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Öğe Acetazolamide in vestibular migraine prophylaxis: a retrospective study(Springer, 2016) Celebisoy, Nese; Gokcay, Figen; Karahan, Ceyda; Bilgen, Cem; Kirazli, Tayfun; Karapolat, Hale; Kose, TimurThe aim of this study is to check the efficacy of acetazolamide in the prophylaxis of vestibular migraine (VM). Treatment options in VM are mainly based on migraine guidelines. We tried to assess the efficacy of acetazolamide in these patients depending on clinical similarities with episodic ataxia type 2 and familial hemiplegic migraine responding to the drug. This is a retrospective cohort study. Among 50 patients with VM and prescribed acetazolamide 500 mg/day, 39 patients were studied as five had been lost on follow-up and six had stopped taking the drug due to side effects. Vertigo and headache frequency determined by number of attacks per month, and the severity determined by visual analog scales measured in centimeters from 0 to 10 were collected from the records. Initial reported figures for frequency and severity were compared with the results gathered after 3 months of treatment. The results were compared. Acetazolamide was effective in reducing both the frequency and severity of vertigo and headache attacks and this effect was more prominent for vertigo frequency and severity.Öğe Acute effect of caffeine on pattern-reversal visual evoked potential: a randomized-controlled study(Taylor & Francis Ltd, 2019) Karti, Dilek Top; Karti, Omer; Gokcay, Figen; Celebisoy, NesePurpose: This study was aimed to investigate the acute effect of caffeine intake on pattern-reversal (PR) visual evoked potential (VEP). Methods: This randomized controlled study included 40 participants who were divided into two groups randomly (group 1 [study group, n = 20] and group 2 [control group, n = 20]). While the study group received coffee beverages made from 6 g pure coffee beans (36 mg of caffeine per gram) containing approximately 216 mg caffeine, the control group was given beverages containing 200 mg lactose without caffeine. PR-VEP test was performed at baseline and 1 h after the beverage intake. The right eyes of both groups were used for the statistical analysis. Results: The median age of group 1 (8 male and 12 female) and group 2 (7 male and 13 female) were 31.0 (range, 21-59) and 36.5 (range, 20-59) years, respectively. No statistically significant difference was found between two groups in terms of age (p = 0.398) and gender (p = 0.744). Before the caffeine intake, median P100 latency and amplitudes were 109.90 ms (range: 99.60-120.60) and 12.45 mu V (range: 5.20-19.30), respectively. One hour after caffeine intake, corresponding values were 110.70 ms (range: 99.00-114.60) and 12.45 mu V (range: 5.70-20.0). Baseline P100 latency and amplitude values were not significantly different from the values recorded 1 h after caffeine intake (p > 0.05). Conclusions: This study showed that ingesting moderate amounts of caffeine did not affect PR-VEP parameters. Therefore, caffeine restriction does not seem to be required before the PR-VEP test. Further studies are needed to confirm our findings.Öğe Acute vestibular syndrome: clinical head impulse test versus video head impulse test(Springer Heidelberg, 2018) Celebisoy, NeseHINTS battery involving head impulse test (HIT), nystagmus, and test of skew is the critical bedside examination to differentiate acute unilateral peripheral vestibulopathy from posterior circulation stroke (PCS) in acute vestibular syndrome (AVS). The highest sensitivity component of the battery has been reported to be the horizontal HIT, whereas skew deviation is defined as the most specific but non-sensitive sign for PCS. Video-oculography-based HIT (vHIT) may have an additional power in making the differentiation. If vHIT is undertaken, then both gain and gain asymmetry should be taken into account as anterior inferior cerebellar artery (AICA) strokes are at risk of being misclassified based on VOR gain alone. Further refinement in video technology, increased operator proficiency and incorporation with saccade analysis will increase the sensitivity of vHIT for PCS diagnosis. For the time being, clinical examination seems adequate in frontline diagnostic evaluation of AVS.