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Öğe Answer to the Letter to the Editor by N. Sethi [Eur Neurol, DOI: 10.1159/000356342](Karger, 2014) Tekatas, Aslan[Abstract Not Available]Öğe A Case of Uncorrected Tetralogy of Fallot Presenting with Acute Ischemic Stroke(Aves, 2014) Tekatas, Aslan; Kehaya, Sezgin; Cagli, Bekir; Akdemir, Vedat; Aynaci, Ozer; Dogru, Yuce; Aksu, FeyzaTetralogy of Fallot (FT) is the most common cyanotic congenital heart disease. FT is mainly composed of ventricular septal defect, right ventricular outflow tract obstruction, pulmonary stenosis and right ventricular hypertrophy, but also can include dextrapositioned aorta (overriding aorta), additional malformations such as atrial septal defect, and coronary artery anomalies. In the first week of life patients undergo palliative anastamosis between a pulmonary artery and subclavian artery and after they become eligible for major surgery total correction isperformed. With neurological involvement ischemic or venous stroke, syncope and seizures can occur. Generally, clinical presentation is cerebral venous thrombosis. IIschemic stroke in children is associated with hyperviscosity and microstasis, and in adults with phlebotomy, microcytosis and traditional stroke risc factors such as hypertension, diabetes mellitus and cardiac rhythm disorders. Patients with uncorrected FT rarely survive adulthood. In this study, we present a case without total correction, who lived up to the age of 39 years and presented with arterial stroke instead of expected venous thrombosis, along with stroke mechanisms in the literature.Öğe A comparison of risk factors and prognosis between intra and extracranial acute atherosclerotic stroke in the Turkish population: a prospective study(Taylor & Francis Ltd, 2016) Keheya, Sezgin; Tekatas, Aslan; Aynaci, Ozer; Utku, Ufuk; Solmaz, VolkanBackground: The aim of this study was to compare the differences in risk factors and prognosis between acute stroke caused by definitive intracranial atherosclerosis (ICAS) or extracranial atherosclerosis (ECAS) in the Turkish population. Methods: This study was prospectively designed in a single centre and conducted with patients who were hospitalised due to acute ischaemic stroke. Inclusion criteria were the diagnosis of atherosclerotic ischaemic stroke, defined as more than 50% stenosis or occlusion in the arterial structure supplying the ischaemic area, having excluded other possible causes. Results: Information on 58 ICAS and 57 ECAS stroke patients was collected in a 13-month period. The ECAS patients had male gender predominance (p = 0.003). Ageing, stroke history and hyperlipidaemia were related with stroke severity in ECAS, and gender was associated with severity in ICAS. Hypertension and being female were related with poor prognosis in ICAS (p = 0.081 vs. 0.087). Congestive heart failure (p = 0.002) was associated with poor prognosis and alcohol with a favourable outcome (p = 0.087) in ECAS. Stroke severity was related with poor prognosis in both groups (p < 0.001). Conclusions: The prevalence of risk factors differs between ICAS and ECAS, and their influence differs for stroke severity and prognosis.Öğe Extraspinal Incidental Findings on Routine MRI of Lumbar Spine: Prevalence and Reporting Rates in 1278 Patients(Korean Radiological Soc, 2015) Tuncel, Sedat Alpaslan; Cagli, Bekir; Tekatas, Aslan; Kirici, Mehmet Yadigar; Unlu, Ercument; Genchellac, HakanObjective: The aim of the present study was to determine the prevalence and reporting rate of incidental findings (IF) in adult outpatients undergoing lumbar magnetic resonance imaging (MRI). Materials and Methods: Re-evaluation of a total of 1278 Lumbar MRI images (collected from patients with a mean age of 50.5 years, range 16-91 years) captured between August 2010-August 2011 was done by a neuroradiologist and a musculoskeletal radiologist. IFs were classified according to organ or system (liver, gallbladder, kidney, bladder, uterus, ovary, lymph node, intestine and aorta). The rate of reporting of a range of IF was examined. The outcome of each patient's treatment was evaluated based on review of hospital records and by telephone interviews. Results: A total of 253 IFs were found in 241 patients (18.8% of 1278). Among these, clinically significant IFs (n = 34) included: 2 renal masses (0.15%), 2 aortic aneurysms (0.15%), 2 cases of hydronephrosis (0.15%), 11 adrenal masses (0.86%), 7 lymphadenopathies (0.55%), 6 cases of endometrial or cervical thickening (0.47%), 1 liver hemangioma (0.08%), 1 pelvic fluid (0.08%) and 2 ovarian dermoid cysts (0.15%). Overall, 28% (71/253) of IFs were included in the clinical reports, while clinically significant findings were reported in 41% (14/34) of cases. Conclusion: Extraspinal IFs are commonly detected during a routine lumbar MRI, and many of these findings are not clinically significant. However, IFs including clinically important findings are occasionally omitted from formal radiological reports.