Browsing by Author "Tombul, T."

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Acute Motor Axonal Neuropathy Cases in Van Region
(Comenius Univ, 2011) Sayin, R.; Tombul, T.; Gulec, T. C.; Anlar, O.; Akbayram, S.; Caksen, H.
Acute motor axonal neuropathy (AMAN) is a form of Guillain Barre Syndrome (GBS) seen in summer months in Northern China to cause epidemics. This form of the disease, which is also sporadically observed in other countries, constitutes less than 5 % of GBS in Western countries. It usually develops with motor findings. No sensory findings are observed. In some of the cases, the severe impairments in tissues improve however slowly and inadequately. In the motor conduction studies of cases with AMAN, motor action potential values are lowered. On needle electromyography (EMG), motor unit potential (MUP) activity is diminished with spontaneous denervation findings. Investigations were conducted on nerve conduction of patients with GBS aged from 1 to 77 years. AMAN was detected in 25 of these patients. In our investigation, AMAN as a GBS variant was detected in 39.7 % of the patients. The conduction velocities of motor nerves were in normal ranges whereas combined muscle action potentials were significantly lower. No F response could be obtained. Although AMAN is a rare variant of GBS and shows different clinical courses, it has been brought under intense scrutiny since there is high prevalence of acute inflammatory neuropathies in our region (Tab. 1, Ref. 7). Full Text in free PDF www.bmj.sk.
Adult-Onset Atypical Form of Hallervorden-Spatz Disease
(2013) Milanlioǧlu, A.; Ayin, M.N.; Gökgül, A.; Hamamci, M.; Tombul, T.
Hallervorden-Spatz syndrome is a rare neurodegenerative disease, resulting from mutation in the Pantothenate kinase-2 gene, and characterized by progressive pyramidal and extrapyramidal dysfunction, dementia, retinal degeneration and optic nerve atrophy. Clinical symptoms are related to abnormal iron deposition in the globus pallidus and substantia nigra. We present a case report of a 50-year old woman that was diagnosed as atypical Hallervorden-Spatz disease with dominant extrapyramidal symptoms and the lack of typical eye-of-the-tiger sign in brain MRI.
Association Between Endothelial Nitric Oxide Synthase Polymorphisms T786c and G894t and Ischaemic Stroke
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Cilingir, V.; Donder, A.; Milanlioğlu, A.; Yilgör, A.; Tombul, T.
Endothelial nitric oxide synthase (eNOS) gene polymorphisms are suspected to increase the risk of ischaemic stroke (IS). eNOS-synthesized NO regulates vascular tone and inhibits the progression of atherosclero sis. The present study aimed to determine the association between eNOS polymorphisms G894T and T786C and IS. Sixty acute IS patients (32 male, 28 female) were included and classified in accordance with the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Genotypes of patients with eNOS G894T and eNOS T786C polymorphisms were determined through polymerase chain reaction. Significant differences were observed in the distribution of eNOS T786C polymorphism among IS subgroups. The eNOS T786C polymorphism heterozygote (TC) and homozygote (CC) genotypes more frequent in patients in the large artery atherosclerosis (LAA) subgroup. Considering a dominant model of inheritance for eNOS T786C polymorphism, the risk of IS was higher for the LAA subgroup than for other IS subgroups. Among potential haplotypes, the eNOS 786C+ eNOS 894G haplotype was associated with an increased risk of LAA; however, this finding was not statistically significant. eNOS gene polymorphisms are suspected to increase the risk of ischaemic stroke. Our results suggest that the eNOS T786C gene polymorphism is associated with LAA in IS patients. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Association Between Insulin-Like Growth Factor-1 and Insulin-Like Growth Factor Binding Protein-3 Levels and Clinical Prognosis in Patients With Ischemic Stroke
(Turkish Society of Cerebrovascular Diseases, 2015) Yasar, H.; Tombul, T.; Milanlioglu, A.
