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Öğe Arterial ischemic stroke in childhood: Risk factors and outcome in old versus new era(Sage Publications Inc, 2007) Goekben, Sarenur; Tosun, Ayse; Bayram, Nuri; Serdaroglu, Gul; Polat, Muzaffer; Kavakli, Kaan; Tekgul, HasanRisk factors of children with arterial ischemic stroke were retrospectively evaluated. The children were grouped according to values on developing diagnostic tools: 13 in the old era (19871994) and 18 in the new era (1995-2004). The old era battery included 5 tests: protein C, protein S, antithrombin, lupus anticoagulants, and anticardiolipin antibodies. The new era battery added 5 more tests: homocystine level, factor VIII level, mutations for factor V Leiden and prothrombin G20210A, and lipoprotein (a) level. At least I risk factor was found in 5 of 13 children (38.5%) in the old era and in 8 of 18 (44.4%) in the new era. The extended battery for prothrombotic disorders revealed 7 risk factors in 4 children (22.2%) in the new era, whereas the limited battery identified a single risk factor in I child (7.7%) in the old era. For the correct etiologic identification, prothrombotic risk factors should be extensively evaluated in patients with arterial ischernic stroke.Öğe Changing views of cerebral palsy over 35 years: the experience of a center(Turkish J Pediatrics, 2013) Tosun, Ayse; Gokben, Sarenur; Serdaroglu, Gul; Polat, Muzaffer; Tekgul, HasanIn this study, it was aimed to evaluate the demographic and clinical characteristics of cerebral palsy (CP) cases over a 35-year period. Findings of 442 patients with CP followed from 1995 to 2006 (Group 2) were compared with 208 patients with CP followed between 1972 and 1994 (Group 1) in the same pediatric neurology division. Ratios of both prematurity (38% vs. 17.7%) and very low birth weight (VLBW) infants (13.8% vs. 1.5%) significantly increased in Group 2. There was also a four-fold increase in cesarean delivery in Group 2 (42.3% vs. 9.6%). A significant increase in the rate of early diagnosis during the first year was also found in this group (56.9% vs. 39.4%). The rate of spastic diparesis cases has significantly increased (33.7% vs. 7.7%), while the rate of spastic tetraparesis cases has significantly decreased (63.5% vs. 37.3%). It was seen that preventable risk factors continue today.Öğe Changing views of cerebral palsy over 35 years: the experience of a center(Turkish J Pediatrics, 2013) Tosun, Ayse; Gokben, Sarenur; Serdaroglu, Gul; Polat, Muzaffer; Tekgul, HasanIn this study, it was aimed to evaluate the demographic and clinical characteristics of cerebral palsy (CP) cases over a 35-year period. Findings of 442 patients with CP followed from 1995 to 2006 (Group 2) were compared with 208 patients with CP followed between 1972 and 1994 (Group 1) in the same pediatric neurology division. Ratios of both prematurity (38% vs. 17.7%) and very low birth weight (VLBW) infants (13.8% vs. 1.5%) significantly increased in Group 2. There was also a four-fold increase in cesarean delivery in Group 2 (42.3% vs. 9.6%). A significant increase in the rate of early diagnosis during the first year was also found in this group (56.9% vs. 39.4%). The rate of spastic diparesis cases has significantly increased (33.7% vs. 7.7%), while the rate of spastic tetraparesis cases has significantly decreased (63.5% vs. 37.3%). It was seen that preventable risk factors continue today.