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Öğe The Alice in Wonderland Syndrome: A Case of Aura Accompanying Cluster Headache(2015) Uca, Ali Ulvi; Kozak, Hasan HüseyinBackground: Cluster headache (CH) is a primary headache which has highly specific and sensitive criteria, and notpresence of an aura. It has been recently reported that CH may not presence with aura more than ever and this condition will be identified by headache specialists as a new form of CH. Case Report: As there is no report to our knowledge on Alice in Wonderland syndrome (AIWS) manifest- ed as CH aura in the literature, we present a case of a 35-year-old man having AIWS as CH aura. Conclusion: Clinically, AIWS is not uncommon and is likely to be underestimated as a diagnostic entity. Val- proate may be preferred for treatment in CH patients with AIWS aura.Öğe Antidepressant-Induced Sleep Bruxism: Prevalence, Incidence, and Related Factors(Lippincott Williams & Wilkins, 2015) Uca, Ali Ulvi; Uguz, Faruk; Kozak, Hasan Huseyin; Gumus, Haluk; Aksoy, Fadime; Seyithanoglu, Abdullah; Kurt, Hatice GuncuObjective The relationship between sleep bruxism and antidepressant drugs in patients remains unclear. In this study, we aimed to investigate the incidence rate of antidepressant-related bruxism and to examine whether antidepressant use is associated with this adverse effect in the patients. Methods The study sample was gathered from 2 hospitals. A total of 807 patients who met the inclusion criteria were included in the study. The sample was divided into 2 groups: the antidepressant group (n = 506) and the control group (n = 301). Sleep bruxism was established with reports from the study participants on the basis of the International Classification of Sleep Disorders: Diagnosis and Coding Manual Second Edition. Results The prevalence of bruxism was significantly higher in the antidepressant group (24.3%) than in the control group (15.3%). The incidence of antidepressant-induced bruxism was 14.0%. The antidepressants most associated with bruxism were paroxetine, venlafaxine, and duloxetine. The patients experiencing antidepressant-induced bruxism had higher age compared with those who did not experience this adverse effect. Conclusions The results of the present study suggest that bruxism is frequently observed in women taking antidepressants and that it seems to be associated with antidepressant use at least in some patients.Öğe Anxiety, Mood, and Personality Disorders in Patients with Benign Paroxysmal Positional Vertigo(2018) Kozak, Hasan Hüseyin; Dündar, Mehmet Akif; Uca, Ali Ulvi; Uğuz, Faruk; Turgut, Keziban; Altaş, Mustafa; Aziz, Suhayb Kuria; Tekin, GoncaIntroduction: This study presents the current prevalence of anxiety,mood, and personality disorders as well as factors associated with theexistence of psychiatric disorders in patients with benign paroxysmalpositional vertigo (BPPV).Methods: The study sample comprised 46 patients with BPPV and 74control subjects. Anxiety and mood disorders were ascertained via theStructured Clinical Interview for the Diagnostic and Statistical Manual(DSM) of Mental Disorders, Fourth Edition/Clinical Version. Personalitydisorders were diagnosed via the Structured Clinical Interview for DSM,Revised Third Edition, Personality Disorders.Results: Of the 46 patients, 18 (39.1%) had at least one mood or anxietydisorder and 13 (28.3%) had at least one personality disorder. The mostcommon Axis I and Axis II disorders in the patient group were majordepression in 8 (17.4%) and obsessive–compulsive personality disorderin 10 (21.7%) patients, respectively. It was found that major depression(p0.021), generalized anxiety disorder (p0.026) and obsessive–compulsive personality disorder (p0.001) were more prevalent in theBPPV group compared with the control group.Conclusion: Results suggest that psychiatric disturbances should becarefully checked in patients with BPPV due to the relatively high rateof comorbidity.