to case reports. Mutation in the ASAH1 gene is also found in another rare syndrome which is Farber disease. We report a case of a 13.5-year-old girl with SMA-PME associated with ASAH1 gene mutation. She presented with progressive muscle weakness, tremor, seizure, and cognitive impairment. Clinical features and electrophysiological investigations revealed a motor neuron disease and generalized epilepsy. The marked difference in disease manifestations may explain why Farber and SMA-PME diseases were not suspected of being allelic conditions. SMA-PME cases with ASAH1 mutation could be treated using therapeutic studies regarding Farber disease. In patients with undefined PME or lower motor neuron disease cases, ASAH1 mutation scans should be studied.
Collapse
Affiliation(s)
- Edibe Pembegül Yildiz
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
| | - Gözde Yesil
- Department of Medical Genetics, Bezmi Alem Vakif University Faculty of Medicine, Istanbul, Turkey
| | - Gonca Bektas
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mine Caliskan
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Burak Tatlı
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Nur Aydinli
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Meral Ozmen
- Division of Pediatric Neurology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
9
|
Abstract
Non epileptic paroxysmal events are recurrent movement disorders with acute onset and ending, which may mimic epilepsy. The duration, place, timing of the attacks, and state of conciousness may confuse pediatricians about the diagnosis of epilepsy and non epileptic paroxysmal events. The key point in the diagnosis is taking an accurate and detailed history. Wrong diagnosis can give rise to anxiety of both the family and the child, interruptions in the child's education, limitations in career planning, and irreversible damages in the long term. The diagnosis can prevent unnecessary drug use and psychological damage. This review aims to discuss the clinical findings, treatment, and differential diagnoses of non epileptic paroxysmal events, and to increase awareness about non epileptic paroxysmal events among pediatricians.
Collapse
Affiliation(s)
- Burak Tatlı
- Department of Pediatrics, Division of Pediatric Neurology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Serhat Güler
- Clinic of Pediatrics, Division of Pediatric Neurology, The Ministry of Health Edirne Public Hospital, Edirne, Turkey
| |
Collapse
|
10
|
Kıztanır H, Bektaş G, Yıldız EP, Uzunhan TA, Tatlı B, Aydınlı N, Çalışkan M, Özmen M. Coexisting neuronal autoantibodies among children with demyelinating syndromes. Brain Dev 2017; 39:248-251. [PMID: 27823947 DOI: 10.1016/j.braindev.2016.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/12/2016] [Accepted: 10/18/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To determine the incidence and clinical relevance of neuronal autoantibodies in children with demyelinating syndromes. METHODS We conducted a prospective study including 31 consecutive children with demyelinating syndromes. Four patients with N-Methyl-D-aspartate receptor (NMDAR) encephalitis, 32 patients with Guillain-Barre syndrome, 13 children with benign childhood epilepsy, and 28 healthy children were used as controls. Prior to initiating immunomodulatory therapy, serum samples were tested for antibodies against NMDAR, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) 1, AMPAR2, leucine-rich glioma-activated protein 1, contactin-associated protein 2, gamma-aminobutyric acid B receptors, paraneoplastic ma antigen 2 (PNMA2/Ta), Yo, Ri, Hu, CV2, amphiphysin, and aquaporin-4 by indirect immunofluorescence assays. RESULTS Three anti-neuronal antibodies were detected; NMDAR antibody in one with multiple sclerosis, PNMA2/Ta antibody in one with multiple sclerosis, and Yo antibody in one with clinically isolated syndrome. The positivity rate of neuronal autoantibodies in demyelinating syndrome was 10%. All seropositive patients were found to be negative for tumor screening. None of these patients exhibited symptoms of encephalitis. CONCLUSION Children with demyelinating syndromes without symptoms of encephalitis can be positive for anti-neuronal antibodies.
