Browsing by Author "Anlar, Ö"

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Bilateral Brachial Plexopathy Complicating Henoch-Schonlein Purpura
(Elsevier Science Bv, 2006) Yilmaz, C; Çaksen, H; Arslan, S; Anlar, Ö; Atas, B; Güven, AS; Odabas, D
An 11-year-old boy presented with convulsion, fever, rash, abdominal pain, swelling on the eyelids, elbow and wrists, oliguria and hematuria. Based on the abnormal findings the patient was diagnosed with Henoch-Schonlein purpura. On the 3rd day of admission, neurological examination showed ataxic gait, loss of deep tendon reflexes, and decreased (4/5) of muscle strength on all extremities. Additionally, bilateral loss of touch, pain and temperature sensation in a glove, from the elbows to distal region (on C5-T1 level) was diagnosed. Cerebrospinal fluid examination and cranial magnetic resonance imaging (MRI) were normal. The patient was discharged with oral prednisolone on the 7th day of admission. One week after discharging from the hospital, he was re-admitted with vertigo and seizures. He was in coma. MRI of cranial, cervical and cervical plexus were normal. Electromyography showed severe bilateral brachial plexopathy. Prednisolone and intravenous immunglobulin (IVIG) therapy were given without significant improvement. He was discharged from the hospital on the 17th day of admission. On the second month of follow-up, a second cure of IVIG was given because of no clinical improvement. Now, he is on the 4th month of follow-up, unfortunately, no improvement was noted on his muscle strength and sensorial abnormalities on the upper extremities. (c) 2006 Elsevier B.V. All rights reserved.
A Case of Enteric Fever Presenting With Insidious Neuropsychiatric Manifestations
(Elsevier Science inc, 2004) Çaksen, H; Akbayram, S; Odabas, D; Anlar, Ö
A Case of Metastatic Spinal Ewing's Sarcoma Misdiagnosed as Brucellosis and Transverse Myelitis
(Springer-verlag Italia Srl, 2004) Çaksen, H; Odabas, D; Demirtas, M; Kiymaz, N; Anlar, Ö; Ünal, Ö; Ugras, S
An 11-year-old girl was admitted with back pain for 2 months, inability to walk for 15 days, and enuresis and encopresis for 2 days. She had been hospitalized with the diagnosis of brucellosis in another hospital. At presentation, she had paraplegia, sphincter dysfunction, and bilateral sensory loss below the T6 level, and was initially diagnosed with transverse myelitis caused by brucellosis. On the third day of hospitalization, however, agglutination test for brucella was negative, but it was positive for Salmonella. Therefore, transverse myelitis was considered to be due to salmonellosis. Thoracic spine magnetic resonance imaging showed an extradural, paraspinal mass at the level of T6-T7. The mass was totally extracted, and histopathological examination revealed Ewing's sarcoma. During follow-up, no improvement in paraplegia was noted and an enlarged presacral decubital ulcer developed. Aside from supportive care, local radiotherapy was applied. Unfortunately, the patient died from probable infection 9 months after the diagnosis. We emphasize that metastatic spinal Ewing's sarcoma may mimic brucellosis and transverse myelitis in childhood.
Central Nervous System Brucellosis
(W B Saunders Co Ltd, 1998) Akdeniz, H; Irmak, H; Anlar, Ö; Demiröz, AP
Although neurological symptoms in brucellosis are frequent,, central nervous system (CNS) involvement is uncommon. Five patients with neurobrucellosis are presented. Three patients presented with meningoencephalitis, one with polyradiculoneuritis and one with myelitis and an eighth nerve palsy. All patients had lymphocytic pleocytosis, low glucose and elevated levels of protein in the cerebrospinal fluid (CSF). Gamma-globulin and IgG values in the CSF were also increased. Results of agglutination tests for Brucella in serum and CSF were positive for all patients, although titres were less in the CSF. Brucella melitensis was cultured from two patients. Treatment included concurrent administration of three of the following drugs: doxycycline, rifampicin, streptomycin, co-trimoxazole, ceftriaxone or ciprofloxacin. The three patients with meningoencephalitis fully recovered; the other two patients were left with minor disability.
