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Ulgen Tekerek N, Dursun O, Asilioglu Yener N, Yildizdas D, Anıl AB, Kendirli T, Koker A, Karalok S, Aksoy A, Kinik Kaya E, Ekinci F, Incecik F, Olgac Dundar N, Durak F, Botan E, Havan M, Sahin S, Duman O, Haspolat S. Posttraumatic epilepsy in critically ill children with traumatic brain injury. Childs Nerv Syst 2023; 39:3207-3214. [PMID: 37480521 DOI: 10.1007/s00381-023-06087-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/17/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE The aim of this study was to determine the clinical, laboratory, and radiological factors related with posttraumatic epilepsy (PTE). METHODS The study is a multicenter descriptive cross-sectional cohort study. Children who followed up for TBI in the pediatric intensive care unit between 2014 and 2021 were included. Demographic data and clinical and radiological parameters were recorded from electronic case forms. All patients who were in the 6-month posttraumatic period were evaluated by a neurologist for PTE. RESULTS Four hundred seventy-seven patients were included. The median age at the time of trauma was 66 (IQR 27-122) months, and 298 (62.5%) were male. Two hundred eighty (58.7%) patients had multiple traumas. The mortality rate was 11.7%. The mean duration of hospitalization, pediatric intensive care unit hospitalization and mechanical ventilation, Rotterdam score, PRISM III score, and GCS at admission were higher in patients with epilepsy (p < 0.05). The rate of epilepsy was higher in patients with severe TBI, cerebral edema on tomography and clinical findings of increased intracranial pressure, blood transfusion in the intensive care unit, multiple intracranial hemorrhages, and intubated patients (p < 0.05). In logistic regression analysis, the presence of intracranial hemorrhage in more than one compartment of the brain (OR 6.13, 95%CI 3.05-12.33) and the presence of seizures (OR 9.75, 95%CI 4.80-19.83) were independently significant in terms of the development of epilepsy (p < 0.001). CONCLUSIONS In this multicenter cross-sectional study, intracranial hemorrhages in more than one compartment and clinical seizures during intensive care unit admission were found to be independent risk factors for PTE development in pediatric intensive care unit patients with TBI.
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Affiliation(s)
- Nazan Ulgen Tekerek
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
- Akdeniz University Hospital, Dumlupınar Boulevard, Konyaalti, Antalya, 07059, Turkey.
| | - Oguz Dursun
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Nazik Asilioglu Yener
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Dincer Yildizdas
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ayşe Berna Anıl
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Katip Celebi University, İzmir, Turkey
| | - Tanil Kendirli
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Alper Koker
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Selen Karalok
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Ayşe Aksoy
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Elif Kinik Kaya
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Faruk Ekinci
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Faruk Incecik
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Nihal Olgac Dundar
- Division of Pediatric Neurology, Department of Pediatrics, Katip Celebi Faculty of Medicine, İzmir, Turkey
| | - Fatih Durak
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Katip Celebi University, İzmir, Turkey
| | - Edin Botan
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Merve Havan
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Suleyman Sahin
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ozgur Duman
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Senay Haspolat
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Ulgen Tekerek N, Dursun O, Karalok S, Koker A, Duman O, Haspolat S. Determinants of Quality of Life after Pediatric Traumatic Brain Injury. J Pediatr Intensive Care 2023; 12:55-62. [PMID: 36742257 PMCID: PMC9894700 DOI: 10.1055/s-0042-1758475] [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: 05/17/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Pediatric traumatic brain injury (TBI) is a significant cause of death and long-term disability. There is a paucity of data on quality of life in survivors of pediatric TBI. The aim of this study is to determine the factors affecting the quality of life after TBI in children. Methods Consecutively admitted 104 of 156 patients to the pediatric intensive care unit (PICU) with TBI between 1 month and 18 years were included in the study. Demographics were obtained from electronic records. Injury severity and mortality scores were calculated. The Pediatric Quality of Life Inventory (PedsQL) scale and Glasgow Outcome Scale (GOS) score were evaluated by interview with patient or the caregiving parents. The Rotterdam computed tomography (CT) score was calculated from the radiology images taken within the first 24 hours after admission to the emergency service. Results Severe TBI, multiple trauma, intracranial hemorrhage from multiple sites, convulsions, high intracranial pressure, emergency operation on admission, and hypotension on admission were associated with low PedsQL values according to results of univariate analysis ( p < 0.05). There was a negative correlation between PedsQL and GOS, mechanical ventilation duration, PICU length of stay (LOS), and hospital LOS. In the linear regression model made by considering the univariate analysis results, it was shown that Rotterdam CT score and PICU LOS are independent variables that determine low PedsQL score. PedsQL scores were lower in children ≥ 8 years of age and in those evaluated within the first year after discharge ( p = 0.003). Conclusion In pediatric TBI, Rotterdam CT score and PICU LOS were found as independent variables determining PedsQL score after discharge.
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Affiliation(s)
- Nazan Ulgen Tekerek
- Division of Pediatric Intensive Care, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Oguz Dursun
- Division of Pediatric Intensive Care, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Selen Karalok
- Division of Pediatric Neurology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Alper Koker
- Division of Pediatric Intensive Care, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Ozgur Duman
- Division of Pediatric Neurology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Senay Haspolat
- Division of Pediatric Neurology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Arikan Y, Berker Karauzum S, Uysal H, Mihci E, Nur B, Duman O, Haspolat S, Altiok Clark O, Toylu A. Evaluation of exonic copy numbers of SMN1 and SMN2 genes in SMA. Gene X 2022; 823:146322. [PMID: 35219815 DOI: 10.1016/j.gene.2022.146322] [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: 10/06/2021] [Revised: 12/20/2021] [Accepted: 02/11/2022] [Indexed: 11/04/2022] Open
Abstract
SMA is a neuromuscular disease and occurs primarily through autosomal recessive inheritance. Identification of deletions in the SMN1 gene especially in the exon 7 and exon 8 regions (hot spot), are used in carrier testing. The exact copy numbers of those exons in the SMN1 and SMN2 genes in 113 patients who presented with a pre-diagnosis of SMA were determined using MLPA method. We aimed to reveal both the most common copy number profiles of different SMA types. It was found that the frequency of homozygous deletions in SMN1 was 15.9%, while heterozygous deletions was 16.9%. The most common SMN-MLPA profile was 0-0-3-3. In the cases with homozygous deletion, SMA type III diagnosis was observed most frequently (44%), and the rate of consanguineous marriage was found 33%. Two cases with the same exonic copy number profile but with different clinical subtypes were identified in a family. We also detected distinct exonic deletion and duplication MLPA profiles for the first time. We created "the SMA signature" that can be added to patient reports. Furthermore, our data are important for revealing potential local profiles of SMA and describing the disease in genetic reports in a way that is clear and comprehensive.