Collapse
Affiliation(s)
- Hikmet Kıztanır
- Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gonca Bektaş
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Edibe Pembegül Yıldız
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tuğçe Aksu Uzunhan
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Burak Tatlı
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nur Aydınlı
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mine Çalışkan
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Meral Özmen
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
11
|
Kepenek-Varol B, Çalışkan M, İnce Z, Tatlı B, Eraslan E, Çoban A. The comparison of general movements assessment and neurological examination during early infancy. Turk J Pediatr 2016; 58:54-62. [PMID: 27922237 DOI: 10.24953/turkjped.2016.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This prospective single-blinded study was performed to evaluate general movements (GMs) in group of high-risk, low-birth-weight and preterm infants and to compare results with neurologic examination. All infants' neurologic examinations, Gross Motor Function Measurement (GMFM) and Bayley-III Scale were performed at the corrected age of 12 months. A total of 22 infants were included. Eight infants (group-1) (mean: 31.6±3.29 weeks, range: 25-36 weeks) had normal GMs in all recordings and were ultimately evaluated as "normal"; 12 (group-2) (mean: 31.6±3.29 weeks, range:2 5-35 weeks) had abnormal GMs during writhing movements period but had normal GMs in subsequent recordings and were evaluated as "normal"; and 2 infants (group-3) (mean:29.5±7.78 weeks, range:24-35 weeks) with consistent abnormal GMs who were evaluated as "abnormal." Complete agreement (kappa=1) was found between GMs and neurologic examination and significant agreement between GMs and cranial ultrasonography (kappa=0.76). When results of GMFM and Bayley-III were compared; statistically significant differences were found between group-1 and group-2 in "standing" parameter of GMFM (p < 0.05) and "cognitive" parameter of Bayley-III (p < 0.05). GMs assessment can help determine neurologic disorders in high-risk infant populations as an adjunct to other diagnostic techniques.
Collapse
Affiliation(s)
- Büşra Kepenek-Varol
- Department of Physiotherapy and Rehabilitation, Bezmialem Vakif University Faculty of Health Sciences, Istanbul, Turkey
| | - Mine Çalışkan
- Divisions of Pediatric Neurology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Zeynep İnce
- Divisions of Neonatology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Burak Tatlı
- Divisions of Pediatric Neurology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Emine Eraslan
- Divisions of Pediatric Neurology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Asuman Çoban
- Divisions of Neonatology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
12
|
Abstract
INTRODUCTION Hypoxic ischemic encephalopathy (HIE) is the most important reason for morbidity and mortality in term-born infants. Understanding pathophysiology of the brain damage is essential for the early detection of patients with high risk for HIE and development of strategies for their treatments. Areas covered: This review discusses pathophysiology of the neonatal HIE and its treatment options, including hypothermia, melatonin, allopurinol, topiramate, erythropoietin, N-acetylcyctein, magnesium sulphate and xenon. Expert commentary: Several clinical studies have been performed in order to decrease the risk of brain injury due to difficulties in the early diagnosis and treatment, and to develop strategies for better long-term outcomes. Although currently standard treatment methods include therapeutic hypothermia for neonates with moderate to severe HIE, new supportive options are needed to enhance neuroprotective effects of the hypothermia, which should aim to reduce production of the free radicals and to have anti-inflammatory and anti-apoptotic actions.
Collapse
Affiliation(s)
| | - Barış Ekici
- b Department of Pediatric Neurology , Liv Hospital , Istanbul , Turkey
| | - Burak Tatlı
- a Department of Pediatric Neurology , Istanbul University , Istanbul , Turkey
| |
Collapse
|
13
|
Bektaş G, Çalışkan M, Aydın A, Pembegül Yıldız E, Tatlı B, Aydınlı N, Özmen M. Aggravation of atonic seizures by rufinamide: A case report. Brain Dev 2016; 38:654-7. [PMID: 26906013 DOI: 10.1016/j.braindev.2016.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 02/03/2016] [Accepted: 02/08/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rufinamide is a novel antiepileptic drug used as adjunctive therapy in patients with Lennox-Gastaut syndrome and provides seizure control especially in tonic and atonic seizures. Rufinamide is expected to be effective in intractable epilepsy when atonic and tonic seizures exist. However, rufinamide induced seizure aggravation has been reported in a few patients, which was not associated with a specific type of seizure. CASE A 12-year-old boy with intractable epilepsy had tonic and atonic seizures despite treatment with valproic acid (3000mg/day), levetiracetam (3000mg/day) and clobazam (40mg/day). Rufinamide was administered as adjuvant therapy. After 2weeks on rufinamide, he experienced atonic seizure worsening, and the frequency of epileptic discharges increased. The deterioration in seizure frequency and epileptiform discharges resolved when rufinamide was discontinued. CONCLUSION Rufinamide may aggravate atonic seizures in patients with intractable epilepsy.
