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AMAÇ: Bu çalýþma multipl skleroz hastalarýnýn umutsuzluk, depresyon ve yaþam doyumu düzeyini belirlemek amacýyla yapýlmýþtýr.
YÖNTEMLER: Çalýþmaya, bir üniversite hastanesinin nöroloji kliniðinde tedavi gören 65 multipl skleroz hastasý alýnmýþtýr. Bu tanýmlayýcý çalýþmada, araþtýrmacýlar tarafýndan geliþtirilen veri toplama formu, Beck Depresyon, Beck Umuzsuzluk ve Yaþam Doyumu Ölçeði kullanýlmýþtýr.
BULGULAR: Hastalarýn yarýya yakýný (%43.1) ciddi depresif semptomlar göstermektedir. Hastalarýn umutsuzluk ve yaþam doyumu düzeyleri ortadýr. Depresyon ve yaþam doyumu ölçek skorlarý ters iliþkilidir. Kadýn cinsiyet, düþük ekonomik düzey, yürümede zorluk ve yorgunluk gibi hasta özellikleri bozulmuþ yaþam doyumuna eþlik ederken; çocuk sahibi olma, düþük ekonomik ve eðitim düzeyi, inkontinans ve yorgunluk deneyimleme gibi deðiþkenler yüksek düzeyde depresif semptomlarla iliþkilidir.
SONUÇ: Hastalarýn çoðunluðu depresyondadýr; yaþam doyumu ve umutsuzluk düzeyleri ortadýr. Linear regresyon analizi eðitim ve duygusal problemin depresyon ölçeðini %42; ve ekonomik düzey ve duygusal problemin yaþam doyumunu %32 belirlediðini göstermiþtir.

OBJECTIVE: This study was carried out to determine the level of hopelessness, depression, and life satisfaction among patients with multiple sclerosis.
METHODS: 65 patients with multiple sclerosis, treated at the neurology clinic of a university hospital, were included in this study. In this descriptive study, a data collection form developed by the researchers, the Beck Depression Scale, and the Beck Hopelessness and Life Satisfaction Scale were used.
RESULTS: Almost half (43.1%) of the patients exhibited severe depressive symptoms. Patients’ hopelessness and life satisfaction levels were moderate. The scores on depression and life satisfaction scales were correlated negatively. While patients’ traits including female gender, low economic level, difficulties in walking, and fatigue were associated with reduced life satisfaction; variables such as having a child, low economic and education levels, experiencing incontinence, and fatigue were related to a higher level of depressive symptoms.
CONCLUSION: The majority of patients were depressed; life satisfaction and hopelessness levels were moderate. Linear regression analysis revealed that education and emotional problems determined 42% of the depression score; and economic level and emotional problems identified 32% of the life satisfaction score.

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AMAÇ: Bu çalýþmada kendi kendine subkutan immünmodülatuar enjeksiyon uygulayan hastalarda, enjeksiyon uygulama özelliklerinin ve enjeksiyon bölgesi reaksiyonlarýnýn incelenmesi amaçlanmýþtýr.
YÖNTEMLER: Çalýþmaya katýlmayý gönüllü olarak kabul eden 50 MS hastasý, araþtýrmanýn
örneklemini oluþturmuþtur. Araþtýrmada veriler literatüre dayalý olarak araþtýrmacýlar tarafýndan geliþtirilen veri toplama formu kullanýlarak toplanmýþtýr. Veriler bilgisayar ortamýnda, SPSS for Windows Ver. 15.0 paket programý ile deðerlendirilmiþ, tanýmlayýcý istatistik olarak; frekans, yüzdelik, ortalama ve standart sapma, istatistiksel olarak önemlilik deðerlendirilmesinde ise Ki-kare ve Mann-Whitney U testi kullanýlmýþtýr.

BULGULAR: Çalýþmamýzda hastalarýn %74’ü en az bir enjeksiyon bölgesi reaksiyonu bildirmiþtir. En sýk görülen enjeksiyon bölgesi reaksiyonlarý; aðrý ve kýzarýklýk olup, en az geliþen reaksiyonlar ise, apse ve lipoatrofidir. Enjeksiyon bölgesi reaksiyonu geliþme durumu ile enjeksiyon uygulama özellikleri, kullanýlan ilaç, ilacý kullanma süresi ve total enjeksiyon sayýsý arasýnda istatistiksel olarak anlamlý bir farklýlýk bulunmamýþtýr (p˃0.05). Ancak enjeksiyon bölgesi reaksiyonu geliþme durumu ile cinsiyet arasýnda istatistiksel olarak anlamlý bir farklýlýk bulunmuþtur (p˂0.05).
SONUÇ: Enjeksiyon uygulama özelliklerinin, enjeksiyon bölgesi reaksiyonlarý üzerinde etkili olmadýðý belirlenmiþtir. Kadýnlarda, erkeklere göre daha fazla enjeksiyon bölgesi reaksiyonu geliþmektedir.

