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Öğe Antiepileptic drug-induced osteopenia in ambulatory epileptic children receiving a standard vitamin D3 supplement(Freund Publishing House Ltd, 2005) Tekgul H.; Dizdarer G.; Demir N.; Ozturk C.; Tutuncuoglu S.Dual energy X-ray absorptiometry (DEXA) is a non-invasive, rapid, accurate and highly reproducible method for the assessment of antiepileptic drug (AED)-induced osteopenia in epileptic children. In this study, we investigated bone mineral density (BMD) using DEXA in 56 epileptic children receiving long-term AED treatment for at least 2 years. All children received AED monotherapy or polytherapy plus a standard vitamin D3 supplement (400 U/day). BMD measurements were made from lumbar spine (L2-L4) regions. Age- and sex-specific BMD SD scores were calculated for each child. Osteopenia was defined as SD scores less than -1.5. There was no significant difference in mean BMD values between epileptic children receiving monotherapy or polytherapy. The results were also compared to the age- and sex-specific BMD SD scores obtained from healthy Turkish children. Only three patients (5%) receiving AED therapy had a BMD SD score less than -1.5. This rate is relatively lower than the rates of previous studies conducted on ambulatory children on long-term AED treatment without vitamin D3 supplementation. © Freund Publishing House Ltd., London.Öğe The evaluation of late sequelae of tetanus infection(Springer India, 1994) Tutuncuoglu S.; Demir E.; Koprubasi F.; Selcuki D.Tetanus is still an important cause of morbidity and mortality in developing countries. Fifty two patients with tetanus were admitted within a 15 year period to our hospital, and 24 of them died. The remaining cases were called for re-evaluation 3-13 years after the infection. Only 10 cases were admitted again, and 6 of them recovered from neonatal tetanus. Their neurological examinations were unremarkable with 5 of them having mild mental retardation. Their EEG's were normal except for one case who had epileptic focus. Their visual and brainstem evoked potentials (VEP, BAEP) were measured and they were in normal ranges. Their results were compared with the results of a control group which consisted of 9 healthy children of matched age and sex. © 1994 Dr. K C Chaudhuri Foundation.Öğe Gastroesophageal reflux in children with cerebral palsy: Efficacy of cisapride(2004) Bozkurt M.; Tutuncuoglu S.; Serdaroglu G.; Tekgul H.; Aydogdu S.The aim of this study was to investigate the presence of gastroesophageal reflux with 24-hour pH monitoring in children with cerebral palsy. In the second part of the study, we started cisapride with the children with documented gastroesophageal reflux and evaluated the efficacy of cisapride with the second 24-hour pH monitoring. This study was performed before discontinuation of cisapride with US Food and Drug Administration reports in Turkish markets. Twenty-eight children who had been followed up in the Department of Pediatric Neurology between 1999 and 2000 were enrolled in the study. Twenty-four-hour pH monitoring was performed on all patients. Two parameters were evaluated as pathologic: a reflux index (percentage of time the pH value was < 4) over 4.5% and reflux longer than 15 minutes even when the reflux index was below 4.5%. Cisapride treatment was assigned to the patients with pathologic monitoring results at a dose of 0.2mg/kg/day for 3 months. Electrocardiograms (ECGs) were analyzed before and after cisapride treatment. Symptoms suggestive of gastroesophageal dysfunction were dysphagia in 18 cases (64.3%), constipation in 8 cases (28.6%), vomiting in 6 (14.2%) cases, and recurrent pneumonia in 2 cases (8.5%). The reflux index was ?4.5% in 13 (46.4%) of the 28 cases. Reflux was longer than 15 minutes in 2(7.1%) cases. Cisapride was started in 15 cases with pathologic monitoring results. Appetite improved in 6 cases and dysphagia disappeared in 8 cases after cisapride therapy (P < .05). pH monitoring was repeated in 12 cases after 3 months and was normal in 8 of them. Improvement in the reflux index and total reflux episodes was statistically significant after therapy (P = .008). No adverse effects occurred. Even though the drug is no longer marketed, we concluded that it improved the symptoms and quality of life in spastic children with gastroesophageal reflux.Öğe Gradenigo syndrome: A case report(Springer-Verlag, 1993) Tutuncuoglu S.; Uran N.; Kavas I.; Ozgur T.The case is presented of a 13-year-old boy with recurrent episodes of otitis media who developed Gradenigo syndrome. Mastoid and petrous bone involvement were demonstrated by CT. Symptoms resolved with antibiotic treatment. © 1993 Springer-Verlag.Öğe Outcome of axonal and demyelinating forms of Guillain-Barré syndrome in children(Elsevier Inc., 2003) Tekgul H.; Serdaroglu G.; Tutuncuoglu S.Previous reports have suggested that outcome is worse in the axonal compared with the demyelinating form of Guillain-Barré syndrome (GBS). We performed a retrospective study of 23 children with electrophysiologically confirmed cases of predominant subtypes of GBS to investigate this issue. The patients were classified based on the electrodiagnostic features: Ten (44%) had acute inflammatory demyelinating polyradiculoneuropathy, eight (35%) had acute motor axonal neuropathy, and five (21%) had acute motor-sensory axonal neuropathy. All patients received a standard intravenous immunoglobulin therapy (0.4 g /kg /day for 5 consecutive days). In the acute phase of the disease, patients with the axonal forms of GBS were more disabled than were those with the demyelinating GBS, as measured by GBS scores. Mechanical ventilation was required in five (38%) patients in the axonal group compared with one (10%) patient in the demyelinating group. There was no significant difference at 6 months in GBS scores between demyelinating and axonal forms of GBS. All 20 survivors recovered completely by 12 months. After standard intravenous immunoglobulin therapy, children with axonal forms of GBS recover more slowly than those with the demyelinating form, but outcome at 12 months appears to be equally favorable in two groups. © 2003 by Elsevier Inc. All rights reserved.