Collapse
Affiliation(s)
- Gonca Bektaş
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey.
| | - Mine Çalışkan
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey
| | - Ali Aydın
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey
| | - Edibe Pembegül Yıldız
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey
| | - Burak Tatlı
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey
| | - Nur Aydınlı
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey
| | - Meral Özmen
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey
| |
Collapse
|
14
|
Güler S, Tatlı B. Rare vascular pathology sinus pericranii; becomes symptomatic with pseudotumor cerebri. Turk J Pediatr 2015; 57:618-620. [PMID: 27735803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Sinus pericranii (SP) is an uncommon vascular pathology that is characterized by a nodular structure emerging from the scalp. It is generally asymptomatic. Typically, it is aclose to soft, compressive, fluctuant swelling, intracranial sinus. The swelling increases during the Valsalva maneuver, jugular vein compression, coughing, or crying attacks. The diagnosis was confirmed by CT, MRI, and MR angiography. Here, we conclude that SP is a rare cause of headache and that the asymptomatic lesion become symptomatic as a result of association with pseudotumor cerebri.
Collapse
Affiliation(s)
- Serhat Güler
- Divisions of Pediatric Neurology, Department of Pediatrics, Bezmialem University Faculty of Medicine, İstanbul, Turkey.
| | | |
Collapse
|
15
|
Gedik AH, Demirkol D, Tatlı B, Bayraktar S, Alkan A, Karabocuoglu M, Yuksel A. Therapeutic plasma exchange for malignant refractory status epilepticus: a case report. Pediatr Neurol 2014; 50:407-10. [PMID: 24630284 DOI: 10.1016/j.pediatrneurol.2014.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 12/24/2013] [Accepted: 01/01/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Refractory status epilepticus is a prolongation of status epilepticus despite anticonvulsant therapy with two or three medications in proper doses; it is defined as malignant status epilepticus if it takes weeks or months. Intravenous immunoglobulin, high-dose steroids, magnesium infusion, pyridoxine, hypothermia, ketogenic diet, electroconvulsive therapy, and surgical therapy are the other treatment options for status epilepticus. PATIENT Our 5-year-old male patient was hospitalized at our pediatric intensive care unit because of status epilepticus secondary to meningoencephalitis. No response could be obtained with many medical and nonmedical therapies in our patient, who developed malignant status epilepticus with unknown etiology. Therapeutic plasma exchange was applied as convulsions continued. RESULT Ours is the first child for whom therapeutic plasma exchange was successfully applied because of malignant refractory status epilepticus secondary to meningoencephalitis. CONCLUSION Therapeutic plasma exchange may be a treatment option for children with refractory status epilepticus following presumed meningoencephalitis.
