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Öğe The association between vitamin D receptor polymorphisms and multiple sclerosis in a Turkish population(Elsevier Sci Ltd, 2018) Kamisli, Ozden; Acar, Ceren; Sozen, Mert; Tecellioglu, Mehmet; Yucel, Fatma Ebru; Vaizoglu, Dilara; Ozcan, CemalBackground: Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system (CNS). Genetic and environmental factors are important in disease development. Many studies have investigated the relationship between MS and VDR polymorphisms. VDR gene polymorphism has not been previously studied in Turkish MS patients. We aimed to investigate the relationship between MS and VDR genotypes Taq I, Apa I and Fok I polymorphisms in a Turkish population. Methods: 167 MS patients and 146 healthy control subjects were included in the present study. MS and the VDR TaqI (rs731236), ApaI (rs7975232), and FokI (rs2228570) polymorphisms were investigated. Results: The study enrolled 167 patients (121 females, 46 males) with MS and 146 healthy individuals (88 females, 58 males). The frequency of only the Fok I polymorphism differed significantly between the two groups (p = 0.002). The TaqI (rs731236) and ApaI (rs7975232) genotype distributions were not significantly different between MS patients and healthy controls (p = 0.626 and p = 0.990, respectively). Also there were no significant gender difference between patients and controls for Taq I and Apa I. Conclusion: In conclusion, we found a significant association between MS and the FokI polymorphism in our region of Turkey. However, the results may be different in other populations. More epidemiological and genetic studies are needed to explain the association between genetic factors and MS.Öğe The beneficial effects of 18?-glycyrrhetinic acid on the experimental autoimmune encephalomyelitis (EAE) in C57BL/6 mouse model(Taylor & Francis Ltd, 2018) Kamisli, Suat; Ciftci, Osman; Taslidere, Asli; Turkmen, Nese Basak; Ozcan, CemalAim: The aim of this study was to investigate the beneficial effects of 18 beta-glycyrrhetinic acid (GA) on the experimental allergic encephalomyelitis (EAE) in C57BL/6 mice. GA is a natural substance found in the root of licorice and is used in traditional Chinese medicine. It has many pharmacological activities such as antioxidant, anti-inflammatory, and anti-cancer effects. Materials and methods: A total of 40 C57BL/6 mice were divided equally into four groups: (1) Control, (2) EAE, (3) GA and (4) GAthornEAE. 14 days after induction of EAE with MOG35-55 and pertussis toxin, mice were treated with GA at doses of 100 mg/kg/day for 7 days intraperitoneally. Results: To our results, oxidative stress and lipid peroxidations (elevated TBARS levels, decreased GPx, SOD, CAT, and GSH levels) were significantly (p<. 01) increased, causing EAE in brain tissue. Also, histopathological damage (Caspase-3 and IL-17 activity, p <=.01) and cytokine levels (TNF-alpha and IL-1 beta, p<. 01) were induced with EAE in mice brain tissue. On the other hand, GA treatment significantly (p<. 01) reversed oxidative histological and immunological alterations caused by EAE. Conclusions: In conclusion, the GA treatment can protect the brain tissue against EAE in mice with its antioxidant and anti-inflammatory properties.Öğe Cerebral MR Spectroscopy Evaluation of the Neuroprotective Effects of Lithium and Olanzapine in Bipolar Affective Disorder Patients(Universitatsverlag Ulm Gmbh, 2008) Cumurcu, Birgul Elbozan; Karlidag, Rifat; Sarac, Kaya; Unal, Suheyla; Ozcan, Cemal; Erkorkmaz, UnalAim: We used the NAA measurements obtained by cerebral magnetic resonance spectroscopy to evaluate the neuroprotective effects of lithium and olanzapine in bipolar affective disorder patients in remissions. Methods:Ten bipolar affective disorder patients on lithium treatment for the last six years and who had not experienced a manic or depressive attack for the last three years and were followed up at the psychiatry outpatients department were included in the study. The patients were evaluated while on lithium, 14 days after lithium was