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    A case of syncopal convulsions triggered by glossopharyngeal neuralgia
    (Türk Algoloji (Ağrı) Derneği (The Turkish Society of Algology), 2021) Taşcı, İrem; Beydilli, İbrahim; Demir, Caner Feyzi; Balgetir, Ferhat; Göen, Murat; Bakır, Meryem
    Syncopal convulsions and epileptic seizures are clinically hard to distinguish and differ in terms of treatment approaches. It is important to consider the cardiac arrhythmias that impair cerebral perfusion in the differential diagnosis of antiepileptic treatment-resistant convulsions. Here, we offer a 72-year-old male patient glossopharyngeal neuralgia (GN) after swallowing associated with recurrent episodes of syncopal convulsions. The patient was successfully treated with temporary pacemaker and carbamazepine. This phenomenon is noteworthy in terms of both asystole triggered by GN and syncopal convulsions which are rare in the differential diagnosis of epileptic seizures.
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    Evaluation of neurological disorders that develop concurrently with COVID-19 pneumonia: a retrospective analysis
    (Associacao Arquivos de Neuro-Psiquiatria Dr. Oswaldo Lange / Associação Arquivos de Neuropsiquiatria Dr Oswaldo Lange, 2022) Taşçı, İrem; Balgetir, Ferhat; Müngen, Bülent; Demir, Caner Feyzi; Gönen, Murat; Delen, Leman Acun; Kurt, Osman
    Background: During the pandemic, many neurological symptoms have been evaluated as complications of COVID-19 pneumonia. Objective: To investigate the frequency and characteristics of neurological findings, and their effects on the prognosis of patients with COVID-19 pneumonia who consulted with the Neurology department. Methods: Data on 2329 patients who were hospitalized with the diagnosis of COVID-19 pneumonia in our hospital were scanned. The clinical, laboratory and radiological findings relating to treatment of 154 patients who required neurological consultation were retrospectively evaluated by reviewing the clinical notes. Results: The number of COVID-19 pneumonia patients who required neurological consultations while hospitalized in the ICU was 94 (61.0%). The most common symptom among these patients was hyperactive delirium. Mean age, ferritin levels and CRP values ??of those with delirium were higher, while the mean lymphocyte percentage were lower, than those of the patients without delirium. Epileptic seizures were observed in eight patients without an epilepsy diagnosis. Two patients were diagnosed with GBS and one patient with ICU neuropathy. The D-dimer levels of patients with acute hemorrhagic CVD and the thrombocyte levels of patients with acute ischemic CVD were found to be higher than in patients without acute ischemic CVD. Conclusion: The proportion of patients who required neurological consultations was higher in the ICUs. We observed neurological symptoms more frequently in the advanced age group. There were no significant increases in the incidence of other neurological conditions except delirium, in COVID-19 patients. We think that further studies are needed to support our data.
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    Myasthenia gravis
    (Akademisyen Yayinevi Kitabevi, 2021) Demir, Caner Feyzi; Taşci, Irem
    Myasthenia gravis (MG) is an autoimmune disease that impairs neuromuscular transmission and causes muscle weakness that worsens with fatigue. The first description of MG was made by an English doctor named Thomas Willis in 1672 in his book \"De anima brutorum\". The term \"myasthenia gravis\" was first used by Friedrich Jolly in 1895, with \"myasthenia\" meaning muscle weakness in Greek and \"gravis\" meaning severe in Latin.The incidence and prevalence of MG have been calculated based on 55 studies published between 1950 and 2007, and it has been found to affect 5.3 and 77.7 million people worldwide, respectively. Furthermore, it has been revealed that the prevalence of MG has been increasing over the past half-century. The reasons for this increase may be attributed to factors such as increased knowledge about the disease and higher diagnostic rates, increased treatment options, advancements in intensive care technology, and improved survival rates among patients. While MG typically affects young individuals, recent epidemiological studies have shown an increased incidence of MG in individuals over the age of 50. MG has a bimodal incidence pattern with two peaks in women, occurring at ages 20-30 and over 50, whereas in men, it is typically seen in individuals over the age of 50. Clearly, MG is more common in young females and does not show a gender preference in older ages. However, the development of MG in children under the age of 1 is unlikely.The pathogenesis of MG involves an autoimmune attack against the postsynaptic acetylcholine receptor (AChR) at the neuromuscular junction. AChR antibodies disrupt neuromuscular transmission in patients with generalized MG (GMG) and ocular MG (OMG). In AChR-negative MG, muscle-specific receptor tyrosine kinase (MuSK) has been identified as another antigenic target. Recently, another autoantibody targeting low-density lipoprotein receptor-related protein 4 (LRP4) has been detected in AChR-negative and MuSK-negative MG. AChR antibodies can be detected in approximately 85% of GMG patients and 50% of OMG patients. MuSK antibodies can be found in 70% of patients without AChR antibodies and these antibodies belong to the IgG4 isotype. LRP4 antibodies have been found to be positive in 18.7% of seronegative MG patients in a recent study evaluating a large patient series. LRP4 antibodies contain complement-activating IgG1 isotype that inhibits agrin-induced AChR clustering. Agrin antibodies are rarely detected in seronegative MG patients and sometimes in GMG patients. © 2021 Akademisyen Kitabevi A.Ş. All rights reserved.