Comparison of Epileptic and Nonepileptic Cases With Centrotemporal Spikes in View of Clinical Findings and Electroencephalographic Characteristics
(Taylor & Francis Ltd, 2006) Tombul, T; Anlar, Ö; Çaksen, H
The morphological features of centrotemporal spike discharges (CTSD) and relationship of them with clinical diagnosis in cases with benign epilepsy of childhood with centrotemporal spikes (BECTS) and the other epileptic syndromes of childhood as well as some nonconvulsive neurological disorders were detected in the routine patient population who referred to the authors' EEG laboratory. Thirty-six cases (21 males, 15 females; 8 months-14 years old), in which awake and/or sleep EEGs revealed CTSD were included in this study. The cases were divided into two groups as epileptic and nonepileptic. The cases with seizure were divided into BECTS and the other epilepsies. Of the epileptic cases, 14 (38.8%) patients had typical rolandic seizures. In five cases, there were partial or secondary generalized seizures. Two cases had myoclonic seizures. In the nonepileptic group, there was mental retardation/behavioral disturbances in five cases; there were periodic syndromes of childhood such as migraine and equivalents of migraine in three cases; febrile convulsion in three cases, breath-holding spells in two cases, and primary enuresis nocturna in two cases. In the nonepileptic group, the discharges were significantly fewer than the other groups (p = .014). More frequent discharges occuring for shorter periods were more significantly observed in BECTS group (64%). Typically isolated spike and slow-waves in T3/T4 and C3/C4 location were significantly more common (86%) in rolandic epilepsy group (p = .01). The EEGs of cases with BECTS had more frequency in the cluster of discharges than the other groups (p = .018). Multifocal discharges were observed in 28.5% of cases with BECTS, in 20% of nonepileptic group, and in 71.4% of other epileptics in the trial. Although these epileptic and nonepileptic conditions have some differences in view of frequency and morphology and location, CTSDs could be manifested in the group without seizure. It was concluded that the similar focal abnormalities which could be seen in rolandic epilepsy may be observed in the other epileptic or nonepileptic disorders of childhood and this condition may be originated from the involvement of similar central structures.
Congenital Cytomegalovirus Infection Associated With Finger Anomaly
(Blackwell Publishing Asia, 2002) Çaksen, H; Odaba, D; Anlar, Ö
Do Not Overlook Acute Isoniazid Poisoning in Children With Status Epilepticus
(B C decker inc, 2003) Çaksen, H; Odabas, D; Erol, M; Anlar, Ö; Tuncer, O; Atas, B
A previously healthy 2-year-old girl was admitted with generalized convulsive status epilepticus. She was in a stupor and could respond only to painful stimuli. She also had severe metabolic acidosis. Although initial liver function tests were nor-Mal, they were found to be moderately high on the fifth day of admission; however, they dropped to their normal ranges on the twelfth day of admission. Initially, the patient was diagnosed as having idiopathic status epilepticus, and classic anticonvulsant agents, including diazepam, phenytoin, and then phenobarbital, were given. However, her seizures did not subside, and diazepam infusion was initiated. After initiation of diazepam infusion, the seizures were completely controlled. On the fourth day of admission, her parents said that she had accidentally received 20 tablets (a total dose of 2000 mg) of isoniazid just before admission to our hospital. Later, we injected 200 mg of pyridoxine intravenously. During follow-up, her general condition improved, and anticonvulsant agents were discontinued because an electroencephalogram was found to be normal. She was discharged from the hospital on the twelfth day of admission. At the fourth month of follow-up, she was seizure free. Because of this case, we would like to re-emphasize that acute isoniazid poisoning should also be considered in a child with unexplained status epilepticus.
The Effect of Ginkgo Extract Egb761 in Cisplatin-Induced Peripheral Neuropathy in Mice
(Academic Press inc Elsevier Science, 2004) Öztürk, G; Anlar, Ö; Erdogan, E; Kösem, M; Özbek, H; Türker, A
Neuroprotective effect of Ginkgo biloba extract EGb761 in cisplatin (cis-diamminedi-chloroplatinum, or CDDP)-induced peripheral neuropathy was investigated. Swiss albino mice were treated with CDDP, 2 mg/kg ip twice a week for nine times. One group of the animals also received EGb761 in the drinking water at an estimated dosage of 100 mg/kg per day. Two other groups received vehicle (control) or EGb761 only. Development of neuropathy was evaluated with changes in sensory nerve conduction velocity (NCV). Following the treatments, dorsal root ganglia (DRGs) were microscopically examined and some were cultured for 3 days. EGb761 proved effective in preventing the reduction in NCV (P < 0.0001) caused by CDDP. CDDP caused a decrease in the number of migrating cells (P < 0.01) and in the length of outgrowing axons (P < 0.01) while EGb761 treatment prevented the latter. CDDP led to smaller nuclear and somatic sizes in neurons (P < 0.01), while with EGb761 co-administration, both were close to control values. Animals having EGb761 only had similar results with controls. In conclusion, EGb761 was found to be effective in preventing some functional and morphological deteriorations in CDDP-induced peripheral neuropathy. (C) 2004 Elsevier Inc. All rights reserved.