Collapse
Affiliation(s)
- Ahmet H Gedik
- Department of Pediatrics, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
| | - Demet Demirkol
- Department of Pediatric Intensive Care, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Burak Tatlı
- Department of Pediatric Neurology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Suleyman Bayraktar
- Department of Pediatric Intensive Care, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Alpay Alkan
- Department of Radiology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Metin Karabocuoglu
- Department of Pediatric Intensive Care, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Adnan Yuksel
- Department of Pediatric Neurology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| |
Collapse
|
16
|
Tatlı B, Ekici B, Özmen M. Current therapies and future perspectives in subacute sclerosing panencephalitis. Expert Rev Neurother 2014; 12:485-92. [DOI: 10.1586/ern.12.21] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
17
|
Uysalol M, Tatlı B, Uzel N, Cıtak A, Aygün E, Kayaoğlu S. A Rare Form of Guillan Barre Syndrome: A Child Diagnosed with Anti-GD1a and Anti-GD1b Positive Pharyngeal-Cervical-Brachial Variant. Balkan Med J 2013; 30:337-41. [PMID: 25207134 DOI: 10.5152/balkanmedj.2013.8334] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 06/01/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Pharyngeal-cervical-brachial (PCB) variant is a rare form of Guillan-Barre Syndrome (GBS). Antibodies against other membrane proteins like GM1b and GD1a have been found only in a small number of patients with Guillan Barre syndrome variant. CASE REPORT Here, we report a 5.5 year-old boy diagnosed early with positive GD1a and GD1b gangliosides of Guillan-Barre syndrome pharyngeal cervical-Brachial variant, who improved and recovered fully in a short period. This is in contrast to those whose recovery period prolongs in spite of early diagnosis and appropriate treatment and/or those who experience incomplete recovery. CONCLUSION In summary, diagnosis of PCB variant of GBS should be considered in infants with sudden onset bulbar symptoms and muscle weakness, and it should be kept in mind that early diagnosis and appropriate treatment can give successful outcomes.
Collapse
Affiliation(s)
- Metin Uysalol
- Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Burak Tatlı
- Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Nedret Uzel
- Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Agop Cıtak
- Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Erhan Aygün
- Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Semra Kayaoğlu
- Department of Pediatrics, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
18
|
Affiliation(s)
- Barış Ekici
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul, Turkey
| | | | | |
Collapse
|
19
|
Dilber C, Calışkan M, Sönmezoğlu K, Nişli S, Mukaddes NM, Tatlı B, Aydınlı N, Ekici B, Özmen M. Positron emission tomography findings in children with infantile spasms and autism. J Clin Neurosci 2012; 20:373-6. [PMID: 23219829 DOI: 10.1016/j.jocn.2012.03.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 01/19/2012] [Accepted: 03/04/2012] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate positron emission tomography (PET) findings in patients diagnosed with infantile spasms and autism. This study includes 90 patients who were diagnosed with infantile spasms at the Department of Pediatric Neurology in the Istanbul University Medical Faculty between 1995 and 2007. Of the 90 patients, 15 patients who were diagnosed with autism using the Autism Behaviour Checklist and Childhood Autism Rating Scale and a control group of nine patients without autism but with infantile spasms underwent PET examination. Mean patient age (± standard error, SE) varied between 3 years and 16 years (7.8 ± 4 years), while the mean follow-up time (±SE) varied between 2 years and 16 years (average: 7.1 ± 4 years). Autism was present in 11 patients with symptomatic spasms and in four patients with cryptogenic spasms (p=0.009). On the PET scans of the 15 patients with autism, 13 (86.7%) had significantly decreased metabolic activity in the temporal lobe (p<0.001), nine (60%) had significantly decreased activity in the frontal lobe (p=0.004), and seven (46.7%) had significantly decreased activity in the parietal lobe (p=0.022). In our opinion, hypometabolism in the frontal and parietal lobes, in addition to that previously reported in the temporal lobe, plays a role in the development of autism in patients with infantile spasms.
