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Öğe Affective Temperament Profiles in Patients with Multiple Sclerosis: Association with Mood Disorders(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2016) Ozkan, Adile; Altinbas, Kursat; Koc, Emine Rabia; Sen, Halil Murat; Karaman, Handan Isin ozisikIntroduction: The aim of the present study was to screen for bipolarity and to investigate the affective temperaments of patients with multiple sclerosis (MS) and the possible association between the clinical and demographic characteristics of MS patients and temperament profiles. Methods: A total of 65 patients with MS and 66 healthy volunteers completed the 32-item hypomania checklist (HCl-32), the Mood Disorder Questionnaire (MDQ), and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A) tests. The HCl-32, MDQ, and TEMPS-A scores were compared between the patients and healthy volunteers. Results: MS patients had significantly higher scores for the depressive, cyclothymic, irritable, and anxious domains of the TEMPS-A scale than the control group, whereas relapsing remitting MS (RRMS) patients had higher MDQ and TEMPS-A hyperthymia scores than secondary progressive MS patients. MS patients who were being treated with interferon beta 1-b therapy had significantly higher MDQ scores than those being treated with interferon beta 1-a, glatiramer acetate, or who were without medication. Expanded Disability Status Scale (EDSS) scores were positively correlated with TEMPS-A depressive and hyperthymic temperaments. Conclusion: Our results suggest that higher scores for affective temperament in MS patients indicate subclinical manifestations of mood disorders. Higher hyperthymia scores and manic symptoms detected in the RRMS group could shed light on the relationship between bipolarity and MS. Thus, the screening of bipolarity and affective temperament profiles in MS patients could help clinicians predict future mood episodes and decrease their impact on disease severity.Öğe An Etiological Cause of Epilepsia Partialis Continua that Should Not be Forgotten: Hyperglycemia(Kare Publ, 2014) Sen, Halil Murat; Ozkan, Adile; Karaman, Handan Isin OzisikEpilepsia partialis continua is generally epileptic seizures, resistant to treatment, consisting of clonic jerks localized to one side of the body that may last from hours to months. In the adult population, brain ischemic lesions, extensive lesions and infections should be ruled out of the etiology. The etiology of easier-to-diagnose metabolic disorders, especially hyperosmolar nonketotic hyperglycemia, should not be forgotten. This is because a significant number of nonketotic hyperglycemia cases develop epilepsia partialis continua; in fact in some patients without diabetes diagnosis, it may be the first finding of diabetes.Öğe Case of Cytomegalovirus Infection Causing Isolated Oculomotor Nerve Palsy(Derman Medical Publ, 2014) Sen, Halil Murat; Tosum, Yeliz Yilmaz; Ors, Ceyda Hayretdag; Karaman, Handan Isin OzisikThe third cranial nerve is called the oculomotor nerve. The pathology is revealed by limitation of eye movement inward-up-down, mydriasis, loss of light reflex and ptosis. Oculomotor nerve pathologies are frequently seen in neurology practice and are situations that may be very difficult for differential diagnosis. Differential diagnosis first involves disqualifying intracranial etiologies by imaging because these intracranial etiologies may be situations that can result in death and should be primarily evaluated. If intracranial events are ruled out, generally rarer etiologic reasons with generally difficult differentiation should be researched. Viral infections are among the rare etiological reasons causing 3rd cranial nerve involvement. Our case was a 71-year old female with etiological research due to 3rd cranial nerve palsy. The patient with diabetes-linked immune deficiency was found to have cranial nerve involvement developed secondary to cytomegalovirus (CMV) infection. We report this case as 3rd cranial nerve involvement is rarely observed developing linked to CMV infection.Öğe Dural sinus filling defect: Intrasigmoid encephalocele(2013) Karatag, Ozan; Cosar, Murat; Kizildag, Betul; Sen, Halil MuratFilling defects of dural venous sinuses are considered to be a challenging problem especially in case of symptomatic patients. Many lesions have to be ruled out such as sinus thrombosis, arachnoid granulations and tumours. Encephalocele into dural sinus is also a rare cause of these filling defects of dural sinuses. Here, we report an extremely rare case with spontaneous occult invagination of temporal brain tissue into the left sigmoid sinus and accompanying cerebellar ectopia. Copyright 2013 BMJ Publishing Group. All rights reserved.