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Türk Silahlý Kuvvetleri, Jandarma Genel Komutanlýðý ve Sahil Güvenlik Komutanlýðý mensubu olan personel, öðrenciler ve bunlarýn adaylarýnýn saðlýk yeteneklerini tespit etmek, Saðlýk Bakanlýðý hastanelerine devredilmiþtir. Saðlýk Bakanlýðý’na baðlý 162 hastane, bu kapsamda rapor vermeye yetkilendirilmiþtir. Öngörülemeyen bu hasta hacminin büyüklüðü ve en önemlisi de mevzuatýn bilinmemesi nedeniyle nöroloji uzmanlarý belirgin zorluk çekmektedirler. Yaklaþýk bir asýra dayanan süredir askeri sistem içerisinde yürütülen askeri saðlýk hizmetleri ve saðlýk kurulu iþlemlerinin Saðlýk Bakanlýðý’na devrinden sonra meslektaþlarýmýzýn karþýlaþabileceði sýkýntýlarý en aza indirmek amacýyla; nörolojik hastalýklar ile iliþkili özelliklerinden en sýk görülenleri, rapor örnekleriyle sunularak bu derleme kaleme alýnmýþtýr.

Determination of the health qualifications of personnel, students, and their candidates, who are members of the Turkish Armed Forces, the General Command of Gendarmerie and the Coast Guard Command has been transferred to Ministry of Health hospitals. One hundred sixty-two hospitals affiliated to the Ministry of Health were authorized to report in this context. The magnitude of this uncertain patient volume, and most importantly, the lack of awareness of the legislation has made the job particularly challenging for neurology specialists. In order to minimize the problems faced by our colleagues after the transfer of military health services and health board processes to the Ministry of Health, which has been performed for about a century in the military system, the most common features of neurologic diseases are presented with report samples.

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Amaç: Bu çalýþmanýn amacý; Erzincan ilinde epilepsi hastalarýnýn demografik ve klinik özelliklerini incelemektir.
Gereç ve Yöntem: Erzincan Üniversitesi Mengücek Gazi Eðitim ve Araþtýrma Hastanesi Nöroloji Polikliniði’ne Ocak 2016-Aðustos 2017 tarihleri arasýnda baþvuran yetiþkin 548 epilepsi hastasý dahil edildi. Hastalarýn yaþ, cinsiyet, epilepsi süresi, risk faktörleri, nöbet sýklýðý ve tipi, kullanýlan ilaç sayýsý, komorbid hastalýklar, elektroensefalografi (EEG) ve nörogörüntüleme sonuçlarý retrospektif olarak deðerlendirildi.
Bulgular: Hastanýn 283’ü erkek (%51,6), 265’i kadýn (%48,4) idi. Yaþ ortalamasý 40,64±17,9, ortalama hastalýk süresi 11±11 yýldýr. Hastalarýn %52,2’sinde epilepsi risk faktörleri saptandý. Hastalarýn %46,8’inde nörogörüntülemede, %48,2’sinde ise EEG’de patolojik bulgu saptandý. Hastalarýn %13’ü ayda birden fazla nöbet geçiriyordu. Hastalarýn %8,9’unda beþ yýldýr nöbetsizlik dönemi mevcuttu. Hastalarýn %54,8’inde fokal, %44,5’inde jeneralize baþlangýçlý nöbet türü mevcuttu. Hastalarýn %58,9’u monoterapi, %40,3’ü politerapi almaktaydý. Hastalarýn %27,7’sinde epilepsiye diðer hastalýklar eþlik etmekteydi. Cinsiyetler arasýnda epilepsi baþlangýç yaþý ve süresi, nöbet sýklýðý, kullanýlan ilaç sayýsý, psikiyatrik komorbidite, EEG’de ve nörogörüntülemede patolojik bulgularýn varlýðý açýsýndan anlamlý fark bulunmamýþtý (p>0,05). On sekiz yaþ ve üzeri epilepsi hastalarýnda nörogörüntülemede patolojik bulgu anlamlý olarak yüksekti (p=0,004). Ayný hastalarda EEG bozukluðu daha sýk saptanmýþtý (p=0,001). Epilepsi süresi, psikiyatrik semptomlarý olanlarda olmayanlara göre daha uzun (p=0,005), kullanýlan antiepileptik ilaç sayýsý daha fazlaydý (p=0,000).
Sonuç: Epilepsi birçok özelliði açýsýndan cinsiyet farký göstermemektedir. Eriþkin baþlangýçlý epilepsi hastalarýnda nörogörüntüleme ve EEG’de patolojik bulgulara sýk rastlanmaktadýr. Psikiyatrik hastalýklarýn eþlik etmesi epilepsinin daha uzun ve dirençli seyri ile iliþkilidir.