Collapse
Affiliation(s)
- Cengiz Dilber
- Department of Pediatric Neurology, Istanbul University, Arpaemini/Fatih, İstanbul 34093, Turkey
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Yıldırım ZH, Aydınlı N, Ekici B, Tatlı B, Calişkan M. Can Alberta infant motor scale and milani comparetti motor development screening test be rapid alternatives to bayley scales of infant development-II at high-risk infants. Ann Indian Acad Neurol 2012; 15:196-9. [PMID: 22919192 PMCID: PMC3424797 DOI: 10.4103/0972-2327.99714] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 12/30/2011] [Accepted: 02/14/2012] [Indexed: 11/23/2022] Open
Abstract
Purpose: The main object of the present study is to assess neuromotor development of high-risk infants by using three tests, and to determine inter-test concordance and the feasibility of these tests. Materials and Methods: One-hundred and nine patients aged between 0 and 6 months and identified as “high-risk infant” according to the Kliegman's criteria were enrolled to the study. Three different tests were used to assess neuromotor development of the patients: Bayley scales of infant development-II (BSID-II), Alberta infant motor scale (AIMS), and Milani Comparetti Motor Development Screening Test (MCMDST). Results: Correlation analysis was performed between pure scores of BSID-II motor scale and total scores of AIMS. These two tests were highly correlated (r:0.92). Moderate concordance was found between BSID-II and AIMS (k:0.35). Slight concordance was found between BSID-II and MCMDST; and the concordance was slight again for AIMS and MCMDST (k:0.11 and k:0.16, respectively) too. Conclusion: AIMS has a high correlation and consistency with BSID-II and can be used with routine neurological examination as it is based on observations, has few items, and requires less time to complete.
Collapse
|
21
|
Yıldız EP, Tatlı B, Ekici B, Eraslan E, Aydınlı N, Calışkan M, Ozmen M. Evaluation of etiologic and prognostic factors in neonatal convulsions. Pediatr Neurol 2012; 47:186-92. [PMID: 22883283 DOI: 10.1016/j.pediatrneurol.2012.05.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Accepted: 05/23/2012] [Indexed: 10/28/2022]
Abstract
This study evaluated etiologic and risk factors affecting long-term prognoses of neurologic outcomes in newborns with neonatal seizures. We enrolled patients at chronologic ages of 23-44 months, referred to the Department of Pediatric Neurology, Istanbul Medical Faculty, from January 1, 2007-December 31, 2009, after manifesting seizures in their first postnatal 28 days. Of 112 newborns, 41 were female, 71 were male, 33 were preterm, and 79 were full-term. Perinatal asphyxia (28.6%) and intracranial hemorrhage (17%) were the most common causes of neonatal seizures. Cerebral palsy developed in 27.6% of patients during follow-up. The incidence of epilepsy was 35.7%. Almost 50% of patients manifested developmental delay in one or more areas. Global developmental delay was the most common (50.8%) neurologic disorder. The correlation between gestational age or birth weight and adverse outcomes was nonsignificant. Etiology, Apgar score, need for resuscitation at birth, background electroencephalogram, neonatal status epilepticus, cranial imaging findings, type/duration of antiepileptic treatment, and response to acute treatment were all strong prognostic factors in neurologic outcomes. Neonatal seizures pose a threat of neurologic sequelae for preterm and full-term infants. Although the number of recognized etiologic factors in neonatal seizures has increased because of improvements in neonatology and diagnostic methods, perinatal asphyxia remains the most common factor.
Collapse
Affiliation(s)
- Edibe Pembegul Yıldız
- Department of Pediatrics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | | | | | | | | | | | | |
Collapse
|
22
|
Tatlı B, Ekici B, Sencer A, Sencer S, Aydın K, Aydınlı N, Calışkan M, Ozmen M, Kırış T. Clinical features, prothrombotic risk factors, and long-term follow-up of eight pediatric Moyamoya patients. J Clin Neurol 2012; 8:100-3. [PMID: 22787492 PMCID: PMC3391613 DOI: 10.3988/jcn.2012.8.2.100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 11/03/2011] [Accepted: 11/03/2011] [Indexed: 01/15/2023] Open
Abstract
Background and Purpose The aim of this study was to elucidate the clinical features, prothrombotic risk factors, and outcome of pediatric Moyamoya patients. Methods Patients diagnosed with Moyamoya disease at a tertiary center between January 2000 and December 2006 were enrolled in this study. The clinical presentations, underlying diseases, prothrombotic risk factors, family history of thrombosis, radiological findings, treatment, and outcome of the patients were reviewed retrospectively. Results Eight patients with angiographically proven Moyamoya disease were identified, one of whom had neurofibromatosis type I and one had Down syndrome. The age at diagnosis varied between 19 months and 11 years (73.4±41.8 months, mean±SD). The follow-up period after diagnosis was 52.5±14.8 months. In six patients, the initial clinical presentation was hemiparesis. None of the patients had any identifiable prothrombotic factors. Despite medical and surgical treatment, three patients had recurrences and one died. Only two patients recovered without sequelae. Conclusions The value of prothrombotic risk factor evaluation appears to be limited in Moyamoya patients; the outcome for pediatric patients remains dismal.