Öğe Chronic inflammatory demyelinating polyradiculopathy: an atypical pediatric case complicated with phrenic nerve palsy(Turkish J Pediatrics, 2007) Polat, Muzaffer; Tosun, Ayse; Serdaroglu, Guel; Caglayan, Engin; Karapinar, Buelent; Goekben, Sarenur; Tekguel, HasanAn atypical form of chronic inflammatory demyelinating polyneuropathy (CIDP) complicated with phrenic nerve palsy is presented with clinical and electrophysiologic features. A seven-year-old girl had initial presentation mimicking Guillain-Barre syndrome based on electrophysiologic characteristics. Between 7-11 years of age, she had five recurrences of subacute onset of weakness which usually developed over at least 2-4 months and progressed to loss of ambulation and to respiratory insufficiency. Radiologic examinations revealed unilateral phrenic nerve palsy associated with CIDP. Our patient demonstrated the rare association of CIDP and phrenic nerve palsy, resulting in diaphragmatic paralysis and respiratory failure.Öğe Convulsive status epilepticus in children: Etiology, treatment protocol and outcome(W B Saunders Co Ltd, 2011) Saz, Eylem Ulas; Karapinar, Bulent; Ozcetin, Mustafa; Polat, Muzaffer; Tosun, Ayse; Serdaroglu, Gul; Gokben, Sarenur; Tekgul, HasanThis study aimed to determine the etiology, treatment protocol and outcome of convulsive status epilepticus (SE) in children. An institutional treatment protocol using benzodiazepines (diazepam and midazolam) was assessed in a retrospective case study. The treatment protocol (Ege Pediatric Status Epilepticus Protocol or EPSEP) was developed based on an operational definition of pediatric SE according to the duration of seizure activity. Pediatric SE is divided into three categories: initial SE (20-30 min), established SE (30-60 min) and refractory SE (>60 min). Eight (30%) of the studied episodes were initial SE, 10 (37%) were established SE, and 9 (33%) were refractory SE. With respect to the etiological spectrum of SE, 11(40%) children had meningitis or encephalitis. Febrile SE was identified in 7 (26%) patients. Only 2 episodes of initial SE (7.5%) were controlled with first step of the protocol (two concomitant-doses of rectal diazepam). Midazolam bolus and infusions (up to 1.2 mu g/kg/min) were used to treat 22 episodes of SE (9 refractory SE, 10 established SE and 3 initial SE). Complete arrest of convulsive SE was achieved in 21 of 22 (95%) episodes with midazolam infusion. We concluded that the combined use of benzodiazepines (diazepam + midazolam) was safe and effective in the treatment of convulsive SE in children. (C) 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.Öğe The effect of depression on academic achievement in children with epilepsy(Academic Press Inc Elsevier Science, 2008) Tosun, Ayse; Gokcen, Sezen; Ozbaran, Burcu; Serdaroglu, Gul; Polat, Muzaffer; Tekgul, Hasan; Gokben, SarenurIn this cross-sectional study our aim was to evaluate the effect of depression on academic achievement in children with epilepsy and low school performance. Fifty-one children with epilepsy and low school performance were evaluated with the Children's Depression Inventory (CDI) to measure depressive symptoms. School performance was evaluated with Achenbach's Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF). Children diagnosed with depressive spectrum disorders received medical therapy. All tests were administered in the first interview and repeated at the end of 6 months of therapy. Forty-three children completed the study. The patients were evaluated with DSM-IV diagnostic criteria. Accordingly, 9 (20.9%) children had Major Depressive Disorder (MDD) and 4 (9.3%) had Depressive Disorder, Not Otherwise Specified (DD-NOS). All children with MDD and DD-NOS received antidepressant medication, but only seven of them completed treatment. Posttreatment CDI scores were significantly lower, and TRF scores also improved. Pediatric neurologists should be aware of the possibility of depressive disorders in children with epilepsy, especially in those with low school performance. (C) 2008 Elsevier Inc. All rights reserved.