Öğe Association between Hemispheric Asymmetry and Horizontal Rapid Eye Movements during Rapid Eye Movement Sleep(2017) Uca, Ali Ulvi; Genç, Bülent Oğuz; Süleyman, İlhanAmaç: İnsanlarda REM uykusunda oluşan hızlı göz hareketlerinin (HGH) fonksiyonel önemi ve orijini tam anlaşılamamıştır. HGH'nin, REM uykusunda rüya görme ve merkezi sinir sistemi aktivasyonuyla eşzamanlı görülmesi ilginçtir. Bu çalışma; REM uykusunda oluşan horizontal hızlı göz hareketlerinin (HHGH) yöneliş-amplitüt-açısal değerlerini ölçmeyi, yaşla ilişkilerini, hızlı göz hareketlerinin temelindeki anatomik, fizyolojik mekanizmaları açıklamayı ve hemisferik asimetri kavramına katkı sağlamayı amaçlamaktadır. Yöntem: Yaşları 19-70 arasında değişen 25 denek bir gecelik spontan uyku esnasında standart prosedürler uygulanarak kayıtlandı. Bir gecelik REM periyodunda sağa ve sola HHGH dağılım analizi, HHGH açısal değerleri ve HHGH amplitüt ortalamaları karşılaştırıldı. Bulgular: Yapılan istatistiki değerlendirmeyle hemisferik bir asimetriyi gösterecek anlamlı bir sonuç elde edilmedi. Sonuç: REM uykusu, HGH ve rüya için dominant bir hemisfer göstermek mümkün gözükmemektedir. Çalışmaların bir kısmı sağ hemisfer bir kısmı sol hemisfer üstünlüğünü ortaya koymaya çalışırken diğer kısım ki (bizim çalışmamızda bunu desteklemekte) iki hemisferin koordineli çalıştığını savunmaktadır.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 Bisoprolol-induced delirium in a patient with ischemic stroke: A case report(2015) Kozak, Hasan Hüseyin; Uca, Ali Ulvi; Uğuz, FarukDeliryum yaygın bilişsel bozukluk, hallüsinasyonlar, duygu-durum değişiklikleri ve uyku-uyanıklık döngüsünde bozulmalar gibi çok sayıda belirtiyi içeren yaygın bir nöropsikiyatrik klinik sendromdur. Hastaneye yatan tüm hastaların %10-30'unda görülmektedir. Ayrıca, Deliryum morbidite, mortalite ve sağlık hizmetlerinin kullanılmasında artmayı içeren kötü sonuçlarla ilişkili yaygınbir durumdur. Kognitif yetersizliğin etiyolojisi multifaktöriyel olarak düşünülse de, ilaçların da deliryumun önemli bir nedeni olduğu bilinmektedir. Bu çalışmada, bisoprololün neden olduğu akutdeliryum tablosuyla gelen ve bisoprololün kesilmesiyle deliryum semptomlarının tamamen kaybolduğu bir hastayı sunuyoruz. Bisoprolol kardiyologlar tarafından hipertansiyon ve aritmi tedavisi için yaygın olarak kullanılmaktadır. Beta blokör ajanların bazen santral sistemi etkilerinin olabildiği ve bu nedenle yaygın psikiyatrik sendromların istenmeyen bir nedeni olabildikleri belirlenmiştir.Öğe BISOPROLOL-INDUCED DELIRIUM IN A PATIENT WITH ISCHEMIC STROKE: A CASE REPORT(Gunes Kitabevi Ltd Sti, 2015) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Uguz, FarukDelirium is a common neuropsychiatric syndrome that involves a number of symptoms including diffuse cognitive impairment, hallucinations, mood lability and disturbances in the sleep-wake cycle. Besides, delirium is a common condition associated with adverse outcomes, including increase in morbidity, mortality, and need of health services utilization. Even though the etiology of cognitive impairment is multifactorial, drugs also are known to be an important cause of delirium. In this study, we present a patient manifesting a bisoprolol-induced acute delirium, for whom the delirium symptoms completely disappear after bisoprolol was ceased. Bisoprolol is widely used in cardiology for the treatment of hypertension and arrhythmia. Beta-blocking agents have been recognized for some time to have central nervous system effects, which could adversely cause common psychiatric syndromes.Öğe A case of rasagiline-induced spontaneous orgasms in a female patient(Elsevier Sci Ltd, 2014) Uca, Ali Ulvi; Kozak, Hasan Huseyin[Abstract Not Availabe]Öğe Clinical and radiologic features and their relationships with neurofunctional scores in patients with acute cerebellar infarct(Medknow Publications & Media Pvt Ltd, 2016) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Poyraz, Necdet; Anliacik, Suleyman Omer; Tokgoz, Osman SerhatBackground: Cerebellar infarct is a rare condition with very nonspecific clinical features. The aim of this study was to assess the full spectrum of the clinical characteristics, neuroimaging findings and neurofunctional analyses of cerebellar infarction, and the relationship between them. Materials and Methods: Data were collected from 59 patients admitted to our department during an 8-year period. We retrospectively analyzed the relationship between demographic characteristics, clinical symptomatology, etiological factors, functional condition, vascular distribution, frequency of subcortical white matter lesions (WMLs), and concomitant lesion outside the cerebellum in patients with acute cerebellar infarct (ACI) at time of admission. Results: The mean age in our series was 65.2 years, with most being male (57.6%). The posterior inferior cerebellar (PICA) artery was the most commonly affected territory at 62.7%. There was concomitant lesion outside the