Fakülteler / Faculties
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Item Overview of Pediatric Peripheral Facial Nerve Paralysis: Analysis of 40 Patients(2015) Ozkale, Yasemin; Erol, Ilknur; Saygi, Semra; Yilmaz, Ismail; 0000-0002-8522-5078; 0000-0003-3009-336X; 0000-0002-3530-0463; 0000-0002-1694-7608; 24810082; AAB-1203-2021; AAL-6136-2021; AAK-4825-2021; AAJ-2992-2021Peripheral facial nerve paralysis in children might be an alarming sign of serious disease such as malignancy, systemic disease, congenital anomalies, trauma, infection, middle ear surgery, and hypertension. The cases of 40 consecutive children and adolescents who were diagnosed with peripheral facial nerve paralysis at Baskent University Adana Hospital Pediatrics and Pediatric Neurology Unit between January 2010 and January 2013 were retrospectively evaluated. We determined that the most common cause was Bell palsy, followed by infection, tumor lesion, and suspected chemotherapy toxicity. We noted that younger patients had generally poorer outcome than older patients regardless of disease etiology. Peripheral facial nerve paralysis has been reported in many countries in America and Europe; however, knowledge about its clinical features, microbiology, neuroimaging, and treatment in Turkey is incomplete. The present study demonstrated that Bell palsy and infection were the most common etiologies of peripheral facial nerve paralysis.Item Association Between Hypocapnia and Febrile Seizures(2014) Kilicaslan, Buket; Erol, Ilknur; Ozkale, Yasemin; Saygi, Semra; Sariturk, Cagla; https://orcid.org/0000-0002-3530-0463; https://orcid.org/0000-0003-3009-336X; https://orcid.org/0000-0002-8522-5078; https://orcid.org/0000-0002-4130-1059; 24396127; AAW-9958-2021; AAK-4825-2021; AAL-6136-2021; AAB-1203-2021; AAS-7129-2021The purpose of this study is to determine whether hyperthermia-induced hyperventilation with subsequent hypocapnia is relevant to febrile seizures in children. This is only the second study to measure pCO2 and pH values in children with febrile seizures. This prospective case-control study enrolled 18 children who presented with febrile seizures and 18 children who presented with a febrile illness without seizures. Venous blood gas analyses were measured both from the febrile seizure and control group. There was no significant difference in mean blood pH between the febrile seizure and control groups but blood pCO2 was significantly lower in the febrile seizure group. Patients with complex febrile seizures exhibited significantly lower pCO2 levels within 1 hour of seizure onset than patients with simplex febrile seizures. These data indicate that febrile seizures may be associated with hyperventilation and that the ensuing hypocapnia may contribute to the development of febrile seizures.Item Congenital Segmental Spinal Muscular Atrophy: A Case Report(2015) Savas, Tulin; Erol, Ilknur; Ozkale, Yasemin; Saygi, Semra; 0000-0002-3530-0463; 0000-0002-8522-5078; 0000-0003-3009-336X; 25300987; AAK-4825-2021; AAB-1203-2021; AAL-6136-2021Spinal muscular atrophies are genetic disorders in which anterior horn cells in the spinal cord and motor nuclei of the brainstem are progressively lost. We present a patient with arthrogryposis due to congenital spinal muscular atrophy predominantly affecting the upper limbs. Spinal muscular atrophies with onset at birth may be a cause of arthrogryposis. Localized forms of neurogenic arthrogryposis have been divided into cervical and caudal forms. Our case is similar to the cases described by Hageman et al (J Neurol Neurosurg Psychiatry 1993;56:365-368): severe symmetric lower motor neuron deficit in the upper extremities at the time of birth, no history of injury to the cervical spinal cord or the brachial plexus during delivery, and severe muscle wasting suggesting chronic denervation in utero. Because there was improvement of our patient's situation, her disease was also possibly nonprogressive and sporadic. To our knowledge, this is the first