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Öğe Are COVID-19 vaccines safe for people with epilepsy? A cross-sectional study(Springer-Verlag Italia Srl, 2022) Ozdemir, Huseyin Nezih; Dere, Birgul; Gokcay, Figen; Gokcay, AhmetBackground COVID-19 disease was first seen in December 2019 and was declared a pandemic soon after. To fight the pandemic, there is an immense need for effective vaccines. The purposes of our study were to investigate the effect of coronavirus vaccines on seizures in people with epilepsy (PWE) and assess the adverse events of COVID-19 vaccine in PWE. Methods This was a cross-sectional study. We included epilepsy patients who got vaccinated with two or three doses at least 1 month earlier. We gathered the data using a standardized form. The form contained questions about patients' demographic features, clinical features, and information about the vaccination and its adverse events. The questionnaire included questions about epilepsy-related adverse events. Results We included 178 people with epilepsy in our study. The frequency of adverse events was lower than clinical studies of the vaccines. The mean number of seizures in the month before the vaccination was 1.62, between the doses was 1.61, and after vaccination was 1.64. There was no significant difference in the number of monthly seizures before the vaccination, the month between the doses, or the month after the vaccination (p = 0.46). Conclusions The vaccines under consideration in our study were tolerated well by the epilepsy patients. The vaccines did not affect the monthly number of seizures of the PWE. A small number of patients had more seizures than normal after vaccination. We think that benefits of the vaccines outweigh the slightly increased possibility of having a seizure after vaccination.Öğe Association between recurrence of stroke and peripheral artery disease after first-ever stroke(Sage Publications Ltd, 2023) Kumral, Emre; Cetin, Fatma Ece; Ozdemir, Huseyin Nezih; Orman, Mehmet[No abstract available]Öğe Biomarkers in patients with autoimmune optic neuritis not associated with multiple sclerosis: Demographic, clinical and prognostic features(Elsevier Sci Ltd, 2024) Ozdemir, Huseyin Nezih; Topcuoglu Karakoc, Mine; Gokcay, Figen; Celebisoy, NeseBackground: The new optic neuritis (ON) classification leads to a change in how ON patients are grouped. Our aim is to appraise the clinical features and prognoses of patients with autoimmune ON not associated with MS. Methods: Patients referred to our neuro-ophthalmology laboratory were enrolled to this retrospective study. Patients with ON associated with MS were excluded. The remaining patients were divided into three groups: aqauaporin-4 (AQP4) antibody ON group, myelin oligodendrocyte glycoprotein (MOG) antibody ON group, and seronegative ON group. The patients were examined on admission, one month after acute treatment, and at the third-year follow-up. We compared demographic, clinical, radiologic, laboratory data, and treatment responses among these three groups. Results: The study included 92 patients. The older age of onset, bilateral simultaneous involvement of the optic nerves, severe vision loss at onset, and need for aggressive treatment were more common in the AQP-ON and the MOG-ON groups than the seronegative ON group (P = 0.01, P = 0.003, P = 0.011, P = 0.007, P < 0.001, P < 0.001, respectively). The presence of optic disc edema was a significant feature of MOG-ON as well as long-length contrast enhancement on MRI (P = 0.003, P = 0.002). Additional autoimmune antibodies and CNS lesions outside the optic nerve were the features of AQP4-ON patients (P < 0.001, P = 0.015). Generalized estimating equations analysis revealed that the presence of AQP4 antibody, increased age and recurrence were associated with visual acuity over time (P = 0.014, P = 0.002, P = 0.016, respectively). Conclusion: The association of serum biomarker status with demographic, clinical features, and visual outcomes indicate the importance of biomarker detection in these patients.Öğe 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 Cognitive and Behavioral Disorders in Patients with Precuneal Infarcts(Karger, 2021) Kumral, Emre; Bayam, Fatma Ece; Ozdemir, Huseyin NezihObjective: Ischemic stroke of the precuneal cortex (PC) alone is extremely rare. This study aimed to evaluate the clinical, neurocognitive, and behavioral characteristics of isolated PC infarcts. Methods: We assessed neuropsychological and behavioral findings in 12 patients with isolated PC infarct among 3,800 patients with ischemic stroke. To determine the most frequently affected brain locus in patients, we first overlapped the ischemic area of patients with specific cognitive disorders and patients without specific cognitive disorders. Second, we compared both overlap maps using the "subtraction plot" function of MRIcroGL. Results: Patients showed various types of cognitive disorders. All patients experienced more than 1 category of cognitive disorder, except for 2 patients with only 1 cognitive