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Öğe Acute 'upside-down' visual inversion due to multiple sclerosis(Sage Publications Ltd, 2008) Okuyucu, Esra Emine; Okuyucu, Semsettin; Karazincir, Sinem; Akoglu, Ertap; Duman, TaskinIn a 20- year- old male patient, a 180 degree inversion of visual image was found as a manifestation of multiple sclerosis. Upside down reversal of vision is not a well- known sign in multiple sclerosis. Exact mechanism is still unknown. Lesions involving cortical areas, mainly the parieto- occipital region, have occasionally been documented. To our knowledge this is the first report of upside- down reversal of vision in multiple sclerosis with cerebra lesion on MRI.Öğe Behçet hastalığında subklinik periferik nöropati(2009) Okuyucu, Esra Emine; Balcı, Didem Didar; Turhanoğlu, Ayşe; Duman, Taşkın; Yılmazer, Serkan; Yenin, Jülide ZeharAmaç: Behçet hastalarında santral sinir sistemi tutulumu iyi bilinmekle beraber periferik sinir sistemi tutulumu henüz netleşmemiştir. Bu çalışmanın amacı Behçet hastalarında elektrofizyolojik inceleme ile subklinik periferik nöropatinin sıklığını ve özelliklerini değerlendirmektir. Gereç ve Yöntem: Çalışmaya, nörolojik olarak semptom ve bulguları olmayan 33 Behçet hastası (23 erkek, 10 kadın) ile yaş ve cinsiyetleri uyumlu 33 sağlıklı gönüllü alındı. Periferik sinir işlevlerini etkileyebilecek diğer etkenleri saptamaya yönelik tetkikleri yapıldı. Çalışmaya katılan tüm hasta ve sağlıklı gönüllülere standart nörografik prosedürler kullanılarak elektrofizyolojik inceleme yapıldı. Sonuçlar Amerikan Diyabet Cemiyeti Diyabetik Nöropati protokolüne göre değerlendirildi. Bulgular: Sinir ileti çalışması 33 hastanın 11’inde (7 erkek, 4 kadın, %33,3) anormaldi. Beş (%15) hastada sensorimotor polinöropati, 4 (%12) hastada sural sensoriyel nöropati, 1 (%3) hastada median ve tibial motor nöropati mevcuttu. Yedi (%21) hastada sural sensöriyel sinir elde edilemedi ve geç F latansı 2 (%6) hastada mevcuttu. Kontrol grubu elektrofizyolojik olarak normaldi ve fark istatistiksel olarak anlamlıydı (p<0,0001). Periferik nöropati varlığı ile cinsiyet arasında da istatistiksel olarak anlamlı ilişki yoktu (p=0,696) Sonuç: Behçet hastalarında detaylı nörolojik muayene normal olmasına rağmen subklinik nöropati gözlenebilir. Elektrofizyolojik inceleme, bu hastalarda subklinik periferik nöropatinin tespitinde faydalı bir yöntemdir.Öğe The effect of subthalamic nucleus - Deep brain stimulation and different stimulation frequencies on cerebral hemodynamics in Parkinson's disease: A transcranial doppler study(Elsevier, 2020) Koban, Orkun; Yildizgoren, Mustafa Turgut; Aras, Mustafa; Oral, Sukru; Uyanik, Sadik Ahmet; Serarslan, Yurdal; Okuyucu, Esra EmineObjectives: To investigate the effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) and to compare low-frequency versus high-frequency STN-DBS on hemodynamic parameters of the middle cerebral artery between patients with advanced Parkinson's disease and age-sex matched healthy controls. Patients and Methods: Eighteen patients with advanced Parkinson's disease (PD) with bilateral STN-DBS and 18 control subjects underwent Transcranial Doppler Ultrasound (TCDU) were included in the study. The hemodynamic parameters including blood flow velocity (FV), pulsatility index (PI) and, resistance index (RI) of the right middle cerebral artery (MCA) were measured and compared during the phases using TCDU. The first DBS-off, the second low-frequency DBS of 60 Hz, and the third high-frequency DBS of 130 Hz were compared. Results: PD patients had significantly higher MCA-PI values compared with controls (0.99 +/- 0.27 vs. 0.82 +/- 0.14) (p = 0.031). Also, the MCA-PI values were higher in the low-frequency DBS (0.94 +/- 0.14) and high-frequency DBS (0.93 +/- 0.16) than in the controls (0.82 +/- 0.14) (p = 0.022 and p = 0.041, respectively). There were no significant differences of FV and RI values among the DBS-on, DBS-off and, controls. The RI values were higher in the PD patients than in the controls, although these were not statistically significant. Also, PI values of the MCA decrease in different frequencies (60 Hz or 130 Hz). Conclusion: The results of this study showed that MCA-PI values are higher in advanced PD compared with controls. These indices indicate that MCA resistances and impedances are increased in advanced PD. Low- or high-frequency DBS treatment have beneficial effect to reduce high PI in advanced PD patients.