Fakülteler / Faculties
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Item Anti-N-Methyl-D-Aspartate Receptor Encephalitis During Pregnancy: A Case Report(2019) Keskin, Ahmet O.; Tanburoglu, Anil; Idiman, Egemen; Ozturk, Vesile; https://orcid.org/0000-0002-2942-323X; https://orcid.org/0000-0001-9627-3502; 30788880; AAJ-2044-2021; AAK-1876-2021Following a generalized tonic-clonic seizure, a previously healthy 27-year-old pregnant woman (18-week pregnancy) was admitted to our emergency department. She experienced lethargy, forgetfulness and persecutory hallucinations the day before hospitalization. Cerebrospinal fluid examination revealed moderate pleocytosis, and abdominal ultrasonography did not detect neoplasia. Orofacial dyskinesia, catatonia and central hypoventilation gradually developed despite medical intervention to ameliorate the symptoms. At 32 weeks of pregnancy, vaginal bleeding and hypotension occurred. Further, owing to septic shock due to fetal demise, the patient died. N-methyl-d-aspartate antibody test results obtained after the patient's death were positive (2++). Currently, no consensus exists on the appropriate treatment and follow-up for pregnant women with anti-N-methyl-d-aspartate receptor encephalitis; however, immunomodulators and teratoma resection may be helpful. Second line immunotherapy (rituximab, cyclophosphamide) and teratoma resection may be necessary in pregnant patients with high N-methyl-d-aspartate receptor antibody titers and inadequate response to first-line treatment.Item Let's Raise The Awareness Of MS Specialists Concerning The Frequency And Impact Of RLS In MS And Consequently The Life Quality Of Patients With MS: Striking Results Of The 'RELOMS-T' Study(2018) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, Murat; Boz, Cavit; Tuncel, Deniz; Karabudak, Rana; Siva, Aksel; Ozcan, Cemal; Neyal, Munife; Goksel, Basak Karakurum; Balal, Mehmet; Sen, Sedat; Ekmekci, Ozgul; Kara, Derya; https://orcid.org/0000-0003-2766-2277; AAE-2609-2021Item Optical Coherence Tomography Angiography (OCTA) In Differential Diagnosis Of Aquaporin-4 Antibody Seronegative NMOSD And Multiple Sclerosis(2022) Tiftikcioglu, Bedile Irem; Emre, Sinan; Idiman, Fethi; Idiman, Egemen; 35030370Backround: Optic neuritis(ON) is a common feature of both relapsing-remitting multiple sclerosis(RRMS) and neuromyelitis optica spectrum disorders(NMOSD). It is crucial to early differentiate these two diseases, as they differ in pathophysiology and treatment.& nbsp;Objective: To compare NMOSD and RRMS patients using optical coherence tomography(OCT) and OCT angiography(OCTA) to assess retinal microvascular network differences.& nbsp;Methods: Fourteen RRMS (28 eyes) and 9 NMOSD patients(18 eyes), and 11 controls were enrolled. Seropositivity for aquaporin-4 antibody (anti-AQP4 Abs) was 44.4%. Peripapillary and macular retinal nerve fiber layer (RNFL) thickness, superficial peripapillary and macular vessel density(VD), area, perimeter and circularity of foveal avascular zone(FAZ) were analyzed.& nbsp;Results: OCTA showed reduction in peripapillary and macular VD and FAZ size in NMOSD+ON compared to RRMS+ON and controls (p = 0.001, p < 0.001 and p = 0.010, p < 0.001 respectively). Peripapillary VD was similar in RRMS +ON and controls. Peripapillary VD in monophasic seronegative NMOSD+ON eyes was significantly lower than monophasic RRMS+ON eyes (p = 0.030), which was no different from controls. FAZ area was smaller in unaffected eyes in NMOSD than RRMS and controls.& nbsp;Conclusions: Both OCT and OCTA revealed considerable differences between RRMS and NMOSD patients, providing promising results in favor of clinical utility of OCTA in differential diagnosis of ON, particularly in antiAQP4 antibody negative patients. OCTA might be a useful biomarker in differentiating NMOSD from MS.Item 'Is RLS a harbinger and consequence of MS?: Striking results of the 'RELOMS-T' study'(2020) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, Murat; Boz, Cavit; Tuncel, Deniz; Karabudak, Rana; Siva, Aksel; Ozcan, Abdulcemal; Neyal, Munife; Goksel, Basak Karakurum; Balal, Mehmet; Sen, Sedat; Ekmekci, Ozgul; Oksuz, Nevra; Kaya, Derya; 0000-0003-2766-2277; 32473575; AAE-2609-2021Background: Although studies report a high prevalence rate of restless legs syndrome (RLS) among patients with multiple sclerosis (PwMS) ranging from 13.3 to 65.1%, little is known about the causes of this relationship. Methods: To ascertain the prevalence, features and impact of RLS among PwMS a nation-wide, multicenter, prospective and a cross-sectional survey, designed to reflect all of the PwMS throughout Turkey, was conducted in 13 centers. Exploring the relationship of the two conditions could possibly contribute to the understanding of the causes of the high and wide-ranging prevalence rates and the pathophysiology of both diseases. Results: Of the 1068 participants 173 (16,2%) found to have RLS [RLS(+)] and 895 (83,8%) did not [RLS(-)]. Among the RLS(+) 173, all but 8 patients (4,6%) were underdiagnosed in terms of RLS. More than half of the patients with RLS had 'severe' or 'very severe' RLS. The onset of RLS was before or synchronous with the onset of MS in about a half of our patients. Conclusion: We conclude that RLS should be meticulously investigated in PwMS and MS can be a direct cause of RLS at least in part of PwMS. Our data about the timing of the onset of MS and RLS, along with the high prevalence of RLS in PwMS suggest that the pathologic changes in the initial phases of MS can possibly trigger RLS symptoms.Item Importance of Optical Coherence Tomography Angiography in Differential Diagnosis of NMOSD and RRMS(2019) Tiftikcioglu, B. Irem; Emre, Sinan; Idiman, Fethi; Idiman, Egemen