stopped and at the end of the 411 week following olanzapine initiation, for a total of three times. Each evaluation consisted of a psychiatric interview, the Hamilton Depression Rating Scale (HDRS) and the Bech-Rafaelson Mania Scale (BRMS) in addition to MR spectroscopy imaging. Results: The cases were compared with a control group consisting of 10 age- and sex-matched healthy subjects. We measured the N-acetyl aspartate (NAA) peak quantitatively in the right dorsolateral prefrontal cortex (DLPF) and left hippocampus areas on MR spectroscopy and checked the ratio to the creatine (Cr) peak. The values from all three imaging studies were compared with each other and with the control subjects. Conclusions: There was no statistically significant difference between the NAA/Cr ratios of the patients receiving lithium, those not on medications or those receiving olanzapine and the healthy subjects. We did not observe any change in cerebral NAA levels following lithium and olanzapine treatment in bipolar affective disorder patients in remission.Öğe Cerebrospinal Fluid Dynamics in Patients with Multiple Sclerosis: The Role of Phase-Contrast MRI in the Differential Diagnosis of Active and Chronic Disease(Korean Radiological Soc, 2018) Oner, Serkan; Kahraman, Aysegul Sagir; Ozcan, Cemal; Ozdemir, Zeynep Maras; Unlu, Serkan; Kamisli, Ozden; Oner, ZulalObjective: Multiple sclerosis (MS) is an inflammatory disease characterized by demyelinating plaques in the white matter. Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a new hypothesis for the etiopathogenesis of MS disease. MS-CCSVI includes a significant decrease of cerebrospinal fluid (CSF) flow through the cerebral aqueduct secondary to an impaired venous outflow from the central nervous system. This study aimed to determine whether CSF flow dynamics are affected in MS patients and the contributions to differential diagnosis in active and chronic disease using phase-contrast magnetic resonance imaging (PC-MRI). Materials and Methods: We studied 16 MS patients with chronic plaques (group 1), 16 MS patients with active plaques-enhanced on MRI (group 2), and 16 healthy controls (group 3). Quantitatively evaluation of the CSF flow was performed from the level of the cerebral aqueduct by PC-MRI. According to heart rates, 14-30 images were obtained in a cardiac cycle. Cardiac triggering was performed prospectively using finger plethysmography. Results: No statistically significant difference was found between the groups regarding average velocity, net forward volume and the average flow (p > 0.05). Compared with the controls, group 1 and group 2, showed a higher peak velocity (5.5 +/- 1.4, 4.9 +/- 1.0, and 4.3 +/- 1.3 cm/sec, respectively; p = 0.040), aqueductal area (5.0 +/- 1.3, 4.1 +/- 1.5, and 3.1 +/- 1.2 mm(2), respectively; p = 0.002), forward volume (0.039 +/- 0.016, 0.031 +/- 0.013, and 0.021 +/- 0.010 mL, respectively; p = 0.002) and reverse volume (0.027 +/- 0.016, 0.018 +/- 0.009, and 0.012 +/- 0.006 mL, respectively; p = 0.000). There were no statistical significance between the MS patients with chronic plaques and active plaques except for reverse volume. The MS patients with chronic plaques showed a significantly higher reverse volume (p = 0.000). Conclusion: This study indicated that CSF flow is affected in MS patients, contrary to the hypothesis that CCSVI-induced CSF flow decreases in MS patients. These findings may be explained by atrophy-dependent ventricular dilatation, which may occur at every stage of MS.