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Affiliation(s)
- Yunus Arikan
- Bozok University School of Medicine, Department of Medical Genetics, Yozgat, Turkey; Radboud University Medical Centre, Department of Human Genetics, Nijmegen, Netherland.
| | - Sibel Berker Karauzum
- Akdeniz University School of Medicine, Department of Medical Biology, Antalya, Turkey; Akdeniz University School of Medicine, Department of Medical Genetics, Antalya, Turkey.
| | - Hilmi Uysal
- Akdeniz University School of Medicine, Department of Neurology, Antalya, Turkey.
| | - Ercan Mihci
- Akdeniz University School of Medicine, Department of Medical Genetics, Antalya, Turkey; Akdeniz University School of Medicine, Department of Pediatry, Antalya, Turkey.
| | - Banu Nur
- Akdeniz University School of Medicine, Department of Medical Genetics, Antalya, Turkey; Akdeniz University School of Medicine, Department of Pediatry, Antalya, Turkey.
| | - Ozgur Duman
- Akdeniz University School of Medicine, Department of Neurology, Antalya, Turkey.
| | - Senay Haspolat
- Akdeniz University School of Medicine, Department of Pediatry, Antalya, Turkey.
| | - Ozden Altiok Clark
- Akdeniz University School of Medicine, Department of Medical Genetics, Antalya, Turkey.
| | - Asli Toylu
- Akdeniz University School of Medicine, Department of Medical Genetics, Antalya, Turkey.
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Arıcan P, Bozkurt O, Cavusoglu D, Gencpınar P, Haspolat S, Duman O, Olgac Dundar N. Various Neurological Symptoms with Vitamin B12 Deficiency and Posttreatment Evaluation. J Pediatr Neurosci 2021; 15:365-369. [PMID: 33936299 PMCID: PMC8078635 DOI: 10.4103/jpn.jpn_130_19] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 01/16/2020] [Accepted: 01/16/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Vitamin B12 deficiency occurs primarily as a result of insufficient dietary intake in children in developing countries. Vitamin B12 deficiency produces a cluster of neurological symptoms in children. Aim: The aim of this study was to describe the vitamin B12 status of patients who were admitted with neurological symptoms and to evaluate the clinical response to vitamin B12 treatment. Materials and Methods: This study was conducted on children who had vitamin B12 deficiency presented with neurological findings from January 2014 to October 2016. Patients with serum vitamin B12 levels lower than 300 pg/mL received intramuscular or oral vitamin B12 treatment. Results: Three hundred and fifty-one patients presenting with neurologic symptoms and who had low serum vitamin B12 deficiency were analyzed. Our study population was composed mainly of adolescent age. The most common symptom with respect to age was headache. In infant patients, most common symptoms were seizure and developmental delay. Conclusion: Early diagnosis and vitamin B12 treatment are advocated to avoid long-term injury. Our study shows that patients with serum vitamin B12 levels lower than 300 pg/mL showed clinical improvement of neurological symptoms after receiving vitamin B12 treatment.
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Affiliation(s)
- Pinar Arıcan
- Department of Pediatric Neurology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Oznur Bozkurt
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Dilek Cavusoglu
- Department of Pediatric Neurology, Izmir Katip Celebi University, Izmir, Turkey
| | - Pinar Gencpınar
- Department of Pediatric Neurology, Izmir Katip Celebi University, Izmir, Turkey
| | - Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Ozgur Duman
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Nihal Olgac Dundar
- Department of Pediatric Neurology, Izmir Katip Celebi University, Izmir, Turkey
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Kaya MA, Erin N, Bozkurt O, Erkek N, Duman O, Haspolat S. Changes of HMGB-1 and sTLR4 levels in cerebrospinal fluid of patients with febrile seizures. Epilepsy Res 2020; 169:106516. [PMID: 33276244 DOI: 10.1016/j.eplepsyres.2020.106516] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 10/01/2019] [Revised: 07/23/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Fever-induced inflammatory processes and pro-inflammatory cytokines have gained importance in recent years in the pathogenesis of febrile convulsion. Increased levels of HMGB1 (high mobility group box 1), one of the most important pro-inflammatory cytokines, are associated with prolongation of seizure duration, recurrence of seizures and the development of epilepsy. Changes in the sTLR4 level (soluble toll-like receptor 4) in the cerebrospinal fluid (CSF) are thought to be associated with memory and learning functions. In our study, we aimed to evaluate changes in HMGB1 and sTLR4 levels in patients who had febrile seizures between 6 months and 6 years. METHODS Forty patients who were admitted to Akdeniz University Medical Faculty Hospital between April 2016 and April 2018 with a complaint of febrile seizure and 45 patients whose CSF samples were taken for complaints other than febrile convulsion (control group) were included in our study. RESULTS Comparison of the CSF HMGB1 levels of the febrile convulsion group and control group revealed a statistically significant increase in patients with febrile convulsions (p: 0.001). Comparison of the subgroups revealed that the mean value of CSF HMGB1 level was highest in the complex FS group with a mean value of 3363.9 ± 835,47 pg/mL. Comparison of the patient and control groups revealed that the changes in CSF sTLR4 levels were not statistically significant. CONCLUSION HMGB1 level, a key inflammatory molecule, was significantly higher in the CSF of children with febrile seizures. Our data suggest that the HMGB1 network may contribute to the generation of febrile seizures in children.
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Affiliation(s)
- Mehmet Akif Kaya
- Department of Pediatrics of Medicine, Akdeniz University Hospital, Antalya, Turkey
| | - Nuray Erin
- Department of Medical Pharmacology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Oznur Bozkurt
- Department of Pediatric Neurology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Nilgun Erkek
- Department of Pediatric Emergency, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Ozgur Duman
- Department of Pediatric Neurology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Senay Haspolat
- Department of Pediatric Neurology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
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Saracoglu M, Kazan MS, Ozak A, Haspolat S. Bobble-Head Doll Syndrome in a Child with Suprasellar Arachnoid Cyst. Mov Disord Clin Pract 2018; 6:83-84. [PMID: 30746423 DOI: 10.1002/mdc3.12680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/29/2018] [Accepted: 08/25/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Mehmet Saracoglu
- Pediatric Neurology, Faculty of Medicine Akdeniz University Antalya Turkey
| | | | - Ahmet Ozak
- Neurosurgery, Faculty of Medicine Akdeniz University Antalya Turkey
| | - Senay Haspolat
- Pediatric Neurology, Faculty of Medicine Akdeniz University Antalya Turkey
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Gencpinar P, Celmeli G, Alaamel A, Kızılay G, Duman Ö, Haspolat S, Uysal H. P237 Axonal excitability findings in type 1 diabetes mellitus – Median nerve versus tibial nerve comparison. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.07.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gencpinar P, Kalay Z, Turgut S, Bozkurt Ö, Duman Ö, Ozel D, Haspolat S. Evaluation of Executive Functions in Patients With Childhood Absence Epilepsy. J Child Neurol 2016; 31:824-30. [PMID: 26738921 DOI: 10.1177/0883073815623632] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 08/06/2015] [Accepted: 10/26/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the executive function of patients with typical absence epilepsy. METHODS Thirty-eight (19 healthy children and 19 patients) individuals were enrolled in this study. Neurocognitive function tests, such as the Serial Digit Learning Test, Wisconsin Card Sorting Test, Visual Aural Digit Span Test-Form B, KAS-Animal Test, Trail Making Test-A Time Test, and STROOP Test, were given to all of the participants. RESULTS There was a significant difference between the groups on the Serial Digit Learning Test (P = .037) and on a subtest of the Wisconsin Card Sorting Test. As for the Wisconsin Card Sorting Test performance, there were significant differences in perseverative errors and perseverative responses between the patient and control groups (P = .011 and P = .010, respectively). CONCLUSION Long-term risk for learning impairments, failure in executive abilities, and short-term memory and attention disorders can occur in children with absence epilepsy.