Öğe Effects of Tannic Acid on the Ischemic Brain Tissue of Rats(Springer/Plenum Publishers, 2015) Sen, Halil Murat; Ozkan, Adile; Guven, Mustafa; Akman, Tarik; Aras, Adem Bozkurt; Sehitoglu, Ibrahim; Alacam, HasanMany studies of brain ischemia have shown the role played by massive ischemia-induced production of reactive oxygen species, the main mechanism of neuronal death. However, currently, there is no treatment choice to prevent cell death triggered by reactive oxygen species. In our study, we researched the effects of tannic acid, an antioxidant, on the ischemic tissue of rats with induced middle cerebral artery occlusion. The animals were divided into three groups of eight animals. The sham group were only administered 10 % ethanol intraperitoneally, the second group had middle cerebral artery occlusion induced and were given 10 % ethanol intraperitoneally, while the third group had middle cerebral artery occlusion with 10 mg/kg dose tannic acid dissolved in 10 % ethanol administered within half an hour intraperitoneally. The rats were sacrificed 24 h later, and brain tissue was examined biochemically and histopathologically. Biochemical evaluation of brain tissue found that comparing the ischemic group with no treatment with the tannic acid-treated ischemia group; the superoxide dismutase (SOD) levels were higher, malondialdehyde (MDA) levels were lower, and nuclear respiratory factor-1 (NRF-1) was higher in the tannic acid-treated group. Histopathological examination showed that the histopathological results of the tannic acid group were better than the group not given tannic acid. Biochemical and histopathological results showed that tannic acid administration had an antioxidant effect on the negative effects of ischemia in brain tissue.Öğe Headache Could Be Finding of Sinus Vein Thrombosis in Behcets Patients(Derman Medical Publ, 2014) Sen, Halil Murat; Ozkan, Adile; Balci, Cagdas; Karaman, Handan Isin OzisikGlobally Behcet's disease (BD) is most frequently seen in Turkey and takes its name from the Turkish dermatologist Hulusi Behbet. Basic findings of the disease are the triad of genital ulcers, oral ulcers and uveiti's. Neurological involvement in BD appears an average of 5 years after the beginning of disease, or the first appearance of the disease may be neurological findings. Sinus vein thrombosis (SVT) is among neurological involvements observed in BD. However diagnosis of SVT is difficult and it is a situation that may cause disability or mortality. Our case was a 24-year old female patient with diagnosed SVT who had a diagnosis of BD from 5 years. In spite of the patient frequently applying to health services, SVT diagnosis was delayed until 15 days after the initial symptoms. BD can cause SVT and SVT may cause disability or mortality but SVT may be diagnosed late, just as in our case. Therefore we present this case to increase awareness of this disease.Öğe Insulinoma May Present as Epilepsy: A Case Report(Derman Medical Publ, 2014) Sen, Halil Murat; Balci, Cagdap; Ozkan, Adile; Karaman, Handan Isin OzisikHypoglycemia developing linked to insulinoma may present with clinical findings similar to epileptic seizures and electroencephalography findings may be in accordance with epilepsy. As a result some insulinoma patients are followed as epilepsy resistant to treatment for years. Our case was a 20-year old female patient and was followed for epilepsy. The blood tests indicated hypoglycemia and the result of examination, the patient diagnosis was insulinoma. We present this case with the aim of emphasizing the importance of not forgetting insulinoma as an etiology in epilepsy resistant to treatment.Öğe Investigation of knee pain in osteoarthritic and neuropathic pain awareness(Acta Medica Belgica, 2015) Golge, Umut Hatay; Sen, Halil Murat; Kuyucu, Ersin; Sen, Hacer; Goksel, Ferdi; Kaymaz, Burak; Komurcu, ErkamThe mechanism of neuropathic pain (NP) and osteoarthritic (OA) pain, although different, are both defined as chronic pain, and combinations are possible. In this study, the awareness of both types of chronic pain was investigated among patients and doctors. This prospective study was planned and coordinated by the orthopedic and internal medicine clinics and included 100 patients with a diagnosis of knee OA evaluated with the DN4 questionnaire. Patients with an OA diagnosis included those with NP linked to diabetes and those without NP, and these groups were compared using a visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritic Index (WOMAC). Data analysis of both groups focused on descriptive statistics of demographic and clinical characteristics. Twenty-four of the patients with type 2 diabetes mellitus (DM) were diagnosed with NP according to DN4 criteria, and began treatment. Of these patients, 21 (84%) had DM for 10 years or more, while 19 (86.4%) had HbA1c of 7 and above. The average WOMAC pain score for patients with NP was 4.33 +/- 1.2 while the score for VAS was 8.25 +/- 0.8. Patients without NP had a WOMAC pain score of 2.49 +/- 0.6 and a VAS of 6.28 +/- 1.8. It was observed that in these two knee OA patient groups, NP had a statistically significant enhancing effect on the WOMAC pain score and the VAS (p < 0.001). As underlying pathophysiological mechanism of pain caused by OA is complex, and OA is considered to have a component of NP, it has been proven to be useful to use drugs apart from conventional treatments for NP. We believe that, as a source of pain that is not relieved after arthroplasty, awareness level of NP among orthopedists should be increased and multi-disciplinary studies are required on this topic.