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    Physical exercise may improve problem-solving skills and emotional intelligence in patients with relapsing-remitting multiple sclerosis: A cross-sectional study
    (Elsevier B.V. All, 2022) Taşcı, İrem; Demir, Caner Feyzi; Bilek, Furkan; Albayrak, Sait
    Background: Multiple sclerosis is a disease that can reduce the quality of life with a physical disability, neuro-psychiatric disorders, and cognitive dysfunctions. Therefore, multiple sclerosis treatment should include treatments for cognitive and neuropsychiatric disorders and pharmacological treatments. This study aimed to examine the effects of exercise on neuropsychiatric disorders, problem-solving skills, and emotional intelligence in multiple sclerosis patients. Methods: Thirty-six female relapsing-remitting multiple sclerosis patients aged between 18 and 45 years, with an Expanded Disability Status Scale between 1 and 3, who were diagnosed with definitive multiple sclerosis according to the revised McDonald criteria were included in the study. Participants completed outcome measures before and after the 12-week exercise program. Demographic/clinical information of the participants was obtained at baseline, neurological examinations were performed, and graded exercise testing on a bicycle ergometer was performed to determine aerobic capacity. Short Form-12 Version 2, Hospital Anxiety and Depression Scale, Modified Fatigue Impact Scale, Problem-Solving Inventory, Emotional Intelligence Scale were evaluated before and after the exercise program of the participants. Results: While a significant increase was observed in the HRpeak values of the participants after the exercise (p <0.05), the VO2max values also showed a highly significant difference compared to the pre-treatment values. (p <0.01). While a significant difference was detected in the mental subparameter of Short Form-12 (p < 0.05), a high level of significant difference was found in the physical subparameter (p< 0.01). While no significant difference was observed in the Hospital Anxiety and Depression Scale anxiety subparameter (p > 0.05), a significant difference was found in the depression subparameter (p < 0.01). There was a significant difference in Modified Fatigue Impact Scale physical and cognitive subparameters compared to pre-treatment (p < 0.01). A significant difference was observed in the Emotional Intelligence Scale total score after the treatment (p < 0.01). Conclusions: The results of our study showed that exercise in relapsing-remitting multiple sclerosis patients provided significant improvements in emotional intelligence, improved neuropsychiatric parameters, and increased problem-solving skills. In addition, to the best of our knowledge, this study is the first study in the literature to investigate the effect of physical activity exercises on problem-solving skills in multiple sclerosis patients.
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    The use of non-steroidal anti-inflammatory drugs in cerebrovascular diseases
    (Nova Science Publishers, Inc., 2021) Demir, Caner Feyzi; Tasci, Irem
    Cerebrovascular diseases (CVD) are a group of diseases resulting from ischemic or hemorrhagic conditions, causing neurological deficits. In developed countries, CVD are the third leading cause of death and the leading cause of disability. In ischemic and hemorrhagic conditions, nonsteroidal and anti-inflammatory drugs (NSAIDs) are commonly used as antiplatelet, anti-inflammatory, and analgesic drugs. On the other hand, these drugs have been associated with increased risk of hemorrhage and thrombosis. One of cyclooxygenase-1 (COX-1) inhibitor, acetylsalicylic acid (ASA), is the most widely used agent in the acute treatment and prophylaxis of ischemic CVD. Moreover, ASA catalyzes the conversion of arachidonic acid into prostaglandin H2 through irreversible acetylation of COX-1 and cyclooxygenase-2 (COX-2), thereby reducing platelet aggregation. Another subgroup of NSAID is known as COX-2 selective NSAIDs including celecoxib, rofecoxib, and valdecoxib. These agents, however, have been removed from the market after being reported to increase the incidence of thrombotic stroke and myocardial infarction. A previous meta-analysis indicated that diclofenac, similar to coxibs, increases the risk of ischemic CVD compared to the nonuse of NSAIDs and also suggested that naproxen appears to have a better CVD safety profile compared to other NSAIDs. As NSAIDs are a chemically heterogeneous group of compounds, the use of each compound may have a different effect on not only thrombotic but also hemorrhagic risk factors. A recent study conducted systematic review to evaluate the risk of CVD associated with the use of individual NSAIDs and revealed that the use of diclofenac and meloxicam is associated with an increased risk of hemorrhagic CVD. The authors also noted that the use of these two NSAIDs leads to vasoconstriction by inhibiting the COX-2 in the kidney and also increases salt and water reabsorption, thereby increasing the risk of hypertension and CVD. In light of these notions, it is safe to assert that when prescribing NSAIDs, these drugs may have procoagulant effects, cause hypertension by increasing fluid and salt retention, may interact with drugs used in CVD prophylaxis. So it should be recognized that these drugs are likely to cause an increased risk of thrombosis and hemorrhage. © 2021 by Nova Science Publishers, Inc. All rights reserved.