Öğe Electrodiagnostic pattern approach for childhood polyneuropathies(Elsevier Science Inc, 2006) Polat, Muzaffer; Tekgul, Hasan; Kilincer, Ahmet; Tosun, Ayse; Terlemez, Semiha; Serdaroglu, Gul; Uludag, Burhanettin; Gokben, SarenurElectrophysiologic studies play a key role in the detection and characterization of the pattern in childhood polyneuropathies. In this study, the etiologic profile of 74 children with polyneuropathy was prospectively evaluated based on the electrophysiologic studies. Five electrodiagnostic patterns were identified in the cohort: (1) acute axonal polyneuropathy (n: 32, 43%); (2) chronic axonal polyneuropathy (n: 16, 22%); (3) demyelinating motor and sensory polyneuropathy (n: 13, 17%); (4) pure sensory polyneuropathy (n: 11, 15%); (5) high-low syndrome (n: 2, 3%). Etiologic factors were identified in all of the patients with three electrodiagnostic patterns of polyneuropathy: acute axonal, pure sensory, and high-low syndrome. However, etiologic factors could not be determined in 5 (31%) children with chronic axonal polyneuropathy and in 3 (23%) children with demyelinating sensory and motor polyneuropathy. Among children with the acute axonal pattern, toxic causes were evident in 18 (56%), acute motor axonal neuropathy in 11 (35%), and acute motor sensory axonal polyneuropathy in 3 (9%). Nine (82%) patients with pure sensory polyneuropathy had diabetes mellitus. In conclusion, a thorough history and physical examination in conjunction with specific electrodiagnostic patterns might provide a cost-effective and rational differential diagnosis of childhood polyneuropathies. (c) 2006 by Elsevier Inc. All rights reserved.Öğe Electrophysiologic assessment of spasticity in children using H-reflex(Turkish J Pediatrics, 2013) Tekguel, Hasan; Polat, Muzaffer; Tosun, Ayse; Serdaroglu, Gul; Gokben, SarenurWe investigated a possible correlation between Hoffmann's reflex (H-reflex) and the Modified Ashworth Scale (MAS) in children with spasticity. H-reflex latencies, amplitudes (H amplitude), Hmax/Mmax amplitude, and MAS were simultaneously measured in 30 children who had bilateral spasticity on the lower extremities. Children with MAS scores of 1 and + 1 composed Group I (n=11), and children with MAS scores of 2 and 3 composed Group II (n=26) and Group III (n=23), respectively. The H-reflex latencies were significantly shorter and Hmax/Mmax ratios were significantly higher in patients with cerebral palsy than controls irrespective of the degree of the MAS. The H-reflex latencies in patients with MAS of 1 or + 1 were significantly longer than in patients with MAS of 2. Other than between these two groups for H-reflex latencies, no significant differences were revealed among the three different MAS groups for either H-reflex latencies or Hmax/Mmax ratios. There is a positive correlation between spasticity assessed by MAS and H-reflex. We concluded that the H-reflex is a reliable electrophysiologic test for assessment of spasticity in children.Öğe The evaluation of muscle biopsy findings in children with neuromuscular disorders(2012) Diniz, Gülden; Tosun, Hülya Yıldırım; Ünalp, Aycan; Barutçuoğlu, Mustafa; Güzel, Orkide; Polat, Muzaffer; Özgönül, FigenAMAÇ: Dünyada çocukluk dönemi kas hastalıklarının klinik ve histopatolojik özelliklerini irdeleyen çalışmalar çok az sayıdadır. Bu çalışma Dr. Behçet Uz Çocuk Hastanesi (BUÇH) patoloji laboratuarında değerlendirilen çocuk kas biyopsilerinin histopatolojik profilini incelemeyi ve klinik ön tanılarla kas biyopsi sonuçlarının uyumunu değerlendirmeyi amaçlamıştır. YÖNTEMLER: Dr.BUÇH patoloji laboratuarında 2004 ile 2011 yılları