Öğe Increased frequency of restless leg syndrome in patients with ankylosing spondylitis(Wiley, 2015) Tekatas, Aslan; Pamuk, Omer N.ObjectiveTo assess the prevalence of restless leg syndrome (RLS) in patients with ankylosing spondylitis (AS) and to investigate factors potentially associated with RLS. MethodsOne hundred and thirty patients diagnosed with AS according to modified New York criteria and 91 age- and sex-matched healthy control subjects were included in this study. The diagnosis of RLS was made according to the criteria of the International RLS Study Group. The factors associated with RLS were evaluated. Electrophysiological procedures were performed in a group of patients with RLS. ResultsRLS was significantly more common in patients with AS (30.8%) than in healthy controls (13.2%). When AS patients with RLS were compared with AS patients without RLS, it was seen that peripheral arthritis, uveitis, anemia, smoking and polyneuropathy were significantly higher in the former group. ConclusionRLS is common in patients with AS and iron deficiency, smoking and small fiber neuropathy seem to be possible causes.Öğe Increased frequency of small fiber neuropathy in chronic lymphocytic leukemia and non-Hodgkin lymphoma patients(Taylor & Francis Ltd, 2015) Pamuk, Gulsum Emel; Maden, Muhammet; Tekatas, Aslan; Pamuk, Omer Nuri[Abstract Not Available]Öğe Investigation of Nerve Conduction Studies of Carpal Tunnel Syndrome Cases With Different Risk Factors: An Electrodiagnostic Study(Lippincott Williams & Wilkins, 2017) Solmaz, Volkan; Yavuz, Selcuk; Inanir, Ahmet; Aksoy, Durdane; Pektas, Elmas; Tekatas, Aslan; Kurt, Semiha G.Purpose:The aim of this study was to determine whether there are electrodiagnostic differences between carpal tunnel syndrome (CTS) patients with diabetes mellitus, CTS + hypothyroidism (HT), CTS + fibromyalgia syndrome, CTS + rheumatoid arthritis (RA), and idiopathic CTS cases, by comparing nerve conduction studies.Methods:This research examined electrophysiologic studies of 47 untreated HT + CTS, 47 diabetes mellitus + CTS, 49 RA + CTS, 52 fibromyalgia syndrome + CTS, 50 idiopathic CTS cases, and a healthy control group of 50 individuals (a total of 293 patients and 433 hands with CTS).Results:There were no significant differences between the groups in terms of sex and age. There was no significant difference between the CTS groupsin terms of numberswith mild, moderate, and severe CTS. When the CTS groups were compared with the control group, in all CTS groups on both left and right hands, there was a significant prolongation in median motor latency and median sensory latency (in the 3rd finger); also a significant decrease in median sensory velocity in the 3rd finger. In diabetes mellitus, HT, and RA groups, the median motor amplitudes in both hands were significantly decreased compared with the idiopathic group. There was a moderate significant negative correlation between disease duration and median motor amplitudes (of both right and left sides) in RA (right; P = 0.028, r = 0.761, left; P = 0.041, r = 0.694) and HT groups (right; P = 0.035, r = 0.637, left; P = 0.049, r = 0.697).Conclusions:Electrodiagnostic results showed both demyelinating injury and axonal damage in diabetes mellitus, HT, and RA patients with CTS, in these patients during treatment for CTS. Early treatment planning should include the risk factor diseases.Öğe Lumbar Opening Pressure and Radiologic Scoring in Idiopathic Intracranial Hypertension: Is There Any Correlation?