Collapse
Affiliation(s)
- Burak Tatlı
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul, Turkey
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Tatlı B, Özer I, Ekici B, Kalelioğlu I, Has R, Eraslan E, Yüksel A. Neurodevelopmental outcome of 31 patients with borderline fetal ventriculomegaly. Clin Neurol Neurosurg 2012; 114:969-71. [PMID: 22405543 DOI: 10.1016/j.clineuro.2012.02.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 02/12/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
Abstract
AIM We present the neurodevelopmental outcome of patients with isolated borderline fetal ventriculomegaly. METHODS The present study was carried out at the Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University in July-December 2010. Prenatal second trimester detailed ultrasound examinations were performed by obstetricians at the Prenatal Diagnosis Department of Istanbul Medical School, and 31 consecutive patients aged 8-33 months have been included in the study. Four patients with atrial diameters of over 15 mm and three patients with central nervous system development anomalies were excluded from the study. In order to assess the neuromotor development of patients, neurologic examinations and the Bayley Scales of Infant Development (BSID-III) were used. RESULTS Nine patients were female (29%) and 22 were male (71%). In the postnatal period, tuberous sclerosis was found in one patient, Down syndrome in one, and equinovarus foot deformity in one. Atrial diameter was <12 mm in 18 patients and >12 mm in 13. Cranial ultrasounds done in the first postnatal month revealed persisting ventriculomegaly in nine patients. The two patients who scored significantly low in all areas on the Bayley Scales of Infant Development were the patients with Down syndrome and tuberous sclerosis. The one scoring low in the motor area was the patient with the equinovarus foot deformity. The BSID-III scores of the patients whose prenatal ventricle diameter was <12 mm were within normal limits. The four patients showing slight developmental delay were the ones whose cranial ultrasound in the first postnatal month showed persisting ventriculomegaly. CONCLUSION In patients with borderline fetal ventriculomegaly, atrial diameter being more than 12 mm, the condition persisting in the first postnatal month and the presence of accompanying syndromes and malformations all constitute clear risk factors for neurodevelopmental outcome.
Collapse
Affiliation(s)
- Burak Tatlı
- Istanbul University, Istanbul Medical Faculty, Department of Pediatric Neurology, Istanbul, Turkey.
| | | | | | | | | | | | | |
Collapse
|
24
|
Ekici B, Bozkurt B, Tatlı B, Calışkan M, Aydınlı N, Ozmen M. Demographic characteristics of SMA type 1 patients at a tertiary center in Turkey. Eur J Pediatr 2012; 171:549-52. [PMID: 22016262 DOI: 10.1007/s00431-011-1607-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 10/07/2011] [Indexed: 12/01/2022]
Abstract
UNLABELLED The aim of this study was to demonstrate demographics of 39 consecutive Spinal Muscular Atrophy (SMA) type 1 patients diagnosed genetically in a tertiary center between June 2006 and June 2009. There was history of consanguineous marriage in 27 (69%) patients. The average patient lifespan was 251 days (30-726 days). The average patient age at diagnosis was 129 days (33-297 days). A statistically significant correlation was found between the age at diagnosis and the lifespan (p = 0.00). No significant correlation was found between the time spent in intensive care and the lifespan (p = 0.43). Routine physical therapy was found to have no significant impact on the lifespan average (p = 0.17). The cause of death in all of our patients was respiratory issues. Genetic counseling was given to 35 families. A second child with SMA was born in three out of the 14 families who declined prenatal diagnosis. CONCLUSION A national program is needed in Turkey for SMA prevention and creation of expert teams for the management of these patients.