arasında incelenen 323 kas biyopsisi retrospektif olarak değerlendirildi. Tüm hastalar klinik olarak nöromuskuler hastalığa sahipti ve kas biyopsi materyalleri 5 farklı nörolojik hastalıklar bölümünden gönderildi. BULGULAR: Hastaların ortalama yaşı 6,15 idi (3 hafta- 18 yaş). Yalnızca 22 olgu (%6,8) 14 yaşın üstünde, 39 (%12,07) olgu 12 aydan küçüktü. Spinal muskuler atrofi (n=11, %28.2) infantil grupta en sık gözlenen patolojiydi. Muskuler distrofi tanısı 148 (%45,7) hastaya kondu ve bunların 102’si distrofinopatiydi. Diğer hastalıklar; 23 primer, 16 inflamatuvar, 19 metabolik/mitokondrial myopati ve 28 nöropatiydi. Yetmiş üç hastada (%22,6) aile öyküsü mevcuttu. Akraba evliliği oranı %25,1 bulundu. Serum enzim yüksekliği, EMG patolojisi ve myofiber tip dağılım bozukluğu sırasıyla 109 (%33,7), 188 (%58,2) ve 85(%26,3) hastada saptandı. Hastalık tipiyle CPK düzeyleri (p= 0,001) ve yaş (p=0,015) arasında istatistiksel olarak anlamlı ilişki vardı. SONUÇ: Bu çalışma Türkiye’nin batısındaki çocukluk çağı kas hastalıklarının panoramasını gözler önüne sermiştir. Gereksiz tanısal işlemler ve tedavilerden sakınmak isteniyorsa, çocukluk çağı kas hastalıklarının değerlendirilmesinde kas biyopsisinin sınırlılığının ve tanısal değerinin farkında olmak gerektiğini düşünmekteyiz.Öğe Evaluation of the cases with acute disseminated encephalomyelitis(All India Inst Medical Sciences, 2009) Tosun, Ayse; Serdaroglu, Gul; Polat, Muzaffer; Tekgul, Hasan; Gokben, SarenurWe aimed to describe the epidemiologic, clinical, laboratory features, neuroimaging, treatment, and outcome of children with acute disseminated encephalomyelitis in a cohort study. In this study, twelve children who were diagnosed as acute disseminated encephalomyelitis were reviewed retrospectively. All of the cases were reevaluated with systemic and neurological examinations, serologic tests, cerebrospinal fluid investigations, magnetic resonance imaging. Their age ranged between 2.5 and 16 years. Five of the cases had initial infections. Patients presented most often with motor deficits (75%), secondly with loss of conscious (33%), and seizures (33%). Spinal fluid abnormalities occurred in 41.6%. Cranial, and spinal magnetic resonance imaging (MRI) revealed hyperintense signal changes mainly in basal ganglia and thalamus (58%), cortical and subcortical areas (33) in T2 weighted images. Myelitis was determined in two cases. Six patients were treated with steroid, and 3 were treated with intravenous immunoglobulin. Ten patients recovered completely. We observed relapse in one case and recurrence in two cases. These cases responded well to high dose intravenous prednisolone followed by oral prednisolone for 6 months. Outlook recovery is generally good in acute disseminated encephalomyelitis. Recurrence and neurological deficits are rarely seen. Early treatment of prednisolone is one of the most important factors to determine the prognosis in this disease.Öğe Evaluation of voiding dysfunctions in children with chronic functional constipation(Turkish J Pediatrics, 2006) Kasirga, Erhun; Akil, Ipek; Yilmaz, Oezge; Polat, Muzaffer; Goezmen, Salih; Egemen, AytenThere are controversial results about the role of dysfunctional bowel emptying in disorders of the urinary tract like urinary tract infection (UTI), vesicoureteral reflux (VUR) and enuresis. Constipation may cause UTI, enuresis and VUR due to the uninhibited bladder contraction. The aim of this study was to investigate the frequency of nocturnal enuresis, UTI and instability symptoms in chronic functional constipation (CFC). This study included 38 children with CFC and 31 children as the control group. Detailed past and present history of UTIs or symptoms pointing to