Öğe Antibodies to DNA repair proteins in headache with neurological deficits and cerebrospinal fluid lymphocytosis (HaNDL) patients(Springer Heidelberg, 2015) Erdag, Ece; Celebisoy, Nese; Yuceyar, Ayse Nur; Kurtuncu, Murat; Vural, Burcak; Tuzun, ErdemAutoimmune mechanisms have been implicated in the pathogenesis of headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL). Pooled sera of five HaNDL patients and 30 controls (10 multiple sclerosis patients, 10 migraine patients, 10 healthy controls) were screened by protein macroarray. All sera were also individually subjected to immunoprecipitation with neuroblastoma cells and the bound antigens were identified by mass spectrometry. Antibodies to three DNA repair proteins (mitogen-activated protein kinase-4, DNA-dependent protein kinase catalytic subunit, DNA excision repair protein ERCC-6) were identified by both macroarray and immunoprecipitation methods in 3/5 HaNDL sera, but in none of the controls. The presence of DNA repair protein antibodies indicates DNA damage and provides further support for the inflammatory etiology of HaNDL.Öğe Antibodies to DNA repair proteins in headache with neurological deficits and cerebrospinal fluid lymphocytosis (HaNDL) patients(Springer Heidelberg, 2015) Erdag, Ece; Celebisoy, Nese; Yuceyar, Ayse Nur; Kurtuncu, Murat; Vural, Burcak; Tuzun, ErdemAutoimmune mechanisms have been implicated in the pathogenesis of headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL). Pooled sera of five HaNDL patients and 30 controls (10 multiple sclerosis patients, 10 migraine patients, 10 healthy controls) were screened by protein macroarray. All sera were also individually subjected to immunoprecipitation with neuroblastoma cells and the bound antigens were identified by mass spectrometry. Antibodies to three DNA repair proteins (mitogen-activated protein kinase-4, DNA-dependent protein kinase catalytic subunit, DNA excision repair protein ERCC-6) were identified by both macroarray and immunoprecipitation methods in 3/5 HaNDL sera, but in none of the controls. The presence of DNA repair protein antibodies indicates DNA damage and provides further support for the inflammatory etiology of HaNDL.Öğe Antibodies to DNA repair proteins in headache with neurological deficits and cerebrospinal fluid lymphocytosis (HaNDL) patients(Springer Heidelberg, 2015) Erdag, Ece; Celebisoy, Nese; Yuceyar, Ayse Nur; Kurtuncu, Murat; Vural, Burcak; Tuzun, ErdemAutoimmune mechanisms have been implicated in the pathogenesis of headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL). Pooled sera of five HaNDL patients and 30 controls (10 multiple sclerosis patients, 10 migraine patients, 10 healthy controls) were screened by protein macroarray. All sera were also individually subjected to immunoprecipitation with neuroblastoma cells and the bound antigens were identified by mass spectrometry. Antibodies to three DNA repair proteins (mitogen-activated protein kinase-4, DNA-dependent protein kinase catalytic subunit, DNA excision repair protein ERCC-6) were identified by both macroarray and immunoprecipitation methods in 3/5 HaNDL sera, but in none of the controls. The presence of DNA repair protein antibodies indicates DNA damage and provides further support for the inflammatory etiology of HaNDL.Öğe Balance in posterior and horizontal canal type benign paroxysmal positional vertigo before and after canalith repositioning maneuvers(Elsevier Ireland Ltd, 2009) Celebisoy, Nese; Bayam, Ece; Gulec, Feray; Kose, Timur; Akyurekli, OenderBenign paroxysmal positional vertigo (BPPV) is characterized by acute, brief and rotatory vertigo attacks provoked by changes in head position. Most patients complain of a loss of equilibrium and unstable gait during and between the vertigo attacks. Canalith repositioning maneuvers (CRM) relieve attacks and improve Postural stability. In this study balance ability of 32 patients with PC BPPV and 12 patients with HC BPPV before and after treatment with CRM was investigated. 