cerebellum in 45.7%. The main etiology in PICA was cardioembolism. While mean National Institutes of Health Stroke Scale on admission was 2.08 +/- 1.67 in study group, modified Rankin Scale (mRS) on admission was detected to be mRS1 (n: 44, 74.5%) and mRS2 (n: 12, 20.3%) most frequently. Fourteen (35%) patients were detected to be in Fazekas stage 0; 11 (27.5%) patients in Fazekas stage 1; 6 (15%) patients in Fazekas stage 2; and 9 (22.5%) patients in Fazekas stage 3. Conclusion: Cerebellar infarct is very heterogeneous. The other cerebral area infarcts which accompany ACI negatively affect neurologic functional scores. Although it is difficult to detect the relationship between WMLs and neurologic functional severity, timely detection of risk factors and their modulation may be associated with prevention and treatability of WMLs, and this may be one of the important points for prevention of stroke-related disability.Öğe Cluster-tic syndrome and bilateral internuclear ophthalmoplegia as the manifestation of multiple sclerosis(Asean Neurological Assoc, 2015) Uca, Ali Ulvi; Kozak, Hasan HuseyinThis report describes a 35-year-old female suffering from a cluster-tic syndrome and bilateral internuclear ophthalmoplegia as the initial manifestation of multiple sclerosis. Magnetic resonance imaging of the brain revealed multiple pontine hyperintense lesions. To our knowledge, there is no previous report of multiple sclerosis presenting as cluster-tic syndrome and bilateral internuclear ophthalmoplegia in the literature. The cluster headache attacks and peri-ocular neuralgiform pain resolved after treatment with intravenous methyl-prednisolone and oral carbamazepine.Öğe Öğe Coexistence of Migraine Headache and Red Ear Syndrome(Galenos Yayincilik, 2014) Uca, Ali Ulvi; Kozak, Hasan Huseyin[Abstract Not Availabe]Öğe Comparison of outcomes of transnasal sphenopalatine ganglion and ultrasound-guided proximal greater occipital nerve blockades in chronic migraine(Asean Neurological Assoc, 2023) Balta, Selin; Uca, Ali Ulvi; Odabas, Faruk Omer; Demir, AysegulBackground & Objective: A need exists for prophylactic treatment options for chronic migraine. Our aim was to evaluate and compare the effect of greater occipital nerve (GON) and transnasal sphenopalatine ganglion (SPG) blockade on headache days, responder rate, attack severity, attack frequency, and medication overuse in patients with chronic migraine. Methods: This was a retrospective study. The GON blockade was performed at the proximal level under ultrasound guidance with 1.5 cc 0.5% bupivacaine, and the SPG blockade was performed transnasally with 0.5 cc 0.5% bupivacaine applied for 30 minutes with swab sticks. Patients who completed bilateral blocks applied in four weekly sessions were included in the analysis. Results: Seventy patients (GON=37, SPG=33) were included in the study. Both groups showed a significant improvement in the number of days with headache, severity of attacks, and frequency of attacks at the first-and third-month follow-up visits compared to the baseline (p<0.001). Responder rates were similar at the first-and third-month follow-up visits (r= 3.707, p=0.054; r=0.071, p=0.790, respectively). At the third-month follow-up, the prevalence of medication overuse decreased from 78% to 13% in the GON group and from 57% to 9% in the SPG group, and these differences were statistically significant (p<0.001 for both groups). No significant difference was noted in efficacy between the treatment groups (p=0.714). No significant adverse effects occurred in either group. Conclusion: Both proximal GON blockade and minimally invasive SPG blockade are effective and safe options for prophylaxis in patients with chronic migraine.Öğe The Comparison of Socio-Demographic and Clinical Variables of Inmates Using Gabapentin For Medicinal Purposes and Those Abusing The Drug(2017) Çicekçi, Faruk; Yüksekkavas, Dinçer; Aydın, Adem; Karaibrahimoğlu, Adnan; Uca, Ali UlviAmaç: Gabapentini tedavi amaçlı-endikasyonlu kullanan mahkumlar ile kötüye kullanan mahkumlar arasındaki sosyodemoğrafik ve klinik verileri karşılaştırmak. Metod: Bu çalışmaya Haziran 2012-Aralık 2014 yılları arasında Konya E Tipi Cezaevinde kalan, cezaevi polikliniğine başvuran ve ağrı polikiliniğimize sevkedilen gabapentin kullananlar mahkumlar dahil edildi. Gabapentini mevcut şikayetlerinden dolayı endikasyonsuz kullananlar (Grup 1), hastalığa bağlı olarak endikasyonlu kullananlar (Grup 2) DSM