this diagnosis, enuresis, encopresis, urgency and urge incontinence was obtained from both groups as well as the family history of UTI. Urinalysis, urine culture and stool parasite analysis as well as abdominal ultrasonography were performed on both groups. Age range of the children with CFC was 6-192 months (mean +/- standard deviation (SD) 63.5 +/- 51 months); that of the control group was 4-180 months (mean +/- SD 82 +/- 46.2 months). Frequency of UTI and urgency was significantly higher in the CFC group. However, frequencies of urge incontinence, nocturnal enuresis, and genitourinary abnormalities were not different between the two groups. In conclusion, risk of UTI and urgency is increased in CFC, but that of other voiding dysfunctions like urge incontinence do not change significantly. Therefore, we suggest that UTI and urgency should be questioned in children with CFC and vice versa.Öğe İdrar yolu enfeksiyonlu çocuklarda sefiksim tedavisinin idrar NAG atılımına etkisi(2004) Akil, İpek; Yazıcı, Püreda; Yılmaz, Özge; Polat, Muzaffer; Ulman, Cevval; Kutay, Fatma Z.İdrar yolu enfeksiyonu (İYE) çocukluk çağının en sık bakteriyel enfeksiyonlarından biridir. Üçüncü jenerasyon sefalosporinler arasında yer alan ve geniş antibakteriyal spektruma sahip olan sefiksimin İYE'nun oral yoldan tedavisinde etkinliği kanıtlanmıştır. Bu çalışmada İYE'lu çocuklarda sefiksimin idrar elektrolit atılımları ve proksimal tübüler fonksiyo¬nun duyarlı bir göstergesi olan N-asetil-beta-D-glukozaminidaz (NAG) atılımına etkisinin araştırılması amaçlanmıştır. Çalışmaya İYE tanısı konan ve sefiksim tedavisi başlanan yaşlan 5-156 ay arasında değişen (medyan yaş: 72 ay) 24 kız, 2 erkek İYE'lu çocuk çalışma grubu olarak alınırken; kontrol grubu olarak son bir ay içinde antibiyotik kullanmamış olan 17 çocuk (yaş dağılımı 8-156 ay arasında, medyan yaş 82 ay, 6 kız, 11 erkek) alınmıştır. İYE'lu hastaların sefiksim tedavisi öncesi ve 10 günlük tedaviden sonra, ayrıca kontrol grubunun açlık spot ilk idrar örneklerinde sodyum, potasyum, kalsiyum, magnezyum, ürik asit, fosfor (Na, K, Ca, Mg, Ürik Asit, P) düzeyleri ve NAG aktiviteleri ölçülerek sonuçlar idrar kreatinine (Kre) oranlanarak hesaplanmıştır. İdrar NAG aktivite ölçümü idrara jel filtrasyonu uygulandıktan sonra paranitrofenol yöntemi ile yapılmıştır. Kontrol grubu ile tedavi öncesi hasta grubunun sonuçlan non-parametrik, Mann Whitney U testi ile; hasta grubunun tedavi öncesi ve tedavi sonrası değerleri Wilcoxon Signed Ranks testi ile karşılaştınlmıştır.Çalışmanın sonuçlarında spot idrarda Na, K, Ca, Ürik Asit, Mg, P'un idrar kreatinine oranları ve NAG/Kre oranları İYE'lu çocuklarda tedavi öncesinde kontrol grubuna oranla farklı bulunmamıştır (p>0,05). İdrar elektrolit ve NAG atılımları da hasta grubunda tedavi sonrasında tedavinin başlangıç düzeylerine oranla farklı değildi (p>0,05).Sonuç olarak, oral yoldan günde tek doz olarak kullanılan ve bu şekilde tedavi uyumu yüksek olan sefiksimin renal tübüler fonksiyonlarda değişiklik yaratmadığı saptandı. Bu sonucun tedavinin güvenilirliğinin belirlenmesi açısından önemli olduğu düşünüldü.Öğe Miller Fisher syndrome: a case with pattern of pure sensory polyneuropathy concomitant with anti-GQ1B antibody(Turkish J Pediatrics, 2007) Akinci, Gulcin; Polat, Muzaffer; Tosun, Ayse; Serdaroglu, Gul; Gokben, Sarenur; Tekgul, HasanMiller Fisher syndrome is characterized by the acute onset of ophthalmoplegia, ataxia, and areflexia. Anti-GQ1b antibodies are useful markers for the differential diagnosis of Miller Fisher syndrome. We describe the case of a seven-year-old male who presented with a four-day history of diplopia and ophthalmoplegia following a febrile flu-like illness with sore throat. On examination he was found to have ataxia, areflexia and ophthalmoplegia, and a diagnosis of Miller Fisher syndrome was made after the exclusion of other conditions and concomitant with electrophysiological findings on electromyography. Although this disorder has a rare incidence, it should still be considered in the differential diagnosis in our country.