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Affiliation(s)
- Pinar Gencpinar
- Department of Pediatric Neurology, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Zuhal Kalay
- Department of Pediatrics, Akdeniz University, Antalya, Turkey
| | - Sevil Turgut
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Öznur Bozkurt
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Özgür Duman
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Deniz Ozel
- Department of Biostatistics, Akdeniz University, Antalya, Turkey
| | - Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
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Dundar NO, Gencpinar P, Sallakci N, Duman O, Haspolat S, Anlar B, Yegin O. Interleukin-12 (-1188) A/C and interferon-γ (+874) A/T gene polymorphisms in subacute sclerosing panencephalitis patients. J Neurovirol 2016; 22:661-665. [DOI: 10.1007/s13365-016-0442-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 03/28/2016] [Accepted: 04/04/2016] [Indexed: 10/21/2022]
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Gencpinar P, Kocabas A, Duman Ö, Dündar NO, Haspolat S, Kardelen F. Cardiac Autonomic Dysfunction in Patients With Infantile Spasm and the Effect of Adrenocorticotropic Hormone Treatment. J Child Neurol 2016; 31:134-7. [PMID: 25953826 DOI: 10.1177/0883073815583998] [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: 05/31/2014] [Accepted: 04/01/2015] [Indexed: 11/16/2022]
Abstract
Infantile spasm is an age-dependent epileptic-encephalopathy syndrome. Cardiac autonomic function is frequently altered in epilepsy. In this study, we examined heart rate variability in patients with infantile spasm before and after treatment. Nineteen patients with infantile spasm and 13 healthy comparisons were enrolled in the study. Cardiac rhythm was recorded with a Holter device for 24 hours before adrenocorticotropic hormone (ACTH) (Synacthen depot) and B6 vitamin administration and 1 month after treatment. Heart rate variability analysis found lower heart rate variability parameters in patients with infantile spasm at the onset of the syndrome, prior to treatment with ACTH. The time domain parameters of heart rate variability values showed a statistically significant increase following ACTH treatment. Our data suggest that patients with infantile spasm exhibit lower heart rate variability parameters, and the treatment of spasms with ACTH and B6 together diminished the autonomic dysfunction in our cohort.
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Affiliation(s)
- Pinar Gencpinar
- Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey
| | - Abdullah Kocabas
- Department of Pediatric Cardiology, Ankara Children's Hematology and Oncology Research and Training Hospital, Ankara, Turkey
| | - Özgür Duman
- Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey
| | - Nihal Olgaç Dündar
- Department of Pediatric Neurology, Katip Çelebi University Hospital, İzmir, Turkey
| | - Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey
| | - Fırat Kardelen
- Department of Pediatric Cardiology, Akdeniz University Hospital, Antalya, Turkey
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Duman Ö, Sindel T, Mihci E, Senol U, Haspolat S. Moyamoya in an infant with Down syndrome. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1557238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Özgür Duman
- Department of Child Neurology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Timur Sindel
- Department of Radiology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Ercan Mihci
- Department of Pediatrics, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Utku Senol
- Department of Radiology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Senay Haspolat
- Department of Child Neurology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
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12
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Gencpinar P, Bozkurt O, Karaali K, Gemici A, Kazan S, Haspolat S. A rare coincidence of torticollis in Familial Mediterranean Fever: atlanto-axial rotatory subluxation. Clin Neurol Neurosurg 2014; 127:158-60. [PMID: 25459264 DOI: 10.1016/j.clineuro.2014.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 10/08/2014] [Accepted: 10/12/2014] [Indexed: 12/27/2022]
Affiliation(s)
- Pinar Gencpinar
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Oznur Bozkurt
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Kamil Karaali
- Department of Radiology, Akdeniz University, Antalya, Turkey
| | - Atilla Gemici
- Department of Pediatric Nephrology, Akdeniz University, Antalya, Turkey
| | - Saim Kazan
- Department of Neurosurgery, Akdeniz University, Antalya, Turkey
| | - Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey.
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Gencpinar P, Çetiner E, Akyuz M, Karaali K, Koken R, Haspolat S. A late-onset seizure in a child due to intracranial needle. Neurol Int 2014; 6:5662. [PMID: 25568741 PMCID: PMC4274411 DOI: 10.4081/ni.2014.5662] [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: 10/08/2014] [Accepted: 10/09/2014] [Indexed: 11/26/2022] Open
Abstract
Placing of sewing needles in the brain through the anterior fontanel is a rare entity. There are very few cases reported in literature. Most of them were asymptomatic, but some of them presented with seizure. We report here a 14-year-old boy, who was admitted to the Pediatric Neurology Department with a history of generalized tonic-clonic seizures due to sewing needle located in the frontal lobe.
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Affiliation(s)
- Pinar Gencpinar
- Departments of Pediatric Neurology Department, Akdeniz University , Afyon, Turkey
| | - Ebru Çetiner
- Departments of Pediatrics, Akdeniz University , Afyon, Turkey
| | - Mahmut Akyuz
- Departments of Neurosurgery, Akdeniz University , Afyon, Turkey
| | - Kamil Karaali
- Departments of Radiology, Akdeniz University , Afyon, Turkey
| | - Resit Koken
- Department of Pediatric Neurology, Kocatepe University , Afyon, Turkey
| | - Senay Haspolat
- Departments of Pediatric Neurology Department, Akdeniz University , Afyon, Turkey
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14
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Gencpinar P, Açıkbaş SC, Nur BG, Karaali K, Arslan M, Gurer EI, Duman O, Haspolat S. Epidural capillary hemangioma: A review of the literature. Clin Neurol Neurosurg 2014; 126:99-102. [PMID: 25233492 DOI: 10.1016/j.clineuro.2014.08.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 04/25/2014] [Revised: 08/15/2014] [Accepted: 08/23/2014] [Indexed: 11/29/2022]
Abstract
Hemangiomas in the spinal epidural area are very rare lesions, and most of these lesions are of the cavernous type. Only seven cases of capillary hemangiomas have been reported in the English literature, and all of these cases occurred in adulthood. Here, we report on a 17-month-old girl who presented with an inability to walk. MRI revealed an epidural mass, which was diagnosed as an epidural capillary hemangioma in the thoracic region. To our best knowledge, this case is the first epidural capillary hemangioma case to occur in childhood that has been reported.
