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Öğe Acute Onset Myositis Associated with Brucellosis, Quite a Rare Diagnosis(Japan Soc Internal Medicine, 2008) Celik, Aygul Dogan; Celik, Yahya; Yulugkural, Zerrin; Balci, Kemal; Utku, UfukBrucellosis is a zoonosis that is transmissible to humans. It is a disease with multi-systemic involvement caused by the genus Brucella. Neurological complications, including meningitis, meningo-encephalitis, myelitis-radiculoneuritis, brain abscess, epidural abscess and meningo-vascular syndromes, are rarely encountered. We present a patient presenting with acute onset myositis. This kind of presentation has not previously been reported in the English language literature. We conclude that the diagnosis of neuro-brucellosis should be considered in patients presenting with muscle weakness.Öğe A case of Guillain-Barre syndrome in a patient with small cell lung cancer treated with chemotherapy(Kare Publ, 2014) Turkmen, Esma; Erdogan, Bulent; Hacibekiroglu, Ilhan; Kodaz, Hilmi; Uzunoglu, Sernaz; Celik, Yahya; Cicin, IrfanGuillain-Barre syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy characterized by bilateral progressive symmetrical paralysis. GBS is rarely seen neuropathy in cancer patients. In the literature some cases of GBS associated with anticancer chemotherapy. In this case; the guillain-barre syndrome developed after the treatment of a 59-year-old male patient with metastatic small cell lung carcinoma who admitted to hospital with neutropenic fever after cisplatin/etoposide chemoteraphy regime is presented. The patients complained of bilteral progressive symmetrical paralysis in upper and lower limbs with depressed deep tendon reflexes and hypoesthesia. There was no pathological findings on electromyography. There was no a sign at radiological imaging that explained cranial and spinal mestastasis. The cerebrospinal fluid had albuminocytologic dissociation. Decline in tumoral lesions were detected on chest radiography. Accompanied by clinical and laboratory findings, a diagnosis of Guillain-Barre syndrome was considered. Semptoms completely disapperared after intravenous immunoglobulin for five days. Recurrence did not during follow-up. The patients was administered a total of 4 cycles of cisplatin/etoposide chemotherapy. The patient died due to disease progression six months later. We think that, in this case GBS was not a paraneoplatic syndrome because there was more than 50% tumor shrinkage. We propose GBS was induced by infection and chemotherapy rather than malignancy.Öğe Cerebral infarction due to traumatic carotid artery dissection(Turkish Assoc Trauma Emergency Surgery, 2008) Kilincer, Cumhur; Tiryaki, Mehmet; Celik, Yahya; Turgut, Nilda; Balci, Kemal; Utku, Ufuk; Cobanglu, SebahattinWith the advent of improved neuroradiological methods, it has been determined that frequency of traumatic carotid artery dissections is higher than previously observed. Since delayed neurological deficits may develop in some asymptomatic undiagnosed cases, it is essential to consider the possibility of the carotid artery dissection and evaluate it properly in suspicious cases. In this article, a case of internal carotid artery dissection and subsequent cerebral infarction following a motor vehicle accident is presented. Pathogenesis, clinical features, diagnostic method choices and treatments in this rare but severe condition are discussed in light of the relevant literature in order to convey current knowledge.Öğe Cerebral sinus thrombosis in patients with inflammatory bowel disease: A case report(Baishideng Publishing Group Inc, 2005) Umit, Hasan; Asil, Talip; Celik, Yahya; Tezel, Ahmet; Dokmeci, Gulbin; Tuncbilek, Nermin; Utku, UfukInflammatory bowel disease (IBD) is an idiopathic inflammatory disease of the gastrointestinal tract. The pathophysiology of IBD is probably the result of the complex interaction of genetic susceptibility and environmental influences. There is a well-known risk of thrombosis in patients with IBD. We present the case of a 53-year-old man with ulcerative colitis, who spontaneously developed intracranial sinus thrombosis that was treated with low molecular weight heparin. Literature was searched to assess the frequency and characteristics of cerebral sinus thrombosis in IBD and the role of certain etiopathological factors in such thrombotic patients. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved.Öğe CEREBRAL VASOMOTOR REACTIVITY IN FIBROMYALGIA PATIENTS AND ITS RELATIONSHIP TO CENTRAL NEUROPATHIC PAIN(Literatura Medica, 2016) Guler, Sibel; Kurtoglu, Hakan S.; Kehaya, Sezgin; Pamuk, Nuri; Celik, YahyaBackground - Cerebral vasomotor reactivity, defined as the cerebral vasculature response to hypoxia, is not well understood in fibromyalgia (FM) patients. This study investigated the difference in the cerebrovascular reactivity (i.e., responsiveness to hypercapnia was evaluated by use of breath-holding index) to the breath-holding index (BHI) between patients with fibromyalgia and a group of normal controls. Methods - The study included 40 FM patients and 40 healthy subjects. Cerebrovascular reactivity was evaluated using the BHI, which is a nonaggressive, well-tolerated, real-time, reproducible screening method to study cerebral haemodynamics. Insonation depth and basal velocity were symmetrical and not significantly different between the two groups (p>0.05). All patients completed the Revised Fibromyalgia Impact Questionnaire (FIQR), Hospital Anxiety and Depression Scale (HADS), visual analogue scale (VAS), and the somatization subscale of the SCL-90-R symptom checklist. Results - The BHI ranged from 0.30 to 2.20 (mean 1.11 +/- 0.45) in the FM patients and 1.10 to 2.80 (mean 1.90 +/- 0.35) in the control group (p<0.001). Disease duration and right BHIaverage and left BHIaverage values exhibited a significant negative correlation (r=-61377; p<0.001, r=-0.842; p<0.001, respectively). As pain and fatigue scores increased, the right BHIaverage and left BHIaverage values decreased (r=-0.431; p=0.005, r=-0.544; p<0.001, r=-0.341; p=0.031, r=-0.644; p<0.001, respectively). Conclusions - BHI values showed that cerebrovascular reactivity in FM patients decreased in comparison to healthy individuals. BHI decreased as disease duration and severity increased. Cerebrovascular reactivity decreased in FM patients, and this phenomenon should be accepted as an abnormality. Additionally, this outcome may have been the result of a mechanism responsible for central neuropathic pain.Öğe Chronic idiopathic demyelinating polyneuropathy (CIDP) associated with Kaposi's sarcoma(Springer, 2006) Celik, Yahya; Turgut, Nilda; Turgut, Burhan; Pamuk, Guelsuem E.; Demir, Muzaffer[Abstract Not Available]Öğe Clinical and Radiological Features in CADASIL and NOTCH3-Negative Patients: A Multicenter Study from Turkey(Karger, 2014) Ince, Birsen; Benbir, Gulcin; Siva, Aksel; Saip, Sabahattin; Utku, Ufuk; Celik, Yahya; Necioglu-Orken, DilekBackground: The diversity of clinical presentation and neuroimaging findings of CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) from different regions of the world has not yet been studied in depth. Here we investigated the variability of clinical, radiological and genetic data of 48 patients analyzed for NOTCH3 mutation in Turkey. Methods: Clinical evaluation was made according to a preformed questionnaire. Cranial neuroimaging findings were determined on the basis of T1, T2, FLAIR and proton-density magnetic resonance scans. For genetic analysis, polymerase chain reaction was performed with primers flanking exons 2-6 and 11 of NOTCH3 gene. Results:Twenty-five patients (52.1%) were diagnosed as CADASIL with NOTCH3 mutation, while 23 patients (47.9%) had no mutation (NOTCH3-negative patients). The mean age and age at stroke onset were lower in male CADASIL patients (p < 0.03). A family history of migraine (p = 0.012), stroke (p < 0.001), recurrent strokes (p = 0.020) and dementia (p = 0.012) was more common in CADASIL patients. Temporal pole involvement was more common in CADASIL patients (p = 0.004). Conclusion: It is of clinical importance to identify the heterogeneity of CADASIL from different countries due to a low correlation of clinical and radiological data with respect to NOTCH3 mutation. (C) 2014 S. Karger AG, BaselÖğe Concomitance of Ankylosing Spondylitis and Multiple Sclerosis: A Case Report(Galenos Yayincilik, 2009) Tastekin, Nurettin; Uzunca, Kaan; Celik, Yahya; Kurtoglu, DilekMultiple sclerosis and ankylosing spondylitis are two autoimmune diseases in which genetic and environmental factors play an important role in the etiopathogenesis. It has been shown in various studies that multiple sclerosis may be associated with various autoimmune pathological conditions such as thyroid disease and pernicious anemia. Moreover, other rheumatic diseases such as rheumatoid arthritis and lupus have been reported to be associated with multiple sclerosis. Also concomitant ankylosing spondylitis patients have been observed among reports in the medical literature. In this case report, a male patient, 39 years old, who was diagnosed as having ankylosing spondylitis and multiple sclerosis has been presented. The etiology and therapy approaches of the concomitance of ankylosing spondylitis and multiple sclerosis were discussed in the light of clinical findings of the case. Turk J Phys Med Rehab 2009;55:39-41.