50 healthy volunteers served as the control group. Static balance was measured as mean center of gravity sway velocity recorded in four different conditions: on a static platform and on foam with eyes open and closed. Dynamic balance was measured in tandem walk test. PC BPPV patients demonstrated greater sway velocity in stance on foam with eyes closed. After CRM the velocity decreased significantly. The results of the HC BPPV patients were not different from the healthy volunteers all through the four test conditions. Walking speed of the patients both with PC BPPV and HC BPPV was significantly low. It increased after treatment in both groups. In conclusion, patients with PC BPPV had impaired static balance ability due to a clot in the affected canal. Dynamic balance ability measured by walking speed was impaired both in PC and HC BPPV patients. Static and dynamic deficits improved significantly after CRM. (C) 2008 Elsevier B.V. All rights reserved.Öğe Balance in Transition: Unraveling the Link Between Menopause and Vertigo(Springernature, 2024) Castillo-Bustamante, Melissa; Celebisoy, Nese; Echavarria, Luis G.; Franco, Isabela; Valencia, Santiago; Gonzalez, Sara; Garcia, AlejandroThe onset of menopause, marked by hormonal fluctuations and a decline in estrogen levels, is suggested to be linked to increased susceptibility to vestibular disturbances. Estrogen, beyond its established association with reproductive physiology, plays modulatory roles in various physiological systems, including neurosensory function. The vestibular system, crucial for balance and spatial orientation, is influenced by hormonal changes during menopause, potentially contributing to the emergence of vertigo symptoms. This interplay between hormones and the vestibular system is a burgeoning area of research with clinical implications, offering insights into novel diagnostic and therapeutic approaches for managing postmenopausal women with vestibular disorders. The article reviews current scientific literature, delves into the hormonal intricacies of menopause, and investigates potential mechanisms underlying the connection between hormonal fluctuations and vertigo symptoms.Öğe Baseline demographics, clinical features, and treatment protocols of 240 patients with optic neuropathy: experiences from a neuro-ophthalmological clinic in the Aegean region of Turkey(Springer, 2019) Karti, Omer; Karti, Dilek Top; Kilic, Ilay Hilal; Gokcay, Figen; Celebisoy, NesePurposeTo analyze the demographic patterns, clinical characteristics, and treatment protocols of optic neuropathies.Materials and methodsThe hospital data of patients with optic neuropathy admitted to the Department of Neuro-ophthalmology in a tertiary referral center in Turkey between January 2010 to January 2017 were retrospectively analyzed. Demographic patterns, clinical features, treatment protocols, and the natural disease courses were assessed.ResultsThe total number of patients with optic neuropathy seen over this period was 240, which consist of 43 with idiopathic optic neuritis (17.9%), 40 with multiple sclerosis-related optic neuritis (16.7%), 12 with chronic relapsing inflammatory optic neuritis (5.0%), 12 with atypical optic neuritis (5.0%), 11 with neuromyelitis optica spectrum disorders-related optic neuritis (4.6%), 90 with non-arteritic ischemic optic neuropathy (37.5%), 4 with arteritic ischemic optic neuropathy (1.7%), 10 with traumatic optic neuropathy (4.1%), 6 with compressive optic neuropathy (2.5%), and 12 with mitochondrial optic neuropathy [9 with toxic optic neuropathy (3.7%) and 3 with Leber's hereditary optic neuropathy (1.2%)]. There were 101 males (42%) and 139 females (58%). The mean age was 43.3415.86years.Conclusion This study reported the demographics, clinical characteristics, and treatment protocols of optic neuropathies in a neuro-ophthalmology specialty clinic at a tertiary referral center in Turkey during the past decade. The data may be useful in assessing the global status of optic neuropathies.Öğe Behcet's disease-associated aneurysm of the internal carotid artery within the cavernous sinus: Report of a patient(Taylor & Francis Inc, 2007) Goekcay, Figen; Celebisoy, Nese; Oran, Ismail; Aksu, KenanBehcet's disease ( BD) is a type of vasculitis with a chronic relapsing course that affects arteries and veins of all sizes. Intracranial aneurysms are rare manifestations. We report a patient with the diagnosis of BD, who had a fusiform aneurysm of the internal carotid artery at the level of the sinus cavernosus. He presented with sinus cavernosus syndrome findings. The aneurysm was treated endovascularly.