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Öğe Brakial pleksopatide klinik, EMG ve MR nörografi bulgularının değerlendirilmesi(2022) Karazincir, Sinem; Turhanoğlu, Ayşe Dicle; Okuyucu, Emine Esra; Burakgazi, GülenAmaç: Çalışmanın amacı brakial pleksopatide MR nörografi sonuçlarını elektrodiagnostik test ile birlikte değerlendirmek ve MR nörografinin yararlığını saptamaktır. Yöntem: Brakial pleksopati şüphesi bulunan ve elektrodiagnostik test yapılan 50 hasta çalışmaya dahil edildi. MR nörografide Brakiyal pleksusun kök, gövde ve kord seviyesinde seyri, kalibrasyonu, sinyal yoğunluğu ve devamlılığı 2 bağımsız radyolog tarafından değerlendirildi. Bulgular: Elektrodiagnostik test altın standart tanı testi kabul edilerek yapılan analizde MR nörografinin tanısal doğruluk, duyarlılık, özgüllüğü; 1. okuyucu için sırasıyla %64, %45.16, %94.73; 2. okuyucu için sırasıyla %74, %67.74, %84.21 idi. Okuyucular arası tutarlılık %78 idi. Sonuç: Brakial pleksopati klinik şüphesi bulunan hastalarda MR’ın duyarlılığı ve okuyucular arasındaki uyum orta derecede bulundu. MR nörografi brakial pleksopatiyi gösterebilir ancak pleksusun normal görünümü pleksopati tanısını dışlamamalıdır.Öğe A Case of Secondary Narcolepsy Presenting with Obstructive Sleep Apnea Symptoms(Galenos Publ House, 2016) Genc, Sebahat; Bilgic, Hatice Kayim; Okuyucu, Emine Esra; Dikmen, Nursel; Duman, TaskinObstructive sleep apnea syndrome (OSAS) and narcolepsy are two diseases causing excessive daytime sleepiness (EDS). As they are often confused, these two disorders can also coexist. Therefore there is need to distinguish these disorders in patients with EDS. We would like to present a case on a patient who sent to our sleep laboratory with a preliminary diagnosis of OSAS and suspicion of narcolepsy in detailed history. The case is a 24 year-old male. He was diagnosed with OSAS and narcolepsy while being investigated for OSAS. Neurological examination revealed an additional diagnosis of multiple sclerosis. In this case report, we emphasize that in patients with EDS, particularly if EDS cannot be explained with OSAS, investigation for narcolepsy should also be done. In addition, when narcolepsy is detected; neurological examination is actually necessary considering the possibility of secondary narcolepsy.Öğe A case with essential tremor refractory to medication successfully treated with deep brain stimulation(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2018) Yilmaz, Atilla; Yildizgoren, Mustafa Turgut; Okuyucu, Emine Esra[Abstract Not Available]Öğe EVALUATION OF HEARING LOSS IN PATIENTS WITH OSAS AND THE RELATIONSHIP BETWEEN S100B AND NSE(2020) Arlı, Cengiz; Sarac, Elif Tugba; Babayıgıt, Cenk; Dıkmen, Nursel; Özcan, Oğuzhan; Dogru, Sibel; Okuyucu, Emine EsraObjective: The aim of the current study was to determine the relationship between serum S100B levels, NSE levels and hearing function in patients with OSAS. Material and Methods: Thirty-five subjects and 30 controls were included in the study. The study group included 35 patients with moderate and severe apnoea (AHI > 15) who were diagnosed by polysomnography (PSG). Control subjects were selected with ESS (Epworth Sleepiness Scale). Serum S100B and NSE levels in the study and control groups were analyzed by ELISA (enzyme-linked immunosorbent assay) and high-frequency audiometry was done for all subjects. Results: Mean S100B levels and NSE levels of the OSAS group were significantly higher than that of the controls (p = 0.039; p = 0.002, respectively). The hearing thresholds between 125-1,000 Hz and between 4,000-12,000 Hz in the study group were found to be significantly higher than the control group. Conclusion: We suggest that hearing function should be evaluated in OSAS patients and a professional consultation should be sought for OSAS treatment. In addition, serum S100B and NSE measurements may be valued as biochemical indicators in determining hearing loss risk caused by OSAS.Öğe Evaluation of hearing loss in patients with OSAS and the relationship between S100B and NSE(PLEKSUS BİLİŞİM TEKN. DANIŞ. TEMS. YAY. ORG. A.