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Öğe Acute Ataxia in Childhood Clinical Presentation, Etiology, and Prognosis of Single-Center Experience(Lippincott Williams & Wilkins, 2021) Kirik, Serkan; Aslan, Mahmut; Ozgor, Bilge; Gungor, Serdal; Aslan, NeslihanBackground Acute ataxia is a common reason for presentation to the pediatric emergency department and the pediatric neurology clinic in childhood. Its incidence is between 1/100,000 and 1/500,000. Its most common reason is infections. Objective The aim of this study was to examine the clinical presentation, etiological factors, and prognosis of patients presenting to our regional tertiary pediatric neurology clinic with a diagnosis of acute ataxia. Methods An evaluation was made of patients younger than 18 years diagnosed with acute ataxia in our tertiary pediatric neurology clinic between 2009 and 2016. Results Thirty-nine children were included in the analysis. Sex, age, diagnoses, treatment options, and clinical and radiological findings were evaluated. Acute postinfectious cerebellar ataxia was the most common diagnosis (21/39 [51.2%]). No agent could be identified in viral serological examination in 34 patients (87.2%). Rotavirus was identified in 2 (10.5%) of the acute postinfectious cerebellar ataxia cases, and varicella-zoster virus, herpes simplex virus, and hepatitis A positivities were each identified in 1 case. In 20 (51.2%) of 39 patients, varying treatments were applied according to the primary etiology. Conclusions Acute ataxia is a significant neurological problem in childhood. In this study, Rotavirus was the most common infectious agent. It may be related to vaccination. This study can be considered of value as the most comprehensive study conducted to date on this subject in the eastern region of Turkey.Öğe Anxiety, depression, sleep disorders and quality of life in parents of children with first unprovoked seizure and epilepsy(Turkish J Pediatrics, 2024) Ozgor, Bilge; Cansel, NeslihanBackground. Parents of a child with neurological problems such as seizures and epilepsy experience significant mental distress. Little is known about the mental state of parents in such a stressful situation. This study aims to determine the prevalence of self-reported depression, anxiety, sleep disorders, and quality of life in parents of children with epilepsy and first unprovoked seizure. Methods. This cross-sectional study was conducted among the parents of children diagnosed with first unprovoked seizure and epilepsy admitted to the Pediatric Neurology Department, Outpatient Unit of Inonu University Medical Faculty Hospital. Participants filled out a questionnaire investigating demographic variables, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and 36Item Short-Form Health Survey (SF-36). Results. 113 parents participated in the study. Depression was found in 7%, anxiety in 14%, and sleep quality disorder in 33.3% of parents of children diagnosed with epilepsy on the basis of moderate or higher severity, while depression was found in 8.9%, anxiety in 14.3%, and sleep disorder in 21.4% of parents of children diagnosed with first unprovoked seizure. There was no statistically significant difference between the groups. Mothers were at higher risk for loss of physical function and social functionality. There was a positive correlation between BAI, BDI, and PSQI scores. Quality of life sub-dimension measured by SF-36 was associated with different levels of depression, anxiety, and sleep quality. Conclusion. Addressing parental psychiatric problems by professionals involved in the treatment of children with a history of seizures may have the potential to provide further support for the family and the care of patients.Öğe Coeliac disease and reproductive disorders(Taylor & Francis Ltd, 2010) Ozgor, Bilge; Selimoglu, Mukadder AyseReproductive problems, such as delayed menarche, amenorrhea, early menopause, infertility, impotence, hypogonadism, recurrent abortions, and low-birth-weight or preterm deliveries, are now known to be among the atypical symptoms of coeliac disease (CD). The pathogenesis of reproductive disorders in CD is unclear, but some hypotheses have been suggested, including autoimmunity and macro- and/or micronutrient deficiency. Recent investigations which have focused on tissue transglutaminase are promising with respect to the clarification of the mechanism of infertility and poor pregnancy outcomes in CD. In this review, the effects of CD on male and female reproductive disorders and pregnancy outcomes are discussed and the need for CD screening in the case of reproductive problems is emphasized.