Yazar "Kilic, Betul" seçeneğine göre listele
Listeleniyor 1 - 9 / 9
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Clinical and Imaging Findings in Childhood Posterior Reversible Encephalopathy Syndrome(Iranian Child Neurology Soc, 2018) Gungor, Serdal; Kilic, Betul; Tabel, Yilmaz; Selimoglu, Ayse; Ozgen, Unsal; Yilmaz, Sezai; Sigirci, AhmetObjective Posterior reversible encephalopathy syndrome (PRES) is characterized by typical radiologic findings in the posterior regions of the cerebral hemispheres and cerebellum. The symptoms include headache, nausea, vomiting, visual disturbances, focal neurologic deficits, and seizures. The aim of this study is to evaluate the clinical and radiological features of PRES in children and to emphasize the recognition of atypical features. Materials & Methods We retrospectively examined 23 children with PRES from Mar 2010-Apr 2015 in Inonu University Turgut Ozal Medical Center in Turkey. We compared the clinical features and cranial MRI findings between underlying diseases of PRES. Results The most common precipitating factors were hypertension (78.2%) and medications, namely immunosuppressive and antineoplastic agents (60.8%). Manifestations included mental changes (100%), seizures (95.6%), headache (60.8%), and visual disturbances (21.7%) of mean 3.6 (range 1-10) days' duration. Cranial magnetic resonance imaging (MRI) showed bilateral occipital lesions in all patients, associated in 82.6% with less typical distribution of lesions in frontal, temporal or parietal lobes, cerebellum, corpus callosum, basal ganglia, thalamus, and brain stem. Frontal involvement was predominant, observed in 56.5% of patients. Clinical recovery was followed by radiologic resolution in all patients. Conclusion PRES is often unsuspected by the clinician, thus radiologists may be the first to suggest this diagnosis on an MRI obtained for seizures or encephalopathy. Atypical MRI finding is seen quite often. Rapid diagnosis and treatment are required to avoid a devastating outcome.Öğe Clinical features and the role of magnetic resonance imaging in pediatric patients with intracranial hypertension(Springer Heidelberg, 2021) Kilic, Betul; Gungor, SerdalIncreased intracranial hypertension (IIH) is a defined clinical condition; however, an unsolved pathophysiologic background usually creates problems in its diagnosis and proper approach. The aim of this study was to emphasize the clinical conditions and brain magnetic resonce imaging (MRI) clues of pediatric patients, especially this clinical entity with high morbidity. Here, we review the etiology, clinical presentation, brain MRI findings, and prognosis of IIH in children. The symptoms' onset age ranged from 9 months to 16 years. Headache (81%), vomiting (37%), and diplopia (33.3%) were the most frequent symptoms. The most common etiologic factors were found to be obesity and dural venous sinus thrombosis. Cerebrospinal fluid (CSF) opening pressure had mean a mean value of 615.2 +/- 248 mm H2O. A significant relationship was found between visual field impairment and height of CSF pressure (p < 0.001). Optic nerve sheath enlargement (88.8%) and optic nerve tortuosity (85.1%) were found as the most common brain MRI findings. Slit-like ventricle (37%), venous sinus thrombosis (29.6%), posterior globe sclera flattening (29.6%), empty sella (25.9%), and intraocular protrusion of the optic nerve (14.8%) were the other findings. A significant relationship was found between CSF opening pressure and the presence of optic nerve tortuosity (p = 0.002), and distension of the optic nerve sheath (p = 0.006). All patients received acetazolamide, only one patient underwent lumboperitoneal shunt, and only one received steroids. In children, IIH can present with different etiologies and symptoms. Brain MRI provides crucial clues in diagnosis. Urgent diagnosis and treatment planning are required to protect vision functions.