Objective: Recent studies report that the insulin-like growth factor system may be involved in stroke pathogenesis, and is reported to increase myelination, maturation, cell proliferation and neuronal sprouting of the central nervous system.The aim of the present study is to demonstrate the role of insulin-like growth factor system in ischemic stroke pathogenesis and its association with the prognosis by investigating insulin-like growth factor-1 and insulin-like growth factor binding protein-3 levels in patients diagnosed with acute ischemic stroke. MATERIAL and METHODS: Sixty-eight patients and 20 healthy individuals were included to this study. Clinical evaluation of the patients was performed according to National Institute of Health Stroke Scale and functional outcomes were graded according to Modified Rankin Scale. Bamford classification was used for the clinical classification of ischemic strokes, and the TOAST system for etiological classification. Each patient's levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 were measured on the first, fifth and thirtieth day of ischemic stroke. RESULTS: Only the levels of insulin-like growth factor binding protein-3 on the day of 5 were significantly decreased compared to the control group. The decrease in IGF-1 values was associated with an increased risk of death and was accompanied by clinical worsening and decreased functionality. CONCLUSION: It has been concluded that the levels of investigating insulin-like growth factor-1 and insulin-like growth factor binding protein-3 may affect mortality risk, clinical condition and functionality outcomes in patients presenting with ischemic stroke, and further studies are needed for the investigation of different effects of insulin-like growth factor- 1 in future.
Brainstem Auditory-Evoked Potentials in Behcet's Disease and Neuro-Behcet Syndrome
(Springer Heidelberg, 2012) Tombul, T.; Gulec, T.; Akdeniz, N.
Cerebral Venous Sinus Thrombosis After Ovarian Hyperstimulation: Two Cases
(Wiley-blackwell, 2010) Tombul, T.; Cogen, E.
Characteristics of Patients With Nocturnal Dissociative Disorders
(2001) Aǧargün, M.Y.; Kara, H.; Özer, O.A.; Semiz, U.; Selvi, Y.; Kiran, U.; Tombul, T.
Frequency of nocturnal dissociative episodes (NDE) in patients with dissociative disorders (DD) was determined and clinical characteristics of patients with nocturnal dissociative disorders was compared with those DD only. Extensive overnight polysomnographic monitoring with nocturnal video-polysomnography was performed in 8 patients with NDE and 21 patients with DD only. We found a 27.5% prevalence of NDE in patients with DD. A clear transition from one personality to another was observed during sleep in 2 (about 7%) patients. Hallucinations, self-mutilating behaviors during sleep, and violent behavior during sleep were more common in the patients with NDE. Sleep may facilitate the transition from one personality to the other one. Patients with DD may use dissociation as a defense mechanism during sleep.
Clinical and Magnetic Resonance Imaging Findings of Siblings From a Turkish Family With Mother Diagnosed as Multiple Sclerosis: Case Report
(Sage Publications Ltd, 2006) Anlar, O.; Sayin, R.; Kayan, M.; Tombul, T.; Unal, O.
Clinical Presentation and the Efficacy of Antiepileptic Therapy in the Patients With Partial and Generalized Epilepsy
(2011) Sayin, R.; Tombul, T.; Anlar, O.; Caksen, H.
Epilepsy is an abnormal recurrent disease, resulting from various disorders of central nervous system. In this study, we aimed to compare the patients in terms of therapeutic efficiency. We enrolled a total of 106 patients in the study and of them, 45 were male and 61 were female, aged between 2 to 52 years. Of these patients, 69 (65%) had partial and 37 (35%) had generalized seizures. Seventy three patients were being treated with monotherapy and 33 patients were being treated with polytherapy. The number of the patients that were taking monotherapy was higher in the pediatric group (age, 0 to 16) compared to adult group (age, above 16). In the study, we tried to express the importance of monotherapy in the pediatric patients, the higher number of the pathologies that can be detected using an imaging method in the patients with partial epilepsy compared to that of generalized epilepsy, and the most frequent occurrence of therapeutic resistance in the partial epilepsies, ©2011 Academic Journals.
