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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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    Melkersson-Rosenthal Syndrome in a Patient with Systemic Lupus Erythematosus: A Rare Comorbidity
    (Turkish League Against Rheumatism, 2012) Degirmenci, Yildiz; Kobak, Senol; Ors, Ceyda Hayretdag; Karaman, Handan Ozisik
    Melkersson-Rosenthal syndrome (MRS) is a rare granulomatous disease characterized by recurrent orofacial edema, facial palsy, and a fissured tongue. In this article, we report a 23-year-old female case with recurrent peripheral facial palsy, mild orofacial edema, and a fissured tongue. She had spots in her feet with a history of oral aphthous ulcers and experienced a relapse once a year. The neuroimaging results were normal, however the laboratory examination indicated systemic lupus erythematosus (SLE). This rare case is presented to emphasize the complete triad of MRS concomitantly occurring with SLE in this patient.
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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.