Öğe Comparison of Nerve, Vessel, and Cartilage Grafts in Promoting Peripheral Nerve Regeneration(Lippincott Williams & Wilkins, 2014) Firat, Cemal; Geyik, Yilmaz; Aytekin, Ahmet Hamdi; Gul, Mehmet; Kamisli, Suat; Yigitcan, Birgul; Ozcan, CemalPeripheral nerve injury primarily occurs due to trauma as well as factors such as tumors, inflammatory diseases, congenital deformities, infections, and surgical interventions. The surgical procedure to be performed as treatment depends on the etiology, type of injury, and the anatomic region. The goal of treatment is to minimize loss of function due to motor and sensory nerve loss at the distal part of the injury. Regardless of the cause of the injury, the abnormal nerve regeneration due to incomplete nerve regeneration, optimal treatment of peripheral nerve injuries should provide adequate coaptation of proximal and distal sides without tension, preserving the neurotrophic factors within the repair line. The gold standard for the treatment of nerve defects is the autograft; however, due to denervation of the donor site, scarring, and neuroma formation, many studies have aimed to develop simpler methods, better functional results, and less morbidity. In this study, a defect 1 cm in length was created on the sciatic nerve of rats. The rats were treated with the following procedures: group 1, autograft; group 2, allogeneic aorta graft; group 3, diced cartilage graft in allogeneic aorta graft; and group 4, tubularized cartilage graft in allogeneic aorta graft. Group 5 was the control group. The effects of cartilage tissue in nerve regeneration were evaluated by functional and histomorphological methods. Group 1, for which the repair was performed with an autograft, was evaluated to be the most similar to the control group. There was not a statistically significant difference in myelination and Schwann cell rates between group 2, in which an allogeneic aorta graft was used, and group 3, in which diced cartilage in an allogeneic aorta graft was used. In group 4, myelination and Schwann cell formation were observed; however, they were scattered and irregular, likely due to increased fibrosis. In all of the groups, nerve regeneration at various rates was observed both functionally and histomorphologically. This study demonstrates that cartilage tissue has promoting effects in nerve regeneration.Öğe Does Psychodrama Affect Perceived Stress, Anxiety-Depression Scores and Saliva Cortisol in Patients with Depression?(Korean Neuropsychiatric Assoc, 2018) Erbay, Lale Gonenir; Reyhani, Ismail; Unal, Suheyla; Ozcan, Cemal; Ozgocer, Tuba; Ucar, Cihat; Yildiz, SedatObjective Little is known about the effects of psychodrama group therapy on the level of stress, anxiety and depression of the group members, and the biological markers of stress. The aim of this study test cortisol level as a biological reflection of some mental characteristics gained by the psychodrama method in coping with stress. Methods Depressive patients aged between 18 and 65 years, who diagnosed with depression according to DSM-5, without psychiatric comorbidity, who do not use drugs and were available for psychodrama were enrolled into the study. These patients were evaluated using the Perceived Stress Scale, State-Trait Anxiety Inventory and Beck Depression Inventory. In order to observe the circadian rhythm of cortisol, samples were collected from the participants before lunch, before dinner and before going to sleep on the day before psychodrama and on the 0, 15th, and 30th minutes after awakening in the morning of the psychodrama day; as well as just before and after the psychodrama session. Saliva cortisol level just before the initial session of psychodrama group therapy was compared with the saliva cortisol level just after the last psychodrama session at the end of 16 weeks. Results Statistically significant difference was determined between the scores of perceived stress scale, STAI-1, STAI-2, beck depression inventory and salivary cortisol level before and after psychodrama session. There was significant decrease in both the scale scores and salivary cortisol after vs. before psychodrama. Conclusion This results is important as it shows the biological aspect of clinical improvement. Further studies would provide us with better understanding of the effects of psychodrama group psychotherapy on depressive mood and biological projections by means of short-term and long-term follow-up studies.Öğe Does psychodrama affect perceived stress, anxiety-depression scores and saliva cortisol in patientswith depression?