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Öğe Can verapamil be effective in controlling vertigo and headache attacks in vestibular migraine accompanied with Meniere’s disease? A preliminary study(Dr. Dietrich Steinkopff Verlag GmbH and Co. KG, 2019) Kaya I.; Eraslan S.; Tarhan C.; Bilgen C.; Kirazli T.; Gokcay F.; Karapolat H.; Celebisoy N.[No abstract available]Öğe Clinical assessment of topiramate therapy in patients with migrainous vertigo(2010) Gode S.; Celebisoy N.; Kirazli T.; Akyuz A.; Bilgen C.; Karapolat H.; Sirin H.; Gokcay F.Objective. - To assess the efficacy of topiramate in reducing both the frequency and the severity of vertigo and headache attacks in patients with migrainous vertigo and to compare 50 and 100 mg/day doses of the drug. Methods. - Thirty patients diagnosed as definite migrainous vertigo were recruited in the study. Vertigo and headache frequency was determined as the monthly number of attacks whereas severity was determined by visual analog scales measured in millimeters from 0 to 100. Patients were randomized to either 50 or 100 mg/day topiramate for 6 months. Vertigo and headache frequency and severity were evaluated at the end of the study period. Results. - Number of mothly vertigo attacks decreased significantly in the overall group after treatment (median from 5.5 to 1; P <.01). The same was true for monthly headache attacks (median from 4 to 1; P <.01). A statically significant improvement in vertigo severity was noted (median from 80 to 20 mm; P <.01). Headache severity showed significant improvement as well (median from 60 to 30 mm; P <.01). No statistically significant difference between high- and low-dose groups was present regarding efficacy (P >.05). Four patients in the high-dose group discontinued treatment at the end of the first month because of adverse effects. Conclusions. - In the overall group, topiramate was found to be effective in reducing the frequency and the severity of vertigo and headache attacks. Both doses of the drug were equally efficacious. The 50 mg/day dose seems to be appropriate as higher adverse effects were noted when 100 mg/day was used. © 2009 American Headache Society.Öğe Establishing a "vestibular migraine diagnosis questionnaire" and testing its validity(Lippincott Williams and Wilkins, 2016) Celebisoy N.; Karapolat H.; Gokcay F.; Bilgen C.; Ozgen G.; Kirazli T.; Kose T.Objective: To establish a questionnaire and check its validity and reliability for the diagnosis of vestibular migraine in patients reporting recurrent vestibular symptoms. Background: Vestibular migraine is the most common cause for recurrent spontaneous vertigo. However, it is still underdiagnosed needing validated and reliable screening instruments such as ID Migraine, that can be used in primary care settings, dizziness, and migraine clinics. Materials and Method: Sixty consecutive patients referred to our dizziness clinic with recurring vestibular symptoms were given a questionnaire that they filled in, consisting of 8 short and simple questions. The questionnaire-based diagnosis was compared with the diagnosis based on face-to-face interview and clinical examination. Test stability was evaluated by asking the patients to fill in the questionnaire a week later during a second visit. ? analysis was used to assess item-specific test-retest reliability and also the conformity between the questionnaire-based diagnosis and the clinical diagnosis. Results: The conformity between the clinical diagnosis and the diagnosis based on the questionnaire was 83.3% and the ? coefficient was 0.666 (good). Sensitivity of the questionnaire was 82.8% (24/29) and the specificity was 83.9% (26/31). The ? values in test-retest repetition were good to excellent (0.71 to 0.87) when each question was considered. Conclusions: The validity of the "Vestibular Migraine Diagnosis Questionnaire" was good and its reliability was good to excellent indicating that it can be used as a screening tool in identifying patients with vestibular migraine in our country. © 2016 Wolters Kluwer Health, Inc. All rights reserved.