Effect of Leukemia Inhibitory Factor in Experimental Cisplatin Neuropathy in Mice
(Academic Press Ltd- Elsevier Science Ltd, 2005) Öztürk, G; Erdogan, E; Anlar, Ö; Kösem, M; Taspinar, M
In this study, the effect of leukemia inhibitory factor (LIF) on cisplatin (CDDP)-induced neuropathy was evaluated. Mice were treated with CDDP, 2 mg/kg i.p. twice a week nine times. During the last week some of the mice were also injected with LIF, 2 mug/kg s.c. every other day for a total of four injections. Development of neuropathy was evaluated with changes in tail flick latency and sensory nerve conduction velocity (NCV). At the end of the treatment period dorsal root ganglia (DRG) were microscopically examined. Some of the DRGs were explanted into extracellular matrix, covered with culture medium and incubated for 3 days. During and at the end of the incubation, cellular migration and axonal outgrowth from the DRGs were quantified. LIF proved effective in reversing the increase in tail flick latency (p < 0.05) and improving the reduction in NCV induced by CDDP. CDDP led to smaller nuclear and somatic size in neurons, while with LIF, the latter was restored to control values (p<0.01). No apoptotic nucleus was observed among DRG neurons while very few and moderate numbers detected among satellite and Schwann cells, respectively. With LIF, none of the cells had apoptosis. CDDP caused a decrease in the number of migrating cells and in the length of outgrowing axons while LIF treatment restored both capacities (p < 0.05) In conclusion, in CDDP-induced neuropathy, LIF was found to be effective in correcting some functional and morphological deteriorations related with major involvement of Schwann cells. (C) 2004 Elsevier Ltd. All rights reserved.
Left Hemisphere and Male Sex Dominance of Cerebral Hemiatrophy (dyke-Davidoff Syndrome)
(Elsevier Science inc, 2004) Ünal, Ö; Tombul, T; Cirak, B; Anlar, Ö; Incesu, L; Kayan, M
Although radiological findings of cerebral hemiatrophy (Dyke-Davidoff-Masson Syndrome) are well known, there is no systematic study about the gender and the affected side in this syndrome. Brain images in 26 patients (mean aged 11) with cerebral hemiatrophy were retrospectively reviewed. Nineteen patients (73.5%) were male and seven patients (26.5%) were female. Left hemisphere involvement was seen in 18 patients (69.2%) and right hemisphere involvement was seen in eight patients (30.8%). We conclude that male gender and left side involvement are frequent in cerebral hemiatrophy disease. (C) 2004 Elsevier Inc. All rights reserved.
Onset of Generalized Seizures After Intrathecal Interferon Therapy of Sspe
(Elsevier Science inc, 2003) Çaksen, H; Odabas, D; Anlar, Ö; Atas, B; Tuncer, O
An 11-year-old male was admitted with inability to walk and speech abnormality. He was diagnosed with subacute sclerosing panencephalitis on the basis of clinical and laboratory findings. Therapy with inosiplex (100 mg/kg/day orally) plus intrathecal interferon-alpha (3 million units/dose twice per week) and ribavirin (15 mg/kg/day orally) was initiated. Ribavirin was given orally because of a lack of parenteral form in our country. During, follow-up, he complained about fever and widespread body pains after intrathecal therapy. On the sixth month of follow-up, generalized tonic-clonic seizures, associated with high fever, and lasting approximately 1-2 minutes occurred about 6 hours after giving interferon-alpha. Four days after the first seizures, a similar seizure attack reoccurred after intrathecal IFN-alpha. An antiepileptic agent was not administered because electroencephalogram results did not indicate epileptic discharges. At the current time, he is in the ninth month of follow-up and remains seizure-free. In conclusion, our case demonstrated that standard dose intrathecal interferon-alpha might cause seizures in children. We think that this unfortunate condition was more common in subacute sclerosing panencephalitis children treated with intrathecal interferon-alpha (C) 2003 by Elsevier Inc. All rights reserved.
