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    A proton magnetic resonance spectroscopic study in juvenile absence epilepsy in early stages
    (Elsevier Sci Ltd, 2010) Kabay, Sibel Canbaz; Gumustas, Oguzhan Guven; Karaman, Handan Ozisik; Ozden, Hilmi; Erdinc, Oguz
    Purpose: The aim of this study to evaluate the hippocampal, frontal and thalamic lobe functions in the early stage of the juvenile absence epilepsy (JAE) by magnetic resonance proton spectroscopy (MRS). Method: Fourteen patients with juvenile absence epilepsy with typical absence seizures and 10 healthy volunteer controls were included in this study. The diagnosis of the patients was in accordance with EEG findings and seizure semiology. All patients had minimum twice EEG recordings and all had typical 3-Hz generalized spike and slow-wave discharges at least on one EEG. All patients had bilateral MRS of frontal, thalamic and hippocampal regions and NAA, NAA/Cr, NAA/Cho, NAA/Cho + Cr levels were detected. Results: The mean age was 14.9 +/- 2.05 and 14.5 +/- 1.7 of the JAE patients and control subjects, respectively. Mean seizure onset duration were 2.3 +/- 0.9 years. In patient group the frontal, thalamic and hippocampal NAA/Cr ratios were 1.65, 1.78, 1.47 in right and 1.75, 1.90, 1.42 in left, respectively. While in the control group NAA/Cr ratios were 1.64, 2.42, 1.57 in right and 1.83, 2.44, 1.47 in left, respectively. There weren't any difference in frontal and hippocampal regions, but the bilateral thalamic NAA, NAA/Cr ratios of the patients were significantly lower than control group even in early stages of the disease. Conclusion: The observed reductions in NAA levels and NAA/Cr ratios of bilateral thalamic regions are consistent with epilepsy related excitoxicity as a possible underlying mechanism even in early stage of JAE. However, we believe that to generalize the results of our study a prospective multicenter study is required. (C) 2009 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
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    Cerebrospinal Fluid and Serum Autoantıbodıes in Drug-Resistant Temporal Lobe Epilepsıes: Case Series
    (2023) Kabay, Sibel Canbaz; Tüzün, Erdem; Akdağ, Gönül; Çetiner, Mustafa; Ayas, Selahattin; Karaman, Handan Işın Özışık; Arıkan, Fatma Akkoyun
    We aimed to investigate the presence of neuronal antibodies in serum and cerebrospinal fluid(CSF) analysis of patients with drug resistant temporal lobe epilepsy. We evaluated 8 patients who accepted lumbar puncture with a diagnosis of drug resistant temporal lobe epilepsy. Neuronal autoantibodies were found to be negative in both serum and CSF in all patients. We investigated neuronal antibodies and clinical features in cases who were followed up for drug-resistant temporal lobe epilepsy and suspected of autoimmune epilepsy. Although neuronal antibodies were not detected in CSF and serum examinations, this may be related to the early age of onset in our study group. Autoimmune epilepsy should be considered among the differantial diagnosis with a subacute clinic, unusually high seizure frequency, variety and variability of seizures, resistance to antiseizure medications(ASMs), presence of an autoimmune disease in the person or his/her family, history of cancer or viral prodroma, demonstration of CNS inflammation and detection of neural antibodies.
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    Fokal eeg anormalliği olan epilepsi hastalarında manyetik rezonans görüntüleme Ve interiktal 99mtc-Hmpao Spect bulguları arasındaki ilişki
    (2011) Özışık, Handan Işın Karaman; Kabay, Sibel Canbaz; Kamışlı, Özden
    Elektroensefalografide fokal anormalliği olan 25 epileptik hastada, retrospektif olarak elektroensefalografi bulguları ile manyetik rezonans görüntüleme ve interiktal 99mTc-HMPAO single foton emisyon bilgisayarlı tomografi (SPECT) bulguları karşılaştırıldı. Sonuçlar, interiktal elektroensefalografi bulguları ile, manyetik rezonans görüntüleme bulgularından ziyade 99mTc-HMPAO SPECT’in bulgularının daha uyumlu olduğunu gösterdi.
