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    Beyond metric scores: The clinical and public health implications of seizure misinformation on social media
    (Wiley, 2026) Yucel, Gul; Ekici, Nur Yucel
    [No abstract available]
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    Comment on 'Exploring the neural basis of rosacea: altered brain activity and its links with social anxiety'
    (Oxford Univ Press, 2026) Yucel, Gul
    Song et al.'s study investigated the complex interaction between rosacea and the central nervous system using resting-state functional magnetic resonance imaging. Two key findings of the study indicate that right superior frontal gyrus activity correlates with erythema severity, forming a neurovascular bridge, and that left orbital middle frontal gyrus activity correlates with social anxiety, suggesting the neuropsychiatric signature of rosacea. These important findings highlight the need to consider neuropsychosocial pathways holistically in the treatment of rosacea and suggest structural neuroimaging and biomarker/treatment monitoring studies for future research.
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    Comment on Early Electroencephalogram to Predict Severity of Injury in Infants With Abusive Traumatic Brain Injury
    (Sage Publications Inc, 2026) Yucel, Gul; Ekici, Nur Yucel
    [No abstract available]
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    Comment on Survival motor neuron protein is the optimal biomarker for evaluating the risdiplam treatment
    (Elsevier, 2025) Yucel, Gul
    [No abstract available]
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    Digital screen exposure and sleep disorders in children with epilepsy: The impact of sociodemographic, clinical, and individual factors
    (Academic Press Inc Elsevier Science, 2026) Yucel, Gul; Arslan, Ahmet Kadir; Bicakcioglu, Isinsu; Ekici, Nur Yucel; Ozgor, Bilge
    Objective: The aim of this study is to determine the relationship between daily digital screen exposure and sleep disorders in children with epilepsy (CWE), focusing on different sleep subdomains. In addition, the possible regulatory role of socio-demographic factors and individual chronotype characteristics affecting digital screen exposure was also evaluated. Methods: This cross-sectional analytical study included 132 CWE and their mothers. Data were collected using sociodemographic/clinical forms, the Sleep Disturbances Scale for Children (SDSC), the Pittsburgh Sleep Quality Index (PSQI), and the Children's Chronotype Questionnaire (CCQ). Digital screen exposure was assessed using a parent-reported form; daily exposure was calculated by taking the weighted average of weekday and weekend usage times. Results: The study found a significant, positive correlation between average digital screen exposure time and total SDSC score (rho = 0.23; p = 0.008). This association was particularly evident in the subdomains of disorders of initiating and maintaining sleep (DIMS), disorders of excessive somnolence (DOES), and sleep--related breathing disorders (SDB). Socio-demographically, maternal education level significantly affected digital screen exposure; children of mothers with a university degree had statistically lower digital screen exposure (p = 0.001). While total digital screen exposure did not differ by chronotype, a stronger positive correlation between digital screen exposure and the SDB subdomain was observed in children with an evening chronotype (rho = 0.363; p = 0.045). Conclusion: These findings indicate that increased digital screen exposure significantly, but only weakly/ moderately, associated with increased the severity of sleep disorders in CWE. Maternal education level and individual chronotype differences play a critical role in managing this negative relationship and identifying at-risk groups. Clinicians should develop personalized intervention programs regarding digital screen exposure, particularly for families with children who have low educational levels and are biologically at risk (evening chronotype).
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    Increased cortical activation in dizziness: Neural compensation or maladaptive load?