OBJECTIVE: This study aims at examining the injection administration features of the patients with multiple sclerosis who self-administer subcutaneous immunomodulator injection and the injection site reactions they experience.
METHODS: AA total of 50 patients who fit the inclusion criteria of the study and volunteered to participate were included in the sample. The data were collected by a questionnaire which was developed by the researchers and based on the literature. The data were analyzed by SPSS 15.0 statistical program pack. Means, standard deviations, frequencies and percentages were calculated following the descriptive statistics. Chi-square test and Mann-Whitney U test were used to analyze the differences between some variables and the injection site reactions.
RESULTS: In our study, 74% of the patients have reported at least one injection site reaction. Pain and redness are among the most common injection site reactions and least developed reactions are abscess and lipoatrophy. No statistical difference was found between the development of the injection site reactions, and injection administration features, the type of the administered medications, the administration period of the medications, and the number of total injections (p˃0.05). A statistical significance was observed between the gender and the development of the injection site reactions (p˂0.05).
CONCLUSION: Injection administration features were not effective factors in terms of the injection site reactions. Injection site reactions were more common in women than in men.

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Daha çok Karadeniz bölgesinde üretilen ve halk arasýnda “deli bal” olarak bilinen balýn hipotansiyon, vertigo yaptýðý bilinmektedir. Bu çalýþmada bal yedikten sonra acil polikliniðimize arka sistem serebrovasküler hastalýk þeklinde semptom veren bir olgu sunulmuþtur.

The honey which is produced in the Karadeniz Region of Turkey and known as the “mad honey” causes hypotension and dizziness. We herein report a patient presented with mimic posterior cerebrovascular disease symptoms following mad honey ingestion.

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Gliomatozis serebri nadir görülen primer diffüz beyin tümörüdür. Beynin ikiden fazla lobunu tutan neoplastik glial hücrelerin diffüz proliferasyonu ile karakterizedir. Kesin taný için histopatolojik inceleme gereklidir. Geliþmiþ manyetik rezonans görüntüleme yöntemleri tümörün preoperatif tanýsýnda, evrelendirilmesinde ve tedavi sonrasý takiplerinde oldukça faydalýdýr. Bu makalede anaplazi gösteren gliomatozis serebri olgusu manyetik rezonans görüntüleme, difüzyon aðýrlýklý görüntüleme ve manyetik rezonans spektroskopi bulgularý eþliðinde sunulmuþtur. Ayrýca manyetik rezonans spektroskopinin gliomatozis serebri taný ve evrelemesindeki, rolü ve önemi deðerlendirilmiþtir.

Gliomatosis cerebri is a rare primary diffuse cerebral malignity. It is characterized by diffuse proliferation of neoplastic glial cells that involve one or more cerebral lobes. For definitive diagnosis histopathological examination is required. Advanced magnetic resonance imaging techniques are very useful in pretreatment diagnosis-staging and post-treatment follow-up. In this report a patient with gliomatozis cerebri was presented associated with the findings of magnetic resonance images, diffusion weighted images and magnetic resonance spectroscopy. Also the importance and role of magnetic resonance spectroscopy in the diagnosis and staging gliomatosis cerebri, was discussed.

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Spinal anestezinin bilenen en sýk komplikasyonu postdural ponksiyon baþaðrýsýdýr. Durada oluþan herhangi bir hasar baþaðrýsýna neden olmaktadýr. Duranýn zedelenmesi ile BOS sýzýntýsý meydana gelebilir ve gerilmeye baðlý olarak korteks ve dural sinüsler arasýndaki venlerin yýrtýlmasý sonucu subdural hematom görülebilir. Bu olgu ile doðum esnasýnda yapýlan spinal anestezi sonrasý geçmeyen baþaðrýsý olan hastayý sunarak nadir de olsa görülebilecek subdural hematom komplikasyonunu vurgulamayý amaçladýk.

The most common complication of spinal anesthesia is postdural puncture headache. Any injury of the dura may cause headache. After the injury of the dura, CSF leakage may occur and due to the tension of the veins between the cortex and the dural sinuses, subdural hematoma may be seen. Herein, we present a patient with persistent headache after the spinal anesthesia given during delivery of her baby, and emphasize a rare complication of spinal anesthesia which is subdural hematoma.

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Konjunktival kýzarýklýk ve göz yaþarmasýnýn eþlik ettiði unilateral kýsa süreli nevraljifom aðrýlar sendromu SUNCT olarak tanýmlanmýþtýr. Seyrek olarak bildirilmesine raðmen, sýklýðý olasýlýkla bilinenden daha yüksektir. Tedavisi de diðer yaygýn baþaðrýsý sendromlarýndan farklý olduðundan tanýnmasý önem taþýmaktadýr. Þimdiye kadar bildirilen vakalar birçok farklý ilaç ile tedavi edilmeye çalýþýlmýþtýr.

Biz burada 30 yaþýndaki nörolojik muayenesi, rutin kan tetkikleri ve görüntülemesi normal olan erkek hastayý sunduk. Hastamýz indometazin, gabapentin ve karbamazepin tedavilerine cevap vermemiþti. Bu vaka steroid ile tedavi edilen SUNCT hastalarýna bir örnektir.

Conjunctival injection and tearing with unilateral short lasting neuralgiform headache syndrome is called as SUNCT. Even though these headaches are reported seldomly, the prevalence is possibly higher than known. It is of importance to recognize these uncommon disorder, since its management differs from common primary headaches. Until today, it was reported to be treated with different types of drugs.

We here reported a 30 years old male patient with normal neurological examination, blood examination and neuroimaging. Our patient gave no response to indomethacin, gabapentine and carbamazepine treatments. This case is an example of SUNCT case treated with steroid.

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