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Affiliation(s)
- Pinar Gencpinar
- Department of Pediatric Neurology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Sabri Cem Açıkbaş
- Department of Neurosurgery, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Banu Güzel Nur
- Department of Pediatric Genetics, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Kamil Karaali
- Department of Radiology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Murat Arslan
- Department of Neurosurgery, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Elif Inanc Gurer
- Department of Pathology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Ozgur Duman
- Department of Pediatric Neurology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University Medical Faculty, Antalya, Turkey.
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Duman O, Koken R, Baran RT, Haspolat S, Topaloglu H. Infantile anti-MuSK positive myasthenia gravis in a patient with autoimmune polyendocrinopathy type 3. Eur J Paediatr Neurol 2014; 18:526-8. [PMID: 24685514 DOI: 10.1016/j.ejpn.2014.02.006] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 02/02/2014] [Accepted: 02/23/2014] [Indexed: 11/24/2022]
Abstract
Myasthenia gravis (MG) is an autoimmune disorder caused by autoantibodies and related to the muscle nicotinic acetylcholine receptor (AChR) or muscle-specific tyrosine kinase (MuSK). Myasthenia gravis with anti-MuSK antibodies rarely occurs in children. The present article reports a childhood onset case of auto-immune MG with anti-MuSK antibodies, part of autoimmune polyglandular syndrome.
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Affiliation(s)
- Ozgur Duman
- Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey.
| | - Resit Koken
- Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey
| | - R Taner Baran
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey
| | - Haluk Topaloglu
- Department of Pediatric Neurology, Hacettepe University Children's Hospital, Ankara, Turkey
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Dundar NO, Aktekin B, Ekinci NC, Sahinturk D, Yavuzer U, Yegin O, Haspolat S. Interleukin-1β secretion in hippocampal sclerosis patients with mesial temporal lobe epilepsy. Neurol Int 2013; 5:e17. [PMID: 24147214 PMCID: PMC3794452 DOI: 10.4081/ni.2013.e17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 01/09/2013] [Accepted: 04/08/2013] [Indexed: 11/23/2022] Open
Abstract
Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is a common medically intractable epilepsy syndrome. Although pathogenesis of HS still remains highly controversial, genetics may play a role as a predisposing factor. Previous evidence in a Japanese population revealed that the homozygotes for allele T at position -511 of the interleukin (IL)-1β gene promoter region (IL-1β-511 T/T) confers susceptibility to the development of HS. However, whether this polymorphism has an effect on IL-1β levels in MTLEHS patients was not demonstrated. This study aimed to analyze the distribution of this particular polymorphism in a group of Turkish HS patients and correlate the polymorphism with IL-1β secretion from the lymphocytes, thus revealing a functional role for IL-1β in the etiopathogenesis of HS. A single base pair polymorphism at position -511 in the promoter region of the IL-1β gene was analyzed. The spontaneous and 1 ng/mL lipopolysaccharidestimulated production of IL-1β by peripheral blood mononuclear cells after 4 and 24 h of incubation were measured by ELISA method. The heterozygous type (-511 C/T) was the most common genotype. There was no difference in frequency of allele -511 T between patients and controls. Analysis of IL-1β levels, genotype and allele distributions showed no significant difference among the groups (P>0.05). Nevertheless, it was seen that patients who carry a T allele at position -511 of the IL-1β gene had increased IL-1β levels. T-allele carriage may be important. Only IL-1β secretion from the lymphocytes has been assessed in this study. Considering the importance of IL-1β in the etiopathogenesis of HS, further studies are needed to evaluate locally produced IL-1β levels.
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Affiliation(s)
- Nihal Olgac Dundar
- Department of Pediatric Neurology, Izmir Katip Celebi University , Izmir
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Dundar NO, Aralasmak A, Gurer IE, Haspolat S. Subacute sclerosing panencephalitis case presenting with cortical blindness: early diagnosis with MRI and MR spectroscopy. Clin Neuroradiol 2013; 24:185-8. [PMID: 23652857 DOI: 10.1007/s00062-013-0218-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 04/03/2013] [Indexed: 11/28/2022]
Affiliation(s)
- N O Dundar
- Department of Pediatric Neurology, Izmir Katip Celebi University, 35620, Izmir, Turkey,
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Duman O, Uysal H, Skjei KL, Kizilay F, Karauzum S, Haspolat S. Sensorimotor polyneuropathy in patients with SMA type-1: Electroneuromyographic findings. Muscle Nerve 2013; 48:117-21. [DOI: 10.1002/mus.23722] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2012] [Indexed: 12/12/2022]
Affiliation(s)
- Ozgur Duman
- Akdeniz University Hospital; H Block; Department of Child Neurology; Antalya Turkey
| | - Hilmi Uysal
- Akdeniz University Hospital; Department of Neurology; Antalya Turkey
| | - Karen L. Skjei
- Children Hospital of Philadelphia; Department of Neurology; Philadelphia Pennsylvania USA
| | - Ferah Kizilay
- Akdeniz University Hospital; Department of Neurology; Antalya Turkey
| | - Sibel Karauzum
- Akdeniz University Hospital; Department of Medical Biology and Genetics; Antalya Turkey
| | - Senay Haspolat
- Akdeniz University Hospital; H Block; Department of Child Neurology; Antalya Turkey
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Nur BG, Sahinturk D, Coskun M, Duman O, Yavuzer U, Haspolat S. Single nucleotide polymorphism and production of IL-1β and IL-10 cytokines in febrile seizures. Neuropediatrics 2012; 43:194-200. [PMID: 22911481 DOI: 10.1055/s-0032-1323849] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [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: 10/28/2022]
Abstract
Inflammation and genetics may play a role in the pathogenesis of febrile seizures. The aim of this study was to investigate the spontaneous and lipopolysaccharide (LPS)-induced production of IL-1β and IL-10, and the association between IL-1β (-511) and IL-10 (-1082) single nucleotide polymorphisms with LPS-induced cytokine production. The study included 92 febrile seizure patients and 132 healthy controls. First, we isolated genomic DNA and by using PCR-RFLP we genotyped the individuals for the cytokines gene polymorphism. Second, peripheral mononuclear cells of the individuals were isolated and stimulated with LPS to measure secretion capacity of IL-1β and IL-10 using specific ELISA kits. We found that both the IL-1β and IL-10 production was increased in febrile seizures. The rapid increase of IL-1β production in the supernatants of the LPS-induced cells was significantly higher at the fourth and the twenty-fourth hours in febrile and complex febrile seizures, respectively. The distribution of IL-10 (-1082) G allele differs significantly between cases and controls. The IL-1β (-511) G/A and the IL-10 (-1082) G/A genotype combination was found to be higher in patients with febrile seizure. Our results showed that IL-1β and IL-10 production was not influenced by the single nucleotide polymorphisms in the pathogenesis of febrile seizures.
