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Öğe Autoimmune polyglandular syndrome type III which accompanies to multiple sclerosis: A case report(2019) Gorgel, Ahmet; Tecellioğlu, Mehmet; Çankaya, CemAbstract: Autoimmune polyglandular syndrome type III (APS III) is characterised by autoimmune destruction of various endocrine and nonendocrine tissues. It differs from APS I and APS II in terms of without adrenal involvement. Although APS III includes a series ofautoimmune disorders, it is rarely associated with multiple sclerosis (MS). A 41-year-old female patient had diplopia, visual blurring,dizziness, and giddiness for 2 weeks. In her medical history, she had a diagnosis of MS and using Teriflunomide. It was detectedpositivity of antinuclear antibody (ANA), anti-thyroid peroxidase (Anti-TPO) and anti-thyroglobulin (Anti-TG) antibodies. Based onthese results, the patient with MS who has chronic autoimmune thyroiditis and primary ovarian failure was diagnosed with APSIII. The coexistence of APS-III and MS is a rare clinical entity. Moreover, hypothyroidism has been detected during teriflunomidetherapy in the patient. Hypothyroidism was most likely a component of APS-III in our case, but it may also have been triggered byteriflunomide.Öğe Beneficial effects of glucan against cisplatin side effects on the nervous system in rats 1(Acta cir brasl, 2016) Kaya, Kürşat; Çiftçi, Osman; Çetin, Aslı; Tecellioğlu, Mehmet; Başak, NeşePURPOSE: To investigate the protective effect of Bg on cisplatin (CP)-induced neurotoxicity in rats. METHODS: Twenty eight rats were randomly distributed into four groups. The first group was kept as a control. In the second group, CP was given at the single dose of 7 mg/kg intraperitoneally. In the third group, βg was orally administered at the dose of 50 mg/kg/day for 14 days. In the fourth group, CP and βg were given together at the same doses. RESULTS: CP treatment caused significant oxidative damage via induction of lipid peroxidation and reductions antioxidant defense system potency in the brain tissue. In addition, histopathological damage increased with CP treatment. On the other hand, βg treatment largely prevented oxidative and histopathological negative effects of CP. CONCLUSIONS: Cisplatin has severe neurotoxic effects in rats and βg supplementation has significant beneficial effects against CP toxicity depending on its antioxidant properties. Thus, it appears that βg might be useful against CP toxicity in patients with cancer in terms of nervous system.Öğe A case of multiple sclerosis presenting as eight and half syndrome(KIrıkkale Üniv Tıp Fak Dergisi, 2015) Kamışlı, Özden; Tecellioğlu, Mehmet; Özcan, Abdul CemalWe present a case young woman who presented with right gaze limitation and right eye limitation of adduction with horizontal nystagmus on abduction left side (one-and-a-half syndrome) in addition to a right-sided lower motor neuron facial nerve palsy which is called eight-and-a-half syndrome. The etiology in our patient was multiple sclerosis which was confirmed by medical history and magnetic resonance imaging.Öğe Cerebral venous sinus thrombosis-related epileptic seizures and their clinical features(Turgut Özal Tıp Merkezi Dergisi, 2016) Tecellioğlu, Mehmet; Kamışlı, Özden; Kablan, YükselAbstract Aim: Cerebral venous sinus thrombosis (CVST) is a severe neurological disease that may cause disability and death. Its clinical symptoms are varied. Epileptic seizures may manifest as early signs of the disease in 30-40% of patients. We aim to compare patients presenting with seizures with those presenting without seizures in CVST patients. Materials and Methods: 50 patients diagnosed with cerebral venous sinus thrombosis were included in the study. The demographic characteristics, initial symptoms, etiologic factors, radiological findings and treatment were analyzed retrospectively. Patients with seizures were evaluated with all their clinical features. Results: There were 10 patients with epileptic seizures (20%). Nine of the patients were females. All nine female patients had pregnancy-associated seizures. Patients with supratentorial lesions seen was greater than the frequency of seizures. All of the seizures were observed as early seizures (within 14 days). 