Öğe A novel SCN1A mutation: A case report(Wolters Kluwer Medknow Publications, 2020) Aslan, Mahmut; Ozgor, Bilge; Kirik, Serkan; Gungor, SerdalIntroduction: Dravet syndrome (DS) is characterized by severe infant-onset myoclonic epilepsy with delayed psychomotor development and increased premature mortality. The seizures triggered by fire have been gradually decreased over time, and finally they start to occur without fever at the age of 2-3 years. Along with its initiation of myoclonic seizures in the early period, other types such as atypical absence, versive, and complex partial seizures occur between 1 and 4 years of age. Case Report: A 3-year-old male patient with refractory epilepsy and neuromotor developmental retardation was admitted to our clinic. The patient initially had seizures in the afebrile period, when he was 4 months old, and he had a total of five seizures by the age of 1 year. Neuromotor developmental retardation developed over time in patients with normal neuromotor development in the early stages of his life. His cranial magnetic resonance imaging and metabolic test findings were normal. The SCN1A mutation was investigated, and a new variant mutation of SCN1A, homozygous (p.Y1599FfsFNx0119-c.4796delA) was detected. The patient's family was also screened and this new mutation was detected as heterozygous mutation. The patient had hepatomegaly. The etiology of hepatomegaly was investigated but no cause was found. Conclusion: Variant mutations of DS should be kept in mind and diagnostic genetic testing should be done in patients with neuromotor developmental retardation starting with afebrile seizures. In DS, hepatomegaly is not an expected condition. Maybe this new mutation might have caused hepatomegaly.Öğe Prevalence of celiac disease in parents of preterm or low birthweight newborns(Wiley, 2011) Ozgor, Bilge; Selimoglu, Mukadder Ayse; Temel, Ismail; Seckin, Yuksel; Kafkasli, AyseAim: Celiac disease (CD) may present with atypical symptoms, including poor pregnancy outcomes, such as preterm and low birthweight (LBW) deliveries, thus we aimed to investigate the frequency of CD in mothers and fathers of preterm or LBW newborns. Materials and Methods: In this study, 316 parents of 164 preterm or LBW newborns and 246 parents of 123 healthy newborns were included. CD was screened using tissue transglutaminase immunoglobulin A. Endoscopic duodenal biopsy was provided in the seropositive cases. Results: Positive tissue transglutaminase immunoglobulin A was found in six (1.1%; 1/94) individuals (three mothers and three fathers); five were from the study group (1.6%; 1/63) and one was from the control group (0.4%; 1/246). CD prevalence in mothers, fathers and parents of preterm newborns was 1/57 (1.8%), 1/57 (1.8%) and 1/29 (3.5%), respectively. In the LBW group, seropositivity in fathers was 1/50 (2%) with no seropositive mothers. Biopsy-proven CD was found in 1/159 mothers (0.6%) and 1/79 fathers (1.3%). Mean birthweights of the newborns of seropositive mothers and fathers were 214 g (P < 0.05) and 320 g lower than those of seronegative ones, respectively. However, in logistic regression analysis it was found that seropositivity of mothers or fathers did not affect gestational age or birthweight of the newborns. Conclusion: Because the prevalence of CD in parents of preterm or LBW newborns is not statistically higher than the healthy population, routine CD screening in that group cannot be recommended at the time being. For more definite conclusions further studies are needed.Öğe A rare case of munchausen syndrome admitted with hemoptysis(2017) Demirtas, Mehmet Semih; Ozgor, Bilge; Gungor, SerdalÖğe A rare case of munchausen syndrome admitted with hemoptysis(Inonu University Faculty of Medicine Department of Pediatric, Neurology, Malatya, Turkey, 2017) Demirtas, Mehmet Semih; Gungor, Serdal; Ozgor, Bilge[Abstract Not Acailable]Öğe The relationship between serum leptin and VO2max levels in pre-puberty swimmer girls: effect of acute exercise(Mattioli 1885, 2020) Gullu, Esin; Gullu, Abdullah; Duzova, Halil; Ozgor, Bilge; Kilinc, Evren; Akcinar, FarukObjective: The aim of this study was to determine the relationship between serum leptin (SL) level, which is the sensor of changes in energy intake and consumption, and maximal oxygen consumption (VO2max) level in pre-puberty swimmer girls. Methods: Voluntary participants were divided into swimmer group (n:16) and the control group (n:15). Bruce protocol was used for acute exercise effect. Body composition, VO2max and SL concentrations of the study group were measured before and after acute exercise. The paired-samples t-test and independent samples t-test were used for intra- and inter-group comparisons. The linear relations between the VO2max and SL levels were determined by Pearson correlation coefficient. The level of significance was used at 0.05. Results: There was a significant difference between the SL level and test stage, test duration, HR of test-end, and VO2max variables in both groups (p<0.05). There was a high level of negative correlation between VO2max and SL levels in both groups after exercise (SG, r=-0.63; p<0.01, and CG, r=-0.60; p<0.05, respectively). Conclusion: Acute exercise resulted in decreased SL levels of both groups. It was concluded that regular swimming sports has a positive effect on body composition, VO2max, and SL values of pre-pubertal girls.Öğe A Retrospective Evaluation of Children Diagnosed with Dermatomyositis: A Single-center Study(Galenos Publ House, 2022) Aslan, Mahmut; Gungor, Serdal; Tabel, Yilmaz; Ozgor, Bilge; Kirik, SerkanObjective: Juvenile idiopathic inflammatory myopathies are systemic autoimmune disorders that are characterized by chronic skeletal muscle inflammation, skin rashes and other systemic involvements. We analyzed the clinical findings, laboratory values at admission and treatment protocols and treatment responses of patients who were followed up with a diagnosis of juvenile dermatomyositis (JDM) in a department of pediatric neurology and rheumatology clinics. Methods: Fifteen patients who were referred to the department of pediatric neurology and pediatric rheumatology clinics, diagnosed with JDM between 2010 and 2017 were evaluated retrospectively via their medical records. Results: Of the study sample, 12 (80%) of the patients were female and 3 (20%) were male, and their mean age was 9.26 +/- 3.21 years. The mean time between complaint and diagnosis was 7.8 +/- 6 months, and the patients were followed up for 24.93 +/- 15.28 months after their diagnosis. The mean creatine kinase levels of the patients were 1.354 +/- 840 U/L. Fifteen (100%) of the patients had muscle weakness, 14 (93.3%) had Gottron's papules and 12 (80%) patients had a heliotrope rash. Ten (66.6%) underwent muscle biopsy, 9 (60%) underwent electromyography and 5 (33.3%) patients underwent muscle magnetic resonance imaging. All the patients were treated with corticosteroids and immunosuppressive agents. Conclusion: JDM is a rare inflammatory myopathy observed during childhood. Better responses can be achieved by early diagnosis, intensive immunosuppressive therapy and effective physical therapy.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.Öğe Risk factors for epilepsy following arterial ischemic stroke childhood: A retrospective cohort study(Academic Press Inc Elsevier Science, 2024) Yucel, Guel; Arslan, Ahmet Kadir; Ozgor, Bilge; Gungor, SerdalAim: PSE is reported more frequently in childhood than in adults. In this study, we aimed to investigate potential risk factors for the development of post-stroke epilepsy (PSE) in children with arterial ischemic stroke (AIS). Material methods: The current retrospective cohort study included the medical records of 50 pediatric participants (aged 29 days to 18 years) diagnosed with AIS at a university hospital between January 2006 and December 2023. All information of the patients who were followed for at least two years for the development of PSE after AIS was entered into the hospital database and recorded in a pre-designed questionnaire. Acute symptomatic seizures were defined as seizures occurring within 7 days after stroke. Two or more late seizures occurring after the acute period (>7 days) were classified as PSE. The incidence of PSE and potential risk factors were investigated. Results: After AIS, more than half of the patients (58 %) developed acute seizures and almost one-third (38 %) developed PSE. Risk factors associated with the development of PSE, very early seizures (within the first six hours), high stroke severity, cortical lesions, neurological deficits and low serum vitamin D levels were detected (p = 0.05, p = 0.036, p = 0.011, p < 0.001, p < 0.001, respectively). Conclusion: Seizures within the first six hours, high stroke severity, and neurological deficits are important risk factors for the development of PSE in children. Knowing the potential risk factors of PSE may be helpful for clinicians to identify high-risk patients. It can also contribute to treatment decision-making and post-discharge follow-up planning.