Öğe Cost of acute ischemic and hemorrhagic stroke in Turkey(Elsevier, 2011) Asi, Talip; Celik, Yahya; Sut, Necdet; Celik, Aygul Dogan; Balci, Kemal; Yilmaz, Arif; Karaduman, FatihObjective: The aim of this study is to examine the direct medical costs and outcomes of patients with stroke. Material and methods: The records of the patients admitted with ischemic and hemorrhagic stroke to the University of Trakya, School of Medicine, Department of Neurology were reviewed retrospectively in year 2007. Direct medical costs (total costs, radiological, laboratory, medicine, and other) were calculated, additionally cost per life saved and per life-year saved were calculated for stroke patients. Results: The study group consisted of 328 patients (169 male/159 female) and mean age was 66.5 +/- 12.4 years. Length of hospital stay was 10.7 +/- 7.5 days. Mortality rate was 20.4% and the mRS score of the patients was 3.2 +/- 2.1. The average cost of stroke was US$ 1677 +/- 2964(29.9% medicine, 19.9% laboratory, 12.8% neuroimaging, and 38% beds and staff). Cost per life saved and per life-year saved were US$ 2108 and US$ 1070, respectively. Conclusion: This is the first study in order to determine direct medical cost of stroke in Turkey, therefore, it may be guideline for disease-cost management of stroke. (C) 2010 Elsevier B.V. All rights reserved.Öğe Differences in platelet-leukocyte aggregates among subtypes of acute cerebral ischemia(Elsevier, 2011) Turgut, Burhan; Turgut, Nilda; Celik, Yahya; Tekgunduz, Emre; Pamuk, Gulsum Emel; Demir, MuzafferBackground: Acute cerebral ischemia is caused by different pathophysiological mechanisms. The role of platelets and other blood cells can be different among the stroke subtypes. Methods: Seventy-two patients with acute ischemic cerebrovascular disease, including 31 patients with large vessel disease, 21 patients with cardioembolic disease, and 20 patients with small vessel disease, were evaluated. P-selectin (CD62P) expression and platelet leukocyte aggregates were measured with flow cytometry at the acute phase after the ischemic event. Markers were also measured in 37 control subjects. In all subjects, the serum high-sensitivity C-reactive protein (CRP) was also measured. Results: The platelet-monocyte aggregates (PMA) and platelet-granulocyte aggregates (PGA) in the large vessel disease group were higher than in control group (P=0.002, and P < 0.0001, respectively). The PMA and PGA in the small vessel disease group were also higher than in the control group (P=0.004 and P < 0.0001, respectively). In contrast, in the cardioembolic disease group, the PMA and PGA were not significantly different from the control group. CD62P expression was higher in all of the patient groups relative to the control group (P < 0.05 for all comparisons). Serum CRP levels were also higher in all of the patient groups than in the control group (P < 0.0001 for all comparisons). Conclusions: In contrast to large vessel and small vessel disease, it seems that platelet-leukocyte association does not play a crucial role in the pathogenesis of cardioembolic stroke. (C) 2011 Elsevier B.V. All rights reserved.