(Korean neuropsychıatrıc assoc, rn 522, g-fıve central plaza 1685-8 seocho 4-dong, seocho-gu, seoul, 137-882, south korea, 2018) Erbay, Lale Gonenir; Reyhani, Ismail; Unal, Suheyla; Ozcan, Cemal; Ozgocer, Tuba; Ucar, Cihat; Yildiz, SedatObjective Little is known about the effects of psychodrama group therapy on the level of stress, anxiety and depression of the group members, and the biological markers of stress. The aim of this study test cortisol level as a biological reflection of some mental characteristics gained by the psychodrama method in coping with stress. Methods Depressive patients aged between 18 and 65 years, who diagnosed with depression according to DSM-5, without psychiatric comorbidity, who do not use drugs and were available for psychodrama were enrolled into the study. These patients were evaluated using the Perceived Stress Scale, State-Trait Anxiety Inventory and Beck Depression Inventory. In order to observe the circadian rhythm of cortisol, samples were collected from the participants before lunch, before dinner and before going to sleep on the day before psychodrama and on the 0, 15th, and 30th minutes after awakening in the morning of the psychodrama day; as well as just before and after the psychodrama session. Saliva cortisol level just before the initial session of psychodrama group therapy was compared with the saliva cortisol level just after the last psychodrama session at the end of 16 weeks. Results Statistically significant difference was determined between the scores of perceived stress scale, STAI-1, STAI-2, beck depression inventory and salivary cortisol level before and after psychodrama session. There was significant decrease in both the scale scores and salivary cortisol after vs. before psychodrama. Conclusion This results is important as it shows the biological aspect of clinical improvement. Further studies would provide us with better understanding of the effects of psychodrama group psychotherapy on depressive mood and biological projections by means of short-term and long-term follow-up studies.Öğe The Efficacy of Lamotrigine and Levetiracetam Therapy on Serum Lipid Profile in Epilepsy Patients(Kare Publ, 2011) Kamisli, Ozden; Kaplan, Yuksel; Kamisli, Suat; Bakir, Meryem; Ozcan, CemalObjectives: We aimed to investigate the efficacy of two new generation antiepileptics, lamotrigine (LTG) and levetiracetam (LEV), on serum lipid levels, since they are reported to be as effective as classical antiepileptics but with fewer side effects. Methods: We analyzed the files of all epileptic patients who were registered at Inonu University Faculty of Medicine, Turgut Ozal Medical Center, Neurology Department between April 2009 - May 2011 retrospectively. Patients treated with LTG and LEV monotherapy were found and total cholesterol (TC), triglyceride, low-density lipoprotein (LDL), very low-density lipoprotein (VLDL) and high-density lipoprotein (HDL) were measured. The patients' data were compared with a control group. Results: Twenty-one patients treated with LTG and 20 patients treated with LEV were included in this study. TC, triglycerides, LDL, VLDL, and HDL values were compared with 21 healthy control subjects. TC, triglycerides, LDL, VLDL, and HDL values showed no statistically significant differences between groups. Conclusion: Neither LEV nor LTG, which are new generation antiepileptics, affected blood lipid levels. We consider that they are safe to use in patients, especially those with atherosclerosis risk.Öğe Evaluation of Cervical Vestibular Evoked Myogenic Potentials in Patients with Migraine(Turkish Neurological Soc, 2013) Kaplan, Yuksel; Tecellioglu, Mehmet; Kamisli, Ozden; Kamisli, Suat; Ozcan, CemalObjective: Recent studies have indicated that the brain stem may contribute in the pathogenesis of migraine through different mechanisms. In addition to being used mainly in otologic diseases, vestibular evoked myogenic potentials (VEMP) testing is also used in neurological diseases affecting the brain stem such as stroke and multipl sclerosis in the literature. Studies involving VEMP testing in patients with migraine are novel and few in number. The purpose of this study was to evaluate