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Affiliation(s)
- B G Nur
- Division of Pediatric Genetics, Department of Pediatrics, Akdeniz University School of Medicine, Antalya, Turkey
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Nur BG, Kahramaner Z, Duman O, Dundar NO, Sallakcı N, Yavuzer U, Haspolat S. Interleukin-6 gene polymorphism in febrile seizures. Pediatr Neurol 2012; 46:36-8. [PMID: 22196489 DOI: 10.1016/j.pediatrneurol.2011.10.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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] [Received: 07/29/2011] [Accepted: 10/19/2011] [Indexed: 10/14/2022]
Abstract
Febrile seizures comprise a common type of pediatric convulsion. Inflammation and genetics may be involved in their pathogenesis. Regarding the role of cytokines (especially interleukin-6) in febrile responses, we performed a case control study of interleukin-6 gene (-174, -572, and -597) single-nucleotide polymorphisms to learn if correlations existed between these particular polymorphisms and febrile seizures. We isolated the genomic DNA of 92 children with febrile seizures and 98 healthy control subjects. We genotyped individuals for their polymorphisms, using polymerase chain reaction-restriction fragment length polymorphism. In our study, the frequencies of -174 G alleles and of the -174 and -572 GG genotypes were observed to be significantly higher in patients than in control subjects. The -174 GG genotype frequency was significantly higher in children with a family history of febrile seizures.
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Affiliation(s)
- Banu Guzel Nur
- Department of Pediatrics, Antalya Education and Research Hospital, Antalya, Turkey
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Akman-Karakaş A, Kandemir H, Senol U, Unal A, Duman O, Ciftcioglu MA, Haspolat S, Alpsoy E. Authors reply: New clues on the path of understanding unilateral naevoid telangiectasia. J Eur Acad Dermatol Venereol 2011; 27:258-9. [PMID: 22188514 DOI: 10.1111/j.1468-3083.2011.04408.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Duman O, Durmaz E, Akcurin S, Serteser M, Haspolat S. Spontaneous endogenous hypermelatoninemia: a new disease? Horm Res Paediatr 2011; 74:444-8. [PMID: 21041995 DOI: 10.1159/000315477] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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: 11/18/2009] [Accepted: 05/10/2010] [Indexed: 11/19/2022] Open
Abstract
Melatonin, a major photoperiod-dependent hormone, regulates circadian rhythms and biological rhythms and acts as a prominent sleep promoter. Symptoms related to hypermelatoninemia have been reported in individuals supplemented with melatonin. However, spontaneous endogenous hypermelatoninemia has not been reported previously. A 6-year-old girl previously diagnosed with Shapiro's syndrome was admitted to our hospital on several occasions during a 1-year period with complaints of altered consciousness, syncope, hypothermia and episodes of sweating. The episodes occurred daily and during sleep and lasted for 1-6 h. During these episodes, she sweated profusely and felt faint and her skin was pale and cool. Other complaints included recurrent abdominal pain, urge incontinence and myopia. She was shown to have hypermelatoninemia (>1,000 pg/ml, normal range 0-150 pg/ml) during these episodes. The duration of her attacks decreased with phototherapy and she was successfully treated with propranolol. To our knowledge, this is the first case of hypermelatoninemia without any detectable organic pathology. We did not determine the exact mechanism of hypermelatoninemia in this patient; however, it might have been related to irregular control of pinealocytes by the suprachiasmatic nucleus or related pathways. Hypermelatoninemia should be considered in patients with spontaneous periodic hypothermia and hyperhidrosis, and also in patients with Shapiro's syndrome.
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Affiliation(s)
- Ozgur Duman
- Department of Pediatric Neurology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Akman-Karakaş A, Kandemir H, Senol U, Unal A, Duman O, Ciftcioglu M, Haspolat S, Alpsoy E. Unilateral nevoid telangiectasia accompanied by neurological disorders. J Eur Acad Dermatol Venereol 2011; 25:1356-9. [DOI: 10.1111/j.1468-3083.2010.03967.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Duman O, Koken R, Haspolat S, Topaloglu H. P2.40 Infantile onset anti-MUSK positive myasthenia gravis: report of two cases. Neuromuscul Disord 2010. [DOI: 10.1016/j.nmd.2010.07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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25
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duman Ö, Kizilay F, Fettahoglu C, Ozkaynak S, Haspolat S. Electrophysiologic and Neuropsychologic Evaluation of Patients with Centrotemporal Spikes. Int J Neurosci 2009; 118:995-1008. [DOI: 10.1080/00207450701768929] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Oguz KK, Kurne A, Aksu AO, Karabulut E, Serdaroglu A, Teber S, Haspolat S, Senbil N, Kurul S, Anlar B. Assessment of citrullinated myelin by 1H-MR spectroscopy in early-onset multiple sclerosis. AJNR Am J Neuroradiol 2009; 30:716-21. [PMID: 19147724 DOI: 10.3174/ajnr.a1425] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Myelin instability and citrullinated myelin basic protein have been demonstrated in the brains of patients with chronic and fulminating forms of multiple sclerosis (MS). Our aim was to trace citrulline in the brains of patients with early-onset MS by using proton MR spectroscopy ((1)H-MR spectroscopy). MATERIALS AND METHODS A short-echo single-voxel (1)H-MR spectroscopy by using the point-resolved proton spectroscopy sequence was performed in 27 patients with MS and 23 healthy subjects. Voxels of interest were chronic demyelinating lesions (CDLs, n = 25) and normal-appearing white matter (NAWM, n = 25) on T2-weighted imaging, and when available in patients with MS, enhancing demyelinating lesions (EDLs, n = 8). Frontal white matter (WM) was studied in control subjects. N-acetylaspartate, choline, and myo-inositol (mIns)-creatine (Cr) ratios and the presence of a citrulline peak were noted. RESULTS Citrulline peaks were more frequently observed in patients with MS than in control subjects (P = .035), located in the NAWM in 8/25 (32%), in CDLs in 7/25 (28%), and in EDLs of 1/8 (12.5%) patients with MS. The presence of citrulline and measured metabolite/Cr ratios was not related to age at imaging, age at disease onset, duration of disease, or number of relapses. There was no significant metabolic difference between the NAWM of patients with MS and the WM of the control subjects. mIns/Cr was significantly greater in CDLs compared with the NAWM of patients with MS and the WM of healthy subjects. CONCLUSIONS Citrulline was more frequently identified in the brains of patients with early-onset MS than in healthy subjects by (1)H-MR spectroscopy, suggesting an association of increased citrullination of myelin proteins with demyelinating diseases.
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Affiliation(s)
- K K Oguz
- Department of Radiology, Hacettepe University, Ankara, Turkey.
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Dundar NO, Boz A, Duman O, Aydin F, Haspolat S. Spontaneous periodic hypothermia and hyperhidrosis. Pediatr Neurol 2008; 39:438-40. [PMID: 19027594 DOI: 10.1016/j.pediatrneurol.2008.08.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [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: 10/26/2007] [Revised: 07/14/2008] [Accepted: 08/13/2008] [Indexed: 11/16/2022]
Abstract
We present a patient diagnosed with Shapiro syndrome without corpus callosum agenesis. A 4-year-old-girl was admitted to the hospital with complaints of sweating, cooling, and drowsiness that continued during the last week of her admission. Attacks occurred almost daily, and lasted for about 1 hour. All laboratory findings, as well as Holter and echocardiography results, were normal. Cranial magnetic resonance imaging demonstrated an intact corpus callosum, and electroencephalography obtained during an attack revealed normal findings. However, technetium 99m-labeled hexamethylpropylene amine oxime brain single-photon emission computed tomography indicated increased perfusion in the right thalamus, basal ganglia, and inferior frontal areas during a hypothermic period. Although oxcarbazepine reduced the frequency of attacks, they were not halted completely. The patient responded better to carbamazepine.
