1987-1991 Çanakkale Devlet Hastanesi Nöroloji Kliniği Uzmanlığı

1991 Dokuz Eylül Üniversitesi Nöroloji Anabilim Dalı Öğretim görevliliği

1995 -2001 Dokuz Eylül Üniversitesi Nöroloji Anabilim Dalı Doçent Öğretim üyesi

2001- 2024 Dokuz Eylül Üniversitesi Nöroloji Anabilim Dalı Profesör Öğretim üyesi

2012-2024 Dokuz Eylül Üniversitesi Nöroloji Anabilim Dalı Klinik Nörofizyoloji Bilim Dalı Başkanı

PROF. DR. BARIŞ BAKLAN

Görev Aldığı Bölümler

Nöroloji

Examining the Effect of Anti-seizure Medications Monotherapy on Cognitive Functions in Patients with Epilepsy: A 1-month Longitudinal Study

By

Boz, HE (Boz, Hatice Eraslan) [1] , [2] , [5] ; Dibek, DM (Dibek, Dilara Mermi) [3] , [4] ; Öztura, I (Oztura, Ibrahim) [4] ; Baklan, B (Baklan, Baris) [4]

 (provided by Clarivate) 

Source

ARCHIVES OF EPILEPSY

Volume

31

Issue

2

Page

47-52

DOI

10.4274/ArchEpilepsy.2024.24140

Published

JUN 2025

Indexed

2025-05-25

Document Type

Article

Abstract

Objective: Cognitive impairment in epilepsy is one of the most important problems affecting daily life. This study aimed to investigate the change in cognitive functions of patients with epilepsy a month after starting anti-seizure medications (ASMs). Methods: Patients with epilepsy who started treatment with ASMs were included. The general cognitive status, attention, memory, executive functions, and language skills of epilepsy patients were evaluated with detailed neuropsychological tests before and one month after the initiation of ASMs. Results: The study included 14 patients with epilepsy. The patients showed increased attention, visual memory, and inhibition skills 1 month after using ASMs compared to pre-treatment status. Conclusion: Appropriate and successful treatment of epilepsy patients can improve cognitive performance in the short term. However, long-term longitudinal studies are needed to support these findings.

Keywords

Author Keywords

Antiseizure medications cognitive impairment epilepsy monotherapy
 

Keywords Plus

OLDER-ADULTSLEVETIRACETAMINTERFERENCETOPIRAMATEIMPAIRMENTINVENTORYFLUENCY

Evaluation of the Results of Polygraphy and Polysomnography Performed at Consecutive Times in the Detection of Obstructive Sleep Apnea: a Retrospective Analysis

By

Özer, IS (Ozer, Inci Sule) [1] ; Dibek, DM (Dibek, Dilara Mermi) [2] ; Agircan, C (Agircan, Cansu) [1] ; Öztura, I (Oztura, Ibrahim) [1] ; Baklan, B (Baklan, Baris) [1]

 (provided by Clarivate) 

Source

JOURNAL OF TURKISH SLEEP MEDICINE-TURK UYKU TIBBI DERGISI

Volume

12

Issue

2

DOI

10.4274/jtsm.galenos.2024.48379

Published

JUN 2025

Indexed

2025-10-19

Document Type

Article

Abstract

Objective: Polysomnography (PSG) performed at a sleep center is the gold standard for diagnosing sleep apnea syndrome. When PSG cannot be performed due to late appointments or in pandemic conditions, the use of home devices such as polygraphs may be preferred. We aimed to investigate the adequacy and deficiencies of polygraphy (PG) in diagnosing obstructive sleep apnea syndrome in adults who underwent PSG and PG recording at our center. Materials and Methods: Patients who underwent cardiorespiratory PG and then PSG at the sleep center with suspicion of sleep apnea syndrome were retrospectively analyzed. Apnea Hypopnea Index (AHI) values were compared. There was a total of 34 patients in the study, 10 females and 24 males. Results: The mean AHI was 38.3 +/- 22.1 in PG and 43.5 +/- 27.5 in PSG. No statistically significant difference was found in AHI values between the two tests (p=0.065). In both groups, one (2.9%) patient had a normal AHI value. The AHI ratings of the patients on PLG were 4 (11.8%) mild, 8 (23.5%) moderate, and 21 (61.8%) severe, and on PSG, they were 5 (14.7%) mild, 6 (17.6%) moderate, and 22 (64.7%) severe. Conclusion: In our study, we found similar AHI values in PG used at home and PSG in the sleep center. When sleep apnea syndrome is suspected, if the PSG appointment in the sleep center is long, or the patient cannot sleep in the sleep center due to the occurrence of a pandemic or other reasons, a PG devices used at home may be preferred.