Öğe Bilateral Congenital Prepapillary Retinal Arterial Loop(Taylor & Francis As, 2020) Karti, Omer; Karti, Dilek Top; Ayhan, Ziya; Celebisoy, Nese; Saatci, Ali OsmanPrepapillary vascular loops are rare congenital vascular abnormalities of the retinal vasculature. This mostly benign condition can sometimes cause complications such as branch retinal artery occlusion and vitreous haemorrhage. Disc collaterals, neovascularisation of the optic disc, idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) syndrome and Wyburn Mason syndrome should be kept in mind for the vascular differential diagnosis. in addition, when the loops present bilaterally and settle into the region adjacent to the optic disc border, they can be misdiagnosed as papilloedema. the diagnosis is usually made clinically by careful fundus examination. Optical coherence tomography and fundus fluorescein angiography might serve as ancillary tools for the diagnosis. in this report, we present a 52-year-old male with bilateral prepapillary arterial loops referred to our clinic with a preliminary diagnosis of papilloedema.Öğe Bilateral Optic Neuropathy Revealing Chronic Hepatitis B Infection: A Report of A Rare Case(Taylor & Francis As, 2020) Korkmaz, Anil; Karti, Dilek Top; Bilgin, Yaprak Ozum Unsal; Karti, Omer; Celebisoy, NeseHepatitis B virus (HBV) infection is a major public health problem. Liver diseases such as cirrhosis and hepatocellular carcinoma are the main causes of mortality and morbidity associated with this viral infection. Ocular manifestations may also arise during the course of HBV infection. We herein present a 44-year-old male with bilateral optic neuropathy revealing chronic HBV infection.Öğe c, Ceyla Atac d, e, Nes , e C,elebisoy e(Elsevier, 2021) Ak, Aysin Kisabay; Cinar, Celal; Dogan, Gozde Nur; Atac, Ceyla; Gokcay, Figen; Celebisoy, NesePatients with indirect carotid cavernous fistulas (CCF) were reviewed to emphasize the importance of diagnosing patients even with trivial findings and to raise awareness. Eighteen patients diagnosed as CCF were included. Neuro-ophthalmological findings before and after treatment, diagnostic investigations, treatment, clinical course was noted. Twelve patients were female (67%), 6 were males (33%) and the mean age at presentation was 54 years (range: 29-70 years). Conjunctival hyperemia was present in all patients. Seventeen (94%) patients had proptosis and diplopia, nine (50%) had orbital pain and/or headache, four (22%) had blurred vision, one (5.5%) had ptosis. On examination, 17 patients (94%) had restricted eye movements, four (22%) had low visual acuity and five patients had (28%) increased intraocular pressure (IOP). One patient had been diagnosed as myasthenia gravis and two as thyroid orbitopathy and had been on treatment accordingly before CCF was diagnosed. In two patients, bilateral findings were present despite unilateral CCF on angiography. Barrow Type B fistula was found in 7 (38%), Barrow Type D in 11 (62%) patients. In three bilateral CCF was detected. All were treated by endovascular intervention. Residual deficits at the sixth month control were, eye movement deficits in seven (39%), decrease in visual acuity in one (5.5%) and elevated IOP in one (5.5%) patient. Indirect CCF patients generally present with mild symptoms and the diagnosis may be overlooked. Mild progressive ophthalmoparesis with conjunctival hyperemia must be warning. Though rare bilateral CCF can be detected as well as unilateral CCF with bilateral findings.Öğe Calcitonin gene-related peptide (CGRP) levels in peripheral blood in patients with idiopathic intracranial hypertension and migraine(Elsevier, 2024) Ak, Aysin Kisabay; Gemici, Yagmur Inalkac; Batum, Melike; Karakas, Burak; Ozmen, Eser Yildirim; Gokcay, Figen; Celebisoy, NeseBackground: Calcitonin gene-related peptide (CGRP) plays a dominant role in migraine. This prospective study was designed to investigate CGRP levels in patients with idiopathic intracranial hypertension (IIH) and compare the results of migraine patients and healthy controls (HC). As a second objective, CGRP levels obtained from IIH patients defining sustained headache after the resolution of papilledema were compared with those not defining post-IIH headache. Methods: Thirty-six patients with IIH, 