reported case of a Turkish patient with congenital cervical spinal muscular atrophy. Congenital cervical spinal muscular atrophy affecting predominantly the upper limbs is a relatively rare form of motor neuron disease and should be considered in the differential diagnosis of infants with congenital contractures and severe muscle weakness by wasting mainly confined to the upper limbs.Item Cerebellar Mutism Caused by Primary Varicella Infection in an Immunocompetent Child(2014) Erol, Ilknur; Ozkale, Yasemin; Saygi, Semra; Alehan, Fusun; https://orcid.org/0000-0002-3530-0463; https://orcid.org/0000-0002-8522-5078; 23446802; AAK-4825-2021; AAB-1203-2021Varicella (chickenpox) is a common childhood infection caused by the varicella-zoster virus, which is often self-limiting and usually benign. Although uncommon, neurologic complications of varicella have been documented that include postinfectious cerebellar ataxia, meningoencephalitis, Reye syndrome, myelitis, optic neuritis, stroke, Guillain-Barre syndrome, seventh cranial nerve palsy, and Ramsay-Hunt syndrome. In this case study, the authors describe a 7-year-old girl who presented with varicella skin rash with unsteady gait and anarthria on day 2, and her condition was attributed to cerebellar mutism. To date, this complication has never been reported in a child with primary varicella infection. Therefore, this case study documents a rare but serious complication of childhood chickenpox.Item Long-Term Accidental Overdose of Levetiracetam in an Infant(2014) Ozkale, Yasemin; Ozkale, Murat; Saygi, Semra; Erol, Ilknur; https://orcid.org/0000-0003-3009-336X; https://orcid.org/0000-0003-0625-1057; https://orcid.org/0000-0002-8522-5078; https://orcid.org/0000-0002-3530-0463; 23520362; AAL-6136-2021; A-7806-2016; AAB-1203-2021; AAK-4825-2021Levetiracetam is one of the new anticonvulsant drugs that has a high therapeutic index and potential antiepileptogenic effects. Herein, we report a patient with multidrug refractory epilepsy and Ohtahara syndrome who was accidentally administered 300 mg/kg/d for 35 days by her mother. To our knowledge, there are only a few cases of accidental overdose of levetiracetam in pediatric patients reported in the literature, and this case study is the first to report such a high and long-term dose in an infant who showed no adverse effects.Item Tic Disorder Probably Associated with Steroid Responsive Encephalopathy with Autoimmune Thyroiditis (SREAT)(2014) Saygi, Semra; Ozkale, Yasemin; Erol, Ilknur; https://orcid.org/0000-0002-8522-5078; https://orcid.org/0000-0003-3009-336X; 24633901; AAB-1203-2021; AAL-6136-2021Steroid responsive encephalopathy with autoimmune thyroiditis (SREAT), a rare disorder in individuals of all age groups, including children, is characterized by high titers of anti-thyroid peroxidase antibodies. The present report concerns a previously healthy 12-y-old boy who presented with motor tics. The patient underwent an extensive work-up to identify the underlying etiologies and risk factors predisposing him to tic disorder. Based on the clinical and laboratory results, a diagnosis of SREAT was made. Although some studies have reported associated behavioral and cognitive changes, myoclonus, seizures, pyramidal tract dysfunction, psychosis, and coma. The authors describe a case of tic disorder, probably due to SREAT, as well as its course of treatment.Item Optic Neuritis as A Presenting Symptom of Mycoplasma Pneumoniae Infection(2015) Ozkale, Yasemin; Erol, Ilknur; Coban Karatas, Muge; Alkan, Ozlem; 0000-0003-3009-336X; 0000-0001-7526-3460; 0000-0002-3530-0463; 27186706; AAL-6136-2021; AAM-4169-2021; AAK-4825-2021A broad range of neurologic disorders has been described in children infected with Mycoplasma pneumoniae, of which encephalitis is among the most common. In contrast, the association between optic neuritis and Mycoplasma pneumoniae infection has been rarely described in children. We report a case of a 12-year-old girl who was seropositive for