Öğe Neuro-Behçet’s disease mimicking cerebral abscess complicated by metronidazole-induced encephalopathy(ASEAN Neurological Association, 2015) Guler A.; Cinar E.; Turhan T.; Pullukcu H.; Akalin T.; Gokcay F.; Celebisoy N.This is the report of a 32-year-old man with Behçet’s disease described dizziness, double vision and headache. The cranial MRI demonstrated a ring enhancing nodular lesion in left medial occipital lobe, and T2 hyperintense lesion in diencephalon mimicking abscesses. A stereotactic biopsy was performed. The histology showed features of neuro-Behçet’s disease and an abscess was ruled out. During the procedure till the histopathologic results were gathered he was given ceftriaxone and metronidazole when cerebellar signs appeared. Cranial MRI showed additional symmetrical hyperintensities in bilateral cerebellar dentate nuclei which was attributed to metronidazole toxicity. Repeat MRI performed forty days later showed complete resolution of both dentate hyperintensities and diencephalic and occipital ring enhancing lesions. This is the first case of neuro-Behcet’s disease complicated by metronidazoleinduced encephalopathy. This case also showed that nodular ring enhancing lesions can be seen in neuro-Behçet’s disease and can lead to difficulties in diagnosis and management. © 2015, ASEAN Neurological Association. All rights reserved.Öğe Neuromyelitis optica and neuromyelitis optica spectrum disorder patients in Turkish cohort demographic, clinical, and laboratory features(Lippincott Williams and Wilkins, 2015) Altintas A.; Karabudak R.; Balca B.P.; Terzi M.; Soysal A.; Saip S.; Kurne A.T.; Uygunoglu U.; Nalbantoglu M.; Celik G.G.; Isik N.; Celik Y.; Gokcay F.; Duman T.; Boz C.; Yucesan C.; Mangan M.S.; Celebisoy N.; Diker S.; Isikay I.C.; Kansu T.; Siva A.Background: Neuromyelitis optica (NMO) is an immune-mediated, chronic relapsing, inflammatory disease characterized by severe attacks of optic neuritis and myelitis. Objective: To determine the demographic, clinical, and laboratory features; antibody status; and treatment modalities of patients with NMO and neuromyelitis optica spectrum disorders in a Turkish cohort from 11 centers. Methods: A total of 182 patients were included in this study. Data on age at disease onset, sex, type of attacks, clinical presentation, analysis of cerebrospinal fluid, serum antiaquaporin-4 antibody status, annual progression index, and medical and family histories were collected. Results: Mean age was 38.43 ± 12.40 years (range, 13 to 75 y), and mean age at disease onset was 31.29 ± 12.40 years (median, 29 y; range, 10 to 74 y). In NMO group, the rate of NMO immunoglobulin (Ig)G positivity was 62.5%. The annual progression index was significantly higher in the longitudinally extending spinal cord lesion. The mean Expanded Disability Status Scale score was higher in the late than early-onset NMO group. Conclusion: Our results revealed a lower rate of NMO IgG positivity, more severe disability in patients with NMO/neuromyelitis optica spectrum disorders presenting with either transverse myelitis or lateonset NMO, and no correlation between disability and NMO IgG status. © 2015 Wolters Kluwer Health, Inc. All rights reserved.Öğe Oxcarbazepine therapy in paroxysmal kinesigenic choreoathetosis [1](2000) Gokcay A.; Gokcay F.[No abstract available]Öğe Rebound intracranial hypertension after noninvasive treatment of intracranial hypotension: Case report and literature review(ASEAN Neurological Association, 2019) Akkoc C.C.; Karti D.T.; Gokcay F.; Celebisoy N.Intracranial hypotension is a clinical syndrome characterized by orthostatic headache and low cerebrospinal fluid pressure. Noninvasive management is the usual first line treatment. Epidural blood patch is the treatment of choice if noninvasive treatments are ineffective. Cases with rebound intracranial hypertension after epidural blood patch treatment have been reported in the medical literature previously. We report here three patients with rebound intracranial hypertension who were treated noninvasively for intracranial hypotension. This phenomenon has not been reported previously. The underlying cause of intracranial hypotension was epidural anesthesia in the first, lumbar disc surgery in the second patient, and idiopathic in the third patient. They had been treated either with bed rest or with medical treatment not requiring epidural blood patch. After a short remission the patients were seen with a different headache pattern. They all had papilledema on examination. Automated perimetry revealed bilateral blind spot enlargement in Patient 1 and peripheral constriction in Patient 2. Cranial MRI and MRV in all three patients were normal. All the patients recovered very quickly with acetazolamide 1.5 or 2gm/day. In conclusion, rebound intracranial hypertension should be kept in mind in patients with intracranial hypotension who developed changes in the headache pattern, had new symptoms of nausea, vomiting, blurred or double vision during follow-up. Rebound intracranial hypertension can develop after conservative treatment of intracranial hypotension. © 2019, ASEAN Neurological Association. All rights reserved.