Öğe The role of mean platelet volume/platelet count in differentiation of simple and complex febrile seizures(2023) Ozgor, Bilge; Kırık, Serkan; Yücel, Gul; Karadağ, MeralAim: Our study aimed to find the relationship between MPV (Mean Platelet Volume) levels, a marker of inflammation, and platelet counts between simple and complex febrile seizures. Materials and Methods: In this retrospective comparative study, we analyzed the records of 283 children between the ages of 6 months and 6 years who were diagnosed with simple and complex febrile seizures (BFN/CFN) in the Pediatric Neurology Clinic of Inonu University, Faculty of Medicine between January 2021 and December 2022. Results: The mean age and gender characteristics of the patients were similar in both groups. The MPV of the CFN group (69 patients) (6.53±0.39fl) was lower than that of the BFN group (214 patients) (7.81±0.43fl) and this difference was statistically significant (p<0.01). The platelet count of the CFN group (257.42×103±126.01×103) was higher than that of the BFN group (191.23×103±68.29×103) and the difference was statistically significant (p<0.01). Conclusion: There was a significant difference between BFN and CFN groups in terms of both MPV values and platelet counts. This study suggests that detailed and comprehensive studies on MPV and platelet counts may guide cases where clinical findings are suspicious and the distinction between BFN and CFN cannot be clearly differentiated.Öğe Sleep quality and depression in mothers of children with epilepsy and its relation to their children's sleep(Academic Press Inc Elsevier Science, 2023) Yucel, Gul; Arslan, Ahmet Kadir; Ozgor, Bilge; Gungor, SerdalObjective: This study aimed to evaluate the relationship between sleep disturbances in children with epilepsy (CWE) and maternal sleep quality and depression severity.Methods: A Cross-sectional study was conducted in pediatric sleep disturbances using questionnaires on mother-reported sleep of CWE [Children's Sleep Habits Questionnaire (CSHQ)], maternal sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and maternal depression status [Self-Rating Depression Scale (SDS)]. 114 dyads consisting of CWE and their mothers were included in this study.Results: Over three-quarters (78.9 %) of mothers reported poor sleep quality (total PSQI score >= 5), and nearly a third (29.8 %) met clinical criteria for moderate or severe depression levels. The mothers' total PSQI scores were between 5.93 +/- 2.44 (range: 2-16 points). The most affected PSQI subcomponents were sleep latency (AUC = 0.826p < 0.001) and daytime dysfunction (AUC = 0.800p < 0.001). The majority of children (88.6 %) were stated by their mothers to have sleep-related problems. The total CSHQ scores of the children were between 49.06 +/- 9.20 (range: 33-86 points). The most affected CSHQ subcomponents were detected sleep anxiety (AUC = 0.856, p < 0.001), bedtime resistance (AUC = 0.818, p < 0.001) and daytime sleepiness (AUC = 0.807, p < 0.001). There was a statistically significant positive correlation between maternal sleep quality and depression severity (rho = 0.842; p < 0.001). A statistically significant positive moderate correlation was detected between sleep problems in CWE and maternal sleep quality and depression severity (rho = 0.406; p < 0.001, rho = 0.399; p < 0.001, respectively). As a result of multiple stepwise logistic regression analysis, the presence of seizures during sleep and generalized epileptiform discharges on electroencephalography were associated risk factors with poor maternal sleep quality (OR:6.6, p = 0.014; OR:11.5, p = 0.018, respectively). A borderline insignificant relationship was observed between a less than 50 % decrease in seizure frequency and the poor maternal sleep quality (OR:20.59p = 0.059). Seizures during sleep was associated risk factor with children's sleep disturbances (OR:7.2, p = 0.02).Conclusions: Sleep problems in CWE may lead to negative consequences such as sleep quality and/or depression in mothers. Interventions planned to correct sleep disturbances in mothers suggest that children's sleep problems should be optimally managed.