Öğe Do you have restless leg syndrome? I understood from your eyes(Springer Heidelberg, 2019) Ozlece, Hatice Kose; Solmaz, Volkan; Ozal, Sadik Altan; Celik, YahyaPurpose According to many studies in the literature, there is a strong association between restless leg syndrome and dopaminergic dysfunction. Dopamine is also the major catecholamine in the retina and is also a possible transmitter of the amacrine and interplexiform cells. The aim of this study is to investigate the possible association between RLS and retinal thickness. Methods In this study, we included 33 patients who were diagnosed with idiopathic RLS according to the International RLS Study Group criteria and 31 healthy subjects. All the patients and controls underwent routine ophthalmologic examination and had spectral-domain optical coherence tomography (OCT) performed. We compared the retinal thickness of the patients and control subjects. Results In the RLS group, foveal thickness was thinner then controls. Also, only inferior, superior, and temporal quadrant retina nerve fiber layer (RNFL) thickness were significantly thinner in the RLS group. The parafoveal ganglion cell complex (GCC) in the superior temporal, inferior temporal, inferior nasal quadrant, and perifoveal superior nasal thickness was also significantly thinner in the patient group. Pearson correlation analyses showed that there were statistically significant negative correlations between disease duration and macular GCC and RNFL thickness. Negative correlations were also detected between parafoveal superior, temporal, inferior and nasal macular thickness, parafoveal superior nasal, inferior temporal GCC thickness, and perifoveal superior nasal GCC thickness and disease duration. Conclusion According to our results; most retinal layers are thinner in RLS patients, so it can be considered that OCT has a predictive value for progression of RLS.Öğe The Effect of Admission Blood Pressure on the Prognosis of Patients with Intracerebral Hemorrhage That Occurred during Treatment with Aspirin, Warfarin, or No Drugs(Informa Healthcare, 2012) Balci, Kemal; Utku, Ufuk; Asil, Talip; Celik, Yahya; Tekinaslan, Ilkay; Ir, Nasif; Unlu, ErcumentBackground. Hypertension is the most important modifiable risk factor for intracerebral hemorrhage (ICH), but blood pressure (BP) management during the acute phase of ICH is still controversial. Approximately one-fourth of ICHs occur during treatment with warfarin or aspirin. Aim. This study was designed to determine the effect of admission BP on the early prognosis of ICH patients by dividing them into three groups (warfarin, aspirin, and no drugs). Methods. Three hundred and sixty-nine patients with supratentorial ICH were divided into three groups according to medication. Each group was evaluated in terms of prognosis and the risk for mortality based on the modified Rankin Scale (mRS) score at discharge (good prognosis: mRS <= 3; poor prognosis: mRS > 3). The effect of admission BP on prognosis was evaluated for each group. Results. The inhospital mortality rate was 72% for ICH patients treated with warfarin, 41.6% for ICH patients treated with aspirin, and 35% for ICH patients treated with no drugs. Admission mean arterial blood pressure (MABP) values were higher in patients with poor prognosis compared with patients with good prognosis for the aspirin (P = .002) and no-drug (P = .001) groups, but not in the warfarin (P = .067) group. Conclusion. A high MABP at admission was found to be an independent predictor of poor prognosis for ICH patients treated with aspirin or with no drugs, but not for ICH patients treated with warfarin.Öğe Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes(Bmc, 2010) Tamagno, Gianluca; Celik, Yahya; Simo, Rafael; Dihne, Marcel; Kimura, Kazumi; Gelosa, Giorgio; Lee, Byung I.Background: The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto's thyroiditis (HT), although fourteen EAATD patients with Graves' disease (GD) have been also reported. Methods: We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. Results: Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. Conclusions: GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.Öğe Erdheim-Chester Disease Presented with Bilateral Carotid Artery Occlusion: Case Report(Turkish Neurological Soc, 2010) Celik, Yahya; Balci, Kemal; Asil, Talip; Tuzun, Erdem; Hamamcioglu, Mustafa Kemal; Temizoz, Osman; Albayram, SaitErdheim-Chester disease is a rare, non-Langerhans form of systemic histiocytosis of unknown etiology. The disease affects multiple organ systems, including musculoskeletal, cardiac, pulmonary, gastrointestinal, and central nervous systems, producing protean manifestations. Neurological manifestations are less frequent. We present a 44-year-old patient with Erdheim-Chester disease who had bilateral carotid artery occlusion and cavernous sinus infiltration.