disorder. Lesion topographical analysis showed that damage within the anterior precuneal region might lead to consciousness disorders (25%), self-processing impairment (42%), visuospatial disorders (58%), and lesions in the posterior precuneal region caused episodic and semantic memory impairment (33%). The whole precuneus is involved in at least one body awareness disorder. The cause of stroke was cardioembolism in 5 patients (42%), large artery disease in 3 (25%), and unknown in 4 (33%). Conclusions: This study showed a wide variety of neuropsychological and behavioral disorders in patients with precuneal infarct. Future studies are needed to achieve a proper definition of the function of the precuneus in relation to the extended cortical areas. PC region infarcts have been found to predict a source of embolism from the large arteries or heart.Öğe A cytotoxic lesion of the corpus callosum (CLOCC) in a patient with headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL): a hint for pathophysiology?(Springer Heidelberg, 2022) Ozdemir, Huseyin Nezih; Celebisoy, Nese; Gokcay, Figen; Gokcay, Ahmet[No Abstract Available]Öğe Effects of comorbid diseases on clinical outcomes in patients with myasthenia gravis(Springer-Verlag Italia Srl, 2023) Ozdemir, Huseyin Nezih; Karasoy, Hatice; Yuceyar, Ayse Nur; Ekmekci, OzgulBackgroundThis cross-sectional study was undertaken to evaluate the existence and distribution of comorbid disorders among myasthenia gravis (MG) patients according to subgroups and to identify the effects of the comorbid diseases of MG patients on clinical outcomes.MethodsThe patients were divided into six subgroups according to serum antibodies, age at onset, and thymoma presence. All patients were treated in line with the International Consensus Guidance for Management of Myasthenia Gravis. To assess the clinical outcome after treatment for MG, we used the MGFA Post-intervention Status. In generalized MG patients, the good prognosis group included patients who were classified as having minimal-manifestation status or better. In ocular MG patients, the remission subgroup included patients who were classified as having complete stable remission or pharmacological remission status.ResultsOur study included 168 MG patients, 85 were female while 83 were male. Comorbid diseases were present in 124 (73.8%) MG cases. After at least 1 year of follow-up, 106 (86.8%) of the generalized MG patients were in the good prognosis group and 16 (13.2%) generalized MG patients were in the poor prognosis group. 27 (58.6%) ocular MG patients were in the remission group and 19 (41.3%) ocular MG patients were in the non-remission group. Hypertension increased the risk of poor prognosis by 3.55-fold among patients with generalized MG and type 2 DM increased the risk of not achieving remission by 9.32-fold among patients with ocular MG.ConclusionHypertension and type 2 DM had negative effects on the clinical outcomes of MG.Öğe Factors determining the response to treatment in patients with vestibular migraine(Taylor & Francis Ltd, 2022) Ak, Aysin Kisabay; Celebisoy, Nese; Ozdemir, Huseyin Nezih; Gokcay, Figen; Durmaz, Gulsum Saruhan; Karti, Dilek Top; Toydemir, Hulya ErtasogluPurpose To find out clinical features associated with poor response to treatment in vestibular migraine (VM) Methods VM patients treated with drugs recommended in migraine prophylaxis were included in this multicenter study. Migraine features including type, age of onset of headache and vertigo attacks, attack frequency, intensity, associated symptoms, triggering factors, presence of interictal dizziness/imbalance, anxiety, depression, history of motion sickness, and family history of migraine were noted. Amitriptyline, flunarizine, propranolol, topiramate and venlafaxine were chosen depending on patients' individual requirements. Maximum dose of each drug was tried for 2 months to decide its efficacy. In the case of inefficacy, it was changed with another preventive drug of different class. If there was still no improvement, two drugs of different classes were combined. >= 50% reduction in attack frequency and severity in patients using one drug and a combination of two drugs was compared, with patients showing <50% reduction despite combination therapy, regarding their clinical features. Results The results of 430 VM patients, 65 men and 365 women with a mean age of 42.2 +/- 12.2 years (range: 17-74 years), were analyzed. Conclusion Cutaneous allodynia frequently associated with female sex, comorbid anxiety and depression and interictal dizziness/imbalance enhanced with comorbid anxiety were risk factors for reduced treatment response. Aural fullness might be the clue of impending concomitant Meniere's disease not responding to migraine preventives.