4 patients focal seizures, secondary generalized seizures were observed in 6 patients. 7 patients who have seizures are also have sagittal sinus thrombosis. Transverse sinus structures affected in the second frequency. Conclusion: Made in previous studies of patients with DVT reported that about half of the early episodes, in our study, this rate was found to be 20%. Patients who had seizures have similar outcomes with patients without seizures.But the attacks early with an effective antiepileptic treatment was considered to be the prevention of deaths and late seizure recurrence. Keywords: Cerebral Venous Sinus Thrombosis; Seizure; Epilepsy.Öğe Chrysin prevents brain damage caused by global cerebralischemia reperfusion in a C57BL J6 mouse model(Turkısh journal of medıcal scıences, 2016) Durak, Mehmet Akif; Öztanır, Mustafa Namık; Türkmen, Neşe Başak; Çiftçi, Osman; Taşlıdere, Aslı; Tecellioğlu, Mehmet; Önder, ArifThe present study investigated the neuroprotective effects of chrysin (CRS) following global cerebral ischemia and reperfusion (I/R) in a C57BL/J6 mouse model. Materials and methods: A total of 40 mice were equally divided into four groups: (1) sham-operated (SH = control), (2) global cerebral I/R (I/R), (3) CRS, and (4) CRS + I/R. In the I/R group, the bilateral carotid arteries were clipped for 15 min and the mice were treated with vehicle (corn oil) for 10 days. In the CRS group, CRS (50 mg/kg) was given for 10 days without carotid occlusion. In the CRS + I/R group bilateral carotid arteries were clipped for 15 min and the mice were also treated with CRS (50 mg/kg) for 10 days. All of the rats were sacrificed under anesthesia on day 10, and neurodegenerative histological changes in the brain and tissue levels of oxidants and antioxidants were evaluated. Results: CRS treatment significantly reversed the oxidative effects of I/R and inhibited the development of neurodegenerative histopathologies. In the CRS + I/R group, the decrease in TBARS levels and increase in GSH levels were similar to those in the SH group. Conclusion: Treatment with CRS can positively affect the neural system of mice and it can be used for the treatment of global cerebral I/R.Öğe Comparative study of multiple sclerosis patients based on distance from the advanced health center(2021) Tosun, Hatice; Tecellioğlu, MehmetAbstract:Aim: There are several reasons for presenting to a hospital for multiple sclerosis (MS), a neurodegenerative disorder. We aimed to determine how distance affects presentation by patients with MS to an advanced health center in Malatya, Turkey. Materials and Methods: The study was performed on 109 patients at the Neurology Department of Inonu University Hospital in 2017. The patients were divided into group-1, who lived in Malatya, and group-2, who live in the upstate region. Demographic and clinical data were analyzed retrospectively from medical records. Chi-square tests, independent sample T-tests, and Mann–Whitney U-tests were used to analyze the data. Results: The duration of the disease was longer among patients who lived in Malatya. In terms of mean expanded disability status scale scores, patients who lived in Malatya had higher scores and patients who lived upstate exhibited more clinical complaints. Among patients who lived upstate, there were more motor problems, vertigo, cognitive impairment, psychiatric disturbances, and visits for blood tests. Conclusion: Distance affected admission to MS outpatient clinics. We should be more careful in terms of attack when assessing the reasons of patients present from outside the province. More meaningful results can be obtained by following more patients for longer periods.