Öğe Somatostatin for the treatment of chylothorax in a premature baby with Down syndrome(Wiley-Blackwell, 2010) Ugras, Meltem; Yakinci, Cengiz; Ozgor, Bilge[Abstract Not Available]Öğe Two siblings with metachromatic leukodystrophy caused by a novel identified homozygous mutation in the ARSA gene(Walter De Gruyter Gmbh, 2018) Aslan, Mahmut; Kirik, Serkan; Ozgor, Bilge; Gungor, SerdalBackground: Metachromatic leukodystrophy (MLD) is an autosomal recessively (AR) inherited disease caused by the deficiency of the enzyme arylsulfatase A (ARSA). Although MLD is the most common form of hereditary leukoencephalopathy, it is still very rare. More than 200 gene mutations have been identified in the ARSA gene. The most frequently identified mutation is the one located on chromosome 22q13.33. In the present study, new mutations are reported in two siblings of different ages and with different clinical presentations. Case presentation: A 9-year-old male patient, suffering from ataxia, attention deficit and perceptual difficulties, was first seen at the age of 7. While the findings of neurological examination and neuroradiological evaluation suggested MLD, the ARSA enzyme levels were analyzed and found to be at a lower limit. Genetic analysis revealed variant homozygous mutations of the ARSA gene at p.N352S/c.1055T>C in exon 6 and at p.E331K/c.991G>A in exon 7. In the genetic analysis of his three siblings and parents, a variant heterozygous mutation of the ARSA gene was detected at p.N352S/c.1055T>C in exon 6 and at p.E331K/c.991G>A in exon 7. Conclusions: MLD is a rare disease; however, it is likely to find different variant forms in our population, in which the frequency of consanguineous marriages is high. Genetic diagnosis is important in symptomatic cases with enzyme levels within the normal ranges.Öğe The Value of Electroencephalogram (EEG) Findings in the Evaluation and Treatment Management of Pediatric Acute Liver Failure(Springernature, 2024) Ozgor, Bilge; Gungor, Sukru; Aladag, Merve; Varol, Fatma I.; Aslan, Mahmut; Yilmaz, Sezai; Gungor, SerdalBackground Pediatric acute liver failure (PALF) is still life -threatening and requires urgent care. The presence of encephalopathy is a clinical diagnosis, but it is more difficult to diagnose in children than in adults, and an electroencephalogram (EEG) can be invaluable. The role of EEG in managing the treatment of patients with PALF, other than the identification of encephalopathy, is unknown. This study aimed to investigate patients' EEGs, which may guide in choosing the most appropriate treatment in encephalopathy children. A further aim was to investigate a new score method, based on the laboratory results, which might indicate the presence of encephalopathy in cases with PALF. Methods Medical data of 33 PALF patients followed in our clinic were reviewed retrospectively. This study included 33 patients, whose EEG recording was taken on the first day of supportive treatment due to liver failure in the pediatric intensive care unit (PICU). The EEG findings were categorized into three classes: normal, epileptic and non -epileptic paroxysmal, and background encephalopathic patterns including widespread slowing and voltage suppression. Result This retrospective study included 13 male and 20 female patients with a mean age at presentation of 4.82 +/- 4.81 months whose EEG was performed on the first day of supportive therapy for liver failure in the PICU. The EEG findings were categorized into three groups: normal, epileptic and non -epileptic paroxysms, and encephalopathic patterns including diffuse background slowing and voltage suppression. Comparing EEG findings and treatments, we found that the normal EEG group responded well to liver -supporting therapy and the rate of plasmapheresis treatment was significantly higher in the diffuse slowing group. Patients with diffuse slowing of the EEG were 9.6 times more likely to receive plasmapheresis. We found that above a cut-off of >= 7.5 for the TAI (total bilirubin, albumin, and international normalized ratio (INR)) score used in our study, the risk of developing encephalopathy increased 14.4 -fold. Conclusions In PALF, EEG findings can provide findings that will help clinicians in determining treatment selection and prognosis, as well as detecting epileptic focus and encephalopathy. The TAI score can be used to assess the risk of encephalopathy in cases of PALF, when it is challenging to identify encephalopathy or when an EEG is not possible.