Objective: The aim of this study was to evaluatethe demographic and clinical findings of patients with epilepsy in Erzincan.
Materials and Methods: Five hundred forty-eight adult patients with epilepsy who were admitted to the neurology outpatient clinic between January 2016 and August 2017 were included in the study. Patients’ age, sex, duration of epilepsy, risk factors, seizure frequency and type, number of drugs used, comorbid diseases, electroencephalography (EEG), and neuroimaging results were evaluated retrospectively.
Results: Two hundred eighty-three patients were men (51.6%), 265 were women (48.4%). The mean age was 40.64±17.9 years, and the mean illness duration was 11±11 years. Risk factors of epilepsy were found in 52.2% of the patients. Pathologic findings in neuroimaging were found in 46.8% of patients, and 48.2% of patients had pathologic findings in EEG. Thirteen percent of patients had more than one seizure per month, 8.9% of patients had a seizure-free period for five years. Focal-onset seizures were present in 54.8% of patients and generalized- onset seizures were present in 44.5% of patients. monotherapy was received by 58.9% of the patients, and 40.3% of the patients received polytherapy. Epilepsy was accompanied by other diseases in 27.7% of the patients. There was no significant difference between the sexes in terms of age of onset and duration, seizure frequency, number of medications used, psychiatric comorbidity, the presence of pathologic findings in EEG, and neuroimaging (p>0.05). Patients with pathological findings in neuroimaging were significantly older than 18 years of age (p=0.004). Pathologic EEG findings were detected more frequently in the same patients (p=0.001). Patients with psychiatric symptoms had longer epilepsy duration (p=0.005), and the number of antiepileptic drugs used was higher (p<0.001).
Conclusion: Epilepsy does not show sex differences in terms of many features. In patients with adult-onset epilepsy, pathologic findings are common in neuroimaging and EEG. Comorbid psychiatric disorders are associated with a longer and more resistant course of epilepsy.

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Amaç: Akatizi ile huzursuz bacaklar sendromu (HBS) arasýnda klinik benzerlikler bulunmaktadýr. Bu nedenle, akatizideki beyin sapý ve rostral baðlantýlarýnýn fonksiyonel deðiþikliklerini HBS’ye kýyasla araþtýrmayý amaçladýk.
Gereç ve Yöntem: Akatizisi bulunan yedi hasta çalýþmaya dahil edildi. Ayrýca HBS tanýsý olan (n=14) hastalardan oluþmuþ bir grup ve saðlýklý gönüllülerden (n=39) oluþan bir kontrol grubu oluþturuldu. Tüm katýlýmcýlarda göz kýrpma refleksi (GKR), iþitsel irkilme refleksi (ÝÝR) ve somatosensoryal irkilme (SSÝ) refleksleri çalýþýldý. Yanýtlarýn baþlangýç latansý, uyarýlabilirliði, amplitüd, patern ve süreleri 3 grup arasýnda karþýlaþtýrýldý.
Bulgular: GKR’de bilateral R2 ve R2k yanýtlarýnýn ortalama baþlangýç latanslarý akatizi grubunda HBS hastalarýna ve saðlýklý bireylere göre daha uzundu. ÝÝR’de yanýtlarýn ortalama latanslarý gruplar arasýnda benzerdi. Toplam ÝÝR saptananlarýn oraný, akatizi ve HBS gruplarýnda saðlýklý bireylerle karþýlaþtýrýldýðýnda daha yüksekti ve bu fark sýnýrda anlamlý bulundu (p=0,047). Akatizi grubunda iþitme stimülasyonundan sonraki cevaplarýn süresi daha uzundu. SSÝ’nin varlýðý ve latansý her üç grup arasýnda da benzerdi.
Sonuç: Akatizi grubunda ÝÝR’de ortalama baþlangýç latanslarýnýn daha uzun ve uyarýlabilirliðin daha yüksek olmasý, bu hastalardaki hipodopaminerjik durum ile iliþkilidir. Bunun yaný sýra akatizide saptadýðýmýz uzun R2-GKR latanslar, bu yolakta gecikmiþ transmisyonunun varlýðýný, dolaylý olarak da yapýsal bir lezyon yokluðunda serotoninerjik yolaklarýn da akatizinin mekanizmasýnda yer aldýðýný düþündürmektedir. Akatizide, HBS’den farklý olarak serotoninerjik tutulumun bulgularý mevcutken, hipodopaminerjik bulgular HBS’li hastalarla oldukça benzerdir.