Öğe Decompressive Surgery for Malignant Middle Cerebral Artery Infarctions(Turgut Özal Tıp Merkezi Dergisi, 2016) Tecellioğlu, Mehmet; Kamışlı, SuatÖz: Amaç: Merkezimizde malign Orta serebral arter tıkanıklığı ile takip edilirken dekompresif cerrahi uygulanmış olan hastaları değerlendirmek ve sonuçlarını güncel literatür bilgileriyle karşılaştırarak tartışmak. Gereç ve Yöntem: Ocak 2013-Mayıs 2015 tarihleri arasında İnönü Üniversitesi Turgut Özal Tıp Merkezi Nöroloji kliniğini inme ünitesinde malign Orta serebral arter tanısı almış ve dekompresif cerrahi yapılmış 31 hasta retrospektif olarak değerlendirilmiştir. Bulgular: Hastaların tamamına dekompresyon+duraplasi cerrahi prosedürü uygulandı. 18 kadın, 13 erkek hastanın yaş ortalaması 65,5'ti. Cerrahi uygulanan hastaların en az altı aylık izlem sonunda sağ kalım oranı %29 olarak bulundu. Yaş <=65 alındığında sağ kalım %50 oranında gözlendi. Sonuç: Mortalite oranı literatür ile karşılaştırıldığında beklenenden yüksek olmakla beraber bu durumun cerrahi için hasta seçiminde kriterlerin daha geniş aralıkta tutulmasından kaynaklandığı düşünülmektedir. İnme için risk faktörü sayısının birden fazla olması ve cerrahiye alınan hastaların yaşının >65 olmasının cerrahi sonrası mortaliteyi istatiksel olarak anlamlı bir şekilde arttırdığı görülmüştür. Uygun hastalarda yapılan dekompresif cerrahi mortaliteyi azaltırken, fonksiyonel anlamda kısmi iyilik hali sağlayabilir. Başlık (İngilizce): Malign Orta Serebral Arter İnfarktında Dekompresif Cerrahi Öz (İngilizce): Aim: The aim of the study is to evaluate patients who underwent decompressive surgery followed by malignant MCA infarction diagnosis in our center and compare and discuss our results with the current literature. Materials and Methods: This is a retrospective evaluation of thirty-one malignant middle serebral artery infarction patients who underwent decompressive surgery and were admitted to the Inonu University Turgut Ozal Medical Center, Neurology Clinic Stroke Unit between January 2013 and May 2015.Results: All patients underwent decompression + duraplasty procedures. The survival rate of the patients who underwent surgery and were followed for at least six months was 29%. The mean age of 18 women and 13 men patients was 65.5 years. The survival rate was 50% in patients under <=65. Conclusion: The mortality rate was higher than expected compared with the literature because of the wide range of indications. We observed that multiple risk factors for cerebrovascular diseases and age (above 65) resulted in a statistically significant increase in postoperative mortality. The decompressive surgery in eligible patients may reduce mortality and may provide partial functional well-being.Öğe Epilepsy, antiepileptic drugs and lipid mechanisms(KARE PUBL, CONCORD ISTANBUL, DUMLUPINAR MAH, CIHAN SK NO 15, B BLOK 162 KADIKOY, ISTANBUL, 00000, TURKEY, 2018) Kamışlı, Özden; Tecellioğlu, MehmetHigh levels of lipids and lipoproteins in young adults are significant risk factors for the development of heart disease in older ages. Increased levels of total cholesterol and triglycerides, high levels of low-density lipoprotein and low levels of high-density lipoprotein contribute to cardiovascular disease. Therefore, when starting antiepileptics, it is important to assess changes in serum lipid levels and choose the safety drug, thus contributing to the prevention of cardiovascular complications in older ages. This paper is a review of the e effects of AED use on plasma lipid parameters.Öğe Hirayama disease: An unusual case report(2018) Sevimli, Reşit; Tecellioğlu, Mehmet; Talu, Burcu; Canbay, Ali; Çalışgan, ElisaAbstract: Hirayama disease is an uncommon and rarely seen lower motor neuron disease. It is usually seen during periods of rapid growth (15-25 years). Distal upper extremities characteristically show weakness and atrophy. In this paper a case is presented of this rare, and difficult to diagnose disease, not previously reported in this age group, and the findings are discussed in the light of information of earlier cases in Turkey. A 53-year old male patient presented at Inonu University Neurology Polyclinic with complaints of motion tremor and atrophy in the left arm, which had been ongoing for 4 years. After electromyography, the deltoid, biceps, triceps, extensor digitorum communis, abductor pollicis brevis and abduction digiti minimi muscles were identified in the upper left limb. This case report presents information about the differential diagnosis, detailed symptoms and treatment methods of a Hirayama patient applying for physical therapy.