antibodies against Mycoplasma pneumoniae and presented with optic neuritis without respiratory symptoms or other neurologic findings.Item Serum Vitamin B12, Folic Acid, and Homocysteine Levels in Children with Febrile Seizure(2015) Ozkale, Yasemin; Erol, Ilknur; Kilicarslan, Buket; Ozkale, Murat; Saygi, Semra; Sariturk, Cagla; Sezgin, Nurzen; 0000-0002-3530-0463; 0000-0002-8522-5078; 0000-0003-0625-1057; 0000-0003-3009-336X; 0000-0002-4130-1059; 27186696; AAK-4825-2021; AAB-1203-2021; A-7806-2016; AAL-6136-2021; AAS-7129-2021The aim of this study is to investigate the associations between febrile seizure and serum levels of vitamin B-12, folic acid, and homocysteine. One hundred and four children who presented with febrile seizure and 75 controls who presented with febrile illness unaccompanied by seizure were enrolled into the study. Mean levels of vitamin B-12, folic acid and homocysteine were compared between two groups. Mean vitamin B-12 level in the febrile seizure group was significantly lower than the control group. The febrile seizure patients with 3 or more had significantly lower serum folic acid than the subgroups with two or one episode only. Serum concentrations of folic acid were significantly lower in the febrile seizure subgroup with body temperature 37.5-39.0 degrees C at time of convulsion. Low serum vitamin B-12 may reduce a child's threshold for seizure and may be a risk factor for febrile seizure. Low serum folic acid level may be predisposed to recurrent febrile seizure.Item Efficacy of Topical 0.05% Cyclosporine Treatment in Children with Severe Vernal Keratoconjunctivitis(2014) Coban-Karatas, Muge; Ozkale, Yasemin; Altan-Yaycioglu, Rana; Sizmaz, Selcuk; Pelit, Aysel; Metindogan, Sevda; Canturk-Ugurbas, Silay; Aydin-Akova, Yonca; https://orcid.org/0000-0003-3009-336X; https://orcid.org/0000-0002-9139-8848; https://orcid.org/0000-0002-0662-2033; 25818961; AAL-6136-2021; AAL-4440-2020; F-2809-2015We aimed to determine the efficacy of topical cyclosporine in children with vernal keratoconjunctivitis refractory to topical mast cell stabilizer and antihistamine therapy. Thirty-one patients, 24 boys and 7 girls younger than 16 years of age, were included in the study. All patients were scored on a four-point scale from 0 to 3 for symptoms and signs. Each patient received topical cyclosporine 0.05% emulsion (Restasis, Allergan Inc., Irvine, CA, USA) four times daily in addition to preservative-free artificial tears and was followed for 6 months. The data was recorded before the initiation of treatment (day 0) and at the 1st, 3rd, and 6th months following treatment. After six months of treatment, severity of all symptoms and signs showed a statistically significant decrease (p<0.05). Patients did not report any serious adverse effects. Topical cyclosporine 0.05% emulsion treatment is a safe and effective treatment option for controlling the symptoms and signs of vernal keratoconjunctivitis in children.Item Toxic Reaction due to Multiple Wasp Stings in a Child: A Case Report(2022) Ozkale, Yasemin; Ozkale, MuratBackground: Poisoning caused by wasp and bee stings is the most common type of poisoning caused by insects in Turkiye. The wasp belongs to the family Vespidae, a subgroup of the class Hymenoptera (membrane-winged insects). While mild symptoms are frequently observed in response to a single wasp sting, multiple wasp stings can cause severe poisoning and toxic reactions. Case Report: We present a case of a 7-year-old male patient who died after developing rhabdomyolysis, acute kidney injury (AKI), and multiple organ failure as a result of multiple wasp stings. Conclusion: The case report of our patient revealed that poisoning from multiple wasp stings can show a fatal course in children. When the number of wasp stings is 20-200 and when stings occur in the head-and-neck regions, AKI and mortality are high. Therefore, these patients should be hospitalized in the pediatric intensive care unit and monitored closely for toxic reactions.