Objective: There are clinical similarities between akathisia and restless legs syndrome (RLS). Thus, we aimed to investigate the functional changes of the brainstem and its rostral connections in akathisia in comparison with RLS.
Materials and Methods: Seven patients with akathisia were included in the study. We also included a group of patients with RLS (n=14), and a control group was formed including healthy volunteers (n=39). Blink reflex (BR), auditory startle reflex (ASR), and somatosensory startle (SSS) reflexes were studied in all participants. Onset latency, probability of response, amplitude, pattern and duration of responses were compared between the 3 groups.
Results: Mean onset latencies of bilateral R2 and R2c were longer in the akathisia group compared with patients with RLS and healthy individuals. The mean latencies of responses after auditory stimulation were similar among the groups. The total ASR probability was higher in the akathisia and RLS groups compared with healthy subjects and this difference showed borderline significance (p=0.047). Duration of responses after auditory stimulation was longer in the akathisia group. Presence and latency of SSS were similar among the three groups.
Conclusion: Longer-onset latencies and the higher probability of ASR in the akathisia group suggest that there is a hypodopaminergic state in this group. On the other hand, the longer latencies of R2-BR in patients akathisia suggest a delayed transmission in its pathway, indirectly showing involvement of serotoninergic pathways in the absence of a structural lesion. Thus, in akathisia, there are findings suggestive of serotoninergic involvement, differing from RLS, whereas findings attributed to dopaminergic deficits were quite similar to patients with RLS.

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Amaç: Çalýþmada status epileptikus (SE) sonrasý immatür, matür ve adölesan sýçanlarda kognitif ve davranýþ deðiþiklikleri, nöronal hasar, gamma-amino bütirik asit-A (GABA-A) alfa 1 reseptör miktarýnýn yaþ baðýmlý olarak deðerlendirilmesi amaçlanmýþtýr.
Gereç ve Yöntem: Ýmmatür (17 gün), adölesan (45 gün) ve matür (150 gün) sýçanlarda pentilentetrazol (PTZ) ile SE oluþturuldu. Adölesan ve matür sýçanlara açýk alan ve morris su labirenti testi uygulandýktan sonra adölesan, matür ve immatür sýçanlarda histolojik incelemeler yapýlarak SE sonrasý nöronal hücre hasarýný deðerlendirmek amacýyla kaspaz ve kalpain aktivitesi, GABA A Alfa 1 reseptör miktarý deðerlendirilerek kontrol gruplarýyla karþýlaþtýrýldý.
Bulgular: SE sonrasý erken dönemde yapýlan hafýza, öðrenme ve belleði deðerlendiren davranýþsal testlerde gerek adölesan gerek matür deney grubunda kontrol grubuna nazaran istatistiksel anlamda farklýlýk izlenmedi. SE sonrasý matür sýçanlarda nekrotik morfolojide kalpain aracýlý nöronal hasar gözlenirken, adölesan ve yavru sýçanlarda kalpain aktivitesine rastlanmadý. Ýmmatür sýçanlarda SE sonrasý apoptotik morfolojide kaspaz aracýlý nöronal hasar bulgularý izlendi. SE sonrasý üç deney grubunda GABA-A alfa 1 reseptör sayýsý kontrol grubuna nazaran azalmýþ olup, azalma en fazla matür deney grubunda izlendi. GABA-A reseptör miktarý hippokampusta, kortekse nazaran daha fazla oranda azalmýþ olarak saptandý.
Sonuç: Bu çalýþma ile elde edilen veriler; PTZ ile indüklenen SE sonrasýnda erken dönemde öðrenme ve davranýþ fonksiyonlarý üzerine olumsuz bir etki görülmezken histolojik olarak nekrozun hakim olduðu kaspaz ve kalpain aracýlý nöronal hasara yol açmakta olduðunu, kalpain aracýlý hücre nekrozunun özellikle matür grupta görüldüðü ve kaspaz baðýmlý apoptotik morfolojilerin immatür sýçanlarda gözlendiðini ve GABA-A alfa 1 reseptör sayýsýnda yol açtýðý azalmanýn ise eriþkinde belirgin olduðunu göstermektedir. SE’ye baðlý hücre hasarýnýn yaþýn artmasýyla daha belirgin olduðu ve kalpain aracýlý hücre hasarýnýn yine matür grupta belirgin olarak gözlendiði ortaya koymaktadýr. SE’ye baðlý hücresel etkilenmenin kognisyon ve davranýþa ait uzun dönemdeki etkilerinin anlaþýlmasý için uzun süreli izlem çalýþmalarýna gereksinim vardýr.