Öğe Is Multiple Sclerosis Patients Receiving Adequate Medical Assesment for Urological Problems?(Derman Medical Publ, 2015) Sen, Halil Murat; Sancak, Eyup Burak; Uludag, Aysegul; Karaman, Handan Isin OzisikAim: The aim of the study was to determine the medical assesment and treatment services for frequently seen urological problems in multiple sclerosis patients. Material and Method: In this study, 50 MS patients were enrolled. Patients were evaluated about appropriate and adequate medical care for low urinary tract symptoms (LUTS) by questionnaire that was prepared by researchers. Results: Eighty percent of patients (n = 40) had LUTS in study. There were 76% of patients (n = 38) declared that they had never been questioned by doctors even had no complaints about LUTS. Only 7.5% (n = 3) of MS patients with LUTS were under treatment. Discussion: Our study showed that MS patients with urological problems were not questioned and evaluated appropriately and adequately.Öğe Neuroprotective Effect of Humic Acid on Focal Cerebral Ischemia Injury: an Experimental Study in Rats(Springer/Plenum Publishers, 2015) Ozkan, Adile; Sen, Halil Murat; Sehitoglu, Ibrahim; Alacam, Hasan; Guven, Mustafa; Aras, Adem Bozkurt; Akman, TarikStroke is still a major cause of death and permanent neurological disability. As humic acids are well-known antioxidant molecules, the purpose of this study was to investigate the potential neuroprotective effects of humic acid in a focal cerebral ischemia model. Twenty-four rats were divided equally into three groups. A middle cerebral artery occlusion model was performed in this study where control (group II) and humic acid (group III) were administered intraperitoneally following an ischemic experimental procedure. Group I was evaluated as sham. Malondialdehyde (MDA), superoxide dismutase (SOD), and nuclear respiratory factor-1 (NRF-1) levels were analyzed biochemically on the right side of the ischemic cerebral hemisphere, while ischemic histopathological studies were completed on the left side to investigate the antioxidant status. Biochemical results showed that SOD and NRF-1 levels were significantly increased in the humic acid group (III) compared with the control group (II) while MDA levels were significantly decreased. On histopathological examination, cerebral edema, vacuolization, degeneration, and destruction of neural elements were decreased in the humic acid group (III) compared with the control group (II). Cerebral ischemia was attenuated by humic acid administration. These observations indicate that humic acid may have potential as a therapeutic agent in cerebral ischemia by preventing oxidative stress.Öğe Neuroprotective effect of p-coumaric acid in rat model of embolic cerebral ischemia(Mashhad Univ Med Sciences, 2015) Guven, Mustafa; Aras, Adem Bozkurt; Akman, Tarik; Sen, Halil Murat; Ozkan, Adile; Salis, Osman; Sehitoglu, IbrahimObjective(s): Stroke poses a crucial risk for mortality and morbidity. Our study aimed to investigate the effect of p-coumaric acid on focal cerebral ischemia in rats. Material and Methods: Rats were randomly divided into four groups, namely Group I (control rats), Group II (ischemia rats), Group III (6 hr ischemia + p-coumaric acid rats) and Group IV (24 hr ischemia + p-coumaric acid rats). Cerebral ischemia was induced via intraluminal monofilament occlusion model. In all groups, the brain was removed after the procedure and rats were sacrificed. Malondialdehyde, superoxide dismutase and nuclear respiratory factor-1 were measured in the ischemic hemisphere. The histopathological changes were observed in the right hemisphere within the samples. Functional assessment was performed for neurological deficit scores. Results: Following the treatment, biochemical factors changed significantly. Histopathologically, it was shown that p-coumaric acid decreased the oxidative damage. The neurological deficit scores of p-coumaric acid-treated rats were significantly improved after cerebral ischemia. Conclusion: Our results showed that p-coumaric acid is a neuroprotective agent on account of its strong anti-oxidant and anti-apoptotic features. Moreover, p-coumaric acid decreased the focal ischemia. Extra effort should be made to introduce p-coumaric acid as a promising therapeutic agent to be utilized for treatment of human cerebral ischemia in the future.