Öğe Leber'in herediter optik nöropatisi ve multipl skleroz birlikteliği: olgu sunumu(2016) Tecellioğlu, Mehmet; Özcan, Cemal; Tosun, HaticeÖz: Leber'in kalıtsal optik nöropatisi (LHON) akut/subakut, ağrısız, santral görme kaybı ile karakterize, mitokondriyal genetik bir hastalıktır. Olguların çoğunda sadece göz tutulumu olur, bazen kardiyak bozukluklar, nörolojik semptomlar, iskelet anormallikleri tabloya eklenir. LHON'lu hastaların beyin ve omurilik MRG'lerinde nadir olmayarak demyelinizan lezyonlar görülebilir, bazen multipl skleroz benzeri klinik tablo ortaya çıkabilir (Harding Sendromu). Bu yazıda, eşzamanlı bilateral görme kaybı yakınması ile başvuran ve mt. DNA gen mutasyonu (mt.DNA 3460G>A) saptanıp LHON tanısı alan, eşlik eden nörolojik belirtileri ve beyin MRG bulguları multipl sklerozu telkin eden erkek olgu sunulmaktadır. Bu olgularda tanı süreçleri ve özellikle MS tedavisi gözden geçirilmektedir.Öğe Lipoid proteinosis and epilepsy: Molecular analysis(2019) Tecellioğlu, Mehmet; Kamışlı, Özden; Acar, Ceren; Mergen, Hatice; Sözen, Mustafa Mert; Karaduman, Tuğçe; Saraç, Gülbahar; Erbay, Mehmet FatihAbstract: Aim: Lipoid proteinosis (LP) is also known as Urbach-Wiethe disease which is a rare autosomal recessive disorder characterized by intracellular accumulation of hyaline material in skin and mucosae. LP has typical neurological, dermatological and radiological findings. The pathogenesis of disease is unknown. In literature several cases have been reported up to date. Mutations in extracellular matrix protein 1 (ECM1) gene have been found to cause the disease. We evaluated the molecular features of a family diagnosed with LP and evaluate the known and novel mutations of LP. Material and Methods: Genomic DNA was extracted from peripheral blood of the patients and family members including clinically normal parents and two siblings of the two affected subjects by using a commercial DNA extraction kit. Polymerase chain reaction was performed for all 10 exons of ECM1 gene by using the primers defined. Results: All of the exons of the ECM1 gene were sequenced and this revealed a 2-bp deletion in exon 7 of the ECM1 gene in both patients and both parents. Patients have the homozygous 2-bp deletions (c735del TG) and the parents and two healthy siblings showed heterozygous 2-bp deletion. Conclusions: Our patients found to be homozygous for the deletion in ECM1 gene. In order to understand the molecular pathology of the disease in detail, further functional analysis of the mutations should be performed.Öğe Migrenli hastalarda vestibüler miyojenik uyarılmış potansiyeller(İnönü Üniversitesi, 2010) Tecellioğlu, MehmetMigren 30-39 yaş grubunda en sık görülen, kadın baskınlığı olan, zonklayıcı karakterde, 4-72 saat kadar süren, uni veya bilateral olabilen, bulantı, kusma, fotofobi, fonofobi gibi bulguların eşlik edebildiği, hareketle genellikle şiddetlenen, ciddi anlamda iş gücü kaybına yol açan, tekrarlayıcı, primer bir baş ağrısıdır. Baş ağrısı atakları öncesinde 5-60 dakika sürebilen, pozitif veya negatif görsel ve duysal semptomlar ve konuşma bozukluğu şeklinde ortaya çıkan aura hastaların bir bölümünde görülebilir. Migren tanısı klinik olarak konulur ve yapılan radyolojik ve laboratuar tetkikleri ancak sekonder nedenleri ekarte etmek için yararlıdır. Migren patogenezi hakkında bugüne kadar birçok hipotez ortaya atılmıştır. Bunlardan son yıllarda en dikkat çekici olanı beyinsapı jeneratörü teorisidir. Bu teori; migren atağının başlamasında ve sonlanmasında beyin sapındaki nöroanatomik yapıların ve beyin sapındaki nörotransmitterlerle ilgili mekanizmaların aktive olmasının patogenezde rolü olabileceğine dikkat çekmektedir. Bu çalışma, İnönü Üniversitesi Turgut Özal Tıp Merkezi Nöroloji Kliniği'nde IHS kriterlerine göre kesin migren tanısı alan 52 hasta ve 52 sağlıklı kontrol grubunda prospektif olarak yapıldı. VEMP çalışmasıyla elde ettiğimiz ölçüm