Coping Strategies and Profile of Mood States in Patients With Multiple Sclerosis
(Sage Publications Ltd, 2013) Milanlioglu, A.; Ozdemir, P. Guzel; Cilingir, V.; Aydin, M. N.; Tombul, T.
Dyke-Davidoff Syndrome With Cerebral Hypometabolism and Unique Crossed Cerebellar Diaschisis in 18f-Fdg Pet/Ct
(2015) Demir, Y.; Sürücü, E.; Çilingir, V.; Bulut, M.D.; Tombul, T.
A 23-year-old man with Dyke-Davidoff-Masson syndrome (DDMS) was admitted to the hospital with increasing frequency of epileptic seizures. Physical examination revealed mental retardation, left facial asymmetry, and left-sided spastic hemiparesis. Dysdiadochokinesia on the left upper limb was detected, and there was no dysmetria. MRI confirmed the well-known radiological features of DDMS. PET/CT demonstrated cerebral and contralateral cerebellar hypometabolism. We present DDMS with crossed cerebellar diaschisis, which was demonstrated by PET/CT.
Effects of Illness Activity on Electrocardiographic Parameters in Patients With Multiple Sclerosis
(Elsevier Ireland Ltd, 2011) Gumrukcuoglu, H. A.; Tuncer, M.; Simsek, H.; Sahin, M.; Akdag, S.; Gunes, Y.; Tombul, T.
Evaluation of Patients With Cerebral Venous Sinus Thrombosis
(Turkish Society of Cerebrovascular Diseases, 2014) Yilgör, A.; Tombul, T.; Milanlioǧlu, A.
OBJECTIVE: The aim of this article is to point out the etiology, risk factors, the rate of recanalization and mortality of cerebral venous sinus thrombosis patients. MATERIAL and METHODS: The current study was planned as retrospectively and fifty patients were included. All the patients were analyzed according to the clinical presentation, etiologic causes, risk factors, presence of MR lesion, the involvement of anatomic localization, recanalization and mortality. RESULTS: The most frequent risk factors of the cases were prothrombotic conditions (34%), pregnancy (14%) and puerperium (8%). The most frequent involvement was transverse sinus and secondly more than one sinüs thrombosis. As clinical application symptoms we detected headache (68%) and then focal neurologic deficiency (30%). On the other hand, at least 3 month's incidence rate of recanalization in the patients was 70.7%. Except for 2 cases that ended with death, the mortality of the cases was low. We could not find a significant association between risk factors and the presence of cerebral MR lesion or not (p=0.42) and also the presence of recanalization or not in the follow-up MR venography (p=0.625). CONCLUSION: We have concluded that, in the diagnosis and follow-up of cerebral venous sinus thrombosis, MR venography is the best method; through early diagnosis and proper treatment, the rate of recanalization will be fairly high and mortality will be low. In etiology, besides trombotic conditions, pregnancy and puerperium must be considered as one of the frequent risk factors.
Food-Borne Botulism Cases in Van Region in Eastern Turkey: Importance of Electromyography in the Diagnosis
(2003) Anlar, O.; Irmak, H.; Tombul, T.; Akdeniz, H.; Caksen, H.; Kose, D.; Ceylan, A.