Öğe Neuroprotective effects of daidzein on focal cerebral ischemia injury in rats(Shenyang Editorial Dept Neural Regeneration Res, 2015) Aras, Adem Bozkurt; Guven, Mustafa; Akman, Tarik; Ozkan, Adile; Sen, Halil Murat; Duz, Ugur; Kalkan, YildirayDaidzein, a plant extract, has antioxidant activity. It is hypothesized, in this study, that daidzein exhibits neuroprotective effects on cerebral ischemia. Rat models of middle cerebral artery occlusion were intraperitoneally administered daidzein. Biochemical and immunohistochemical tests showed that superoxide dismutase and nuclear respiratory factor 1 expression levels in the brain tissue decreased after ischemia and they increased obviously after daidzein administration; malondialdehyde level and apoptosis-related cysteine peptidase caspase-3 and caspase-9 immunoreactivity in the brain tissue increased after ischemia and they decreased obviously after daidzein administration. Hematoxylin-eosin staining and luxol fast blue staining results showed that intraperitoneal administration of daidzein markedly alleviated neuronal damage in the ischemic brain tissue. These findings suggest that daidzein exhibits neuroprotective effects on ischemic brain tissue by decreasing oxygen free radical production, which validates the aforementioned hypothesis.Öğe Parkinson's Disease and Headache(Turkish Neurological Soc, 2014) Sen, Halil Murat; Tunc, Tugba Oruc; Inan, Levent ErtugrulObjective: The etiology and frequency of headache complaint were examined in patients diagnosed with idiopathic Parkinson's disease. Materials and Methods: 60 patients diagnosed with idiopathic Parkinson's disease in policlinic and a healthy control group of 100 people of similar age and sex were included in the study. Results: Headache was found in 26 of the patients (43.3%) with idiopathic Parkinson's disease. There was not a significant difference between the ages of patients with and without headache. The duration of the disease was significantly longer in the patients without headache when compared to those with headache. Conclusion: The frequency of headache in patients with idiopathic Parkinson's disease is not higher than the healthy population.Öğe Remote Cerebellar Hemorrhage Presenting with Cerebellar Mutism after Spinal Surgery : An Unusual Case Report(Korean Neurosurgical Soc, 2017) Sen, Halil Murat; Guven, Mustafa; Aras, Adem Bozkurt; Cosar, MuratDural injury during spinal surgery can subsequently give rise to a remote cerebellar hemorrhage (RCH). Although the incidence of such injury is low, the resulting hemorrhage can be life threatening. The mechanism underlying the formation of the hemorrhage is not known, but it is mostly thought to develop after venous infarction. Cerebellar mutism (CM) is a frequent complication of posterior fossa operations in children, but it is rarely seen in adults. The development of CM after an RCH has not been described. We describe the case of a 65-year old female who lost cerebrospinal fluid after inadvertent opening of the dura during surgery. Computerized tomography performed when the patient became unable to speak revealed a bilateral cerebellar hemorrhage.Öğe Sleep disturbance among women with chronic pelvic pain(Elsevier Ireland Ltd, 2014) Cosar, Emine; Gungor, Aysenur Cakir; Gencer, Meryem; Uysal, Ahmet; Hacivelioglu, Servet O.; Ozkan, Adile; Sen, Halil MuratObjective: To investigate the effect of chronic pelvic pain (CPP), a debilitating condition, on sleep quality. Methods: The present case-control study enrolled women older than 18 years attending the Gynecology Clinic of Canakkale Onsekiz Mart University Hospital, Canakkale, Turkey, with CPP between August 2011 and August 2012. The control group was selected from women attending the clinic for another complaint. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, and differences between the groups were compared by t and chi(2) tests. Results: During the study period, 157 women were enrolled. Seventy-two had CPP symptoms, and 85 attended the clinic for other complaints. Poor sleep quality was found in 80% (n = 58) of the women with CPP, and 55% (n = 47) of the control group (P < 0.05). Conclusion: Women with CPP were found to have poor sleep quality. Sleep education should be recommended in psychiatry and neurology clinics to increase the awareness of sleeping problems among these women. (C) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.