Öğe Neuropsychologic Impairment in Children With Rolandic Epilepsy(Elsevier Science Inc, 2009) Ay, Yilmaz; Gokben, Sarenur; Serdaroglu, Guel; Polat, Muzaffer; Tosun, Ayse; Tekgul, Hasan; Solak, Ufuk; Kesikci, HandeAlthough patients with benign childhood epilepsy with centrotemporal spikes exhibit normal intelligence, they frequently display neuropsychologic abnormalities. Thirty-five patients with rolandic epilepsy were included in this study. They were divided into three subgroups. Group I comprised patients with rolandic focus who were not receiving treatment. Group II comprised patients with rolandic focus who were receiving treatment. Group III comprised patients who demonstrated improved foci and were not receiving treatment. The control group comprised 16 children who were similar to patients in terms of age, sex, and sociocultural level. All children underwent standardized neuropsychologic testing, including the Wechsler Intelligence Scale for Children-Revised subtests, Bender Gestalt Test, Stroop Test, Visual Aural Digit Span, Reading and Writing Performance, and Dichotic Listening Test. Patients exhibited significantly impaired visuomotor and reading ability and attention to verbal stimuli compared with control subjects. Reading disability persisted in patients in remission from seizures and epileptic discharges. Contrary to the presumed benign nature of rolandic epilepsy, this disorder may cause learning disabilities. Therefore, patients must be followed longitudinally to identify any learning problems. (C) 2009 by Elsevier Inc. All rights reserved.Öğe Neuropsychologic Impairment in Children With Rolandic Epilepsy(Elsevier Science Inc, 2009) Ay, Yilmaz; Gokben, Sarenur; Serdaroglu, Guel; Polat, Muzaffer; Tosun, Ayse; Tekgul, Hasan; Solak, Ufuk; Kesikci, HandeAlthough patients with benign childhood epilepsy with centrotemporal spikes exhibit normal intelligence, they frequently display neuropsychologic abnormalities. Thirty-five patients with rolandic epilepsy were included in this study. They were divided into three subgroups. Group I comprised patients with rolandic focus who were not receiving treatment. Group II comprised patients with rolandic focus who were receiving treatment. Group III comprised patients who demonstrated improved foci and were not receiving treatment. The control group comprised 16 children who were similar to patients in terms of age, sex, and sociocultural level. All children underwent standardized neuropsychologic testing, including the Wechsler Intelligence Scale for Children-Revised subtests, Bender Gestalt Test, Stroop Test, Visual Aural Digit Span, Reading and Writing Performance, and Dichotic Listening Test. Patients exhibited significantly impaired visuomotor and reading ability and attention to verbal stimuli compared with control subjects. Reading disability persisted in patients in remission from seizures and epileptic discharges. Contrary to the presumed benign nature of rolandic epilepsy, this disorder may cause learning disabilities. Therefore, patients must be followed longitudinally to identify any learning problems. (C) 2009 by Elsevier Inc. All rights reserved.