Objectives: Food-borne botulism is an acute form of poisoning that results from ingestion of a toxin produced by Clostridium botulinum. Botulism toxin causes its major effect by blocking neuromuscular transmission in autonomic and motor nerve terminals. Methods: In this study, we present the features of eleven cases of food-borne botulism admitted to our hospital in 2001. All of the cases were caused by home-prepared foods; green beans. In these cases, the main symptoms and signs were generalized muscular weakness, dry mouth, dysphagia, dispnea and diplopia. Electrophysiological studies were performed on four patients. Results: Motor conduction studies showed that compound muscle action potentials were decreased with normal latencies and conduction velocities. The needle electromyography showed signs of denervation potentials like fibrillation and positive waves in four patients. Repetitive nerve stimulation with high frequency (20 Hz) induced an increment close to 100% in the amplitudes in 2 of 4 patients. Conclusion: Although toxin could not be detected in the patients, the electromyographic findings supported our diagnosis. We concluded that electromyography has an important role in diagnosis of botulism, especially in the condition that serologic tests are negative or cannot be performed.
Hoigne’s Syndrome Following the Injection of Repeating Benzathine Penicillin G: a Case Report
(Ondokuz Mayis Universitesi, 2018) Gönüllü, H.; Karadaş, S.; Aykaç, M.C.; Tombul, T.
Hoigne’s syndrome is characterized by the development of acute neuropsychiatric symptoms which are mainly panic-like anxiety state and conversive neurosis. We here report a 60-year-old man with Hoigne’s syndrome. Emergency physicians should always keep in mind Hoigne’s syndrome. © 2018 OMU
Impaired Heart Rate Variability as a Marker of Cardiovascular Autonomic Dysfunction in Multiple Sclerosis
(Blackwell Publishing, 2004) Tombul, T.; Anlar, O.; Tuncer, M.; Huseyinoglu, N.; Eryonucu, B.
Intravenous Aspirin Use in Migraine Attacks
(Turkish Society of Cerebrovascular Diseases, 2003) Anlar, Ö.; Tombul, T.; Kisli, M.
Aspirin is an efficient and cheap analgesic drug, which is used frequently. It is given orally in our country up to date. Use of aspirin intravenously in migraine headache has recently been tried and satisfying results were reported. Thirty-five patients with migraine attacks were admitted to emergency service. Twenty-three patients were treated by 900 mg Lysine acetylsalicylate (LASA)-equivalent of 500 mg aspirin intravenously (I.V). Twelve patients were treated by subcutaneous (S.C) injection of 6 mg sumatriptan. In the patients treated with LASA, the headache relieved clearly in 15 (62.5%) within 4-15 minutes. A moderate pain relief was obtained in 4 patients (17.4%) and there was slight improvement headache in 3 patients (13.1%). There was no response in one patient (4.3%). The pain was disappeared within 30-120 minutes in ten patients (83%) who were treated by sumatriptan. Sumatriptan was not beneficial in two patients (17%). Because of its rapid action and low cost, LASA I.V can be accepted as an effective therapy in migraine attacks treatment.
Ischemic Stroke in a Young Man With Mthfr A1298c and Ace I/D Polymorphism
(Turkish Society of Cerebrovascular Diseases, 2014) Çilingir, V.; Milanlioǧlu, A.; Tombul, T.
Ischemic stroke is a leading cause of death and disability worldwide. Mutations in several candidate genes involving angiotensin-converting enzyme (ACE) and methylenetetrahydrofolate reductase (MTHFR) gene have been found to be associated with ischemic stroke. This report describes the case of a 29 year-old man who presented with sudden onset left hemiparesis and hemihipoestesia. Magnetic resonance imaging investigations showed acute ischemic infarct in the right parietal region. Mutation analysis revealed homozygout MTHFR A1298C and ACE I/D polymorphisms and laboratory invastigations showed mild hyperhomocysteinemia. No other risk factor was detected for ischemic stroke etiology.
Rhythmic Tremor Artifact Mimicking Ictal Epileptiform Pattern on Eeg of Non-Epileptic Psychogenic Seizures
(Wiley-blackwell, 2012) Tombul, T.; Milanlioglu, A.
Venlafaxine Treatment in a Patient With Narcolepsy
(2002) Tombul, T.; Özbek, H.; Kara, H.; Kiran, Ü.; Özer, Ö.A.