Öğe Location of the contrast extravasation is important in predicting outcome of anterior circulation stroke patients(Asean Neurological Assoc, 2024) Ozdemir, Huseyin Nezih; Karaman, Bedriye; Guler, Ayse; Dere, Birgul; Cinar, Celal; Kumral, Dursun Emre; Sirin, HadiyeObjectives: Contrast extravasations (CE) are frequently seen on postprocedural computed tomography after endovascular therapy (EVT). This study aimed to investigate the relationship between patients' outcomes and CE after EVT. Methods: Stroke patients who had received EVT between 2019 and 2021 were reviewed retrospectively. The CEs were mapped using MRIcroGL software. The rate of in-hospital mortality and modified Rankin Scale at 90 days were taken as outcome measures. Stepwise logistic regression analyses were performed. Three models were created with and without pure CE to predict the patients' outcomes. Results: There were 126 patients included in the study. According to the univariable analysis, CE (OR = 0.70, 95% CI = 0.18-2.68, P = 0.26) and CE-ASPECTS (OR = 1.21, 95% CI=0.60-2.44, P = 0.57) were not related with in-hospital mortality after EVT. The lesion mapping showed that the most common CE locations among the patients with a poor prognosis was the M6 area. The multivariable logistic regression analysis showed that CE in the M6 area (OR = 6.87, 95% CI = 1.27-144.92, P = 0.006) increased the risk of a 3-month poor outcome. The study showed that adding CE to the well-known risk factors for poor prognosis improves the predictive power of the models (Delta AUC of 0.07, P = 0.02). Conclusion: CE has a prognostic value after EVT in anterior stroke patients. The prognostic value is the highest when present in the M6 area.Öğe Oculogyric Crisis with Downward Deviation - A Photo Essay(Taylor & Francis As, 2018) Ozdemir, Huseyin Nezih; Celebisoy, NeseOculogyric crisis (OGC) describes the clinical phenomenon of sustained dystonic, conjugate and typically upward deviation of the eyes. A few cases with downward or lateral deviations have been described.(1/2)Öğe Orgasm-induced Seizures: A Case Report and Review of the Literature(Turkish Neurological Soc, 2021) Ozdemir, Huseyin Nezih; Samedli, Kamran; Gokcay, Figen; Gokcay, AhmetCertain types of stimuli can trigger epileptic seizures in patients with epilepsy. This phenomenon is defined as reflex seizure. Stimuli may be in visual, auditory, tactile, or cognitive forms, and orgasm may trigger epileptic seizures. A 42-year-old man was admitted to our department with orgasm-induced generalized seizures that had started 6 months ago. He was examined using electroencephalography and cranial magnetic resonance imaging, and was treated with levetiracetam and clobazam. His seizures were controlled well. In this article, we aim to present our case and review the literature on the subject.Öğe Quality of Life in Patients with Idiopathic Intracranial Hypertension and the Impact of the COVID-19 Pandemic(Taylor & Francis As, 2022) Celebisoy, Nese; Ak, Aysin Kisabay; Ozdemir, Huseyin Nezih; Gokcay, Figen; Eser, ErhanThe COVID-19 pandemic became a challenge to maintain care for patients with idiopathic intracranial hypertension (IIH). We aimed to find out how they were affected during lockdown. Thirty IIH patients admitted to hospital during the COVID-19 pandemic were studied. Their demographic and neuro-ophthalmological findings were evaluated. The World Health Organization - Five Well-Being Index (WHO-5), the EUROHIS Quality of Life (QOL) 8-item index, National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), Headache Impact Test (HIT-6), and COVID-19 Fear Scale were used to assess QOL and pandemic-associated fear. Thirty age, sex, and body mass index matched volunteers constituted the control group. Apart from the COVID-19 Fear Scale and colour vision subscale of the NEI-VFQ-25, all scale scores were worse in IIH patients than in healthy control subjects. Patients with severe visual field defects had higher HIT-6 scores (p = .036). Both vision-specific and overall QOL was reduced in patients with IIH. Headache severity and disability were more prominent in patients with severe visual loss. Fear caused by the COVID pandemic was not different in IIH patients than in healthy control subjects.Öğe Risk for generalization in ocular onset myasthenia gravis: experience from a neuro-ophthalmology clinic(Springer Heidelberg, 2021) Kisabay, Aysin; Ozdemir, Huseyin Nezih; Gokcay, Figen; Celebisoy, NeseConversion to generalized myasthenia gravis (GMG) within the first 2 years has been reported in 18-85% of patients with ocular myasthenia gravis (OMG). The aim of the study was to investigate the risk factors for generalization in patients with OMG admitted to a neuro-ophthalmology clinic and to determine if there were differences between patients with GMG with predominant bulbar (GMG-B) or extremity muscle (GMG-E) involvement according to the 6th and 24th-month Myasthenia Gravis Foundation of America classification ranks. Patients with OMG who were followed-up for at least 24 months were retrospectively analyzed. Demographic, clinical, laboratory features and treatment strategies that can be associated with generalization and time to generalization were evaluated. of the 139 patients with OMG, 54 (39%) showed generalization with a mean time of 10.3 (range 2-24) months. GMG-B and GMG-E were diagnosed in 31 (22.3%) and 23 patients (16.5%), respectively. Seropositivity for acetylcholine receptor and muscle-specific tyrosine kinase antibodies, abnormal single-fiber electromyography (SFEMG), and the presence of thymic abnormalities (thymoma and hyperplasia) were factors associated with generalization on multivariate analysis without a significant difference between the GMG-B and GMG-E groups. in addition, an abnormal repetitive nerve stimulation test was related to a shortened time to generalization. Bilateral ptosis at onset was found as a risk factor for generalization. in a neuro-ophthalmology clinic, bilateral ptosis as an initial feature of OMG must be approached cautiously because it may be the first sign of impending GMG.