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    Evaluation of cognitive impairment after posterior cerebral artery infarction [Posteri·or serebral arter i·nfarkti sonrasi geli·şen bi·li·şsel bozulmanin degerlendi·ri·lmesi·]
    (Turkish Society of Cerebrovascular Diseases, 2013) Çinar N.; Şahin Ş.; Önay T.O.; Batum K.; Karsi¸dag S.
    OBJECTIVE: The assessment of cognitive impairment after posterior cerebral artery (PCA) ischemic infarction has not been well documanted. MATERIAL and METHODS: Twenty-six oriented, cooperated and non-aphasic consecutive patients with right or left (10/16) PCA infarction who were hospitalized between the years 2010-2012 were enrolled to the study. The branches of PSA were dealt as cortical and subcortical infarct under two groups. Short mental state examination test and cognitive test battery (CTB) created from Wechsler memory scale (WMS), word-catogory association test and similarity test parameters were applied to the patients at the first week and third month follow-up visits and the groups were compared with each other. RESULTS: There was a significant improvement in catogory association test and total score of cognitive test battery (CTB) in right PCA group, also there was a significant improvement in catogory association test in left PCA group at the first and 3th month evaluations. At the first month evaluations, total score of CTB of the subcortical segment PCA infarcts are lower than the cortical segment PCA infarcts. At the 3th month evaluations the scores increased in the both groups; but the scores in the subcortical PCA infarcts were lower than the cortical PCA infarcts. CONCLUSION: Our findings suggest that there was a cognitive impairment in patients with PCA infarction. The impairment in verbal fluency which was showed by catogory association test was found more prominent in the second evaluation. Further studies including functional imaging methods and cortical function tests are needed.
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    Interictal psychiatric disorders in epilepsy [Epİlepsİde İnterİktal psİkİyatrİk bozukluklar]
    (2012) Çinar N.; Şah S.; Batum K.; Karşidag S.
    Epilepsy can cause many different problems such as psychosocial problems except seizures. According to the temporal distribution, the psychiatric disorders which epilepsy caused can be addressed into the two main groups such as peri-ictal (preictal, ictal, postictal) and interictal. The interictal findings tend to be permanent. This study aimed to reveal interictal psychiatric disorders in detail. Totally 180 patients who are followed by our clinic for at least two years were evaluated retrospectively. Epileptic seizures are classified according to criterias of International League Against Epilepsy 1981 and Semiological Classification-1998 (Hans Lüders-Soheyl Noachtar), psychiatric disorders are classified according to criterias of DSM-IV. The cases were divided into two groups according to the presence of psychiatric disorders. The mean age was 35 ± 19 (9-87) years, female / male ratio was105/75, mean age at onset of epilepsy was 25 ± 20 years. Psychiatric disorder ratio was found 43.3% of cases. They are (in order of frequency); depression, generalized anxiety disorder, psychotic disorder, attention deficit, obsessive-compulsive disorder, panic disorder and affective disorder. Four percent of the patients had a history of attempting suicide. There was no statistical difference between the groups which psychiatric disorders detected and undetected about age, gender, seizure type, antiepileptic drugs and drugs number. Despite, there was no statistical reflection, the ratio of symptomatic epilepsy, frequent seizure and aura was relatively high in psychiatric disorder group. The most common psychiatric disorders are depression and anxiety disorders in the interictal period. This situations may even cause person commit suicide. It must be considered and measures should be taken that, psychiatric disorders can prepare a ground for several problems such as control of epileptic seizures and some psycho-socio-economic complexities.
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    Is herpes zoster merely a simple neuralgia syndrome? [Herpes zoster sadece basit bir nevralji sendromu mudur?]
    (2011) Çinar N.; Şahin S.; Okluoglu T.; Batum K.; Karşidag S.
    Aim: Although, herpes zoster usually presents with postherpetic neuralgia (PHN) localized at single dermatome, it may also manifest with different clinical presentations. To clarify of these rare conditions, we aimed to examine the cases of PHN followed by our clinic in more details. Method: Medical records of 26 patients in total monitored by the neurology outpatient clinic for PHN between 2008 and 2010 were reviewed. Result: The mean age of the patients was 61.9±16.4 years, with a female-male ratio of 15/11. Ten of the patients (38%) had a chronic illness history such as solid cancer, lymphoma, diabetes mellitus, cardiac valve prosthesis and Parkinson's disease. Eight of the patients had trigeminal nerve lesions (ophthalmic in 7 and mandibular in 1), 3 had spinal cervical lesions, 8 had spinal thoracic lesions and 7 had spinal lumbar dermatomic lesions. Three (11.5%) patients had motor involvement (C7 in one and L4-L5 innervated muscles in two). Four patients (15.3%; symmetric sides of the same dermatome in two and at different dermatomes in another two) had multiple dermatomal involvements. Conclusion: Immunosuppression and advanced ages are known to facilitate varicella reactivation. By reviewing patients with zona zoster monitored by our clinic for accompanying conditions, anatomical localizations and presence of multiple dermatomal involvements, the present study emphasizes that zona may also cause 'motor involvement' besides sensory involvement. Our findings demonstrate that zona is a complex syndrome which may manifest as varying clinical presentations.