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Affiliation(s)
- Nihal Olgac Dundar
- Department of Child Neurology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Abstract
Cerebrovascular disorders are increasingly recognized as important causes of mortality and morbidity in the pediatric population. Risk factors for stroke in childhood are different from those in adults. Human chorionic gonadotropin is a polypeptide hormone produced by the human placenta and is composed of an alpha-subunit and a beta-subunit. Pregnyl (human chorionic gonadotropin for injection) is a highly purified pyrogen-free preparation obtained from the urine of pregnant females. Ischemic cerebral infarction is seen in the young infertile male and female patients after gonadotropin treatment. The authors describe the case of a boy with right-sided hemiparesis following Pregnyl injection and discuss its possible pathogenetic mechanisms.
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Duman O, Ozdem S, Turkkahraman D, Olgac ND, Gungor F, Haspolat S. Bone metabolism markers and bone mineral density in children with neurofibromatosis type-1. Brain Dev 2008; 30:584-8. [PMID: 18362054 DOI: 10.1016/j.braindev.2008.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [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] [Received: 09/25/2007] [Revised: 02/05/2008] [Accepted: 02/11/2008] [Indexed: 11/17/2022]
Abstract
Some experimental studies suggested that there may be a bone formation defect rather than a disorder in bone resorption in patients NF1. The aim of this study was to determine bone mineral density (BMD) with dual-energy X-ray absorptiometry (DEXA) and investigate specific bone formation and bone resorption and bone turnover markers in children with NF1. Thirty-two children and adolescents (16 boys, 16 girls; 16 prepubertal, 16 pubertal) with NF1 were recruited. Their age ranged from 3 to 17 years. They were compared with matched healthy children. Dual-energy X-ray absorptiometry were applied to 26 patients and 27 controls. Nine of 32 subjects with NF1 had a skeletal abnormality. BMD of the lumbar spine, and femoral neck in NF1 patients significantly decreased compared to that of healthy subjects. They were also significantly decreased in pubertal patients when compared to pubertal controls and in prepubertal patients when compared to prepubertal controls. Patients with skeletal abnormalities were found to have significantly lower level of osteocalcin when compared to patients without skeletal abnormality. Other biochemical markers did not exhibit any difference between the groups. In conclusion, our findings suggest that bone formation markers rather than DEXA could be good predictors of skeletal abnormalities among NF1 patients. However, in our study the number of the NF1 patients with skeletal abnormality and the number of bone formation markers studied were all limited. It is appropriate to perform larger studies with other bone formation markers beside osteocalcin.
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Affiliation(s)
- Ozgur Duman
- Akdeniz University, Faculty of Medicine, Department of Child Neurology, 07070 Antalya, Turkey.
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Ozkaynak S, Kizilay F, Duman O, Gungor HA, Haspolat S. P050 Cortical silent period and cortical motor threshold in patients with benign rolandic epilepsy. Clin Neurophysiol 2008. [DOI: 10.1016/s1388-2457(08)60321-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Duman O, Aralaflmak A, Duranoglu Y, Karaali K, Haspolat S. 'Torticollis secondary to monocular viewing in an infant with unilateral hypoplasia of the internal carotid artery'. Dev Med Child Neurol 2007; 49:876-7. [PMID: 18018330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Abstract
Hypokalemic periodic paralysis can occur secondarily to excessive potassium loss. Thyrotoxicosis, diuretic ingestions, hyperaldosteronism, barium poisoning, Gitelman syndrome, and Bartter syndrome are among the disorders causing secondary hypokalemic periodic paralysis. Clinical presentation of Bartter syndrome with hypokalemic periodic paralysis is rare. A 12-year-old boy was admitted to our hospital because of transient paralysis. He had been suffering from transient weakness attacks for 2 years and had had a total of 10 attacks, lasting 1 to 3 days. He had growth retardation, polyuria, and polydipsia. Laboratory examinations revealed hypokalemic alkalosis, normomagnesemia, hypercalciuria, and hyperaldosteronism. The clinical and laboratory findings were in accordance with Bartter syndrome. He has been followed up for 6 months and has suffered no further paralytic attacks under indomethacin therapy. This case highlights the importance of blood pH measurement in patients with hypokalemic periodic paralysis; it might prevent misdiagnosis and mismanagement in such diseases.
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Affiliation(s)
- Ozgür Duman
- Department of Pediatric Neurology, School of Medicine, Akdeniz University, Antalya, Turkey
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Ozkan O, Duman O, Haspolat S, Ozgentaş HE, Dikici MB, Gürer I, Güngör HA, Güzide Gökhan A. Effect of Systemic Creatine Monohydrate Supplementation on Denervated Muscle During Reinnervation: Experimental Study in the Rat. J Reconstr Microsurg 2005; 21:573-9. [PMID: 16292735 DOI: 10.1055/s-2005-922438] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this experimental study was to evaluate possible upgrading effects of systemic creatine monohydrate administration on the reinnervation of denervated muscle. At the same time, the protective effect of the agent on denervated muscle until ultimate reinnervation after nerve repair was quantified. The functional outcome of muscle reinnervation after creatine monohydrate application was compared with a control group. Forty adult Wistar rats weighing 180 to 220 g were used. The right sciatic nerve was dissected, exposed, and cut at the level of the midthigh in all rats. The experimental design consisted of two groups: experimental (animals were fed creatine monohydrate) and control (gavage feeding was provided by saline). Both groups were divided into two subgroups: subgroups A and B for the experimental group, and subgroups C and D for the control group. In subgroups A and C, the nerves were repaired with four 10-0 epineurial stitches. In subgroups B and D, both the proximal and distal ends of the nerves were ligated and no neural anastomosis was performed. In the experimental groups (subgroups A and B), the rats were fed by daily supplementation of oral creatine monohydrate, 300 mg/kg body weight. In the controls (subgroups C and D), oral supplementation was provided by saline. Functional recovery was evaluated using walking track analysis, pinching test, and limb circumference and toe contracture measurements at the end of 6 months, after which the rats were sacrificed and nerve specimens from both ends of the repair sites and the whole gastrocnemius muscle were obtained to document the results of the histomorphometric and histochemical studies, including light microscopic examinations and muscle weight measurements. The mean functional recovery values in subgroups A, B, C, and D were 91 percent, 80 percent, 87 percent, and 59 percent, respectively. Functional recovery improved significantly in the experimental groups (in both the surgically repaired and unrepaired subgroups), compared with the control groups (p<0.05). The pinching test revealed a statistically significant difference in nerve conduction between the experimental and control groups (p<0.05). The limb circumference ratio of the surgically treated side to the untouched side in subgroups A, B, C, and D were noted as 0.95, 0.89, 0.91, and 0.87, respectively, and the difference between the experimental and the control groups was statistically significant (p<0.05). The differences between subgroups A and B, C and D, A and C, and B and D were also significant. The surgically repaired and creatine-supplemented subgroups demonstrated the best results in toe contracture index. The muscle weight measurement results were concordant with the results of the limb circumference ratio. In both surgically repaired subgroups (subgroups A and C), there were qualitatively significant amounts of myelinated fibers in the nerve distal to the anastomotic site; there were no myelinated fibers in the distal stumps of subgroups B and D. Histochemical analyses of the contents of the muscle fiber types also revealed no significant difference. Overall, the results showed the useful effect of oral creatine supplementation on both surgically repaired and unrepaired nerve injuries. The best results were obtained from surgically repaired nerve injuries and also from the systemic creatine-supplemented subgroups. This study confirms that systemic administration of creatine monohydrate has a protective and upgrading effect on the functional properties of denervated muscle, especially in surgically reinnervated subjects.