Öğe Subclinical Peripheral Neuropathy in Behcet's Disease(Deri Zuhrevi Hastaliklar Dernegi, 2009) Okuyucu, Esra Emine; Balci, Didem Didar; Turhanoglu, Ayse; Duman, Taskin; Yilmazer, Serkan; Yenin, Juelide ZehraBackground and Design: Central nervous system involvement is well known in patients with Behcet's disease but studies evaluating peripheral nervous system is not usual. The aim of this study is to evaluate the frequency and characteristics of subclinical neuropathy in patients with Behcet's disease. Material and Method: Thirty three Behcet's disease patients (23 male, 10 women) with no evident neurological sign and symptom and 33 healthy volunteers were enrolled to the study. To exclude the other causes of peripheral neuropathy, some laboratory investigations were made. Electrophysiological studies of peripheral nerves were performed to all patients and healthy volunteers. The results were assessed according to the American Diabetes Association Diabetic Neuropathy Protocol. Results: Nerve conduction studies were abnormal in 11 of 33 patients (7 men, 4 women; 33.3%). Five patients (15%) had sensorymotor polyneuropathy, 4 (12%) has sural sensory polyneuropathy, 1 (3%) had median and tibial motor neuropathy. Sural nerve were unobtainable in 7 (21%) patients. 2 patients (6%) had prolonged F latency. Control group were normal electrophysiologically and the difference was statistically important (p < 0.0001). There was no correlation between peripheral neuropathy and gender (p=0.696). Conclusion: Despite the detailed neurological examination, subclinical peripheral neuropathy can be seen in patients with Behcet's disease. Electrophysiological studies are useful for the early detection of peripheral neuropathy in these patients. (Turkderm 2009; 43: 61-4)Öğe Sympathetic Skin Response in Patients with Vitiligo(Deri Zuhrevi Hastaliklar Dernegi, 2009) Dogramaci, Asena Cigdem; Okuyucu, Esra EmineBackground and Design: The sympathetic skin response (SSR) is a electrophysiological test used as an index of sudomotor sympathetic function. The aim of this study was to evaluate possible sympathetic nervous system dysfunction in vitiligo patients with the sympathetic skin response. Material and Method: Sympathetic skin response was studied in 26 patients (20 female and 6 male) with clinical definitely generalized vitiligo and 23 healthy controls (18 female and 5 male). This study was performed in a semi-darkened room while the patients were in supine position. SSR recordings in all of the subjects were performed by a Medelec electroneuromyograph. Results: The average age of patients and controls were 30.6 +/- 12.8 and 29.7 +/- 10.5, respectively. No demographic differences existed statistically between patients and controls (p > 0.05). The mean latency of SSR in vitiligo patients [mean SSR latency in patients, 1.48 +/- 0.58 ms vs controls, 1.52 +/- 0.46 ms (p=0.944)] was not significantly different compared with the controls. The mean amplitude of SSR in vitiligo patients (mean SSR amplitude in patients, 3.83 +/- 2.95 mV vs controls, 5.09 +/- 3.60 mV) was smaller compared with the controls, but this difference was not significant (p=0.100). Conclusion: We conclude that vitiligo has no significant effect on the sympathetic skin response. (Turkderm 2009, 43: 58-60)Öğe Vitiligo hastalarında sempatik deri cevabı(2009) Doğramacı, Çiğdem Asena; Okuyucu, Esra EmineAmaç: Sempatik deri cevabı (SDC), sudomotor sempatik fonksiyonu değerlendirmek amacıyla kullanılan elektrofizyolojik bir testtir. Bu çalışmanın amacı, vitiligo hastalarında bu test kullanılarak sempatik sinir sistemi disfonksiyonunu değerlendirmektir. Gereç ve Yöntem: Çalışmaya jeneralize vitiligo tanısı almış 26 hasta (20 kadın, 6 erkek) ile yaş ve cinsiyetleri uyumlu 23 sağlıklı gönüllü (18 kadın, 5 erkek) alındı. Katılımcıların SDC’ı yarı karanlık bir odada, “supine” pozisyonunda Medelec elektronöromyografi cihazı kullanılarak değerlendirildi. Bulgular: Hastaların yaş ortalaması 30,6±12,8, kontrol grubunun ise 29,7±10,5 idi. İki grup arasında yaş ve cinsiyet açısından istatistiksel olarak anlamlı farklılık yoktu (p>0,05). Ortalama latans vitiligo hastalarında 1,48±0,58 ms, kontrol grubunda ise 1,52±0,46 ms olarak bulundu (p=0,944). Ortalama amplitüd ise vitiligo hastalarında kontrol grubuna göre küçük olmakla birlikte fark istatistiksel olarak anlamlı değildi (sırasıyla, 3,83±2,95 mV ve 5,09±3,60 mV) (p=0,100). Sonuç: Vitiligo hastalığının sempatik deri cevabı üzerinde herhangi bir etkisi olmadığı tespit edildi.