(Int Scientific Information Inc, 2017) Tuncel, Sedat Alpaslan; Yilmaz, Erdem; Cagli, Bekir; Tekatas, Aslan; Celik, Yahya; Unlu, Mehmet ErcumentBackground: To investigate correlation between lumbar opening pressure (LOP) and radiological scores based on cranial MRI and contrast-enhanced MR venography in patients with idiopathic intracranial hypertension (IIH). Material/Methods: Patients with IIH who underwent brain MRI and contrast-enhanced MR venography before measurement of LOP between 2010-2014 were evaluated retrospectively. Three experienced radiologists (blinded to LOP values) evaluated a total of 51 patients. They reached a consensus on the presence or absence of 6 radiological findings identified in the literature as characteristic for IIH: empty sella, perioptic dilation, optical tortuosity, flattening of the posterior globe, swelling of the optic disc, and bilateral transverse sinus stenosis. The radiological score was obtained by giving 1 point for the presence of each finding, with the highest possible score of 6 points. The correlation between the calculated radiological scores and LOP was evaluated. Results: There was no significant correlation between LOP and radiological scores (r=0.095; p=0.525, Spearman's rank coefficient). Similarly, no significant correlation was detected between LOP and each of the radiological findings (partial empty sella [p=0.137], perioptic dilation [p=0.265], optical tortuosity [p=0.948], flattening of the posterior globe [p=0.491], swelling of the optic disc [p=0.881], and bilateral dural sinus stenosis [p=0.837], Mann-Whitney U test). Conclusions: There was no significant correlation between LOP and reliable radiological features of IIH.Öğe Migraine Headache Triggered Specifically by Sunlight: Report of 16 Cases(Karger, 2013) Tekatas, Aslan; Mungen, BulentMigraine headaches may take place due to various triggering factors. One or more triggering factors can be detected in a migraine patient. To our knowledge, a factor that is known to trigger migraine attacks in a patient does not cause headache each time the patient is exposed to it. Migraine headaches also can be experienced without these factors. Here, we describe a case series of 16 sunlight-induced migraine patients. Records of patients admitted to Firat University Faculty of Medicine Clinic of Neurology with a complaint of headache between January 2001 and June 2010 were scanned. Among those patients, the ones suffering headaches after being exposed to sunlight were examined comprehensively. Nine patients were female and 7 were male. Fourteen patients had the characteristics of migraine without aura, while 2 patients had the characteristics of migraine with aura. The mean times to headache onset after sunlight exposure were 5-10 min in summer and 60 min in winter. Migraine headaches can be triggered by many different causes. We view sunlight as a single triggering factor which should be questioned in migraine patients. (C) 2013 S. Karger AG, BaselÖğe Neuroprotective effects of octreotide on diabetic neuropathy in rats(Elsevier France-Editions Scientifiques Medicales Elsevier, 2017) Solmaz, Volkan; Cinar, Bilge Piri; Yigitturk, Gurkan; Ozlece, Hatice Kose; Eroglu, Huseyin Avni; Tekatas, Aslan; Erbas, OytunThe purpose of the present study is to investigate the possible healing effects of octreotide (OCT) on motor performance, electrophysiological and histopathological findings of diabetic neuropathy in a rat model of diabetes mellitus (DM). To induce diabetes, rats were administered a single dose (60 mg/kg) of streptozotocin (STZ). Diabetic rats were treated either with saline (1 ml/kg/day, n = 7) or OCT (0.1 mg/kg/ day, n = 7) for four weeks. Seven rats served as control group and received no treatment. At the end of the study, electromyography (EMG), gross motor function (inclined plate test), general histology and the perineural thickness of sciatic nerve were evaluated. At the end of study, weight loss was significantly lower in OCT treated rats than that of saline treated ones (p < 0.001). Electrophysiologically, compound muscle action potential (CMAP) amplitudes of the saline treated DM group were significantly reduced than those of controls (p < 0.0001). Also, distal latency and CMAP durations were significantly prolonged in saline treated DM group (p < 0.05) compared to control. However, treatment of diabetic rats with OCT significantly counteracted these alterations in EMG. Furthermore, OCT significantly improved the motor performance scores in diabetic rats (p < 0.05). Histomorphometric assessment of the sciatic nerve demonstrated a significant reduction in perineural thickness in OCT treated group compared to saline group. In conclusion, OCT possesses beneficial effects against STZ-induced diabetic neuropathy, which promisingly support the use of OCT as a neuroprotective agent in patients with diabetic neuropathy. (C) 2017 Elsevier Masson SAS. All rights reserved.