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    İntrakranyal yer kaplayan Lezyonlu epileptik Olgularda postoperatif değerlendirme
    (2009) Kabay, Sibel Canbaz; Karaman, Özışık Handan; Erdinş, Oğuz; Durmaz, Ramazan
    Beyin tümörlü hastaların %30-50 sinde jeneralize, parsiyel veya parsiyel başlayıp jeneralize olannöbetlere rastlanır. Parsiyel nöbetler tümör yerinin belirlenmesinde yardımcıdır. Yer kaplayan lezyonu (YKL) olan hastalarda lezyonun eksizyonu sonrasında da nöbetler devam edebilir. Burada intrakranyal tümoral lezyonu olan hastaların operasyon sonrası izlemleri değerlendirilmiştirYaşları 18-70 arasında değişen intrakranyal yer kaplayan lezyon nedeni ile opere olan 3’ü erkek toplam 6 hasta mevcuttu. Bunlardan hipofiz adenomu tanısı alan 1 erkek hasta dışında hepsinin preoperatif dönemde epileptik nöbet öyküsü vardı. Diğer 5 hastada nöbet başlangıcı ve operasyon arası süre 1 ay ila 5 yıl idi. Preoperatif nöbet özellikleri fokal motor nöbet, kötü koku ile karakterize basit parsiyel nöbet ve sekonder jeneralize nöbetler şeklinde idi. Post operatif tanı 2 hastada menengiom, 1 astrositom, 1 oligodendrogliom, 1glial tm ve 1 hipofiz adenomu idi. Post operatif dönemde hiçbir hasta da nörolojik defisit oluşmadı. Post operatif izlem süresi 6 ay ila 9 yıl idi. Astrositom, Oligodendrogliom, Menengiom ve Hipofiz adenomu tanısı alan 4 hasta 1 ila 4 yıl arayla ikinci kez opere edilmişti.Glial tümör tanısı alan 50 yaşındaki bayan hastada post operatif dönemde nöbetler azalmakla beraber karakteristiği değişti. Post operatif en uzun nöbetsizlik süresi 6 yıl idi. Post operatif en erken nöbet, menengioma tanısı alan 1 hastada, yoğun bakımda fokal motor nöbet şeklinde idi. Bu hastanın pre ve post operatif dönemde nöbet sıklığında değişiklik olmadı. Parasagittal oligodendrogliom nedeni ile opere olan 18 yaşındaki bayan hasta da post operatif dönemde nöbet sıklığında artış gözlendi. 2 hastada antiepileptik tedavimonoterapi, 4 hastada politerapi şeklinde devam ediyordu. İntrakranyal tümoral lezyonu olan epileptik hastalarda post operatif nöbet seyri lezyonun yeri, büyüklüğü, patolojik tanısı, geçirilen operasyon ile ilişkilidir. Bu hastalardan ikinci kez opere olanların nöbet kontrolünün daha güç olduğu dikkat çekicidir.