IV-TR ye göre madde bağımlılığı, madde kötüye kullanımı ve gabapentin kötüye kullanımı yönünden araştırıldı. Bulgular: Endikasyonsuz gabapentin kullanan mahkumların (Grup 1) tamamına yakını (n:21) gabapentini kas ağrıları, nöropatik ağrı, uyku bozukluğu, anksiyete belirtileri, terleme, titreme ve bulantı-kusma için kullandığını belirtirken, endikasyonlu olarak gabapentini kullanan mahkumlar (Grup 2) daha çok mevcut hastalıklarının belirtilerini baskılamak için (diyabetik nöropati, ve epilepsi) kullandıkları tespit edilmiştir. Endikasyonsuz kullanan grubun birinci derece yakınlarında alkol/madde kullanımının daha yüksek olduğu belirlenmiştir (P0.001). Grup 1 için madde bağımlılığı (n10) ve madde kötüye kullanımı (n13) anlamlı olarak Grup 2den yüksek bulunmuştur (P0.001). Sonuç: DSM IV-TRye göre madde bağımlılığı ve madde kötüye kullanımı tanısı alan mahkumların cezaevine girdikten sonra özellikle opioid çekilme belirtilerini engellemek için gabapentin kullandıkları ve gabapentin kötüye kullanımı tanımına uydukları görülmüştür.Öğe Conjunctival impression cytology and tear film parameters in patients with multiple sclerosis(Springer, 2022) Belviranli, Selman; Oltulu, Pembe; Uca, Ali Ulvi; Gundogan, Ali Osman; Mirza, Enver; Altas, Mustafa; Turk, NazliPurpose To evaluate conjunctival impression cytology (CIC) findings and tear film parameters in patients with multiple sclerosis (MS) compared with controls. Methods Thirty-three patients with MS (MS group) and 33 age- and sex-matched healthy subjects (control group) were included in this cross-sectional comparative study. CIC grades, tear break-up time (TBUT), Schirmer 1 test results, and Ocular Surface Disease Index (OSDI) scores were compared between the two groups, and correlations between CIC grade, TBUT, Schirmer 1 test result, OSDI score, Expanded Disability Status Scale score, and disease duration were analyzed. Results Mean CIC grade was higher in the MS group than in the control group (1.48 +/- 0.71 and 0.39 +/- 0.56, respectively; p < 0.001). In the MS group, CIC of the 14 participants (42.4%) was grade 2-3. In the control group, CIC of the only one participant (3.3%) was grade 2, and none of them was grade 3. TBUT (8.12 +/- 3.16, 13.06 +/- 4.23 s in MS and control groups, respectively; p < 0.001) and Schirmer 1 test results (8.45 +/- 5.75, 17.36 +/- 10.89 mm in MS and control groups, respectively; p < 0.001) were lower, and OSDI score (36.36 +/- 19.19, 13.70 +/- 15.36 in MS and control groups, respectively; p < 0.001) was higher in the MS group compared to the control group. Conclusion In patients with MS, objective findings of dry eye, subjective symptoms related to dry eye, and CIC abnormalities, including high grades of conjunctival squamous metaplasia and goblet cell loss, are more common. Patients with MS should be monitored for ocular surface alterations and dry eye disease.Öğe Cortical Blindness(Journal Neurological Sciences, 2013) Uca, Ali Ulvi; Kozak, Hasan HuseyinWhen bilateral retrochiasmal lesions from the beginning of the lateral geniculate body to the occipital cortex are present, there is a cortical blindness.Öğe Could Hemiplegia Vegetativa Alterna be a Cerebral Sign of Heart Valve Disease?(2014) Uca, Ali Ulvi; Kozak, Hasan Hüseyin; Seyithanoğlu, Abdullah; Poyraz, NecdetÖğe A cross-sectional study to assess the association between major depression and inflammatory markers in patients with acute ischemic stroke(Wolters Kluwer Medknow Publications, 2019) Kozak, Hasan Huseyin; Uguz, Faruk; Kilinc, Ibrahim; Uca, Ali Ulvi; Tokgoz, Osman Serhat; Guney, Figen; Ozer, NejlaBackground: Increased interest in the relationship between affective disorder and long-term health consequences has generated recent examinations of depression and stroke. Observations suggest that depressive disorder is associated with abnormal physiological and immunological responses and a resultant increase in inflammatory markers. Given the high prevalence of stroke and associated costs for the community, it is important to understand the mechanisms that may impact on the outcome to achieve the best possible prognosis. Aims: The view that inflammatory factors contribute to depression is predicated on findings that circulating cytokines and other inflammatory factors are increased in depressed patients. Therefore, it has been hypothesized that inflammation could be one of the mechanisms by which depression increases risk for ischemic stroke. Our aim was to determine