Öğe Posterior Reversible Leukoencephalopathy Secondary to Gemcitabine(Turkish Neurological Soc, 2014) Tekatas, Aslan; Cagli, Bekir; Tuncel, Sedat Alpaslan; Kirici, Mehmet Yadigar; Unlu, Ercument[Abstract Not Available]Öğe Pruritus: Do A? fibers play a role?(Wiley, 2014) Tekatas, Aslan; Arican, Ozer; Guler, Sibel; Aynaci, Ozer; Dincer, NejlaNeuropathological and molecular basis of pruritus has not been clarified and the presence of certain specific neural circuits have been proposed. Our aim in this study was to evaluate the role of A fibers in the neural circuits of pruritus by cutaneous silent period (CSP). Thirty-six patients with chronic idiopathic generalized pruritus and 32 healthy controls were enrolled in the study. CSP and nerve conduction studies of upper and lower extremities were performed in both groups. Latencies of CSP in the upper and lower extremities were observed to be prolonged in the patient group compared with the controls while durations were shortened (all P<0.001). However, these values were not correlated with sex, age, duration or severity of the disease (all P>0.05). Our data suggest that pruritus may be developed by a nerve conduction abnormality in the afferent fibers of A, or cortical hypersensitivity, abnormality of the cortical inhibitory mechanisms or lack of inhibition in the intermediate spinal inhibitory neurons generating CSP. This topic needs to be evaluated thoroughly in larger series with more detailed studies.Öğe R-R interval variation and sympathetic skin response in systemic lupus erythematosus(Springer London Ltd, 2014) Tekatas, Aslan; Koca, Suleyman Serdar; Tekatas, Demet Deniz; Aksu, Feyza; Dogru, Yuce; Pamuk, Omer NuriThe involvement of the autonomic nervous system is less common than that of the central and peripheral nervous system in systemic lupus erythematosus (SLE) patients. However, its involvement can negatively affect the quality of life of the patient and cause life-threatening situations. In this study, autonomic function was evaluated in SLE patients who did not show any sign of autonomic involvement using R-R interval variation (RRIV) and sympathetic skin response (SSR) electrophysiological tests. SSR was used to evaluate the sympathetic nervous system, whereas RRIV was used for the parasympathetic nervous system. We included 23 SLE patients and 21 healthy volunteers in the study. Of the 23 SLE patients, 20 (86.9 %) were female and 3 (13.1 %) were male. The age range of the patients was between 19 and 52 years, with a mean age of 32.5 +/- 9.1 years. Routine nerve conduction studies and autonomic tests were performed on patients in the electromyography (EMG) laboratory. Lower extremity SSR latencies were prolonged and a significant loss of amplitude was observed in comparison to the control group. Furthermore, deep-breath RRIV values for the patient group were significantly lower than that of the control group. Both sympathetic and parasympathetic nervous system involvement was seen in our study. In conclusion, EMG can reveal a possible underlying involvement in the absence of signs of autonomic involvement.Öğe A Rare Cause of Headache and Increased Intracranial Pressure: Primary Leptomeningeal Melanomatosis(Turkish Neurological Soc, 2014) Tekatas, Aslan; Gemici, Yagmur I.; Tuncel, Sedat Alpaslan; Cagli, Bekir; Tastekin, Ebru; Unlu, Ercument; Celik, YahyaPrimary leptomeningeal melanomatosis is a rare central nervous system neoplasm originating from leptomeningeal melanocytes. The cases can be presented with focal neurologic deficit, seizure, neuropsychiatric symptoms or increased intracranial pressure symptoms along with encephalitis or meningitis. Diagnosis can be made upon imaging studies, cytopathologic examination of cerebrospinal fluid and biopsy. Biopsy can return false negative since the leptomeningeal involvement is not diffuse. In this study, a case is presented who admitted to hospital with leptomenengitis symptoms such as headache, fever and altered state of consciousness and developed additional neurologic signs after months. First biopsy came out as normal while the second one did as positive. This case has been found worth presenting since this is a tumor of rare existence and the diagnosis was made upon the second biopsy.