whether VEMP values in patients with migraine provide additional information regarding the pathogenesis. Methods: This study included 52 patients with migraine and 52 control subjects. In both patients and controls, VEMP examination was performed using click stimuli, and all responses were recorded for both portions of the sternocleidomastoid muscle. Latency, amplitude and threshold values of the P1-N1 wave were compared between the two groups. Results: The amplitude of the left p1 was 4.47 +/- 3.52 mu v in patients and 6.15 +/- 4.79 mu v in the controls, and the difference was statistically significant. On the left, the average difference in the P1-N1 amplitude was 9.04 +/- 6.13 mu v in patients and 12.03 +/- 7.79 mu v in the controls; this difference was also statistically significant. Conclusion: The available studies on the pathophysiology of migraine show that the brain stem is particularly affected at the upper part. However, VEMP testing is mainly used for the assessment of the neuronal pathway starting from the saccula-macula and finishing at the sternocleidomastoid muscle in the lower brain stem. In this study, the only significant differences in amplitude were found in left-P1 and P1-N1. The results of our study show that in patients with migraine, neuroanatomical structures in the lower brain stem can be asymmetrically affected.Öğe The Evaluation of Premenstrual Dysphoric Disorder Incidence and it's Relationship with Antiepileptic Drugs in Epilepsy Patients(Kare Publ, 2013) Kamisli, Ozden; Kamisli, Suat; Kartalci, Sukru; Bakir, Meryem; Kaplan, Yuksel; Ozcan, CemalObjectives: Premenstrual dysphoric disorder (PMDD) is a condition characterized by psychiatric and somatic symptoms commonly seen in women of childbearing age. There are few studies investigating the prevalence of PMDD in patients with epilepsy. In this study we investigate the frequency of PMDD in epilepsy patients and evaluate the relationship between antiepileptic drugs and PMDD. Methods: The subjects were 93 women with epilepsy and 30 controls. Patients were divided into five subgroups according to their medications as carbamazepine, oxcarbazepine, valproic acide, lamotrigine, and levetiracetam. Each group were examined for the frequency of PMDD. In addition, the incidence of PMDD was compared according to antiepileptic drugs in subgroups. Results: The frequency of PMDD was similar in patients with and without epilepsy. Focal epilepsy group, especially temporal lobe epilepsy, has a higher incidence of PMDD, but similar results were also found in women without epilepsy. Looking at the relationship between antiepileptic treatments and PMDD, patients treated with lamotrigine had the lowest frequency. Conclusion: The frequency of PMDD was similar in patients with and without epilepsy. Focal epilepsy patients, especially temporal lobe epilepsy patients, had a higher incidence of PMDD. The LTG group had the lowest rate of PMDD. In terms of PMDD, LTG may be beneficial for young women with epilepsy.Öğe The evaluation of sensory gating with P50 paradigm in chronic obstructive pulmonary disease(European Respiratory Soc Journals Ltd, 2012) Kamisli, Ozden; Ermis, Hilal; Kamisli, Suat; Gulbas, Gazi; Ozcan, Cemal[Abstract Not Available]Öğe Guillain-Barré Syndrome after COVID-19 accompanied by Dysautonomia(2021) Tecellioglu, Mehmet; Ozcan, CemalThe COVID-19 pandemic that emerged in Wuhan, Hubei Province, China in December 2019 is ongoing. COVID-19 may also cause neurological symptoms with central or peripheral nervous system or skeletal muscle involvement. Guillain–Barré syndrome (GBS) is an autoimmune disorder of the peripheral nervous system that is usually triggered by bacterial or viral infections. Autonomic nerve involvement can be seen in GBS. Case reports suggest that GBS is linked to COVID-19 infection. Here, we present a case of GBS occurring after COVID-19, accompanied by dysautonomia.