sonuçları migren tanısı almış hastalar ile kontrol grubunda karşılaştırıldı. Migrenli hastalarda sol p1 amplitüdünde ve sol p1-n1 amplitüd farkında anlamlı düşüklük saptandı. Buna karşılık, n1 amplitüd değerleri, p1 ve n1 latans değerleri, sağ-sol kulak p1 latans farkı, sağ-sol kulak n1 latans farkı, sağ-sol kulak p1-n1 amplitüd farkı değerleri kontrol grubuyla karşılaştırıldığında istatistiksel olarak fark göstermiyordu. Tek taraflı olarak saptanan p1 amplitüdündeki ve p1-n1 amplitüd farkındaki kısalmanın migrenli hastalarda daha önce yapılan VEMP çalışmaları göz önüne alındığında anlamlı olmadığı düşünüldü. Sonuç olarak; VEMP testinin migrendeki kullanımını ve anlamlılığını destekleyecek geniş hasta gruplarıyla birçok çalışmaya ihtiyaç vardır.Öğe Molecule associated with autism: Folic acid. Do we use it correctly?(2019) Senol, Deniz; Karataş, Mehmet; Karataş, Turgay; Özbağ, Davut; Tecellioğlu, Mehmet; Canbolat, MustafaAbstract: Aim: Neural tube defects (NTD) are among most commonly found congenital anomalies. Sufficient amount of folic acid taken in preconception period is reported to prevent NTD development. There are studies in literature which make an association between high doses of folic acid taken during pregnancy and autism. When folic acid supplement began to be made on foods to protect from neural tube defects a concurrent increase has been mentioned in autism prevalence. Today pregnancy and folic acid supplement are currently indispensable. Physicians have made this supplement a routine. Aim of study is to assess if every woman in Malatya has a deficiency which requires routine use of folic acid through the folic acid levels of women who refer to health institutions. Material and Methods: Study conducted on the records of 1003 female patients in reproductive age group who referred to neurology and internal medicine polyclinics for any reason and whose folic acid levels were checked by the related physician. Results: Serum folic acid level averages of all women whose records were taken is 7,69±3,03ng/ml. Only 27 (2,69%) women’s folic acid levels lower than 3,08 ng/ml. 699 (69,69%) women’s serum folic acid levels higher than 6 ng/ml. Conclusions: If these 1003 women were pregnant, they would routinely be started folic acid. However, folic acid levels of a great majority (69,69%) was found to be higher than 6 ng/ml. We believe that physicians should start folic acid after taking into consideration the nutritional habits and socioeconomic characteristics of the region they live in and after they check serum folic acid level.Öğe Multiple sclerosis associated with leber's hereditary optic neuropathy: a case report(Turgut Özal Tıp Merkezi Dergisi, 2016) Tecellioğlu, Mehmet; Özcan, A. Cemal; Tosun, HaticeAbstract Leber’s hereditary optic neuropathy (LHON) is a mitochondrial inherited disease characterized by acute/subacute painless central visual loss. Except for optic atrophy, LHON patients are usually otherwise healthy. Occasionally, LHON is associated with neurological, cardiac, and skeletal changes. The same MRI pattern of abnormalities can be found in patients with LHON. It is sometimes associated with clinical signs of multiple sclerosis (Harding Syndrome). In this report, we present the case of a male patient with complaints of bilateral visual loss, who was diagnosed with Leber's hereditary optic neuropathy that was confirmed by the presence of a mutation at 3460G>A position. He was also diagnosed with comorbid multiple sclerosis which was confirmed by clinical findings and MR imaging. Keywords: Optic Neuropathy; Leber; Multiple Sclerosis; Hereditary.