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Öğe 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, OguzPurpose: 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.Öğe 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, HilmiAims: 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.Öğe 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, HilmiOBJECTIVE 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.Öğe The division level of the sciatic nerve and its relevance to popliteal nerve block. A cadaveric study(Riyadh Armed Forces Hospital, 2009) Barut, Cagatay; Comert, Ayhan; Esmer, Ali F.; Sevinc, Ozdemir; Ozden, Hilmi; Tekdemir, Ibrahim; Elhan, Alaittin[Anstract Not Available]