Öğe Early and late neurological complications of liver transplantation in pediatric patients(Wiley, 2017) Gungor, Serdal; Kilic, Betul; Arslan, Mujgan; Selimoglu, M. Ayse; Karabiber, Hamza; Yilmaz, SezaiNCs occur commonly after solid organ transplantation and affect 15%-30% of liver transplant recipients. The aim of this retrospective study was to evaluate the type and incidence of neurologic events in pediatric patients following LT. Between May 2006 and June 2015, 242 patients (118 females, 124 males) requiring LT for different etiologies at the nonu University Liver Transplantation Institute were included. The incidence, types, and risk factors of NCs that occurred following LT were evaluated retrospectively. Neurologic events occurred in 57 (23.5%) of the patients. Early NCs were encephalopathy (12.4%), seizures (11.5%), and PRES (7%). Of 57 patients, five (8.7%) experienced NCs at least 1 month after LT; these late NCs included tremor, headaches, encephalopathy, ataxia, and neuropathy. The psychiatric symptoms after LT were noted in 42 patients (17.4%). The mortality rate after LT in those with or without neurological events was not significantly different (P=.73). There was a high incidence of serious neurologic events after LT. The major neurologic manifestation in our patients was encephalopathy followed by seizures.Öğe Efficacy of Levetiracetam Monotherapy in Childhood Epilepsy(Kare Publ, 2017) Arslan, Mujgan; Gungor, Serdal; Kilic, BetulObjectives: Levetiracetam (LEV) is an antiepileptic drug approved particularly for treatment of focal seizures. The aim of this study was to investigate efficacy and tolerability of LEV monotherapy in pediatric patients. Methods: In the present study, records of 225 children (aged 1 month-18 years) treated with LEV and with follow-up for at least 1 year were evaluated. Diagnosis of epilepsy included history of 2 or more unprovoked seizures. Demographic characteristics, reason for antiepileptic treatment, dosage of levetiracetam, duration of treatment, antiepileptic drugs used previously, seizure type, seizure duration, cranial magnetic resonance images, electroencephalogram results, seizure etiology, and side effects of the drug were documented. Results: Total of 225 patients, 95 girls and 130 boys, were enrolled in the study. Of those, 125 (55.6%) patients had generalized seizures, 90 (40%) had focal seizures, and 10 (4.4%) had other type of seizures. In treatment, 186 (82.7%) patients remained seizure-free. There was no difference in effectiveness of LEV on partial or generalized epilepsy. Overall, 8 (18%) patients had adverse events. Most common side effects observed were irritability and nervousness. There was no relationship between drug dosage and side effects. Conclusion: LEV monotherapy is effective in childhood epilepsy with focal or generalized seizures. It is well tolerated in spite of mild and transient side effects, which do not require drug discontinuation.Öğe Hodgkin's lymphoma associated with paraneoplastic cerebellar degeneration in children: a case report and review of the literature(Springer, 2017) Gungor, Serdal; Kilic, Betul; Arslan, Mujgan; Ozgen, Unsal; Dalmau, JosepParaneoplastic cerebellar degeneration (PCD) can occur severely and appear as subacute cerebellar syndrome. PCD may be associated with small cell lung cancer, adenocarcinoma, breast cancer, ovarian carcinoma, and Hodgkin's lymphoma. An 11-year-old male was admitted with acute cerebellar ataxia, dysarthria, and diplopia. Mediastinal conglomerated lymph nodes were depicted in a chest computed tomography (CT) examination, and diagnosis of stage IV Hodgkin's lymphoma was obtained after a lymph node biopsy. The antibodies against Purkinje cells (anti-Tr antibody) were positive immunohistochemically. Thus, paraneoplastic cerebellar degeneration depending on Hodgkin's disease was diagnosed. Despite the completion of chemotherapy, neurological recovery was not observed in the patient and plasmapheresis with immunoadsorption, and intravenous immunoglobulin (IVIG) was performed. Truncal ataxia, gait disturbance, and tremors decreased. Consequently, we thought that plasmapheresis with the immunoadsorption method and IVIG therapy might be a treatment option for cerebellar ataxia caused by a mechanism of immune ancestry.Öğe Hodgkin's lymphoma associated with paraneoplastic cerebellar degeneration in children: a case report and review of the literature (vol 33, pg 1025, 2017)(Springer, 2017) Gungor, Serdal; Kilic, Betul; Arslan, Mujgan; Ozgen, Unsal; Dalmau, Josep[Abstract Not Available]Öğe Is Bilateral Facial Paralysis an Indicator of Respiratory Outcome in Guillain-Barre Syndrome?