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Öğe Atypical Sporadic Creutzfeldt-Jakob Disease Mimicking Nonconvulsive Status Epilepticus(Kare Publ, 2014) Uca, Ali Ulvi; Genc, Bulent Oguz; Guney, Figen; Akpinar, ZehraSporadic Creutzfeldt- Jakob disease (sCJD) is the most common disorder among the very rare prion diseases (human transmissible subacute spongiform encephalopathies). The diagnosis might be easy if a patient with characteristics features of myoclonus, progressive dementia and periodic electroencephalography activity. Diagnosis of some patients with unusual symptoms and signs may be challenging. The reported case is a 65 years old female patient who was finally diagnosed as CJD, after previously being misdiagnosed with depression, dementia and refractory nonconvulsive status epilepticus.Öğe A Case of Gelastic Epilepsy Associated with Tuberosclerosis: Where is the Lesion Corresponding to Electroencephalography?(Kare Publ, 2020) Turkmen, Nur; Genc, Bulent OguzGelastic seizures are typically associated with hypothalamic hamartoma. Given the rarity of gelastic seizures, pathways for the motor and emotional aspects of laughter have been hypothesized but remain unclear. Only few case reports of patients with tuberous sclerosis complex who developed gelastic epilepsy have been reported. In this case study, we report a case ofTS that presented itself mainly with dermatologic manifestations and without any neurological findings other than gelastic seizures. Ictal EEG revealed an active epileptic activity on the right fronto-temporal region. Clinical and laboratory findings were consistent with gelastic epilepsy that originated from temporal and extra -tem-poral lobes. Seizures were controlled using carbamazepine and levetiracetam polytherapy. In our case, there is no evidence of cortical and subcortical tubers, subependymal glial nodules, giant cell astrocytomas or aneurysm.Öğe A Case of Gelastic Epilepsy Associated with Tuberosclerosis: Where is the Lesion Corresponding to Electroencephalography?(Kare Publ, 2020) Turkmen, Nur; Genc, Bulent OguzGelastic seizures are typically associated with hypothalamic hamartoma. Given the rarity of gelastic seizures, pathways for the motor and emotional aspects of laughter have been hypothesized but remain unclear. Only few case reports of patients with tuberous sclerosis complex who developed gelastic epilepsy have been reported. In this case study, we report a case ofTS that presented itself mainly with dermatologic manifestations and without any neurological findings other than gelastic seizures. Ictal EEG revealed an active epileptic activity on the right fronto-temporal region. Clinical and laboratory findings were consistent with gelastic epilepsy that originated from temporal and extra -tem-poral lobes. Seizures were controlled using carbamazepine and levetiracetam polytherapy. In our case, there is no evidence of cortical and subcortical tubers, subependymal glial nodules, giant cell astrocytomas or aneurysm.Öğe Efficacy, tolerability, and retention rates of zonisamide in older adult patients with focal-onset epilepsy: Experiences from two tertiary epilepsy centers(Academic Press Inc Elsevier Science, 2017) Dogan, Ebru Apaydin; Genc, Emine; Genc, Bulent Oguz; Erdogan, CaglaObjective: The objective of this study was to evaluate the efficacy, tolerability, and retention rates for zonisamide (ZNS) in older adult patients with focal-onset epilepsy. Patients and methods: Chart reviews of patients aged 60 years and older with focal-onset epilepsy treated with ZNS in two tertiary epilepsy centers were analyzed retrospectively. Results: Eighty-five patients (41 males, 44 females) aged over 60 years (range: 60-81) with focal-onset epilepsy treated with ZNS were identified; 55.3% of the patients (n = 47) were on monotherapy. The median and average doses of ZNS doses were 200 mg/day (range: 100-400) and 212.9 +/- 84.2 mg/day, respectively. With ZNS treatment, 67.1% of the patients (n = 57) were seizure-free for a median of 28 months (range: 10-56) whereas 20% (n = 17) of the patients had seizures that were unresponsive to ZNS treatment. Best seizure control was achieved in patients with poststroke epilepsy; seizure freedom was 80% in this subgroup. Overall retention rate was found to be 83.5%. There was no significant relation between receiving poly- or monotherapy and discontinuation of ZNS (p = 0.18). Thirty-two of the patients (37.6%) lost weight. Median weight loss was 8 kg (range: 2-16). There was no significant correlation between weight loss and the administered doses of ZNS (r = 0.34; p = 0.12). Conclusion: Despite limitations due to the retrospective design of the study, the results show that ZNS is a well-retained drug with high efficacy in older adult patients with epilepsy. (C) 2017 Elsevier Inc. All rights reserved.