Objective: In this study, we aimed to evaluate age-dependent cognitive and behavioral changes, neuronal damage, and the amount of gamma-aminobutyric acid-A (GABA-A) alpha 1 in immature, mature, and adolescant rats after status epilepticus (SE).
Materials and Methods: SE was induced in immature (17 days), adolescant (45 days), and mature (150 days) rats using pentylenetetrazole (PTZ). After SE, adolescant and mature rats underwent open field test and Morris water maze test. After behavioral tests, the animals were sacrificed and we performed histologic investigations on the immature, adolescant, and mature rats to assess neuronal cell damage (caspase and calpain activity) and amount of GABA-A alpha 1 receptor and compared them with a control group.
Results: There were no statistically significant differences between the control and experimental groups in behavioral tests in the early stage after SE. Calpain-mediated neuronal damage was observed in mature rats with necrotic morphology after SE, but this was not observed in adolescant and immature rats. Caspase-mediated neuronal damage was observed in immature rats with apoptotic morphology after SE. The amount of GABA-A alpha 1 receptor was decreased in the three experimental groups compared with the control groups. The decrease in GABA-A alpha 1 receptor amount was highest in the mature experimental group.The amount of GABA-A alpha 1 receptor in the hippocampus decreased to level higher than in the cortex.
Conclusion: This study show that there is no negative impact on learning and behavioral functions in the early stage after PTZ-induced SE, but histologically led to necrosis dominant calpain and caspase-mediated neuronal damage, calpain-mediated cell necrosis is seen particularly in the mature group and caspase-dependent apoptotic morphology observed in immature rats.The decreased of GABA-A alpha 1 receptor is highest in the adults. Our study supports that SE-induced cell damage is more pronounced with increased age, and calpain-mediated cell damage that can clearly be observed in the mature group. Long-term follow-up studies are needed to understand the long-term effect of SE-dependent neuronal damage on cognition and behavior.

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Amaç: Migren, iskemik inme ve bazý yapýsal beyin lezyonlarý geliþimi gibi vasküler risk faktörlerinde artýþ ile iliþkilendirilmektedir. Bununla birlikte bu iliþkinin patogenezi halen netleþmemiþtir. Kardiyak hastalýklar ve iskemik inme ile komorbidite gösterebilen migrenin bunlarla baðlantýsý, hem kalp hem de beyni etkileyen vasküler bir hastalýk olmasý þeklinde açýklanabilir. Bu çalýþmada, geleneksel vasküler risk faktörleri olmayan genç-eriþkin migren hastalarýnda mitral kapak prolapsusu (MVP) ile migren ve beyaz cevher hiperintensitesi (BCH) arasýndaki iliþki incelendi.
Gereç ve Yöntem: Bu retrospektif çalýþmaya 400 olgu alýndý (200 migren ve 200 saðlýklý kontrol; yaþ aralýðý 18-50 yaþ). Migren tanýsý Uluslararasý Baþ Aðrýsý Toplumu-2 kriterlerine göre kondu. Katýlýmcýlarýn bilinen vasküler risk faktörleri, enflamatuvar veya eþlikçi baþka hastalýklarý yoktu. Migrenli kiþiler ve saðlýklý kontrollere transtorasik ekokardiyografi yapýlarak MVP varlýðý; beyin manyetik rezonans görüntüleme yapýlarak BCH olup olmadýðý tarandý.
Bulgular: Migrenli kiþilerde MVP prevelansý, kontrollere göre anlamlý yüksek (p<0,011) bulundu. Migrenli kiþilerde MVP varlýðý odds oraný (OR): 2,44 [%95 güven aralýðý (GA): 1,25-4,74; p=0,0086] saptandý. Migrenli kiþiler ve kontrol grubu BCH varlýðý açýsýndan karþýlaþtýrýldýðýnda OR oraný 5,88 (%95 GA: 3,42-10,10; p<0,001) bulundu. Karýþtýrýcý faktörlere göre uyarlandýktan sonra yapýlan çoklu doðrusal regresyon analizleri migrenin, MVP (p=0,044), triküspid yetmezliði (p=0,03) ve BCH varlýðý (p<0,001) ile baðýmsýz, pozitif korele olduðu; migrenin ve mitral yetmezliðin BCH açýsýndan baðýmsýz, pozitif korelasyon gösterdiði gözlendi (p<0,05, p<0,001).
Sonuç: MVP varlýðý, kontrollerle karþýlaþtýrýldýðýnda migren ile baðýmsýz iliþkili bulundu. Bu nedenle MVP varlýðýnýn, migren ile iliþkili olabileceði düþünüldü. Bununla birlikte, MVP ile BCH arasýnda pozitif bir korelasyon bulunamadýðý için MVP’nin, migrenli olgularda BCH geliþimine bir katkýsý olmadýðý düþünüldü.