Öğe Systematic evaluation of diagnostic tests including vestibular evoked myogenic potentials and Multi-Frequency Tympanometry in the differential diagnosis of Episodic Vertigo(2012) Gode S.; Kirazli T.; Celebisoy N.; Gokcay F.; Ozturk K.; Bilgen C.Objective: To evaluate the additional role of multi-frequency tympanometry (MFT) and vestibular evoked myogenic potentials (VEMP) in the differential diagnosis of episodic vertigo. Study Design: Controlled cross-sectional. Setting: Tertiary referral center. Patients: 60 samples (15 healthy controls(HC), 15 Meniere's disease(MD), 15 recurrent vestibulopathy(RV), 15 migrainous vertigo(MV)) were included. Interventions: Pure tone audiometry, VEMP and MFT were performed to all patients and healthy controls, caloric test was performed only to the patients. Main Outcome Measure: "Audio-vestibular diagnosis score" was described and calculated which was based on the evaluation of the results of four diagnostic tests. Results: Ear resonance frequency (RF) was 921. 6 Hz and 1092. 3 Hz in healthy subjects and Meniere patients respectively (p<0. 01). VEMP thresholds were 84 and 97. 3 dB on 250 Hz, 89 and 104 dB on 500 Hz, 97. 6 and 110. 7 Hz on 1000 Hz in HC and MD respectively (p<0. 01). "Audio-vestibular diagnosis score" was effective in differentiating MD from other etiologies (p<0. 01). Conclusions: RF was significantly higher in MD and this might indicate pressure of the hydropic saccule on stapes footplate. VEMP thresholds were significantly higher in MD. "Audio-vestibular diagnosis score" was helpful in the differential diagnosis of episodic vertigo with the additional role of MFT and VEMP especially in patients with RV or patients with ovelapping diseases such as MD+Migraine or MV+hearing loss. Relatively normal inner ear function in MV patients may enlighten the controversial pathophysiology of this disease in the favor of central hypotheses. © The Mediterranean Society of Otology and Audiology.Öğe What is the optimal dose of acetazolamide in the treatment of idiopathic intracranial hypertension(ASEAN Neurological Association, 2020) Aysin Kisabay A.; Tata G.; Gokcay F.; Celebisoy N.Objective: Acetazolamide is preferred as the first-line drug for the medical treatment of idiopathic intracranial hypertension. In this study, the efficacy of different doses of the drug on visual functions; visual acuity, optic disc appearance-papilledema grade and visual field-mean deviation (VF-MD) were evaluated. Methods: The medical records of 73 patients diagnosed as idiopathic intracranial hypertension based on Modified Dandy Criteria and treated with acetazolamide who were on follow-up between 2010 and 2017 at the Neuro-ophthalmology Unit of Ege University Medical School, Department of Neurology were analyzed. Improvement in the visual functions at the end of the sixth month in three groups taking different doses of the drug; low (500, 750, 1000 mg/day), moderate (1500, 1750, 2000 mg/day) and high (3000, 4000 mg/day) were compared. Results: Improvement in visual acuity (p: 0.784), was not affected from different doses of the drug whereas papilledema grade (p: 0.014) and VF-MD (p<0.001) were affected. Binary comparisons revealed significant improvement in the high dose group when compared with the moderate and low dose groups both for the papilledema grade (low-high: p: 0.003, moderate-high: p: 0.024) and VF-MD (low-high: p<0.001, moderate-high: p: 0.001) Conclusion: Treatment with high doses of acetazolamide is associated with improvement in visual field defects and regression of optic disc edema in idiopathic intracranial hypertension. © 2020, ASEAN Neurological Association. All rights reserved.