Öğe Normative Values of Transcranial Magnetic Stimulation-Evoked Parameters for Healthy Developing Children and Adolescents(Wolters Kluwer Medknow Publications, 2021) Tekgul, Hasan; Saz, Ulas; Polat, Muzaffer; Tekgul, Nurdan; Kose, TimurContext: Normative data-containing transcranial magnetic stimulation (TMS) evoked parameters are essential for correctly interpreting healthy development and assessing neuroplastic changes in certain neurologic disorders. Aims: The aim is to investigate corticospinal pathways by applying TMS to healthy developing children and adolescents. Settings and Design: In this cross-sectional study, we measured TMS evoked parameters associated with cortical and spinal stimulation obtained from the four extremities of 46 healthy children and adolescents (21 boys and 25 girls; mean +/- standard deviation age: 6.4 +/- 1.2 years; range: 3.0-20.5 years). Statistical Analysis: Spearman's correlation coefficients were calculated for each variable (weight and height) as a function of motor evoked potential (MEP) response latency and central motor conduction time (CMCT). Pearson's Chi-square test was used to determine the inter-variable correlations. Results: Latencies of MEPs were correlated with age (P < 0.001, r = 0.6948) and height (P < 0.006, r = 0.7994). Amplitudes of active-state MEPs were significantly higher than those of resting-state MEPs associated with the upper and lower extremities. The mean values for active-state MEP latencies were lower than those for resting-state MEPs. The CMCT and magnitudes of latency jumps were calculated using reliable MEP data for children and adolescents. Additionally, the unresponsiveness rates were significantly higher for children aged below 7 years. Conclusion: The TMS evoked parameters investigated in this study are necessary to accurately assess corticospinal pathway development in healthy children and adolescents.Öğe A novel candidate gene for neurodevelopmental disorders: JKAMP(Springernature, 2024) Avci Durmusalioglu, Enise; Isik, Esra; Polat, Muzaffer; Canda, Ebru; Atik, Tahir[Abstarct Not Available]Öğe Oksipital epilepsili olgularda nörokognitif değerlendirme(Ege Üniversitesi, 2010) Polat, Muzaffer; Gökben, SarenurOksipital paroksizmli çocukluk çağı epilepsisi (OPÇE), çocukluk çağının selim fokal epilepsileri içinde ikinci sıklıkta görülmektedir. Selim kelimesi, epileptik nöbetin nadir tekrarlaması ve adölesan döneminin sonuna kadar kendiliğinden düzelmesi ve nörolojik/ nöropsikolojik bozukluk olmaması anlamında kullanılmaktadır. Çalışmada OPÇE’li olgularda bilişsel fonksiyonların değerlendirilmesi ve bulguların semptomatik oksipital epilepsili olgular ve sağlıklı kontrol grubu verileri ile karşılaştırılması amaçlanmıştır. Ege Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Çocuk Nörolojisi Bilim Dalı’nda 1996–2005 yılları arasında izlenen OPÇE’li 17, semptomatik oksipital epilepsili 11 ve kontrol 17 olgu olmak üzere toplam 45 çocuk çalışmaya alındı. Çalışmaya alınan olgulara görsel uzaysal algılama başta olmak üzere bellek, öğrenme güçlüğü ve dikkat eksikliği gibi bilişsel fonksiyonların öğrenilmesini sağlayan Wechsler Çocuklar İçin Zekâ Ölçeği- Geliştirilmiş Formu (WÇZÖ-R), Görsel-işitsel sayı dizisi testleri; GİSD-B ve Bender Gestalt Görsel-Motor Algılama Testi (B-G) uygulandı. Performans IQ skorlarının geç başlangıçlı OPÇE’li olgularda kontrol grubuna göre düşük olduğu görüldü. Ayrıca semptomatik epilepsili grupta da performans IQ anlamlı düşük saptandı (p:0.00). GİSD-B testinde ise sadece semptomatik grupta kontrol grubuna göre anlamlı düşük puanlar bulundu. Görsel motor koordinasyonu değerlendiren Bender-Gestalt testinde organisite erken ve geç OPÇE’li olgularda kontrol grubuna göre yüksek bulundu (p:0.019, p:0.001). Kontrol grubu ile semptomatik oksipital epilepsili hastalar karşılaştırıldığında, beklenildiği gibi semptomatik grupta organisite oranı çok yüksek bulundu (p:0.00). OPÇE’li çocuklarda bilişsel değerlendirmenin yapıldığı çalışmalar çok sınırlıdır. Bu çalışma erken ve geç başlangıçlı OPÇE olarak ayrılıp olguların değerlendirildiği ilk çalışmadır. Çalışma sonunda OPÇE’li olgularda, özellikle geç başlangıçlı formda, görsel- uzaysal algılama, hafıza ve dikkat bozuklukları saptandı. Hastaların, akademik başarılarının dikkatli izlemi ve gerektiğinde nörokognitif işlevlerin değerlendirilmesi ve hastalara uygun eğitim desteğinin sağlanması gerektiği düşünülmüştür.