Objective: Migraine is linked with an elevation in vascular risk factors, ischemic stroke, and a variety of constitutional brain lesions. However, the pathogenesis of this relationship is still inexplicit. The link between cardiac diseases and comorbid migraine-ischemic stroke might be a vascular disease involving both heart and brain. In this study, an association between mitral valve prolapse (MVP), migraine, and the presence of brain white matter hyperintensities (WMHs) were evaluated among adult subjects with migraine headache devoid of any traditional vascular risk factors.
Materials and Methods: Four hundred subjects (200 subjects with migraine headache, 200 healthy controls; age range 18-50 years) were incorporated in the retrospective study. Existence of a headache compatible with migraine was diagnosed according to the International Headache Society-2 criteria. The participants were devoid of any known comorbid diseases, vascular risk factors or inflammatory diseases. All patients, both those with migraine and controls were screened with echocardiography to assess for MVP and with brain magnetic resonance imaging to evaluate the presence of any WMHs.
Results: The prevalence of MVP was found to be higher in the migraine group (p<0.011). The odds ratio (OR) for the presence of MVP in patients with migraine compared with controls was 2.44 [95% confidence interval (CI): 1.25-4.74; p=0.0086]. The OR for the presence of WMHs in patients with migraine compared with controls was 5.88 (95% CI: 3.42-10.10; p<0.0001). After modifying for confounding factors, multiple linear regression analyses revealed that migraine was independently and positively associated with MVP (p=0.044), tricuspid regurgitation (p=0.003), and WMHs (p<0.001), and mitral regurgitation and migraine was independently and positively connected with WMHs (p<0.005 and p<0.001, respectively).
Conclusion: MVP is found to be independently associated with migraine when compared with controls. Therefore, we suggest that MVP might have an association with migraine. Nevertheless, we could not demonstrate any correlation between MVP and WMHs. Hence, we suggest that MVP might not be involved in the evolution of WMHs in migraine.

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Sifiliz, Treponema pallidum’a baðlý olarak geliþen bir spiroket hastalýðýdýr. Cinsel yolla bulaþabilir ve anneden bebeðe diklemesine geçebilir. Nörolojik tutulum daha çok geç dönemde görülür. Yaygýn antibiyotik kullanýmý hastalýðýn doðal seyrini deðiþtirebilir. Bu nedenle sifiliz farklý nörolojik bulgular ile ortaya çýkabilir. Kýrk dokuz yaþýnda erkek hasta iki aydýr dalgalanma gösteren çift görme ve sol göz kapaðýnda düþüklük þikayeti ile baþvurdu. Nörolojik muayenesinde; pupiller mid-dilate idi. Bilateral direkt ve indirekt pupil ýþýk cevabý alýnamýyordu. Sol gözde tüm yönlere ve sað gözde sadece saða bakýþta hareket kýsýtlýlýðý vardý. Ayný zamanda bilateral pitozu olduðu görüldü. Beyin manyetik rezonans görüntüleme ve repetetif uyarým dahil elektrofizyolojik incelemeler normaldi. Kan ve beyin omurilik sývýsý (BOS) incelemeleri sonucunda sifiliz tanýsý konuldu. Uzun süre yüksek doz intravenöz penisilin tedavisi uygulandý. Oküler bulgular geç dönem nörosifilizin önemli bir göstergesidir. Hastalýðýn primer etkisi ile meydana gelen oküler tutulum oldukça nadirdir. Eðer menenjite baðlý BOS absorbsiyon bozukluðu geliþirse, göz hareket bozukluðu ve pupil anormallikleri görülebilir. Nörosifilizin tanýsý farklý klinik görünümleri nedeni ile gecikebilmektedir. Oküler bulgular varlýðýnda nörosifiliz tanýsý da akla gelmelidir.