36 with episodic migraine (EM), 18 with chronic migraine (CM), and 36 HC were included in the study. CGRP levels were studied from blood samples obtained from the antecubital vein by using a commercial ELISA kit. Results: Serum CGRP levels of the patient groups were significantly higher than the HC (p < 0.001). As compared with controls, both CM (p Adj<0.001) and IIH (p Adj=0.039) had significantly increased levels of CGRP. Levels recorded from EM patients did not differ from the HC (p Adj=0.661). In 16 IIH patients, persistent headache was reported after the normalization of intracranial pressure (ICP). Twenty patients did not report post-IIH headaches. Comparison of serum CGRP levels of these two groups revealed significantly higher CGRP levels in patients with sustained headaches obtained from blood samples both at the initial and control visit (p Adj <0.001). Conclusions: CGRP levels of the patient groups were higher than the HC. High levels recorded in patients with IIH indicates the role of CGRP in IIH related headache and even higher levels in patients with sustained headache after normalization of ICP strengthens this finding.Öğe Can verapamil be effective in controlling vertigo and headache attacks in vestibular migraine accompanied with Meniere's disease? A preliminary study(Springer Heidelberg, 2019) Kaya, Isa; Eraslan, Sevinc; Tarhan, Ceyda; Bilgen, Cem; Kirazli, Tayfun; Gokcay, Figen; Karapolat, Hale; Celebisoy, NeseÖğe Can vestibular migraine development be predicted in patients with new onset migraine headaches?(Asean Neurological Assoc, 2022) Celebisoy, Nese; Ak, Aysin Kisabay; Atac, Ceyla; Ozdemir, Huseyin Nezih; Gokcay, Figen; Durmaz, Gulsum Saruhan; Karti, Dilek TopObjective: This study aims to determine the clinical features associated with the development of vestibular migraine (VM) in patients with migraine headaches. Methods: A cross-sectional, multicenter study was performed in nine tertiary neurology clinics. Patients with migraine without vestibular symptoms were classified as having migraine only (MO) and compared with patients with VM to determine any differences in clinical features, associated disorders, past medical history, and family history of migraine headaches. Moreover, we investigated the features that might predict the development of VM. Results: Two hundred forty-four patients with MO and 461 patients with VM were included. The age of onset of headache attacks was later in life for patients with VM (p<0.001). Migraine without aura (MwoA) was significantly more common than migraine with aura (MwA) in patients with VM (p=0.016). All associated features of migraine headaches were significantly more frequent in patients with MO than patients with VM (p<0.005). The same was true for all triggers, including fasting, sleep disturbances, menstruation, stress, flickering lights, and smartphones/computer games (p<0.005). A family history of migraine headaches was more common in MO patients (p=0.002). However, a previous history of motion sickness was significantly more common in patients with VM (p<0.001), as was aural fullness/tinnitus accompanying attacks (p<0.001). Logistic regression analysis indicated that aural fullness/tinnitus accompanying attacks and a previous history of motion sickness were risk factors for the development of VM. Conclusion: Patients with migraine reporting aural symptoms accompanying attacks and motion sickness in their past medical history are at increased risk of vestibular attacks fulfilling the diagnosis of VM later in life.Öğe Can vestibular-evoked myogenic potentials be used in the assessment of reflex habituation? A preliminary report(Wolters Kluwer Medknow Publications, 2023) Uyaroglu, Feray Gulec; Sariteke, Roza Ucar; Celebisoy, NeseBackground: Vestibular-evoked myogenic potentials (VEMPs) provide an electrophysiological evaluation of vestibular reflexes. The aim of the study was to search for the habituation of ocular and cervical VEMPs (cVEMPs). Materials and Methods: A total of 20 healthy volunteers (10 men and 10 women), with a mean age of 32.4 years (range: 25-45 years) were included in the study. cVEMP and ocular VEMP (oVEMP) tests were performed using click stimuli. In cVEMP and oVEMP tests, the latency and amplitude of the responses recorded with 100 and 250 stimulus sequences were compared. Results: When the traces recorded with 100 repetitions for both tests were compared with the traces obtained with 250 repetitions, it was observed that the latencies increased while the amplitudes decreased with increasing number of stimuli, which was statistically significant. Conclusion: Our results showed that an increase in the number of stimuli in oVEMP and cVEMP tests in healthy individuals led to a decrease in amplitude and an increase in latency. As noninvasive, short, and inexpensive evaluation methods, VEMP tests may be used in evaluating the habituation response and may find new areas of investigation.