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    Long Term Sustained Therapeutic Effects of Percutaneous Posterior Tibial Nerve Stimulation Treatment of Neurogenic Overactive Bladder in Multiple Sclerosis Patients: 12-Months Results
    (Wiley, 2017) Kabay, Sibel Canbaz; Kabay, Sahin; Mestan, Emine; Cetiner, Mustafa; Ayas, Selahattin; Sevim, Mehmet; Ozden, Hilmi
    Aims: The aim of this study is to determine the sustained therapeutic efficacy and treatment intervals for PTNS in NOAB with MS, offering periodic additional treatments during 1 year in patients who completed an initial course of 12 consecutive weekly sessions. Methods: A total of 34 patients enrolled to the PTNS treatment and 21 patients completed the 1 year PTNS treatment with a tapering protocol of 6, 9, and 12 months of therapy, respectively. After 12 weeks of therapy, PTNS was applied at 14 day intervals for 3 months, 21 day intervals for 3 months, and 28 day intervals for 3 months. The patients completed a 3-day voiding diary at 3rd, 6th, 9th, and 12th month. The patients requested to complete validated questionnaires (ICIQ-SF, OAB-V8, OAB-q SF) were carried out within 3-month intervals thereafter during their enrolment in the study. Results: A total of 21 patients were enrolled in the study. Of these 5 (23.8%) were men and 16 (76.2%) women. The improvements for all voiding diary parameters were significant in the 6th, 9th, and 12th months when compared with baseline. Mean values between baseline and 12 month parameters suggested that daytime frequency decreased by 5.4 voids daily, urge incontinence decreased by 3.4 episodes daily, urgency episodes decreased by 7.4 episodes daily, nocturia decreased by 2.6 voids, and voided volume improved by a mean of 72.1 cc. Conclusion: These results have demonstrated NOAB symptom improvement in MS patients can be achieved with 12 weekly PTNS treatments which show excellent durability over 12 months. (C) 2015 Wiley Periodicals, Inc.
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    Perception of epilepsy in Turkey in the light of two different cities
    (2013) Degirmenci, Yildiz; Kabay, Sibel Canbaz; Yilmaz, Zahide; Bakar, Coskun; Karaman, Handan Isin Ozisik
    The aim of this study was to investigate the perception of epilepsy in Turkey, from west to east, in Kutahya and Yuksekova, two cities of different sociocultural and ethnic status. This was a retrospective comparison study which evaluated the results of two prior studies investigating stigmatization of patients diagnosed with epilepsy and their first-degree relatives in two different cities of Turkey, Kutahya and Yuksekova. The Survey of Epileptic Patient Relatives on the Knowledge, Attitudes, and Behavior Regarding the Disorder was used and included questions on descriptive characteristics, familiarity with epilepsy, attitudes toward epilepsy, and understanding of epilepsy. Data collected by use of the SPSS 15.0 software were analyzed with ?2-test. In Yuksekova group, 88.5% of first-degree relatives of people with epilepsy felt primarily fear when they heard the diagnosis of epilepsy in their relatives; in Kutahya group, the respective rate was 19.1% (p<0.05). The number of participants who objected their child marrying someone with epilepsy was significantly higher in Yuksekova group (p<0.05); however, if married, the Yuksekova group significantly stated that they should have a baby, revealing the importance of children as an indicator of power and dignity in the eastern region of Turkey (p<0.05). Although understanding of epilepsy was favorable, educating the community about epilepsy and personal contacts are the major strategies against epileptic stigmatization.
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    PERCEPTION OF EPILEPSY IN TURKEY IN THE LIGHT OF TWO DIFFERENT CITIES
    (Sestre Milosrdnice Univ Hospital, 2013) Degirmenci, Yildiz; Kabay, Sibel Canbaz; Yilmaz, Zahide; Bakar, Coskun; Karaman, Handan Isin Ozisik
    The aim of this study was to investigate the perception of epilepsy in Turkey, from west to east, in Kutahya and Yuksekova, two cities of different sociocultural and ethnic status. This was a retrospective comparison study which evaluated the results of two prior studies investigating stigmatization of patients diagnosed with epilepsy and their first-degree relatives in two different cities of Turkey, Kutahya and Yuksekova. The Survey of Epileptic Patient Relatives on the Knowledge, Attitudes, and Behavior Regarding the Disorder was used and included questions on descriptive characteristics, familiarity with epilepsy, attitudes toward epilepsy, and understanding of epilepsy. Data collected by use of the SPSS 15.0 software were analyzed with chi(2)-test. In Yuksekova group, 88.5% of first-degree relatives of people with epilepsy felt primarily fear when they heard the diagnosis of epilepsy in their relatives; in Kutahya group, the respective rate was 19.1% (p<0.05). The number of participants who objected their child marrying someone with epilepsy was significantly higher in Yuksekova group (p<0.05); however, if married, the Yuksekova group significantly stated that they should have a baby, revealing the importance of children as an indicator of power and dignity in the eastern region of Turkey (p<0.05). Although understanding of epilepsy was favorable, educating the community about epilepsy and personal contacts are the major strategies against epileptic stigmatization.
