Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Vaccination in Individuals with Multiple Sclerosis - Part I(2023) Cinar, Bilge Piri; Tuncer, Asli; Bilge, Nuray; Bunul, Sena Destan; Gozubatik Celik, Rabia Gokcen; Ciftci, Eda Derle; Genc, Gencer; Karaman, Bedriye; Kilic, Ahmet Kasim; Sariteke, Alp; Seferoglu, Meral; Tiftikcioglu, Bedile Irem; Tunc, Abdulkadir; Uncu, Gulgun; Yavas, Irfan; Yetkin, Mehmet Fatih; Efendi, Husnu; Siva, Aksel; 0000-0001-6900-4702Multiple sclerosis (MS) is an autoimmune and demyelinating disease of the central nervous system. It is a chronic disease, and in the evaluation of all other health and vital processes, decisions should be made by considering the disease process and the drugs used by the patient. Since vaccination can be performed at every stage of life, from childhood to adulthood, immune system activity, except where it is characteristic of the vaccine, should be reviewed in patients with MS. In this review, the applications of different vaccines in individuals with MS are discussed in two separate sections.Item Effects of Body Temperature Lowering on Visual Evoked Potentials in Patients with Multiple Sclerosis(2021) Poyraz, Turan; Idiman, Fethi; Keskin, Ahmet Onur; Karaoglan, Leyla Iyilikci; Idiman, EgemenObjective: Aggravation of neurologic symptoms in patients with multiple sclerosis (MS) due to heating is well known. This phenomenon, known as Uhthoff phenomenon (UP), is explained by transient conduction block in demyelinated nerve fibers and transected axons. The threshold of conduction block dependent on temperature is probably proportional to the degree of demyelination or axonal injury. On the other hand, about half of all patients reported improvement in a cold bath (anti-UP effect). This study aimed to assess the effects of body cooling on clinical parameters lneuro-opthalmologic examination and contrast sensitivity in visual acuity/Sloan letter rest, and the Expanded Disability Status Scale (EDSS)] and electrophysiologic measurements [visual evoked potentials (VEP)] in patients with MS previously clinically affected by optic neuritis. Materials and Methods: Twenty patients who described a UP or anti-UP effect with definite MS according to the McDonald and Poser criteria were enrolled in the study. Before the cooling process, all patients with a history of optic neuritis (at least once) were examined clinically, neurologically and neuro-ophthalmologically, and electrophysiologically. Body cooling was achieved using a "Medivance Arctic Sun Temperature Management System" and the body temperature was decreased by about 1 degrees C. After that, all patients were re-evaluated clinically and electrophysiologically. Results: After the cooling process, P100 latency significantly shortened at the 1st, 6th and 24th hours (p<0.001, p<0.001, p<0.001) and EDSS scores improved significantly (p<0.001). Visual acuity, including contrast sensitivity and color vision, significantly improved in both affected and unaffected eyes (p<0.001). Conclusion: These results suggest that heat caused a conduction block in demyelinated or transected axons in the visual pathways. Our results also demonstrate that the cool: o process had beneficial effects on clinical disability scores (EDSS) and the visual system based on clinical and electrophysiologic (VEP) evaluations. These find suggest that the cooling process may be used for symptomatic therapy and increasing life quality of patients with MS.Item Childhood traumas in patients with multiple sclerosis and its relationship with suicide probability(2019) Ulusoy, Selen Isik; Horasanli, BahriyeObjective: It is known that suicide probability is more than the normal population in patients with multiple sclerosis (MS). It has been reported that childhood trauma increases suicide probability in many psychiatric disorders. The aim of this study is to investigate the relationship between childhood traumas and the probability of suicide in patients with MS..Method: The study included 61 patients with MS. The functional status of the patients with MS was evaluated with the Expanded Disability Status Scale (EDSS). Hospital Anxiety Depression Scale (HAD), Childhood Trauma Inventory (CTQ-28) and Suicide Probability Scale (SPS) were applied to all patients. Results: The patients were divided into two groups as 26 patients with childhood trauma (CTQ >= 35) and 35 patients without childhood trauma (CTQ<35). The most common childhood trauma was emotional neglect (n=28; 45,90%) and the patients' mean EDSS score was 2.43 +/- 1.68. The mean of HAD anxiety subscale (HAD-A) scores (p=0,005), HAD depression subscale (HAD-D) scores (p=0,034), SPS despair subscale scores (p=0,031) and SPS total scores (p=0,020) were higher in patients with childhood trauma. All CTQ subscales, except physical neglect, were found positively correlated with the SPS total score. Discussion: Suicide probability was significantly higher in patients with MS with childhood trauma. Patients should be evaluated in terms of childhood traumas in order to take necessary measures for suicide probability and to perform correct interventions in patients with MS.Item A Case of Multiple Sclerosis Presented with 5th, 6th and 7th Cranial Nerve Paralysis(2015) Sarıgul, Almila; Bayar, Sezin Akca; Singar, Evin; Pinarci, Eylem Yaman; Oto, SibelA 36-year-old female patient was admitted to our clinic with complaints of numbness in hands, double vision, and inability to close her left eye. Her physical examination revealed horizontal diplopia, underactivity of the left lateral rectus muscle, left peripheral facial paralysis, and trigeminal sensorial neuropathy. The magnetic resonance imaging revealed hyperintense lesions, which were compatible with multiple sclerosis (MS). Therefore, systemic steroid treatment (1000 mg/day intravenous methylprednisolone for 5 days, 1 mg/kg/day oral prednisolone, reduced slowly) was administered to the patient. Within five weeks, her symptoms were regressed, and no recurrence was observed during the follow-up period of 4 years. As this case proves, MS can present with cranial nerve palsies in addition to many other different neurological symptoms. Although 5th nerve palsy is the most common cranial nerve palsy detected in MS patients, 7th and 6th nerve involvement are rarely reported in the literature. MS should always be considered in the differential diagnosis of cranial nerve palsies especially in young patients.