Öğe Polyneuropathy in obstructive sleep apnea patients(2022) Tosun, Hatice; Tecellioğlu, Mehmet; Ermiş, Hilal; Özcan, CemalAim: Hypoxemia due to obstructive sleep apnea (OSA) is thought to cause peripheral nerve damage. A case-control study was conducted to test the accuracy of this phenomenon. Materials and Methods: The patient group consisted of 45 patients with OSA who had an apnea-hypopnea index (AHI) score of >10 and were newly diagnosed with OSA and control group consisted of 37 individuals who did not have OSA. Sensory and motor nerve conduction investigations were performed on both the upper and right lower extremity Mann-Whitney U, chi square and independent sample T tests were carried out. Results: Both groups had the same average age of 46. The mean body mass index (BMI) in patients with OSA was 31.81; the average AHI was 55.17; the periodic leg movements in sleep (PLMS) was 30.71; the T90 value was 74.23; the lowest saturation was 37; the average saturation value was 72.97. The other nerves’ sensory and motor distal latency lengths were more prolonged than the control group, except the ulnar nerve. The averages of the left median, ulnar, and right peroneal motor nerves’ compound motor action potential (CMAP) amplitude were lower in individuals with OSA than in the control group. Compared to the control group, patients with OSA had slower right tibial nerve motor conduction velocity. The mean snap amplitude of bilateral median and left ulnar sensory nerve were higher in patients with OSA. Conclusion: OSA-induced hypoxia may have an impact on peripheral nerve damage.Öğe Traditional and complementary medicine use in multiple sclerosis: A cross-sectional study(2022) Tekin, Çiğdem; Tecellioğlu, Mehmet; Şekerci, Güldeniz; Özcan, CemalAim: This objective of this study is to determine the TCM usage rates of the MS patients who are followed up at a Tertiary Healthcare Centre, the practices they mostly prefer, their level of satisfaction from these practices and their socio-demographic characteristics which may have an impact on their preferences Materials and Methods: This cross-sectional type study has been conducted on 107 MS patients who are followed up at a neurology clinic. The Kurtzke Expanded Disability Status Scale is used in order to assess the clinical inadequacy. The form of questionnaire conducted includes the questions asking their socio-demographic characteristics and TCM use of the patients. Results: It is found out that 29.9% of the MS patients have sought for the GETAT practice at least once, and 51.5% of them have intended to overcome the disease. The practices mostly used are cupping therapy/bloodletting, leech therapy, herbal medicines/phytotherapy, which are followed by osteopathy, ozone therapy and music treatment. 65.6% of the participants stated that they satisfied with or benefited from the TCM practices. It is found out that there is no significant difference (p>0.05) between the TCM use and the socio-demographic characteristics of the patients but a significant and inverse relationship between TCM use and their EDDS scores (p=0.010) exists. Conclusion: It is concluded that the MS patients use the TCM practices widely, stating that they benefited substantially from these practices. It is recommended that the behaviors of the patients regarding the use of these practices be examined in order to understand the efficacy of the medical treatment and management of the symptoms.Öğe Two New Cases and Literature Review of CLIPPERS Syndrome with LongTerm Follow-up(2020) Kamışlı, Özden; Tecellioğlu, Mehmet; Erbay, Mehmet Fatih; Kamışlı, Suat; Özcan, CemalAbstract: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory disorder of the central nervous system. The pathophysiology of CLIPPERS is unknown. The disease has characteristic radiological lesions located in the pons, bulbus, and cerebellum. Here we report two new cases and review the literature on CLIPPERS syndrome. A 35-year-old woman presented with a 2-month history of progressive double vision, vertigo, gait ataxia, nausea, and vomiting. The second case was that of a 40-year-old Iraqi man who presented with a 3-month history of vertigo, headache, and gait ataxia. Diagnosis of CLIPPERS was established based on findings of punctate, nodular enhancing lesions in the pons and bulbus in the first case and in the cerebellum in the second. Our patients responded well to steroid therapy and remained relapse-free for 2 years. CLIPPERS is a rare autoimmune disorder with characteristic radiological findings. Long-term immunosuppressive therapy is necessary for treatment.