    (Elsevier, 2026) Yucel, Gul; Ekici, Nur Yucel
    [No abstract available]
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    Integrating the postictal state into clinical practice and patient education
    (Wiley, 2026) Yucel, Gul; Ekici, Nur Yucel
    [No abstract available]
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    Knowledge and Self-Efficacy Levels of Family Physicians on Epilepsy Management in Türkiye: Pre-and Post-Education Evaluation
    (Kare Publ, 2025) Yucel, Gul; Tetik, Burcu Kayhan; Arslan, Ahmet Kadir; Kucuk, Yusuf
    Objectives: Family physicians (FPs) are directly responsible for the care of people with epilepsy. However, their education about epilepsy may be inadequate or lacking. The aim of this study was to assess the basic knowledge and self-efficacy levels regarding epilepsy among FPs and to identify their educational needs in managing epilepsy. Methods: The sample for this pre-test-intervention-post-test study consisted of 60 FPs. FPs attended a four-hour training on epilepsy management. The effectiveness of the training was assessed with the Epilepsy Knowledge and Self-Efficacy (EKSE) scale before and after the training. In addition, a survey was conducted to determine the problems encountered in the follow-up of epilepsy patients and their training needs. Results: 60 physicians participated in the study [37 males (61.7%), mean age 37.97 +/- 8.92 years and professional duration 80.48 +/- 70.59 months]. While the total EKSE score of FPs was 90.23 +/- 10.97 before the training, it increased to 112.3 +/- 15.26 points after the training (p<0.001). After the training, significant score increases were observed in all subcomponents of the EKSE compared to before the training. After the training, there was a significant improvement in the physicians' ability to recognize diseases accompanying epilepsy, to have sufficient knowledge about antiseizure medications, and to follow up patients with epilepsy compared to before the training (p<0.001, p=0.001, and p=0.002, respectively). Conclusion: This study demonstrated that FPs have need for education regarding epilepsy management and that the education provided has a positive impact.
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    Letter regarding the article The impact of intraventricular hemorrhage on brainstem auditory function in preterm babies
    (Elsevier, 2025) Yucel, Gul; Ekici, Nur Yucel
    [No abstract available]
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    Microstructural White Matter Alterations in Pediatric Idiopathic Intracranial Hypertension: A Diffusion Tensor Imaging Study
    (Mdpi, 2025) Ozgor, Bilge; Ayvaz, Huseyin; Tan, Mahir; Demiroz Tasolar, Sevgi; Yucel, Gul; Bicakcioglu, Isinsu; Gungor, Serdal
    Highlights What are the main findings? Fractional anisotropy values in the optic radiation and posterior limb of the internal capsule were significantly reduced in pediatric idiopathic intracranial hypertension, indicating microstructural white matter alterations detectable by diffusion tensor imaging. DTI metrics-particularly FA-demonstrated strong discriminative accuracy (AUC = 0.83) for distinguishing affected patients from healthy controls, outperforming conventional MRI markers. What are the implications of the main findings? DTI may serve as a complementary tool to conventional MRI in the diagnostic evaluation of pediatric IIH, providing quantitative insights into pressure-related white matter changes. These findings suggest that advanced diffusion imaging could aid early detection and monitoring of intracranial pressure-related alterations, warranting validation in larger, prospective pediatric cohorts.Highlights What are the main findings? Fractional anisotropy values in the optic radiation and posterior limb of the internal capsule were significantly reduced in pediatric idiopathic intracranial hypertension, indicating microstructural white matter alterations detectable by diffusion tensor imaging. DTI metrics-particularly FA-demonstrated strong discriminative accuracy (AUC = 0.83) for distinguishing affected patients from healthy controls, outperforming conventional MRI markers. What are the implications of the main findings? DTI may serve as a complementary tool to conventional MRI in the diagnostic evaluation of pediatric IIH, providing quantitative insights into pressure-related white matter changes. These findings suggest that advanced diffusion imaging could aid early detection and monitoring of intracranial pressure-related alterations, warranting validation in larger, prospective pediatric cohorts.Abstract Background/Objectives: Idiopathic intracranial hypertension (IIH) is an uncommon but clinically important cause of elevated intracranial pressure in children. Conventional MRI findings such as perioptic subarachnoid space (SAS) distension and posterior globe flattening are helpful but may lack sensitivity or specificity in certain cases. Diffusion tensor imaging (DTI), which quantifies white matter microstructure through metrics such as fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), offers additional diagnostic potential, yet its role in pediatric IIH remains insufficiently defined. Methods: This retrospective case-control study included 26 pediatric patients with IIH and 26 age- and sex-matched controls who underwent brain MRI with DTI between 2010 and 2025. DTI parameters were measured in major white matter tracts, and conventional MRI findings associated with raised intracranial pressure were recorded. Associations between DTI metrics and conventional imaging markers were analyzed using standardized statistical tests. Results: Children with IIH demonstrated significantly reduced FA and increased MD and RD values in several key white matter regions, particularly within the optic radiation, splenium of the corpus callosum, and posterior limb of the internal capsule. FA values showed a negative correlation with perioptic SAS width, while RD and MD were positively correlated with posterior globe flattening and empty sella grade. Receiver operating characteristic analysis identified FA in the optic radiation as the strongest discriminator between IIH and controls (AUC = 0.83). Inter-observer reliability for FA measurements was excellent (ICC = 0.91). Conclusions: Pediatric IIH appears to be associated with pressure-related microstructural alterations in white matter, detectable through DTI. Among the diffusion metrics, FA demonstrated the strongest diagnostic potential and may serve as a complementary tool to conventional MRI. Validation in larger, prospective pediatric cohorts is required to establish its clinical utility.