Öğe Unusual vessel wall magnetic resonance imaging findings in a cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy patient(Wolters Kluwer Medknow Publications, 2023) Ozdemir, Huseyin Nezih; Karakaya, Hanife; Goekcay, Figen[No abstract available]Öğe Vestibular migraine and persistent postural perceptual dizziness: Handicap, emotional comorbidities, quality of life and personality traits(Elsevier, 2022) Ak, Aysin Kisabay; Celebisoy, Nese; Ozdemir, Huseyin Nezih; Gokcay, FigenObjective: To compare vestibular migraine (VM) and persistent postural-perceptual dizziness (PPPD) regarding dizziness associated handicap, emotional and somatic disorders, health-related quality of life (QoL) and per-sonality traits.Methods: Thirty patients for each group [VM, PPPD and healthy volunteers (HC)] were studied. Dizziness Handicap Inventory (DHI), Beck depression and anxiety scales, Somatic Symptom Scale-8 (SSS-8), Short Form (36) Health Survey (SF 36) and the Big Five Inventory (BFI) were used.Results: DHI sub-scores were significantly high in both patient groups in comparison with the HC (p < 0.001 for all). Emotional (p = 0.001) and functional (p = 0.022) sub-scores of the PPPD patients were worse. Anxiety and somatic symptom scores of VM (p = 0.026 and p < 0.001 respectively) and PPPD (p < 0.001 for both) and depression scores of the PPPD (p = 0.003) were higher than the HC. Both anxiety (p = 0.009) and somatization (p = 0.005) scores of the PPPD patients were higher than the VM. SF-36subscales were affected in both groups (p < 0.05). Vitality (p = 0.002), mental health (p = 0.045) and social role functioning (p = 0.006) of the PPPD group were worse than the VM. Higher scores for neuroticism (p < 0.001) was present for both groups. Scores for extraversion was low in PPPD patients (p = 0.010) in comparison with the HC.Conclusion: Dizziness associated handicap, anxiety and somatic symptom burden is high in both groups, even higher in PPPD with additional depression. Severe impairment in QoL is present with more severe impairment in emotional aspects in patients with PPPD. Neuroticism is a common personality trait for both groups with additional introversion in PPPD.Öğe Vestibular migraine, demographic and clinical features of 415 patients: A multicenter study(Elsevier, 2022) Celebisoy, Nese; Ak, Aysin Kisabay; Ozdemir, Huseyin Nezih; Gokcay, Figen; Durmaz, Gulsum Saruhan; Karti, Dilek Top; Toydemir, Hulya ErtasogluObjective: To evaluate demographic and clinical features of vestibular migraine (VM) patients Methods: Four hundred fifteen patients with VM were evaluated by using a structured questionnaire in addition to clinical examination. Results: The mean age of headache and vertigo onset was 25 years and 39 years, respectively. In 12.3%, benign paroxysmal positional vertigo (BPPV) was detected during the interictal period. Ten percent had hearing loss on audiometry, in 8.7% it was one-sided low-frequency sensory-neural hearing loss below 2000 Hz and the history was typical for Meniere's disease (MD) in addition to VM. Tinnitus was present in 94.4%, aural fullness in 83.4%, nausea in 72.2% and vomiting in 30.5% of patients with VM/MD. The prevalence of these symptoms was higher in patients with VM/MD than in pure VM. Median attack severity determined by visual analog scale measured in centimeters from 0 to 10 was 8 for headache and 7 for vertigo for the whole group. Severe headache was significantly correlated with age of < 43 years (OR: 6.831, 95% CI: [4.10-11.63]; p < 0.001) and severe vertigo was significantly correlated with age > 41 years (OR: 7.073, 95% CI: [4.55-10.98]; p < 0.001). Motion sickness was revealed from past medical history in 51.8%. Family history of migraine was present in 72.5% and the age of onset of both migraine headaches (p = 0.008) and vertigo attacks (p = 0.004) was lower in these patients. Conclusion: Younger patients suffered more severe headache attacks whereas vertigo attack severity was higher in the elderly. BPPV and MD were commonly associated with VM and VM/MD was accompanied by aural and autonomic features more frequently than pure VM. Previous history of motion sickness was detected in more than half of the whole group. Family history of migraine was associated with younger onset of migraine headaches and vertigo attacks.