Öğe Prediction of neurodevelopmental outcome in term neonates with hypoxic-ischemic encephalopathy(Elsevier Sci Ltd, 2013) Polat, Muzaffer; Simsek, Ayse; Tansug, Nermin; Sezer, Rabia G.; Ozkol, Mine; Baspinar, Pinar; Tekgul, HasanBackground: Hypoxic ischemic encephalopathy may result in many neurological deficits. It is crucial to make early diagnosis and assess the prognosis correctly. Aims: We aimed to determine the factors to evaluate the prognosis of hypoxic ischemic encephalopathy. Methods: Electroencephalography, neuroimaging, periodic neurological exams and a developmental test at 44-48 months after discharge from the hospital were performed on twenty five term newborn infants with clinical evidence of hypoxic ischemic encephalopathy. Results: Normal/mildly abnormal neonatal electroencephalography correlated with favorable outcome, particularly if neuroimaging was normal. The cranial MRI sensitivity was 83.3%, while the specificity was 57.9%, the positive predictive value was 38.5%, and the negative predictive value was 91.6%. Moderate/severely abnormal electroencephalography and multifocaVdiffuse cortical or deep gray matter lesions correlated with poor outcome. Conclusions: Newborn infants with hypoxic ischemic encephalopathy should be treated in neonatal intensive care units, assessed with periodic neurological examination, electroencephalogram and brain imaging. This would help to initiate early intervention and improve the outcome of patients. (C) 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.Öğe Ratios of Nine Risk Factors in Children With Recurrent Febrile Seizures(Elsevier Science Inc, 2010) Tosun, Ayse; Koturoglu, Guldane; Serdaroglu, Gul; Polat, Muzaffer; Kurugol, Zafer; Gokben, Sarenur; Tekgul, HasanFebrile seizures are the most common convulsive disorder of childhood, with a recurrence probability of 33%. The aim of the study was to determine the risk factors for recurrence of febrile seizures in children. In this descriptive, cross-sectional study, nine risk factors of recurrence of febrile seizures were investigated in 259 children with febrile seizures: (1) sex; (2) domicile; (3) income level; (4) family history of febrile seizures; (5) family history of epilepsy; (6) level of fever; (7) duration of fever; (8) type of seizure, simple vs complex; and (9) age at seizure onset. The risk factors were compared for 119 children with isolated febrile seizures (45.9% of the total) and 140 children with two or more febrile seizure recurrences (54.1%). Among the patients with and without recurrent febrile seizures, 32% and 18% were domiciled in nonurban areas, respectively (P = 0.012). There was a family history of febrile seizures in 57% and 44% of cases with and without recurrent febrile seizures, respectively (P = 0.031). According to the logistic regression analysis, a family history of febrile seizures was a risk factor that affected recurrence (P = 0.018; odds ratio OR = 1.933; 95% confidence interval CI = 1.121-3.333). We also found that domicile (P = 0.001) and income (P = 0.013) were risk factors for recurrence. A family history of epilepsy was not a significant risk factor (P = 0.129; OR = 2.110; 95% CI = 0.804-5.539). (C) 2010 by Elsevier Inc. All rights reserved.