Report of a Turkish Child With Sjogren-Larsson Syndrome Associated With Peripheral Nerve Involvement
(Japanese dermatolgical Assoc, 2003) Akdeniz, N; Çalka, Ö; Anlar, Ö; Akbayram, S; Çaksen, H; Metin, A; Çinal, A
Sjogren-Larsson syndrome is a rare hereditary neurocutaneous disorder characterized by ichthyosis, spastic di- or tetra-plegia, and mild to moderate mental retardation. In this article, we present a nine-year-old girl with the classical features of the syndrome associated with peripheral nerve involvement because of its rare presentation. To the best of our knowledge, only three cases of Sjogren-Larsson syndrome with peripheral nerve involvement have been previously reported in the literature. We assume that Sjogren-Larsson syndrome involves extensive disorders of the ectodermal tissues, including the peripheral nerves as well as the skin and the central nervous system.
Severe Peripheral Polyneuropathy in a Child With Infective Endocarditis Caused by Staphylococcus Aueus
(Acta Medica Belgica, 2004) Çaksen, H; Üner, A; Arslan, S; Anlar, Ö; Odabas, D; Tosun, N; Akgün, C
Although central nervous system complications such as stroke, encephalopathy and meningitis are commonly described in Staphylococcus aureus endocarditis, peripheral nervous system involvement is rarely reported in the literature. In this article we report on a 13-year-old boy with infective endocarditis caused by Staphylococcus aureus in whom severe polyneuropathy developed during hospitalization. To the best of our knowledge this is the first child case with infective endocarditis associated with peripheral polyneuropathy in the literature.
Use of Biperiden Hydrochloride in a Child With Severe Dyskinesia Induced by Phenytoin
(B C decker inc, 2003) Çaksen, H; Odabas, D; Anlar, Ö
A 5-year-old girl was admitted with a 3-day history of speech disorder and gait abnormality She had been diagnosed with idiopathic epilepsy and was given phenytoin 2 months before admission to our hospital. On physical examination, she had severe lingual-facial-buccal extrapyramidal movements, slurred speech, and ataxic gait. During examination, she was repetitively scratching her scalp with her right hand every 30 to 60 seconds. Serum phenytoin level was 10 mug/mL (normal 8-20 mug/mL). Electroencephalography showed diffuse slow waves. Magnetic resonance imaging of the brain was normal. During hospitalization, her abnormal findings were thought to be attributable to phenytoin; it was immediately discontinued, and biperiden was initiated. After biperiden was administered, her abnormal movements markedly decreased; later, they almost completely disappeared. In conclusion, we would like to emphasize that severe dyskinesia can be observed during phenytoin therapy and that biperiden can be successfully used in the treatment of this unpleasant condition.
Variants and Deformities of Atlas Vertebrae in Eastern Anatolian People
(Saudi Med J, 2004) Kavakli, A; Aydinlioglu, A; Yesilyurt, H; Kus, I; Diyarbakirli, S; Erdem, S; Anlar, Ö
Objective: At the craniocervical junction, developmental anomalies of the atlas may produce clinical symptoms by compressing on the vertebral artery, particularly during extreme rotational movements of the cervical spine. The aim of the present study was to investigate several varieties and deformities of the atlas vertebra from the skeletal specimens of Eastern Anatolian people. Methods: This study was carried out over a 3-year period, 2000 through to 2002 in the Department of Anatomy, Firat, Yuzuncu Yil and Ataturk University, Turkey. Developmental anomalies and the variants of the first vertebrae were investigated on 86 atlas. Results: Ponticulus posterior was observed with a low frequency on right as 2.3%. The bilateral localization was 10.5% and the left-side localization was 9.3%. Ponticulus lateralis showed an equal localization as 1.2% on the right, 1.2% on the left and 1.2% bilateral. In the present study, a complete subdivision of the joint surface was observed in 11 atlases (12.8%). Processus infratransversarius atlantis with a frequency between 1.2-7%, arthrotic formation and corona atlantis peridentals in 8 cases (9.3%) were also found. Conclusion: The low frequency for fonticulus posterior might be peculiar to the population living in this area.