Öğe Small fiber neuropathy and related factors in patients with systemic lupus erythematosus; the results of cutaneous silent period and skin biopsy(Bmc, 2020) Tekatas, Aslan; Tekatas, Demet Deniz; Solmaz, Volkan; Karaca, Turan; Pamuk, Omer NuriIntroduction Evaluating small nerve fibers in patients with systemic lupus erythematosus (SLE) using cutaneous silent period (CSP) and skin biopsy and assesssing the relationship between clinical signs, autoantibodies and neuropathic pain score. Objective - methods Fifty one SLE patients and 46 healthy volunteers were included in this study. Nerve conduction studies and CSP were performed both on upper and lower limbs in subjects. Skin biopsy was performed and the number of epidermal nerve density and IL-6 staining were evaluated. Results In SLE patients, CSP latencies were significantly prolonged both in lower and upper limbs and lower and upper extremity CSP durations were significantly shorter when compared to controls (p < 0.001). The number of epidermal nerve was significantly lower in SLE patients when compared to healthy controls (p < 0.001). Conclusion We detected marked small nerve fiber damage in both lower and upper limbs in SLE patients using CSP. Decreased epidermal nerve density also supports this finding.Öğe Spontaneous intracranial hypotension presenting with coma: a case report and literature review(Kare Publ, 2015) Celik, Yahya; Tekatas, Aslan; Albayram, Sait; Gunduz, Aysegul; Asil, Talip; Unlu, Ercument; Ozlece Kose, HaticeSpontaneous intracranial hypotension is characterized by orthostatic headache in the absence of a history of head trauma or lumbar puncture, and diagnosis is confirmed by a specific cerebrospinal fluid pressure and neuroimaging findings. It rarely presents with coma. A 62-year-old man presented with progressive cognitive decline of 2 to 4 weeks' duration. He was diagnosed with spontaneous intracranial hypotension according to cerebrospinal fluid pressure and neuroimaging findings, and treated conservatively.Öğe VITREOUS HUMOR DIFFUSION MEASUREMENTS FROM DIFFUSION-WEIGHTED IMAGING IN IDIOPATHIC INTRACRANIAL HYPERTENSION(Literatura Medica, 2016) Cagli, Bekir; Tuncel, Sedat Alpaslan; Yilmaz, Erdem; Tekatas, Aslan; Ermis, VeliBackground - Idiopathic intracranial hypertension is a disease with uncertain etiology. It is not caused by an intracranial mass lesion or hydrocephalus and is characterized by abnormal elevation of intracranial pressure and normal composition of the cerebrospinal fluid. The orbita and intracranial area are closely related anatomically. Elevated intracranial pressure can be transmitted to the orbita through the cerebrospinal fluid around the optic nerve sheath changes at the vitreous humor on diffusion-weighted imaging have not been systemically studied in idiopathic intracranial hypertension. Purpose - The purpose of this study was to investigate diffusion changes in the vitreous humor in patients with intracranial hypertension. Methods - In this retrospective study, 25 patients with papilledema and who had been definitively diagnosed with idiopathic intracranial hypertension and 20 control participants were evaluated. Control subjects and patients were scanned with a 1.5 Tesla magnetic resonance imaging. Apparent diffusion coefficient maps were obtained from diffusion-weighted imaging with a b value of 1000 s/mm(2) and apparent diffusion coefficient values were automatically calculated. These images were obtained by a radiologist who was blinded to the details of the study for center of each vitreous humor and the body of lateral ventricle. The mean apparent diffusion coefficient values of each vitreous humor and the body of the lateral ventricle were calculated for each group (control group and patients) and quantitative comparisons were performed. Results - There were no statistically significant differences in mean apparent diffusion coefficient values of the right vitreous humor, left vitreous humor and the body of the lateral ventricle between the patients with idiopathic intracranial hypertension and the control group (p=0.766, p=0.864, p=0.576, respectively). Discussion - Vitreous humor is a closed system and has no direct relationship with the cerebrospinal fluid or cerebral tissue and although morphological changes occur in the orbital structures, including the optic disk and optic nerve in idiopathic intracranial hypertension, the indirect effects of these changes on the vitreous humor may be too subtle to measure. Conclusion - We did not find a significant difference in the mean apparent diffusion coefficient value of the vitreous humor between the patients with idiopathic intracranial hypertension and the control group. However, future studies will be necessary to determine if changes in the vitreous humor can be used to diagnose intracranial hypertension.