Collapse
Affiliation(s)
- Barış Ekici
- Department of Pediatric Neurology, Istanbul Medical Faculty, Ortaköy Dereboyu cad. Arkeon sitesi A 5 blok D 3, Beşiktaş, Fatih, Istanbul, Turkey.
| | | | | | | | | | | |
Collapse
|
25
|
Ekici B, Demir IH, Ocak S, Yeşil G, Tatlı B, Çelebi A. An infant with spinal muscular atrophy and tetrology of Fallot. Clin Neurol Neurosurg 2012; 114:1033-4. [PMID: 22366241 DOI: 10.1016/j.clineuro.2012.01.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Revised: 01/24/2012] [Accepted: 01/25/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Barış Ekici
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey.
| | | | | | | | | | | |
Collapse
|
26
|
Ozmen M, Dilber C, Tatlı B, Aydınlı N, Calışkan M, Ekici B. Severe myoclonic epilepsy of infancy (Dravet syndrome): Clinical and genetic features of nine Turkish patients. Ann Indian Acad Neurol 2011; 14:178-81. [PMID: 22028529 PMCID: PMC3200039 DOI: 10.4103/0972-2327.85879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/11/2011] [Accepted: 05/16/2011] [Indexed: 11/12/2022] Open
Abstract
Purpose: Mutations of the α-1 subunit sodium channel gene (SCN1A) cause severe myoclonic epilepsy of infancy (SMEI). To date, over 300 mutations related to SMEI have been described. In the present study, we report new SCN1A mutations and the clinical features of SMEI cases. Materials and Methods: We studied the clinical and genetic features of nine patients diagnosed with SMEI at the Pediatric Neurology Department of Istanbul Medical Faculty. Results: Five patients had nonsense mutations, two had missense mutations, one had a splice site mutation and one had a deletion mutation of the SCN1A gene. Mutations at c.3705+5G splice site, p.trip153X nonsense mutation and deletion at c.2416_2946 have not been previously described. The seizures started following whole cell pertussis vaccination in all patients. The seizures ceased in one patient and continued in the other eight patients. Developmental regression was severe in three patients, with frequent status epilepticus. The type of mutation was not predictive for the severity of the disease. Two of the three patients with severe regression had nonsense and missense mutations. Conclusions: Dravet syndrome can be result of several different types of mutation in SCN1A gene. Onset of the seizures after pertussis vaccination is an important clue for the diagnosis and neuro- developmental delay should be expected in all patients.
Collapse
Affiliation(s)
- Meral Ozmen
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul
| | | | | | | | | | | |
Collapse
|
27
|
Ekici B, Ergül Y, Tatlı B, Bilir F, Binboğa F, Süleyman A, Tamay Z, Calışkan M, Güler N. Being ambulatory does not secure respiratory functions of Duchenne patients. Ann Indian Acad Neurol 2011; 14:182-4. [PMID: 22028530 PMCID: PMC3200040 DOI: 10.4103/0972-2327.85889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 03/08/2011] [Accepted: 05/17/2011] [Indexed: 11/11/2022] Open
Abstract
Aim: The aim of this work was to assess the respiratory functions of ambulatory Duchenne patients and to propose an earlier time period for intervention. Materials and Methods: Lung functions and North Star Ambulatory Assessment (NSAA) scores of Duchenne patients were evaluated simultaneously. Results: Thirty ambulatory Duchenne patients were included in this study. NSAA scores of the patients were directly correlated with arm abduction, arm adduction, and shoulder flexion strengths. Forced expiratory volume in 1 second percent predicted and forced vital capacity (FVC) percent predicted correlated inversely to age and to the NSAA score. Twelve of 13 patients with FVC values lower than 80% of predicted had NSAA scores below 24 points. None of the patients who were younger than 7 years had FVC values lower than 80% of predicted. Conclusion: Annual spirometry is necessary for Duchenne patients older than 6 years regardless of the ambulatory status.