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    Pan-Immune Inflammation Value and Clinical Outcomes in Subacute Sclerosing Panencephalitis: A Retrospective Study
    (Mdpi, 2025) Ozgor, Bilge; Sahin, Murat Caglar; Bicakcioglu, Isinsu; Yucel, Gul; Karadag, Meral; Gungor, Serdal
    Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal neurological disorder caused by persistent measles virus infection. Reliable prognostic biomarkers remain limited. Systemic inflammation has been implicated in the pathogenesis of neuroinfectious diseases, and hematology-derived indices are increasingly recognized as accessible markers of inflammatory burden. This retrospective case-control study was conducted at & Idot;n & ouml;n & uuml; University Faculty of Medicine, Malatya, T & uuml;rkiye, between 2010 and 2025, including 40 pediatric patients with SSPE and 40 age- and sex-matched healthy controls. Demographic and laboratory data were retrieved from institutional records, and disease severity was classified according to Jabbour stages. Compared with controls, patients with SSPE had significantly higher pan-immune inflammation value (PIV: 710.5 [320-1050] vs. 280.0 [150-460], p < 0.001), systemic immune-inflammation index (SII: 640.0 [310-1240] vs. 410.0 [210-720], p = 0.02), and neutrophil-to-lymphocyte ratio (NLR: 2.1 [1.2-3.8] vs. 1.6 [1.0-2.5], p = 0.03), along with lower lymphocyte counts (p = 0.04). Elevated PIVs were strongly associated with advanced Jabbour stages, impaired ambulation, and a higher case-fatality ratio (35%). Multivariate regression identified PIV as an independent predictor of death (OR: 3.25, 95% CI: 1.45-7.28, p = 0.004), and receiver operating characteristic analysis demonstrated superior discriminative accuracy of PIV (AUC = 0.87) compared with other indices. These findings suggest that PIV, a simple and inexpensive biomarker derived from routine blood tests, may provide useful prognostic information in SSPE and aid early risk stratification. Further multicenter, prospective studies are warranted to validate its clinical utility.