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Affiliation(s)
- Omer Ozkan
- Department of Plastic and Reconstructive Surgery, Akdeniz University School of Medicine, Antalya, Turkey
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Abstract
Febrile seizures are the most common form of childhood seizures. The exact mechanism promoting convulsions during a common febrile illness remains unknown, but it is accepted that genetic influences are likely to account for at least some of the cases. Previous studies reported high interleukin-1beta levels in the cerebrospinal fluid of patients with febrile seizures. Recently, an association between a regulatory polymorphism in the genes encoding interleukin-1beta and interleukin-1Ra and febrile seizures was reported. In this study, we attempted to confirm these findings. We analyzed the cytokine gene polymorphisms of interleukin-1beta, interleukin-1alpha, and interleukin-1Ra of 73 children with febrile seizure and 152 healthy controls. The distribution of interleukin-1beta -511, interleukin-1alpha -889, and interleukin-1Ra genotypes and alleles did not differ significantly between cases and controls. Our data suggest that the studied gene polymorphisms of interleukin-1beta, interleukin-1alpha, and interleukin-1Ra do not have a significant role in the pathogenesis of febrile seizures.
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Affiliation(s)
- Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University Medical School, Antalya, Turkey.
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35
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Duman O, Haspolat S. Hormonal regulation of adipocytes and its probable effects on resting energy expenditure in muscular dystrophy. Neuromuscul Disord 2005; 15:515-6; author reply 516. [PMID: 15935666 DOI: 10.1016/j.nmd.2005.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2005] [Revised: 04/18/2005] [Accepted: 04/18/2005] [Indexed: 11/18/2022]
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Bilgen T, Keser I, Mihci E, Haspolat S, Tacoy S, Luleci G. Molecular analysis of fragile X syndrome in Antalya Province. Indian J Med Sci 2005; 59:150-5. [PMID: 15876779] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Detection of the (CGG)n repeats in the FMR1 gene that cause the fragile X syndrome (FXS), has become a milestone for phenotype-genotype correlation in FXS. AIMS To screen the FMR1 gene CGG repeats in index cases with FXS and their family members in the Antalya Province. SETTING AND DESIGN This study was prospectively conducted between January 2000 and March 2005 in Department of Medical Biology and Genetics, Faculty of Medicine, Akdeniz University, Antalya. MATERIALS AND METHODS A series of 132 cases from three hospitals in Antalya Province were studied. All cases were molecularly screened using non-radioactive Expand Long PCR method that was confirmed by Southern blotting. RESULTS Seventeen out of 132 cases were found to have a full mutation, including three that were mosaic for premutations/full mutations. Of the 132 cases, eight were found to have the premutation size of the CGG repeats. The remaining 107 cases were identified as normal. CONCLUSIONS Due to premature ovarian failure and Fragile X premutation Tremor/Ataxia Syndrome related with the premutation, the detection of the premutation will provide valuable information both for clinical follow-up and genetic counseling. In conclusion, our data suggest that expansion of CGG repeats in the FMR1 gene can be analyzed by Expand Long PCR, an efficient and non-radioactive method that can be used to monitor the expansion of premutation to full mutation, which would eventually lead to reduce the FXS prevalence.
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Affiliation(s)
- T Bilgen
- Department of Medical Genetics, School of Medicine, Akdeniz University, Antalya, Turkey
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Haspolat S, Duman O, Senol U, Yegin O. Extrapontine myelinolysis in infancy: report of a case. J Child Neurol 2004; 19:913-5. [PMID: 15658799] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Osmotic myelinolysis is a rare, acute, demyelinating process that involves the pons (central pontine myelinolysis) and other locations of the central nervous system (extrapontine myelinolysis). Central pontine myelinolysis is described in children, usually associated with rapid correction of hyponatremia. Other conditions, such as hypernatremia and hyperglycemia, have also been reported as being responsible for pontine myelinolysis. Extrapontine myelinolysis in childhood is very rare and presents in a wide variety of locations. We report a patient who developed extrapontine myelinolysis in the cerebellum during treatment of hyponatremic dehydration. This is the first case reported during infancy.
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Affiliation(s)
- Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University, Medical School, Antalya, Turkey.
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Duman O, Balta G, Metinsoy M, Haspolat S. Unusual manifestation of subacute sclerosing panencephalitis: case with intracranial high-pressure symptoms. J Child Neurol 2004; 19:552-5. [PMID: 15526963] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Subacute sclerosing panencephalitis can show variations in clinical course, and some ophthalmologic abnormalities can be seen as cortical blindness and optic atrophy. A 4-year-old girl was referred to our hospital with a complaint of diplopia, vomiting, and ataxia. On physical examination, she was found to have stage IV papilledema with retinal hemorrhage. She was diagnosed as having idiopathic intracranial high pressure until magnetic resonance imaging demonstrated T2-weighted hyperintense lesions. After observation of head drop attacks and detection of elevated antimeasles antibodies in cerebrospinal fluid, the diagnosis of subacute sclerosing panencephalitis was established, and isoprinosine and carbamazepine were started for treatment. However, because carbamazepine failed to control the head drop attacks, topiramate was also included, and the attacks were kept under control with topiramate. The case presented in this article is a good example of subacute sclerosing panencephalitis in which, at early stages, some of the signs and symptoms can lead to an erroneous diagnosis. In addition, we have demonstrated that topiramate might be a good choice for treatment for the persistent myoclonus seen in this type of patient.
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Affiliation(s)
- Ozgur Duman
- Department of Pediatric Neurology, Akdeniz University Medical School, Antalya, Turkey.