Öğe Electroencephalographic Findings in Patients with COVID-19: A Single-center Experience(Galenos Publ House, 2021) Turkmen, Nur; Bugrul, Ahmet; Genc, Bulent OguzObjective: Neurological manifestations associated with coronavirus disease-2019 (COVID-19) are broad and heterogeneous. Although the predominant clinical presentation is respiratory dysfunction, concerns have been raised about the neurological hallmarks. Many reports suggest some findings on electroencephalography (EEG) can be relevant to COVID-19. Materials and Methods: Patients with COVID-19 admitted to hospital and referred for EEG from March 1, 2020 to February 15, 2021, were retrospectively enrolled. When research databases were queried with the terms COVID-19 (ICD code:10: U07.3) and EEG, total number of patients obtained was 32. Number of patients excluded due to unconfirmed diagnose with COVID-19 was 12. Twenty adult patients with certain diagnose of COVID-19 who underwent 21-electrode routine EEG during the outbreak with neurological deterioration were identified. Results: Background abnormalities was evident in one of fourth patients (n=5, 25%). Mild diffuse slowing (n=3, 15%) and focal slowing (n=3, 15%) with left frontotemporal tendency (n=2, 10%) were observed. Epileptiform abnormalities and seizures were detected showing focal (n=4, 20%) or generalized onset (n=1, 5%). Conclusion: Here we performed a retrospective single-centre study to evaluate the electroencephalographic findings in patients diagnosed with COVID-19 since it remains unknown. it needs to be more clarified with increasing number of recordingsÖğe Epilepsy and Sex Hormones(Kare Publ, 2018) Genc, Emine; Genc, Bulent OguzThere is a mutual interaction between sex steroid hormones and epilepsy. Although female and male sex hormones and their metabolites access the brain via the blood brain barrier, they can also be synthesized de novo from cholesterol within the glia and neurones (neurosteroids). While estrogens enhance neuronal excitability, progesterone and its metabolites exert anticonvulsant effects. Testosterone, on the other hand, has a less consistent effect on seizure susceptibility, depending on the ratio of its conversion to estrogens. This paper focuses on the effects of neurosteroidal sex hormones on seizure susceptibility. Further study is required to identify the future role of their use in the treatment of epilepsy.Öğe Epilepsy and Sex Hormones(Kare Publ, 2018) Genc, Emine; Genc, Bulent OguzThere is a mutual interaction between sex steroid hormones and epilepsy. Although female and male sex hormones and their metabolites access the brain via the blood brain barrier, they can also be synthesized de novo from cholesterol within the glia and neurones (neurosteroids). While estrogens enhance neuronal excitability, progesterone and its metabolites exert anticonvulsant effects. Testosterone, on the other hand, has a less consistent effect on seizure susceptibility, depending on the ratio of its conversion to estrogens. This paper focuses on the effects of neurosteroidal sex hormones on seizure susceptibility. Further study is required to identify the future role of their use in the treatment of epilepsy.Öğe QT interval alterations in epilepsy: A thorough investigation between epilepsy subtypes(Elsevier Sci Ltd, 2022) Gurses, Asli Akyol; Genc, Emine; Gurses, Kadri Murat; Altiparmak, Taylan; Yildirim, Irem; Genc, Bulent OguzObjectives: Cardiac disturbances and rhythm abnormalities which potentially lead sudden unexpected death in epilepsy, have been extensively studied in focal epilepsies. However, studies including generalized epilepsies are scarce and it is not clear whether electrocardiogram parameters reflecting vulnerability to ventricular arrhythmias differ between these groups.Methods: Medical records of patients who were followed in epilepsy department of a tertiary center between October 2015 and September 2016 were retrospectively reviewed. 66 generalized and 64 focal epilepsy patients with eligible electrophysiological data were analyzed. QTc interval, QTcd and other electrocardiographic indices were compared between patients with focal vs generalized epilepsy. Another analysis was performed in order to disclose any difference between patients with epilepsy (n:130) and psychogenic non-epileptic seizures. A two-tailed p value < 0.05 was considered significant.Results: There was no difference in terms of QTc and QTcd between patients with focal and generalized epilepsy [median: 406 ms vs 404 ms, p = 0.119; and median: 46 ms vs 44 ms, p = 0.497, respectively]. However patients with epilepsy were found to have longer QTc and QTcd when compared to ones with psychogenic non-epileptic seizures (p = 0.035 and p < 0.001, respectively).Conclusion: Current findings demonstrate that patients with epilepsy have longer QTc and QTcd than patients with pure psychogenic non-epileptic seizures. Since there was no difference between patients with focal and generalized epilepsy; QTc interval, QTcd and potential susceptibility to cardiac arrhythmias as a result, could be a consequence of epilepsy itself regardless of origin.Öğe Sleep- Related Hypermotor Epilepsy: A Rare Case(Aves, 2022) Leba, Leyla Kose; Kenar, Safiye Gul; Genc, Bulent OguzSleep-related hypermotor epilepsy is a subgroup of sleep-related epilepsies and is very rare among focal epilepsies. It is a type of epilepsy that can be confused with the primary diseases of sleep and is diagnosed late. Here, we present a case diagnosed with elect roenc ephal ograp hy (video-EEG) monitoring 13 years later.