Öğe The Neuroprotective Effect of Glycyrrhizic Acid on an Experimental Model of Focal Cerebral Ischemia in Rats(Springer/Plenum Publishers, 2015) Akman, Tarik; Guven, Mustafa; Aras, Adem Bozkurt; Ozkan, Adile; Sen, Halil Murat; Okuyucu, Ali; Kalkan, YildirayCerebral ischemia is still one of the most important topics in neurosciences. Our study aimed to investigate the neuroprotective and anti-oxidant effects of glycyrrhizic acid on focal cerebral ischemia in rats. Twenty-four rats were divided equally into three groups. A middle cerebral artery occlusion model was performed in this study where sham and glycyrrhizic acid were administered intraperitoneally following middle cerebral artery occlusion. Group I was evaluated as control. Malondialdehyde (MDA), superoxide dismutase (SOD), and nuclear respiratory factor-1 (NRF1) levels were analyzed biochemically on the right cerebral hemisphere, while ischemic histopathological studies were completed to investigate the anti-oxidant status. Biochemical results showed that SOD and NRF1 levels were significantly increased in the glycyrrhizic acid group compared with the sham group while MDA levels were significantly decreased. On histopathological examination, cerebral edema, vacuolization, degeneration, and destruction of neurons were decreased in the glycyrrhizic acid group compared with the sham group. Cerebral ischemia was attenuated by glycyrrhizic acid administration. These observations indicate that glycyrrhizic acid may have potential as a therapeutic agent in cerebral ischemia by preventing oxidative stress.Öğe The protective effect of syringic acid on ischemia injury in rat brain(Tubitak Scientific & Technological Research Council Turkey, 2015) Guven, Mustafa; Aras, Adem Bozkurt; Topaloglu, Naci; Ozkan, Adile; Sen, Halil Murat; Kalkan, Yildiray; Okuyucu, AliBackground/aim: Brain ischemia and treatment are important topics in neurological science. Free oxygen radicals and inflammation formed after ischemia are accepted as the most significant causes of damage. Currently there are studies on many chemopreventive agents to prevent cerebral ischemia damage. Our aim is to research the preventive effect of the active ingredient in syringic acid, previously unstudied, on oxidative damage in cerebral ischemia. Materials and methods: The rats were randomly divided into 4 groups: control group (no medication or surgical procedure), sham group (artery occlusion), artery occlusion + syringic acid group sacrificed at 6 h, and artery occlusion + syringic acid group sacrificed at 24 h. Obtained brain tissue from the right hemisphere was investigated histopathologically and for tissue biochemistry. Results: Superoxide dismutase and nuclear respiratory factor 1 values decreased after ischemia and they increased after syringic acid treatment, while increased malondialdehyde levels after ischemia were reduced after treatment. Caspase-3 and caspase-9 values increased after ischemia and decreased after treatment; this reduction was more pronounced at 24 h. Conclusion: Our study revealed that syringic acid treatment in cerebral ischemia reduced oxidative stress and neuronal degeneration. In the light of the biochemical and histopathologic results of the present study, we think that syringic acid treatment may be an alternative treatment method.Öğe The Reasons Why Patients with Headache Choose Neurosurgery Outpatient Clinics(Turkish Neurological Soc, 2014) Sen, Halil Murat; Aras, Adem Bozkurt; Guven, Mustafa; Akman, Tarik; Uludag, Aysegul; Karaman, Handan Isin OzisikObjective: We aimed to investigate reasons for the preference of patients who were admitted to the neurosurgery clinic with complaints of headache for admission in this clinic. Materials and Methods: Questioned the reasons for choosing the neurosurgical and most preferred cause of including word for brain surgery of the brain named (n=54, 54%). Patients were questioned about their knowledge of neurology and demostrated that they do not have the basic knowledge of this branch of medicine (n=66, 66%). Results: Questioned the reasons for choosing the neurosurgical and most preferred cause of including word for brain surgery of the brain named (n=54, 54%). Patients were questioned about their knowledge of neurology and demostrated that they do not have the basic knowledge of this branch of medicine (n=66, 66%). Conclusion: Headache causes loss of the financial and workforce. Consulting in the wrong department of the hospital by such patents, as a result of misdiagnosis and inadequate treatment, increases the number of hospital admissions. This finding emphasizes the importance of the names and descriptions of departments.Öğe Wernicke's Encephalopathy Following Gastrointestinal Surgery: MRI and DWI Findings(Turkish Neurological Soc, 2014) Kizildag, Betul; Canan, Arzu; Sen, Halil Murat; Tas, Sukru; Cikman, Oztekin; Dagistan, EmineWernicke's encephalopathy (WE) is a neurologic disorder resulting from thiamine (vitamin B1) deficiency characterised by the ocular signs, altered consciousness and ataxia. It is usually associated with chronic alcohol abuse. Recently, it emerged as a complication following bariatric surgery. The classical clinical triad occurs in a small group of patients, and early replacement of thiamine is an important prognostic factor. Hence, magnetic resonance imaging (MRI) is useful to support the diagnosis. In this case, we report MRI and diffusion weighted imaging findings of WE in a patient without history of alcoholism after gastrointestinal surgery.