Ş., 2020) Arlı, Cengiz; Saraç, Elif Tuğba; Özcan, Oğuzhan; Babayiğit, Cenk; Dikmen, Nursel; Doğru, Sibel; Okuyucu, Emine EsraObjective: The aim of the current study was to determine the relationship between serum S100B levels, NSE levels and hearing function in patients with OSAS. Material and Methods: Thirty-five subjects and 30 controls were included in the study. The study group included 35 patients with moderate and severe apnoea (AHI > 15) who were diagnosed by polysomnography (PSG). Control subjects were selected with ESS (Epworth Sleepiness Scale). Serum S100B and NSE levels in the study and control groups were analyzed by ELISA (enzyme-linked immunosorbent assay) and high-frequency audiometry was done for all subjects. Results: Mean S100B levels and NSE levels of the OSAS group were significantly higher than that of the controls (p = 0.039; p = 0.002, respectively). The hearing thresholds between 125-1,000 Hz and between 4,000-12,000 Hz in the study group were found to be significantly higher than the control group. Conclusion: We suggest that hearing function should be evaluated in OSAS patients and a professional consultation should be sought for OSAS treatment. In addition, serum S100B and NSE measurements may be valued as biochemical indicators in determining hearing loss risk caused by OSAS.Öğe Investigating the effect of STN-DBS stimulation and different frequency settings on the acoustic-articulatory features of vowels(Springer-Verlag Italia Srl, 2018) Yilmaz, Atilla; Sarac, Elif Tugba; Aydinli, Fatma Esen; Yildizgoren, Mustafa Turgut; Okuyucu, Emine Esra; Serarslan, YurdalIntroduction Parkinson's disease (PD) is the second most frequent progressive neuro-degenerative disorder. In addition to motor symptoms, nonmotor symptoms and voice and speech disorders can also develop in 90% of PD patients. The aim of our study was to investigate the effects of DBS and different DBS frequencies on speech acoustics of vowels in PD patients. Methods The study included 16 patients who underwent STN-DBS surgery due to PD. The voice recordings for the vowels including [a], [e], [i], and [o] were performed at frequencies including 230, 130, 90, and 60 Hz and off-stimulation. The voice recordings were gathered and evaluated by the Praat software, and the effects on the first (F1), second (F2), and third formant (F3) frequencies were analyzed. Results A significant difference was found for the F1 value of the vowel [a] at 130 Hz compared to off-stimulation. However, no significant difference was found between the three formant frequencies with regard to the stimulation frequencies and off-stimulation. In addition, though not statistically significant, stimulation at 60 and 230 Hz led to several differences in the formant frequencies of other three vowels. Conclusion Our results indicated that STN-DBS stimulation at 130 Hz had a significant positive effect on articulation of [a] compared to off-stimulation. Although there is not any statistical significant stimulation at 60 and 230 Hz may also have an effect on the articulation of [e], [i], and [o] but this effect needs to be investigated in future studies with higher numbers of participants.Öğe Investigating the effects of subthalamic Nucleus-Deep brain stimulation on the voice quality(Taylor & Francis Ltd, 2020) Sarac, Elif Tugba; Yilmaz, Atilla; Aydinli, Fatma Esen; Yildizgoren, Mustafa Turgut; Okuyucu, Emine Esra; Okuyucua, Semsettin; Akakin, AkinIntroduction: Deep brain stimulation (DBS) is a standard surgical treatment method which is generally applied to subthalamic nucleus in Parkinson's patients in cases where medical treatment is insufficient in treating the motor symptoms. It is known that Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) treats many motor symptoms. However, the results of studies on speech and voice vary. The aim of the study is analysing the effect of STN-DBS on the characteristics of voice. Materials/methods: A total of 12 patients, (8 male-4 female) with an age average of 58.8 +/- 9.6, who have been applied DBS surgery on STN included in the study. The voice recordings of the patients have been done prior to surgery and 6 months after the surgery. The evaluation of voice has been carried out through the instrumental method. The patients' voice recordings of the /a,e,i/ vowels have been done. The obtained recordings were evaluated by the Praat programme and the effects on jhitter, shimmer, fundamental frequency (F0) and noise harmonic rate (NHR) were analysed. Results: Numerical values of F0 of all female participants have been decreased for all of the vowels postoperatively. In the females; jhitter and fraction parameters were found to be significantly different (0.056 and 0.017, perspectively) for the vowel /e/. In addition, p values in the shimmer for vowels /e,i/ were thought to be clinically significant (.087, .079 and .076) respectively. All these changes in second measurements were found to indicate worsening vocal quality after the DBS in females. In males, there is not any significant difference observed between two measures in any of the parameters of any vowels. Conclusions: Acoustic voice quality deteriorated after STN-DBS predominantly for females however this deterioration was not prominent audio-perceptually. This finding commented as a result of the fact that that voice quality deviance of the participants was not severe.