Öğe Cervical Vestibular Evoked Myogenic Potentials in Idiopathic Intracranial Hypertension(Lippincott Williams & Wilkins, 2022) Uyaroglu, Feray G.; Ucar, Roza; Sengul, Gulgun; Celebisoy, NesePurpose: Idiopathic intracranial hypertension (IIH) is raised intracranial pressure without any identifiable etiology. The inner ear structures are susceptible to cerebrospinal fluid (CSF) pressure changes because of connections between the CSF space and the labyrinth to explain the audiovestibular symptoms, such as pulsatile tinnitus or dizziness, reported in 50% to 60% of these patients. The aim of this study was to investigate the vestibular functions using cervical vestibular evoked myogenic potentials (cVEMPs) in IIH. Methods: cVEMPs were recorded in 30 patients with IIH before lumbar puncture. Thirty healthy volunteers constituted the control group. The latencies of peaks p13 and n23 and peak-to-peak amplitude of p13-n23 were measured. Results: Responses were gathered bilaterally from all healthy controls. In 30 patients with IIH, 49 responses could be gathered from 60 tests (81.7%). The potential was absent bilaterally in five and unilaterally in one patient. When recorded, the latency and amplitude values of the responses of the patients were not significantly different from the healthy controls (P > 0.005). A correlation between CSF pressure and response persistence could not be determined. Conclusions: cVEMPs are affected in patients with IIH and the main finding is the absence of the responses. Increased intracranial pressure causing sound transmission changes within the inner ear can affect the saccular afferents and may end up with absent responses on air-conducted cVEMP recordings. To comment on the correlation between the CSF pressure and cVEMP changes, successive cVEMP recordings with longitudinal CSF pressure monitoring seem necessary.Öğe CERVICAL VESTIBULAR EVOKED MYOGENIC POTENTIALS IN IDIOPATHIC INTRACRANIAL HYPERTENSION(Sage Publications Ltd, 2020) Uyaroglu, Feray G.; Ucar, Roza; Sengul, Gulgun; Celebisoy, Nese[No abstract available]Öğe Cervical vestibular evoked myogenic potentials in patients with the first episode of posterior canal benign paroxysmal positional vertigo before and after repositioning(Taylor & Francis Ltd, 2020) Saruhan, Gulsum; Gokcay, Ahmet; Gokcay, Figen; Celebisoy, NeseBackground Cervical vestibular evoked myogenic potentials (cVEMPs) are used to assess the sacculo-collic pathways. Benign paroxysmal positional vertigo (BPPV) is mainly a utricular disorder. Objectives To investigate cVEMPs in BPPV patients before and after repositioning maneuvers. Methods Forty patients with posterior canal BPPV with new onset symptoms underwent cVEMP testing at the time of diagnosis and a month after successful repositioning maneuver. p13, n23 latency and amplitude ratio values were compared with the results of 40 healthy controls. Results p13 and n23 latencies of the affected side were significantly longer than the healthy controls more prominent for the p13 latency. Comparison of the affected side with the non-affected side revealed delayed p13 latency on the affected side. Though a significant improvement in p13 latency was observed after repositioning, it was still prolonged when compared with the healthy controls. An abnormality regarding amplitudes was not present. Conclusions and significance cVEMP abnormalities in patients with BPPV indicate saccular dysfunction accompanying utricular dysfunction which seems to be confined to the symptomatic side at least in the early phase of the disease. Partial recovery can be seen after treatment with residual findings following even the first attack.