Öğe Hesperidin protects brain and sciatic nerve tissues against cisplatin-induced oxidative, histological and electromyographical side effects in rats(Sage Publications Inc, 2015) Kamisli, Suat; Ciftci, Osman; Kaya, Kursat; Cetin, Asli; Kamisli, Ozden; Ozcan, CemalIn the present study, the beneficial effect of hesperidin (HP), a citrus flavonoid, on cisplatin (CP)-induced neurotoxicity was investigated. A total of 28 rats were equally divided into four groups; the first group was kept as control. In the second and third groups, CP and HP were given at the doses of 7 and 50 mg/kg/day, respectively. In the fourth group, CP and HP were given together at the same doses. The results indicated that although CP caused significant induction of lipid peroxidations and reduction in the antioxidant defense system potency in the brain and sciatic nerve, HP prevented these effects of CP. Besides, CP led to histopathological damage, mainly apoptosis, as well as electromyographical (EMG) changes in sciatic nerve. On the other hand, HP treatment reversed histopathological and EMG effects of CP. In conclusion, CP had severe dose-limiting neurotoxic effects and these effects of CP can be prevented by HP treatment. Thus, it appears that coadministration of HP with CP may be a useful approach to attenuate the negative effects of CP on the nervous system.Öğe Hesperidin, a Citrus Flavonoid, Has the Ameliorative Effects Against Experimental Autoimmune Encephalomyelitis (EAE) in a C57BL/J6 Mouse Model(Springer/Plenum Publishers, 2015) Ciftci, Osman; Ozcan, Cemal; Kamisli, Ozden; Cetin, Asli; Basak, Nese; Aytac, BilalThe aim of this study was determined the effects of Hesperidin (HP) on neuronal damage in brain tissue caused by Experimental allergic encephalomyelitis (EAE), an established model of multiple sclerosis in C57BL/J6 mice. To explore 40 mice were equally divided into four groups: (1) Control, (2) EAE, (3) HP, and (4) HP + EAE. 14 days after induction of EAE with MOG35-55 and pertussis toxin, the mice treated with HP at the doses of 50 mg/kg/day for 7 days subcutaneously. To our results HP treatment prevents the oxidative stress caused by EAE via a decrease in lipid peroxidations and increase in elements of the antioxidant defense systems in brain tissue. Also, EAE elevate the IL-17, express the pro-inflammatory cytokines, and caspase-3-like immunreactivity, show apoptosis, staining in EAE mice brain and increased the incidence of histopathological damage. However, immonohistochemical and histological changes were reversed with HP. Moreover, elevated TNF-alpha and IL-1 beta levels, a result of EAE, were decreased in serum and neurological deficits as clinical signs were reversed with HP treatment in EAE mice, given HP. In conclusion, HP treatment effectively prevents oxidative, immunological and histological damage in the brain caused by EAE. It was thought that the beneficial effects of HP are likely a result of its strong antioxidant and anti-inflammatory properties.Öğe Investigation of neuromuscular transmission in patients with chronic obstructive pulmonary disease: A preliminary report(European Respiratory Soc Journals Ltd, 2012) Kaplan, Yuksel; Gulbas, Gazi; Ermis, Hilal; Kamisli, Ozden; Kamisli, Suat; Ozcan, Cemal[Abstract Not Available]Öğe Jaffe Campanacci Syndrome and Non-Convulsive Status Epilepticus: A Case Report(Galenos Yayincilik, 2010) Kamisli, Ozden; Kamisli, Suat; Altinayar, Sibel; Kablan, Yueksel; Ozcan, CemalJaffe-Campanacci syndrome consists of non-ossifying fibromas of the bones and cafe au lait spots. Mental retardation is also observed in some patients. Non-convulsive status epilepticus may be associated with various diseases. However, to our knowledge, no association between these two conditions has been reported in the literature. We report a patient with Jaffe-Campanacci syndrome who developed non-convulsive status epilepticus. (Archives of Neuropsychiatry 2010; 47: 78-80)Öğe 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(Lıppıncott wıllıams & wılkıns, two commerce sq, 2001 market st, phıladelphıa, pa 19103 usa, 2018) Neyal, Munife; Ozcan, Cemal; Goksel, Basak Karakurum; Sevim, SerhanÖğe Listeria monocytogenes rhombencephalitis in a patient with multiple sclerosis during fingolimod therapy(Elsevier