whether there is any relationship between major depression and tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), IL-18, brain-derived neurotrophic factor (BDNF), and neuron-specific enolase (NSE) in patients with acute ischemic stroke (AIS). Study Design: This was as a cross-sectional design. Materials and Methods: This study has a cross-sectional design, and it was conducted in Necmettin Erbakan University, the Meram Faculty of Medicine in Konya, Turkey, between 2014 and 2015. Fifty-three AIS patients admitted to the hospital within the first 24 h after stroke onset were recruited. Major depression was ascertained by means of the structured clinical interview for the diagnostic and statistical manual of mental disorders, Fourth Edition/Clinical Version. The enzyme-linked immunosorbent assay was used to measure the serum levels of TNF-alpha, IL-1 beta, IL-18, BDNF, and NSE at admission. Results: A total of 53 patients with a mean age of 65.9 years were recruited. Of these patients, 17 (32.1%) had major depression. Depressive and nondepressive patients had similar demographical and clinical features. There was no significant statistical difference between depressive and nondepressive patients with AIS with respect to levels of TNF-alpha, IL-1 beta, IL-18, BDNF, and NSE. Conclusion: This study suggests that in patients who have experienced AIS, there is no significant relationship between major depression and basal proinflammatory cytokines (TNF-alpha, IL-1 beta, IL-18), BDNF, and NSE.Öğe Cystatin C as a potential biomarker to evaluate migraine(Assoc Arquivos Neuro- Psiquiatria, 2020) Akdag, Turan; Uca, Ali UlviBackground: Migraine is a multifactorial neurovascular syndrome and closely associated to inflammation. Cystatin C (Cys C) is a neuroendocrine polypeptide which also plays a role in inflammation. Objective: To investigate the levels of Cys C in migraine patients without aura. Methods: A total of 80 participants were included in the study; 40 patients and 40 healthy controls. Serum Cys C levels were investigated by using enzyme-linked immunosorbent assay (ELISA). Statistical analysis were performed using Statistical Package for the Social Sciences (SPSS) version 22.0 (SPSS Inc, IL, USA). Results: Serum Cys C levels were found as 73.88 ng/mL in the patient group and 24.92 ng/mL in the healthy control group, being significantly higher among patients (p=0.000). Serum Cys C levels were significacntly different across age subgroups among patients (p=0.049), but not among controls. However, visual analog scale (VAS) (p=0.707), disease duration time (p=0.725) and body mass index (p=0.136) were not significantly different between the two groups. Conclusion: Our findings demonstrate that high serum Cys C levels are independently associated to migraine without aura. To the best of our knowledge, this is the first study to determine the serum levels of Cys C in patients with migraine. Thus, serum Cys C may be a potential biomarker of migraine.Öğe Cystatin C as a potential biomarker to evaluate migraine(Assoc Arquivos Neuro- Psiquiatria, 2020) Akdag, Turan; Uca, Ali UlviBackground: Migraine is a multifactorial neurovascular syndrome and closely associated to inflammation. Cystatin C (Cys C) is a neuroendocrine polypeptide which also plays a role in inflammation. Objective: To investigate the levels of Cys C in migraine patients without aura. Methods: A total of 80 participants were included in the study; 40 patients and 40 healthy controls. Serum Cys C levels were investigated by using enzyme-linked immunosorbent assay (ELISA). Statistical analysis were performed using Statistical Package for the Social Sciences (SPSS) version 22.0 (SPSS Inc, IL, USA). Results: Serum Cys C levels were found as 73.88 ng/mL in the patient group and 24.92 ng/mL in the healthy control group, being significantly higher among patients (p=0.000). Serum Cys C levels were significacntly different across age subgroups among patients (p=0.049), but not among controls. However, visual analog scale (VAS) (p=0.707), disease duration time (p=0.725) and body mass index (p=0.136) were not significantly different between the two groups. Conclusion: Our findings demonstrate that high serum Cys C levels are independently associated to migraine without aura. To the best of our knowledge, this is the first study to determine the serum levels of Cys C in patients with migraine. Thus, serum Cys C may be a potential biomarker of migraine.