Syphilis is a spirochete disease that occurs due to Treponema pallidum infection. It can be sexually transmitted and can be transmitted from mother to baby vertically. Neurological involvement is more common in the late period. The use of common antibiotics may alter the natural course of the disease. Because of this, syphilis may present with different neurological findings. A 49-year-old male patient was admitted to our clinic with complaints of fluctuating double vision and droopy left eyelid for two months. In the neurological examination, pupils were mid-dilated, direct and indirect pupillary light reflexes were bilaterally absent, movements of the left eye in all directions and rightward movement of the right eye were restricted. Also, bilateral ptosis was detected. Brain magnetic resonance imaging and electrophysiological studies including repetitive stimulation were normal. Syphilis was diagnosed with blood and cerebrospinal fluid (CSF) tests. He was treated with long-term high-dose intravenous penicillin. Ocular findings are an important indicator of neurosyphilis. Ocular involvement due to primary disease process is rare. If meningitis-related CSF absorption defect develops, eye movement disorders and pupil abnormalities may occur. The diagnosis of neurosyphilis may be delayed due to different clinical manifestations. Neurosyphilis should be considered in case of ocular findings.

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Lyme hastalýðý (LH), kene ýsýrýðý ile bulaþan, etkeni spiroket Borrelia burgdorferi olan, deri, kas iskelet sistemi, kardiyovasküler sistem ve sinir sistemini tutan bir hastalýktýr. Sinir sistemi tutulumu tedavi edilmemiþ olgularýn %12-15’inde görülür. Kuzey Amerika ve Kuzey Avrupa’da endemik olarak bulunur. Endemik sayýldýðý bir bölgede, hatýrlanan kene ýsýrýðý varsa, tipik lezyon görülüyorsa taný koymak kolay olsa da; Türkiye gibi endemik olmayan bölgelerde akla gelmesi zor bir tanýdýr. Türkiye’de LH’nin görülmediðine dair genel bir kaný olmasýndan ve LH’nin taklitçi doðasý nedeniyle bu olgularýn tanýsý konamayabilir. Bu yazýda bacaklarýnda aðrý ve güçsüzlük nedeniyle kliniðimize baþvuran ve nöroborelyoz tanýsý konan bir olgu sunulup literatür bilgisi eþliðinde olgumuz tartýþýlacaktýr.

Lyme disease (LD) is a tick-borne multisystem disease caused by infection with the spirochete Borrelia burgdorferi. LD is associated with numerous neurologic, rheumatologic, and cardiac manifestations. Neurologic manifestations are seen in 12-15% of untreated patients. LD is endemic in North America and Northern Europe. It is easy to diagnose LD in an endemic area if tick bite is recognized and the typical lesion erythema migrans is seen; however, it is a diagnostic challenge if the typical lesion is not seen in a country in which LD is not endemic. These cases may be underdiagnosed in Turkey because of the imitator nature of the disease and the belief that LD does not exist in Turkey. We report a patient who presented with acute asymmetrical paraparesis and was diagnosed and treated as having LD and discuss our case accompanied a literature review.

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SUNCT/SUNA nadir görülen, þiddetli, nevraljiform karakterde, frekansý yüksek, çoðu zaman primer bir baþ aðrýsý türüdür. Görülme zamanýna göre epizodik ve kronik form olarak ayrýlmaktadýr. Atak zamanýnda hastanýn günlük yaþamýný oral beslenemeyecek kadar etkileyebilmektedir. Bu nedenle özellikle atak döneminde hastanýn aðrýsýnýn hýzla giderilmesi önemlidir. Biz burada günlük yaþamý aðrý nedeniyle oldukça etkilenmiþ atak dönemindeki bir hastada intravenöz lidokain ile elde edilen uzamýþ remisyonu göstermeyi amaçladýk.

SUNCT/SUNA are rare, severe, neuralgiform headaches with high frequency. They are often considered as a primary headache type. It is called episodic or chronic according to the peridiocity. At the time of attack, it can affect the daily life of the patient such that it can keep the patient from oral feeding. Therefore, it is specifically important to relieve the pain of the patient during the headache episode. Here, we present a patient treated with IV lidocaine during an acute episode that gained sustained remission.

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