(Mdpi, 2019) Gungor, Serdal; Kilic, BetulBackground and objectives: Bilateral facial paralysis is a rare and specific clinical manifestation of various neurological disorders. Bilateral facial paralysis has been reported as an essential feature of Guillain-Barre syndrome (GBS) for many years. We aim to describe the incidence of bilateral facial paralysis and prognosis in our GBS patients. Materials and Methods: A retrospective chart review of all patients with GBS and bilateral facial paralysis who were treated at the Inonu University Medical Faculty was performed. Results: A total of 45 cases of GBS were reviewed. Four out of 45 patients (8.8%) had associated bilateral facial paralysis. Only one of the patients also had acute multiple cranial neuropathies. All patients experienced sudden deterioration and respiratory distress. In one of our patients who had multiple cranial neuropathies, serum antiganglioside antibody assay was performed, and anti-GQ1b IgG antibody positivity was observed. The cerebrospinal fluid had albuminocytological dissociation in all patients, and axonal involvement was present in nerve conduction studies (NCS). Three patients improved with immunotherapy; one patient died due to cardiac arrest after resistant hypotension. Conclusion: Bilateral facial paralysis is a rare condition in children. We wanted to emphasize bilateral facial involvement and poor prognosis in our GBS patients.Öğe Is cerebral spinal fluid flow associated with body mass index and head circumference in healthy children? A phase contrast magnetic resonance imaging study(Springer, 2020) Demirtas, Gokhan; Sigirci, Ahmet; Ozturk, Mehmet; Gorkem, Sureyya Burcu; Kilic, Betul; Gungor, SerdalBackground The aim of this study was to investigate the relationship between age, gender, body mass index (BMI), and head circumference (HC) and cerebral spinal fluid (CSF) flow dynamics in the pediatric population. The prospective study included a total of 137 participants, 75 boys and 62 girls, ranging in age from 2 to 204 months. Quantitative evaluation of CSF flow was made by using phase contrast magnetic resonance imaging (PC-MRI) in the axial plane at the level of the aqueductus cerebri. Flow dynamics were recorded as peak and mean velocity (cm/s); cranial, caudal, and net volume (ml); and aqueductus cerebri area (mm(2)). Correlation between baseline descriptive parameters, including age, gender, BMI, and HC, and the aforementioned CSF flow dynamics were investigated. Results The net volume was significantly lower in girls (p= 0.002). There was no association between age and aqueduct area, mean velocity, and cranial volume. The peak velocity was remarkably higher in children (p= 0.03), whereas cranial and net volume were found to be lower in infants (p= 0.04 andp= 0.03, respectively). Notably, cases with HC below normal values had lower cranial, caudal, and net volume and aqueductus cerebri area (p= 0.01,p= 0.03,p= 0.03, andp= 0.04, respectively). There was no association between BMI and indicators of CSF flow dynamics in PC-MRI. Conclusion BMI and HC may be associated with CSF flow dynamics in children. A smaller HC is accompanied by a lower forward flow volume, reverse flow volume, net volume, and aqueductal diameter. These points should be remembered during the design of further trials on determinants of CSF flow in children.Öğe Reversible Splenial Lesion Syndrome Associated with Encephalitis/Encephalopathy and Hyponatremia(Georg Thieme Verlag Kg, 2020) Gungor, Serdal; Kilic, Betul; Aslan, Mahmut; Ozgor, BilgeReversible splenial lesion syndrome (RESLES) is a rare occurrence with a broad clinical and radiological spectrum due to several conditions and diseases. Generally, clinical symptoms of RESLES include mildly altered states of consciousness, delirium, and seizures. RESLES can be shown in conjunction with central nervous system infections, especially in children. Hyponatremia is also described as a potential cause of reversible splenial lesions. Reversible signal changes on diffusion-weighted images are detected in patients for diagnosis. The prognosis is usually good but it depends on the underlying disease, neurological and imaging findings. Here we present two pediatric patients with RESLES accompanied by hyponatremia.