Collapse
Affiliation(s)
- Barış Ekici
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul, Turkey
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
|
29
|
Ekici B, Aydın K, Cantez S, Ergül Y, Tatlı B. Etanercept-induced encephalopathy in a 7-year-old child. Pediatr Neurol 2011; 45:271-3. [PMID: 21907894 DOI: 10.1016/j.pediatrneurol.2011.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Revised: 03/29/2011] [Accepted: 06/22/2011] [Indexed: 01/08/2023]
Abstract
Adverse events were reported in various patients treated with etanercept, including infections (sepsis and tuberculosis), malignancies (e.g., lymphoma), demyelinating disorders, and autoimmune diseases. Only two adult patients with etanercept-related encephalopathy were previously reported. We describe a 7-year-old patient who developed encephalopathy immediately after his third dose of etanercept. To the best of our knowledge, ours is the first report of a pediatric patient with a diagnosis of systemic arthritis and who developed etanercept-related encephalopathy.
Collapse
Affiliation(s)
- Barış Ekici
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Fatih, Istanbul, Turkey.
| | | | | | | | | |
Collapse
|
30
|
Tatlı B, Aydınlı N, Calışkan M, Ozmen M, Kara B, Yaramış A, Dilber C, Yılmaz K, Küçükuğurluoğlu Y, Ekici B. Clinical features of nine patients with alternating hemiplegia of childhood. J Paediatr Child Health 2011; 47:734-6. [PMID: 21449903 DOI: 10.1111/j.1440-1754.2011.02042.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To define clinical features of patients with alternating hemiplegia of childhood. METHODS We retrospectively reviewed the clinical presentation and course of the disease in patients diagnosed between January 2003 and December 2008 at the Pediatric Neurology Department of the Istanbul Medical Faculty. RESULTS The nine patients had a mean age of 6.6 months (2-15 months) at the onset of symptoms. Paroxysmal eye movements were the early symptom of five patients. All patients had recurrent alternating hemiplegic episodes and relief of symptoms while sleeping. Duration of events varied widely from few minutes to several days and was associated with slowly progressive neurological deterioration. Flunarizine might decrease frequency of events but is not effective to neurological deterioration. Amantadine as an alternative agent is used in add-on therapy, but epileptogenic side effect prevented the evaluation of long-term efficacy. CONCLUSION Trials on new agents like amantadine are necessary for more effective control of the disease.
Collapse
Affiliation(s)
- Burak Tatlı
- Department of Pediatric Neurology, Istanbul Medical Faculty, Fatih, Istanbul, Turkey
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Sevketoglu E, Tatlı B, Tuğcu B, Demirelli Y, Hatipoglu S. An unusual cause of fulminant Guillain-Barré syndrome: angel's trumpet. Pediatr Neurol 2010; 43:368-70. [PMID: 20933184 DOI: 10.1016/j.pediatrneurol.2010.05.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Revised: 03/03/2010] [Accepted: 05/17/2010] [Indexed: 11/19/2022]
Abstract
A 5-year-old previously healthy boy presented with typical findings of Guillain-Barré syndrome and unilateral tonic pupil. He was placed on mechanical ventilation for 35 days for respiratory failure. Plasmapheresis and two courses of intravenous immunoglobulin therapy were given to the patient, and he experienced stepwise recovery from his illness. This case of acute motor axonal neuropathy type Guillain-Barré syndrome is novel in that the cause was established as ingestion of a toxic solanaceous plant, angel's trumpet (Brugmansia suaveolens; syn. Datura suaveolens). Understanding the signs and symptoms of angel's trumpet toxicity can allow for early diagnosis and proper case management.
Collapse
Affiliation(s)
- Esra Sevketoglu
- Pediatric Intensive Care Unit, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey.
| | | | | | | | | |
Collapse
|