Öğe Evaluation and follow-up of cognitive functions in patients with minor stroke and transient ischemic attack(Dove Medical Press Ltd, 2016) Deniz, Cigdem; Celik, Yahya; Gultekin, Tugce Ozdemir; Baran, Gozde Eryigit; Deniz, Cagla; Asil, TalipBackground and purpose: We aimed to examine the incidence of cognitive impairment among patients with stroke, the associated risk factors, progression of the cognitive impairment, and the association between the localization of the lesion(s) as detected by magnetic resonance imaging and the affected areas of cognitive function. Methods: A total of 40 patients over 18 years of age enduring a transient ischemic stroke or minor stroke within the past 3 months who had a minimum life expectancy of 1 year were included in this study. Same number, age-, and sex-matched individuals were included as controls. Patients were inquired on the presence of risk factors for stroke. A series of neuropsychological test batteries were administered in patient and control subjects for assessing cognitive functions. These tests were readministered at 6 and 12 months of follow-up to assess the progression of cognitive functions. Results: In this study among the patients with stroke, a significant impairment was seen in multiple cognitive functional tests following ischemic stroke as compared to control groups. The most common risk factors for stroke included hypertension (72.5%), hyperlipidemia, and cigarette smoking. The number of cognitive domains with an impairment was highest ( in four cognitive tests) among those with coronary artery disease and atrial fibrillation, followed by those who had a > 50% stenosis in Doppler (three cognitive tests). These findings suggest that the frequency of risk factors associated with stroke does not correlate with the frequency of risk factors associated with cognitive dysfunction. The stroke localizations were classified among the patients with stroke and reviewed in accordance with cognitive impairment. Conclusion: Neuropsychological tests, clinical findings, and imaging studies should be used to document the poststroke cognitive dysfunction.Öğe Evaluation of the association between sexual dysfunction and demyelinating plaque location and number in female multiple sclerosis patients(Taylor & Francis Ltd, 2018) Solmaz, Volkan; Ozlece, Hatice Kose; Him, Aydin; Gunes, Ayfer; Cordano, Christian; Aksoy, Durdane; Celik, YahyaPurpose: To investigate the frequency of sexual dysfunction (SD) in female multiple sclerosis (MS) patients and to explore its association with the location and number of demyelinating lesions. Material and Methods: We evaluated 42 female patients and 41 healthy subjects. All patients underwent neurological examination and 1.5 T brain and full spinal MRI. All subjects completed the female sexual function index (FSFI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Short-Form 36 Quality of Life Scale (SF-36). All participants were also evaluated for serum thyroid stimulating hormone (TSH), T4, estradiol, and total testosterone. Results: No statistically significant differences between the MS and control groups were found for age, body mass index (BMI), serum TSH, T4, E2, and total testosterone level. MS patients had a statistically significantly lower FSFI and SF-36 scores and higher BDI and BAI scores compared with healthy subjects. The location and number of demyelinating lesions were not associated with SD. Conclusion: In our cohort, this difference in SD appears unrelated to the location and number of demyelinating lesions. These findings highlight the importance of the assessment and treatment of psychiatric comorbidities, such as depression and anxiety, in MS patients reporting SD.Öğe General Approach to Diagnosis and Treatment of Multiple Sclerosis in Turkey(Turkish Neurological Soc, 2009) Terzi, Murat; Celik, Yahya; Kilinc, Munire; Seleker, Feray; Isik, Nihal; Gedizlioglu, Muhtesem; Zorlu, YasarObjective: The clinical progress of multiple sclerosis (MS), initial symptoms and problems during the course of a disease that can be seen, may vary among the patients. Therefore, different applications occurs in the disease diagnosis and treatment plan. The difficulties of diagnosis, treatment and progress of MS disease, experienced by the neurology residents and experts from different regions of the Turkey is intended to introduce. Materials and Methods: Interactive meetings was arrenged in total 11 cities from different regions of Turkey, between March 2008 and June 2008. The data obtained as a result of the responses of participants were evaluated. Results: Neurology specialist and research assistant, total of 242 persons participated. It was observed that 14 percent of visual evoked potential, 40 percent of cerebrospinal fluid (CSF) oligoclonal band review and one percent of magnetic resonance imaging examinations used in diagnosis of MS can't be done. There was significant differences between regions about feasibility of CSF OCB. Sixty one percent of participants thought to start immunomodulatory treatment to typical relapsing-remitting multiple sclerosis patients, filled in the Mc Donald diagnostic criteria and had two attack story. Conclusion: As all the world, in Turkey being very much difference about clinical, radiological and laboratory features of MS lead to the neurology experts work hard and the emergence of different applications about the disease diagnosis and treatment plan.Öğe Hepatic Encephalopathy and Atypical Cortical Involvement in Cranial MRI: case report(Aves Yayincilik, Ibrahim Kara, 2009) Celik, Yahya; Ozbek, Bahar; Balci, Kemal; Unlu, Ercuement; Utku, UfukHepatic encephalopathy is characterized by neuropsychiatric abnormalities occurring in patients with liver dysfunction. It most commonly occurs in association with cirrhosis, portal hypertension, portal-systemic shunts and acute liver failure. Clinical features of hepatic encephalopathy varies between mild cognitive impairment to deep coma. Several neuroimaging techniques, especially magnetic resonance imaging (MRI), may eventually be useful for the diagnosis of hepatic encephalopathy. Cranial MRI may demonstrate high signal intensity in the bilateral globus pallidum on T1-weighted images. Cortical involvement due to hepatic encephalopathy is rarely reported in the literature. We presented here a case of hepatic encephalopathy with cortical and subcortical involvement.Öğe Hereditary neuropathy with liability to pressure palsies in a Turkish patient (HNPP)(Turkish Neurosurgical Soc, 2008) Celik, Yahya; Kilincer, Cumhur; Hamamcioglu, M. Kemal; Balci, Kemal; Birgili, Baris; Cobanoglu, Sebahattin; Utku, UfukHereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant nerve disease usually caused by 1,5 Mb deletion on chromosome 17p11.2.2-p12, the region where the PMP-22 gene is located. The patients with HNPP usually have relapsing and remitting entrapment neuropathies due to compression. We present a 14-year-old male who had acute onset, right-sided ulnar nerve entrapment at the elbow. He had electrophysiological findings of bilateral ulnar nerve entrapments (more severe at the right side) at the elbow and bilateral median nerve entrapment at the wrist. Genetic tests of the patient demonstrated deletions in the 17p11.2 region. The patient underwent decompressive surgery for ulnar nerve entrapment at the elbow and completely recovered two months after the event. Although HNPP is extremely rare, it should be taken into consideration in young adults with entrapment neuropathies.Öğe High asymmetric dimethylarginine, symmetric dimethylarginine and L-arginine levels in migraine patients(Springer-Verlag Italia Srl, 2017) Reyhani, Aylin; Celik, Yahya; Karadag, Hakan; Gunduz, Ozgur; Asil, Talip; Sut, NecdetExperimental and clinical data strongly suggests that nitric oxide (NO) plays a pivotal role in migraine. This is also supported by studies of migraine induced by substances that release NO. NO is synthesized from L-arginine by endothelial NO synthase (NOS). Asymmetric dimethylarginine (ADMA) is the major endogenous competitive inhibitor of NOS. Symmetric dimethylarginine (SDMA) is an inactive stereoisomer of ADMA. It may reduce NO production by competing with arginine for cellular uptake. The aim of this study was to measure the levels of ADMA, SDMA and L-arginine in migraine patients during the interictal period. One hundred migraine patients and 100 healthy volunteers were recruited. The patients were in the interictal period and classified into two groups as having migraine with aura and migraine without aura. Their serum ADMA, SDMA and L-arginine levels were measured by high-performance liquid chromotography (HPLC) method. ADMA, SDMA and L-arginine levels were significantly higher in migraine patients compared to the control group. But there was no difference between the patients with and without aura. These results suggest that NOS inhibitors and L-arginine/NO pathway plays an important role in migraine pathopysiology.