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Anlar B, Basaran C, Kose G, Guven A, Haspolat S, Yakut A, Serdaroglu A, Senbil N, Tan H, Karaagaoglu E, Karli Oguz K. Acute disseminated encephalomyelitis in children: outcome and prognosis. Neuropediatrics 2003; 34:194-9. [PMID: 12973660 DOI: 10.1055/s-2003-42208] [Citation(s) in RCA: 128] [Impact Index Per Article: 6.1] [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] [Indexed: 10/27/2022]
Abstract
BACKGROUND Acute disseminated encephalomyelitis (ADEM) is the most common demyelinating disorder of childhood. Its clinical features, prognosis and treatment vary in different reports. OBJECTIVES To examine a series of children with ADEM for clinical findings, course, recurrences, and possible variables affecting outcome. METHODS Multicentric data collected from 7 tertiary referral centers were registered and evaluated in a central database in 1990 - 2001 for clinical, laboratory, and MRI features. Course and prognosis were assessed in patients with at least 12 months' follow-up. RESULTS Forty-six patients were evaluated. Median age at onset was 8 years, M/F ratio, 1.7/1. Most common symptoms and signs pertained to the motor system and consciousness. Of 39 children with 12 months' follow-up, 71 % recovered completely. Thirteen (33 %) children had relapses. Patients who had more than one relapse (n = 4) presented with new symptoms at each attack. Treatment with high-dose methylprednisolone was associated with complete recovery, and tapering over more than 3 weeks, with a lower rate of relapses. MRI lesions could persist even in asymptomatic patients; in particular, periventricular lesions tended to disappear later than others. CONCLUSIONS Complete clinical recovery is common and serious complications are rare in childhood ADEM, but the rate of relapses is considerable. Clinical picture at first relapse may help to identify patients likely to experience multiple relapses. The timing and duration of steroid treatment affects outcome.
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Affiliation(s)
- B Anlar
- Hacettepe University Department of Pediatric Neurology, Ankara, Turkey.
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Abstract
Proinflammatory cytokines (such as interleukin-1beta, tumor necrosis factor-alpha) and nitric oxide are known to have both direct and indirect modulating effects on neurons and neurotoxic neurotransmitters released during excitation or inflammation. We measured interleukin-1beta, tumor necrosis factor-alpha, and nitrite levels in the peripheral blood and cerebrospinal fluid of children with febrile seizures and compared our results with those of children with febrile illnesses without seizures. Twenty-nine children with febrile seizure and 15 controls were studied. The mean concentrations of interleukin-1beta and nitrite were significantly increased in the cerebrospinal fluid (P < .01) of the children with febrile seizure. There were no significant changes in serum interleukin-1beta, tumor necrosis factor-alpha, nitrite, and cerebrospinal fluid tumor necrosis factor-alpha levels. Our data support the hypothesis that increased production of interleukin-1beta in the central nervous system or increased diffusion of interleukin-1beta through the blood-brain barrier is involved in the pathogenesis of febrile seizures.
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Affiliation(s)
- Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University Medical School, Antalya, Turkey.
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Mihçi E, Taçoy S, Haspolat S, Karaali K. Central nervous system abnormalities in Kabuki (Niikawa-Kuroki) syndrome. Am J Med Genet 2002; 111:448-9. [PMID: 12210310 DOI: 10.1002/ajmg.10573] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
BACKGROUND Subacute sclerosing panencephalitis (SSPE) is a chronic central nervous (CNS) system infection caused by measles virus. Because changing immunization practices affect the epidemiology of measles and consequently SSPE, we examined the epidemiological data of our SSPE registry. MATERIALS AND METHODS Age of onset, age at onset of measles, duration of Latent period and immunization status were examined in cases recorded at the SSPE Registry Center in Turkey between 1975 and 1999. RESULTS Age of onset diminished from 13 years before 1994 to 7.6 years after 1995; age at onset of measles declined from 29 months to 20 months and the Latent interval from 9.9 years to 5.9 years. Age at onset of measles and immunization status did not directly affect the duration of the Latent period. CONCLUSION Although its incidence has decreased in Turkey, SSPE has been seen at younger ages in recent years. This change cannot be attributed solely to younger age at onset of measles. Factors affecting the duration of the Latent period should be investigated further.
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Affiliation(s)
- B Anlar
- Hacettepe University Dept. of Pediatric Neurology, Ankara, Turkey.
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Haspolat S, Anlar B, Köse G, Coskun M, Yegin O. Interleukin-1beta, interleukin-1 receptor antagonist levels in patients with subacute sclerosing panencephalitis and the effects of different treatment protocols. J Child Neurol 2001; 16:417-20. [PMID: 11417607 DOI: 10.1177/088307380101600606] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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] [Indexed: 11/16/2022]
Abstract
Subacute sclerosing panencephalitis is a rare progressive inflammatory disease of the central nervous system caused by a persistent aberrant measles virus infection. Cytokines are polypeptides that regulate immune responses and inflammatory reactions. Interleukin-1beta has been implicated as a central mediator of tissue damage and destruction in a number of central nervous system diseases. Interleukin-1 receptor antagonist could function as an important anti-inflammatory cytokine. We studied interleukin-1beta and interleukin-1 receptor antagonist levels in the cerebrospinal fluids of patients with subacute sclerosing panencephalitis and evaluated the effects of different treatment protocols on these cytokines. Interleukin-1beta and interleukin-1 receptor antagonist levels were measured in 15 patients who had a recent diagnosis of subacute sclerosing panencephalitis (group 1), 6 patients who had been treated with isoprinosine (group 2), 5 patients with intraventricular interferon-alpha (group 3), and 6 patients with interferon-beta (group 4). The results were compared within the groups and also with the results of 10 patients with other neurologic disease (group 5). The interleukin-1beta concentrations in cerebrospinal fluid and sera were all below the detection limits (3.9 pg/mL). Interleukin-1 receptor antagonist levels were not statistically different, except for the group treated with intraventricular interferon-alpha. Interleukin-1 receptor antagonist levels were 170 +/- 52, 175 +/- 58, 1605 +/- 518, 77.5 +/- 24, and 108 +/- 18 pg/mL in groups 1 to 5, respectively. Interleukin-1 receptor antagonist levels and cerebrospinal fluid serum ratios were significantly increased during interferon-alpha treatment. In conclusion, interleukin-1 and interleukin-1 receptor antagonist levels were not elevated in the patients with subacute sclerosing panencephalitis. The only treatment protocol that affects interleukin-1 receptor antagonist levels in cerebrospinal fluid was intraventricular interferon-alpha. Further studies on higher numbers of patients may better document the immunologic status of patients with subacute sclerosing panencephalitis and the effects of different treatment modes.
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Affiliation(s)
- S Haspolat
- Department of Pediatric Neurology, Akdeniz University Medical School, Antalya, Turkey.
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Abstract
The most common pattern in subacute sclerosing panencephalitis, is in the cerebral hemisphere white matter on T2-weighted images with or without atrophy. Brain-stem lesions are rare. We report brain-stem involvement in two children with subacute sclerosing panencephalitis. A peculiar pattern, with involvement of the pons with extension to both middle cerebellar peduncles and substantia nigra but sparing the pontine tegmentum, is suggested.
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Affiliation(s)
- U Senol
- Akdeniz University, Faculty of Medicine, Department of Radiodiagnostics, 07070 Antalya/Turkey.
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Affiliation(s)
- U Senol
- Department of Radiology, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey
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