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    Pan-immune-inflammation value as a predictor of loss of ambulation in duchenne muscular dystrophy: a retrospective cohort study
    (Bmc, 2026) Ozgor, Bilge; Bicakcioglu, Isinsu; Tan, Mahir; Yucel, Gul; Karadag, Meral; Gungor, Serdal
    Background Duchenne muscular dystrophy (DMD) is a progressive X-linked neuromuscular disorder marked by early functional decline and considerable variability in the timing of loss of ambulation (LOA). Readily accessible biomarkers to predict this decline remain limited. The pan-immune-inflammation value (PIV ), derived from routine blood counts, has been studied in various inflammatory conditions, but its relevance in DMD is not yet well defined. Methods This retrospective cohort study included 86 children and adolescents with genetically or biopsy-confirmed DMD followed between 2010 and 2025. Baseline neutrophil, lymphocyte, monocyte and platelet counts were used to calculate PIV and other systemic inflammation indices (NLR, PLR, MLR, SII, SIRI). Results Fifty-two patients (60.5%) experienced LOA during follow-up. Those who developed LOA had significantly higher neutrophil (4.6 +/- 1.8 vs. 3.4 +/- 1.2 & times; 10(9)/L, p = 0.001), monocyte (0.58 +/- 0.20 vs. 0.46 +/- 0.14 & times; 10(9)/L, p = 0.006) and platelet counts (351 +/- 82 vs. 308 +/- 65 & times; 10(9)/L, p = 0.02), along with lower lymphocyte counts (2.7 +/- 0.8 vs. 3.4 +/- 0.7 & times; 10(9)/L, p < 0.001). Median PIV was higher in the LOA group (312.5 [256-412] vs. 158.7 [106-209], p < 0.001). In ROC analysis, PIV showed the highest discriminative performance (AUC = 0.84; 95% CI, 0.76-0.91) compared with NLR, PLR, MLR, SII and SIRI. In multivariable Cox regression, PIV was independently associated with earlier LOA (HR = 1.42 per 100-unit increase; 95% CI, 1.18-1.72; p < 0.001). Age-stratified analyses suggested a stronger association between elevated PIV and earlier LOA in younger children (2-6 and 7-9 years; p = 0.006 and p = 0.018), whereas this association did not reach statistical significance in patients aged >= 10 years. Conclusion In this cohort, PIV was significantly associated with loss of ambulation and demonstrated higher discriminative performance than other hematologic inflammation indices. The observed age-dependent pattern suggests that elevated PIV at younger ages may be linked to early inflammatory activity relevant to disease progression. However, given the retrospective design, exploratory subgroup analyses, and the multifactorial nature of DMD, these findings should be interpreted with caution. PIV may represent an adjunctive and accessible marker or early risk stratification, but larger prospective studies with longitudinal inflammatory assessment are required to validate its prognostic value and clarify its role in clinical practice
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    Prediction of recurrent febrile seizures risk during the same febrile illness in children at a single tertiary centre in Turkiye
    (Bmj Publishing Group, 2025) Yucel, Gul; Arslan, Ahmet Kadir; Ozgor, Bilge; Gungor, Serdal
    Background This study aimed to develop a risk prediction model based on association rule mining to predict recurrent febrile seizures (RFS).Methods This is a retrospective observational study that examined the medical records of 105 children who were followed up with febrile seizure (FS) in a tertiary paediatric emergency department between October 2022 and December 2023. Children were divided into RFS and simple FS groups. RFS was defined as seizures occurring more than once within 24 hours of the first FS in the same febrile illness. Risk factors associated with RFS were determined by univariate and multivariate analyses. chi 2, Mann-Whitney U, receiver operating characteristics (ROC), multiple logistic regression and Classification Based on Association Rules Algorithm (CBA) analyses were applied to the dataset to obtain high-level outputs.Results RFS was detected in 32 out of 105 cases with FS (30.5%). Potential risk factors contributing to the development of RFS were seizure duration, number of recurrent seizures, family history, body temperature, time from fever onset to seizure, time from seizure onset to arrival at the emergency department, hyponatraemia, osmotic pressure and low haemoglobin level. The CBA algorithm obtained a total of 11 classification rules for the two patient groups. Additionally, the cut-off values obtained from CBA and ROC analysis showed satisfactory consistency. The CBA model achieved 97% overall accuracy classification performance.Conclusion The developed CBA model shows good predictive ability for RFS. The relevant model can be used as a risk estimation tool to identify children at risk of developing RFS.