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    Reflex epilepsies: a review
    (Kare Publ, 2008) Kabay, Sibel Canbaz; Karaman, Handan Ozisik; Celikkas, Emine; Erdinc, Oguz
    Reflex seizures are evoked by a specific afferent stimulus or by activity of the patient and are divided into those characterized by generalized seizures and those principally manifested by focal seizures. Reflex epilepsies are syndromes in which all epileptic seizures are precipitated by sensory stimuli. Three categories of reflex seizures encountered clinically include pure reflex epilepsies, reflex seizures that occur in generalized or focal epilepsy syndromes that are also associated with spontaneous seizures, and isolated reflex seizures occurring in situations that do not necessarily require a diagnosis of epilepsy. Generalized reflex seizures are precipitated by visual light stimulation, thinking, and decision making. Numerous triggers can induce focal reflex seizures. The triggers include reading, writing, other language functions, startle, somatosensory stimulation, proprioception, auditory stimuli, immersion in hot water, eating, and vestibular stimulation. The classification and characteristics of reflex seizures and epilepsies are described in this review. Findings on EEG and advanced neuroimaging in the reflex seizures and epilepsies, treatment and preventive options are also discussed.
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    The Clinical and Urodynamic Results of Percutaneous Posterior Tibial Nerve Stimulation on Neurogenic Detrusor Overactivity in Patients With Parkinson's Disease
    (Elsevier Science Inc, 2016) Kabay, Sahin; Kabay, Sibel Canbaz; Cetiner, Mustafa; Mestan, Emine; Sevim, Mehmet; Ayas, Selahattin; Ozden, Hilmi
    OBJECTIVE To investigate the effect of percutaneous posterior tibial nerve stimulation (PTNS) treatment after 12 weeks on urodynamic and clinical findings in patients with Parkinson's disease (PD) with neurogenic detrusor overactivity. METHODS A total of 47 patients with PD with neurogenic detrusor overactivity were enrolled in the study. Urodynamic studies before and after 12-week PTNS treatment were performed. International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Overactive Bladder Questionnaire (OAB-V8), and Overactive Bladder Questionnaire Short Form (OAB-q SF) have been assessed before and after PTNS treatment. RESULTS The mean first involuntary detrusor contraction volume (1st IDCV) on standard cystometry was 133.2 +/- 48.1 (24-265) mL, whereas it was 237.3 +/- 43.1 (145-390) mL after PTNS. The mean maximum cystometric capacity (MCC) on standard cystometry was 202.2 +/- 36.5 (115-320) mL, whereas it was 292.1 +/- 50.6 (195-395) mL after stimulation. The improvements in the first involuntary detrusor contraction volume and maximum cystometric capacity were statistically significant after stimulation. The mean Pdetmax at first involuntary detrusor contraction, maximal detrusor pressure at maximum cystometric capacity, PdetQmax, Qmax, and post-void residual volume were statistically significant after 12-week stimulation. Mean parametric improvements at 12-week PTNS treatment from baseline included daytime frequency decreased by 5.6 voids daily, urge incontinence decreased by 3.1 episodes daily, urgency episodes decreased by 6.3 episodes daily, nocturia decreased by 2.7 voids, and voided volume improved by a mean of 92.6 mL. The change from baseline on the ICIQ-SF, OABv8, and OAB-q at 12-week PTNS treatment demonstrated statistically significant improvements. CONCLUSION These results have demonstrated that PTNS improves the lower urinary tract symptoms and urodynamic parameters in patients with PD. (C) 2015 Elsevier Inc.