Öğe Klinik ve elektrofizyolojik tanılar arasındaki tutarlılık(2009) Okuyucu, Emine Esra; Turhanoğlu, Ayşe Dicle; Duman, Taşkın; Savaş, Nazan; Mengüloğlu, Necdet; Melek, İsmet MuratAMAÇ: Bu çalışma incelenmek üzere elektronöromiyografi (ENMG) laboratuvarına gönderilen hastaların klinik ön tanı ile ENMG sonuçlarının tutarlı olup olmadığını araştırmak amacıyla retrospektif olarak yapıldı. YÖNTEMLER: ENMG laboratuvarına çeşitli anabilim dallarınca yönlendirilen ve çeşitli klinik ön tanılarla istemleri yapılan 957 hasta bu çalışmaya dahil edilmiştir. Demografik bulguları, muhtemel klinik tanı, istemin yapıldığı anabilim dalı ve elektrofizyolojik inceleme sonrasında elde edilen sonuç kayıt edildi ve istatistiksel olarak değerlendirildi. BULGULAR: ENMG incelemesi yapılan 957 hastanın 644 (%67.3)’ü kadın, 313 (%32.7)’ü erkekti ve yaş ortalaması 45.40 ± 14.54 idi. Hastaların ENMG istemleri nöroloji, ortopedi, nöroşirürji ve fizik tedavi ve rehabilitasyon kliniklerince yapıldı. Hastalara uygulanan elektromiyografi sonucuna göre; hastaların %53.6’sının (n= 513) sonucu ön tanı ile uyumlu bulunurken, %41.5’inin (n= 397) ENMG’si normal olarak değerlendirildi, %4.9’una (n= 47) ise ön tanılardan farklı tanılar koyuldu. Ön tanıların ENMG ile de desteklenmesi bakımından analiz edildiğinde istem yapılan klinikler arasında istatistiksel bir farklılık saptanmadı (p= 0.794). Karpal tünel sendromu, polinöropati, radikülopati-pleksopati, tuzak nöropati ve miyopati ön tanılarının ENMG ile de desteklenmesi arasındaki farklılık istatistiksel olarak analiz edildiğinde; bu ön tanılar arasında ENMG ile uyum bakımından farklılık saptandı (p< 0.001). SONUÇ: Periferik sinir sistemi tutulumu gösteren hastalıkların tanısında önemli rol oynayan ENMG incelemesi nörolojik muayenenin bir devamıdır. Bu nedenle ENMG istemi klinik olarak koyulan tanıyı desteklemek için olduğu kadar, diğer olası ön tanıları dışlamak amacıyla da yapılabilir. Bu da çalışmamızdaki ön tanı ile ENMG sonrası tanılar arasındaki uyumdaki azlığın nedeni olabilir.Öğe Polisomographic Investigation of Sleep Disorders in Patients with Sickle Cell Anemia and Evaluation of the Effect on the Prognosis(Aves, 2022) Dikmen, Nursel; Okuyucu, Emine Esra; Guntel, Murat; Ucar, Edip; Ilhan, Gul; Babayigit, Cenk; Karadag, MehmetOBJECTIVE: The aim of this study is to identify sleep disorders in adults with sickle cell disease and to examine the effects of accompanying sleep disorders on the prognosis of sickle cell disease. MATERIAL AND METHODS: Twenty-eight patients followed up with a diagnosis of sickle cell disease and 22 healthy volunteers were included in our study. RESULTS: Both groups had similar characteristics in terms of age, gender, and body mass index. More obstructive sleep apnea syndrome was detected in the sickle cell group than in healthy volunteers. Statistically, the sickle cell patient group had higher apnea-hypopnea index and lower nighttime oxygen desaturation. As the degree of obstructive sleep apnea syndrome increased in the sickle cell group, it was found that there were more emergency admissions and hospitalization due to painful crises and/or acute chest syndrome in the last 1 year. Also, lower sleep efficiency was found in the sickle cell disease patient group. In the sickle cell group, it was found that the restless leg syndrome severity was statistically significantly more. CONCLUSION: As hypoxia deepens in sickle cell patients, mortality and morbidity due to the disease increase significantly. Comorbid sleep disturbances in sickle cell patients exacerbate nocturnal hypoxia and negatively affect the prognosis of the disease. Therefore, patients with sickle cell disease should be questioned in detail in terms of obstructive sleep apnea syndrome and, if necessary, polysomnographic evaluation should be performed to provide treatment for sleep disorders in the early period.