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    Prognosis, Social Cognition, and Management Implications in Studies of Corpus Callosum Agenesis
    (Sage Publications Inc, 2025) Yucel, Gul; Ekici, Nur Yucel
    [No abstract available]
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    Risk factors for acute symptomatic seizure in children with cerebral sinovenous thrombosis: Experience from a tertiary center
    (Elsevier, 2024) Yucel, Gul; Arslan, Ahmet Kadir; Ozgor, Bilge; Sahin, Murat caglar; Oncul, Yurday; Tasolar, Sevgi Demiroz; Akyay, Arzu
    Objective: To investigate the risk factors for acute symptomatic seizure (ASS) in children with Cerebral Sinovenous Thrombosis (CSVT) and to evaluate the effect of ASS on outcome. Methods: Cross-sectional, single-center, hospital-based retrospective analysis of 42 children with neuroimagingconfirmed CSVT recorded between December 2009 and January 2023. ASS was defined as a seizure occurring within 7 days after CSVT. Predictors for ASS were analyzed by univariate and multivariate logistic regression. Functional outcomes were evaluated using the Pediatric Stroke Outcome Measure (PSOM). Results: The average age of the 42 patients included in the study sample was 105.36 +/- 63.1 months. Almost onethird (28.6 %) of patients with CSVT developed ASS. In univariate analysis, factors associated with seizure risk were young age, low Glasgow Coma Scale at admission, long hospital stay, headache, change of consciousness, focal neurological findings, cerebral hemorrhage, motor deficit and high D-dimer level (p=0.018, p<0.001, p= 0.016, p= 0.001, p=0.014, p<0.001, p<0.001, p=0.019 and p=0.013, respectively). In multivariate analysis young age, focal neurological findings and D-dimer levels were potential predictors of ASS (p=0.004, p=0.003, p=0.036, respectively). Receiver operating characteristic (ROC) analysis for D-dimer diagnostic accuracy in patients with CSVT revealed D-dimer > 498 ng/mL (AUC=0.743). In both cohorts, PSOM scores at last follow-up were worse in those with acute seizures compared to those without (p<0.001). Conclusion: Acute seizures occurred in approximately one-third of our cohort. Young age, focal neurological findings, and high D-dimer levels are potential predictors of ASS in children. Children with ASS had worse outcomes than those without.
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    Risk factors of disease severity and mechanical ventilation requirement in childhood Guillain-Barre Syndrome
    (Turkish J Pediatrics, 2024) Yucel, Gul; Arslan, Ahmet Kadir; Ozgor, Bilge; Gungor, Serdal
    Background. This study aimed to investigate the risk factors associated with the severity of the disease, the need for mechanical ventilation (MV) and poor prognosis in the early stages of Guillain-Barre Syndrome (GBS). Methods. Data of children who met GBS diagnostic criteria were evaluated retrospectively. The sample was divided into three binary subgroups according to severe GBS (Hughes Functional Grading Scale [HFGS] >= 4 at admission), mechanical ventilation (MV) requirement, and poor prognosis (inability to walk independently, HFGS >= 3 after six months). Various clinical, laboratory and electrophysiological parameters were compared between these subgroups. Results. The mean age of 63 children with GBS was 91.55 +/- 49.09 months. 13 (20.6%) patients required MV and 4 (6.3%) patients died. Associated risk factors for the need for MV in severe GBS were found to be autonomic dysfunction, bulbar palsy, sensory impairment, lowest total Medical Research Council (MRC) scale for muscle strength score at admission, high modified Erasmus GBS respiratory failure score (mEGRIS), high neutrophillymphocyte ratios (NLR) and high systemic immune-inflammation index (SII) values (p<0.001, p =0.003, p =0.033, p <0.001, p <0.001, p =0.037 and p =0.042, respectively). The lowest total MRC scale for muscle strength score at admission was a significant indicator of poor prognosis (p<0.001). Conclusions. Autonomic dysfunction, bulbar palsy, sensory impairment, lowest total MRC scale for muscle strength score at admission, high mEGRIS score, high NLR and SII values are potential risk factors for the need for MV in children with severe GBS. The lowest total MRC scale for muscle strength score at admission was associated with poor prognosis.