Sci Ltd, 2019) Tecellioglu, Mehmet; Kamisli, Ozden; Kamisli, Suat; Erdogmus, Umut Adem; Ozcan, CemalObjective: To describe a case of Listeria monocytogenes rhombencephalitis in a patient receiving fingolimod. Methods: This is a case study. Results: Our patient developed acute rhombencephalitis with hydrocephalus induced with Listeria monocytogenes while on fingolimod. Shunt surgery was performed for the hydrocephalus and patient recovered partially after medical and surgical therapy. Conclusion: We describe the first probable case of fingolimod-associated Listeria monocytogenes rhombencephalitis in a patient with multiple sclerosis. Clinicians should be aware of listeriosis and implement measures for its prevention.Öğe Lower extremity isokinetic muscle strength in patients with Parkinson's disease(Elsevier Sci Ltd, 2010) Durmus, Bekir; Baysal, Ozlem; Altinayar, Sibel; Altay, Zuhal; Ersoy, Yuksel; Ozcan, CemalWe evaluated lower extremity isokinetic muscle strength to determine affected muscle groups and their dependence on movement velocity, and to establish the relationship between muscle strength and clinical severity, as well as muscle strength and falls, in Parkinson's disease (PD) Twenty-five patients diagnosed with PD and 24 healthy volunteers were enrolled in this study Lower extremity muscle strength was measured using an isokinetic dynamometer Each participant's clinical status was examined in accordance with the Unified Parkinson's Disease Rating Scale, fall history was also recorded We observed a significant decrease in isokinetic muscle strength in the patient group, especially in both hip and knee flexors and extensors Decreased muscle strength was independent of velocity, and col related with clinical severity and falls Movement velocity-independent lower extremity isokinetic muscle weakness has been observed in patients with PD, especially in the knee and hip joints The evaluation of isokinetic muscle strength may be a useful tool for the assessment of clinical severity and falls in PD (C) 2010 Elsevier Ltd All rights reservedÖğe Neurological autoantibodies in drug-resistant epilepsy of unknown cause(Irısh journal of medıcal scıence, 2018) Tecellioglu, Mehmet; Kamisli, Ozden; Kamisli, Suat; Yucel, Fatma Ebru; Ozcan, CemalBackgroundAutoimmune epilepsy is a rarely diagnosed condition. Recognition of the underlying autoimmune condition is important, as these patients can be resistant to antiepileptic drugs.AimsTo determine the autoimmune and oncological antibodies in adult drug-resistant epilepsy of unknown cause and identify the clinical, radiological, and EEG findings associated with these antibodies according to data in the literature.MethodsEighty-two patients with drug-resistant epilepsy of unknown cause were prospectively identified. Clinical features were recorded. The levels of anti-voltage-gated potassium channel complex (anti-VGKCc), anti-thyroid peroxidase (anti-TPO), anti-nuclear antibody (ANA), anti-glutamic acid decarboxylase (anti-GAD), anti-phospholipid IgG and IgM, anti-cardiolipin IgG and IgM, and onconeural antibodies were determined.ResultsSerum antibody positivity suggesting the potential role of autoimmunity in the aetiology was present in 17 patients with resistant epilepsy (22.0%). Multiple antibodies were found in two patients (2.6%). One of these patients (1.3%) had anti-VGKCc and ANA, whereas another (1.3%) had anti-VGKCc and anti-TPO. A single antibody was present in 15 patients (19.5%). Of the 77 patients finally included in the study, 4 had anti-TPO (5.2%), 1 had anti-GAD (1.3%), 4 had anti-VGKCc (5.2%) 8 had ANA (10.3%), and 2 had onconeural antibodies (2.6%) (1 patient had anti-Yo and 1 had anti-MA2/TA). The other antibodies investigated were not detected. EEG abnormality (focal), focal seizure incidence, and frequent seizures were more common in antibody-positive patients.ConclusionAutoimmune factors may be aetiologically relevant in patients with drug-resistant epilepsy of unknown cause, especially if focal seizures are present together with focal EEG abnormality and frequent seizures.