Keywords

Author Keywords

Polygraphy (PG) polysomnography  (PSG)obstructive sleep apnea syndrome (OSAS)
 

Keywords Plus

DIAGNOSIS

Altered cervical proprioception and biomechanics in obstructive sleep apnea: a case-control study

By

Dogru, M (Dogru, Mahbube) [1] ; Colak, GY (Colak, Gamze Yalcinkaya) [2] ; Sengul, YS (Sengul, Yesim Salik) [3] ; Oztura, I (Oztura, Ibrahim) [4] ; Baklan, B (Baklan, Baris) [4]

 (provided by Clarivate)

Source

SLEEP AND BREATHING

Volume29Issue1

DOI10.1007/s11325-024-03184-0

Article Number

25

Published

MAR 2025

Indexed

2024-12-11

Document Type

Article

Abstract

Purpose This study aimed to compare cervical proprioception and related biomechanical factors among patients with Obstructive Sleep Apnea (OSA) and asymptomatic controls. Methods In this case-control study, polysomnography scores (apnea-hypopnea index-AHI) were examined to determine the disease severity of the OSA group. Also, we evaluated cervical proprioception by using a laser pointer to detect joint repositioning error sense in cervical rotational movements. Comparison statistics were also conducted for the cervical musculoskeletal variables such as range of motion (ROM) with bubble inclinometer, cranio-cervical (CVA), and thoracic posture (TKA) through photometric analysis, neck flexor muscle endurance test, and pain pressure thresholds of trapezius (PPT). Results This case-control study included 59 male participants: patients with OSA (n = 29; mean age = 49.10 years; mean BMI = 28.41 kg/m2) and asymptomatic controls (n = 30; mean age = 49.73 years; mean BMI = 26.89 +/- 3.60 kg/m2). The mean AHI score was 26.06 events/hour, categorizing the severity of OSA as mild (31.03%), moderate (31.03%), and severe (37.94%). Patients with OSA demonstrated significantly poorer cervical proprioception compared to controls for both sides of cervical rotation with larger effect sizes (d:1.36-1.45; p < 0.05). Also, cervical ROM, CVA, TKA, neck flexor muscle endurance test, and PPT values were altered in the OSA group compared to the control group (p < 0.05). Conclusion Impaired cervical proprioception may be a previously unrecognized factor associated with OSA. This finding has implications for understanding the mechanisms underlying cervical musculoskeletal changes in OSA and for developing potential new interventions or exercise designs targeting postural control.

Keywords

Author Keywords Obstructive sleep apnea Proprioception Cervical spine Cervical postüre Biomechanics

Keywords Plus CERVICOCEPHALIC KINESTHETIC SENSIBILITYNECK-PAINRELIABILITYPOSTUREHEADVALIDITY

The Importance of Epileptiform Activities in Breach Rhythms

By

Dibek, DM (Dibek, Dilara Mermi) [1] , [2] ; Öztura, I (Oztura, Ibrahim) [2] ; Baklan, B (Baklan, Baris) [2]

 (provided by Clarivate) 

Source

ARCHIVES OF EPILEPSY

Volume

30

Issue

4

Page

114-119

DOI

10.4274/ArchEpilepsy.2024.24122

Published

DEC 2024

Indexed

2024-11-30

Document Type

Article

Abstract

Objective: The breach rhythm is a benign activity variant that can be confused with epileptiform discharges. We aimed to investigate the relationship between breach rhythms and seizures, even though they are known as benign variants. In addition, to identify whether the seizure was related to seizures and which conditions should be considered by electroencephalographers. Methods: Electroencephalograph records recorded between October 2017 and March 2021 were re-examined. Breach rhythms were classified for localization, frequency, morphology, and presence/absence of sporadic epileptiform discharges. The placement of skull defects, etiology of skull defects, presence of encephalomalacia, symptomatic seizures, and anti-seizure medication use were documented. Statistical analysis was performed using Statistical Package for Social Sciences software version 26.0. Results: We included 71 recorded breach rhythm activities. All breach rhythms had a similar placement to skull defects. Twenty-three (32.4%) patients had an epileptiform abnormality with a breach rhythm in the same area. The presence of epileptiform abnormalities was associated with seizures more than 4.5 times [p=0.004, odds ratio (OR): 4.667]. The theta frequency was related to the presence of sporadic epileptiform activity exceeding 3.3 times (p=0.029, OR: 3.316). Conclusion: Our study showed that breach rhythms are unrelated to seizure unless sporadic epileptiform activity is present. If the breach rhythm frequency is theta, the risk of sporadic epileptiform activity is higher than the alpha or beta frequency breach rhythm. According to our study results, the breach rhythm is a benign variant, unless accompanied by sporadic epileptiform discharges.

Keywords

Author Keywords

Benign variants breach effect breach rhythm epileptiform discharges seizure

Investigation of the Effect of Antiseizure Medications on Cognition in Patients With Epilepsy

By

Dibek, DM (Dibek, Dilara Mermi) [1] , [2] ; Boz, HE (Boz, Hatice Eraslan) [3] ; Öztura, I (Oztura, Ibrahim) [1] ; Baklan, B (Baklan, Baris) [1]

 (provided by Clarivate) 

Source

CLINICAL EEG AND NEUROSCIENCE

Volume

55

Issue

6

Page

643-650

DOI

10.1177/15500594241266283

Published

NOV 2024

Early Access

JUL 2024

Indexed

2024-08-01

Document Type

Article

Abstract

Background. The effect of antiseizure medications (ASMs) on cognition varies depending on the type of ASM. We aimed to investigate the effects of ASMs on patients with epilepsy based on the conflicting findings in the literature. Methods. Patients diagnosed with epilepsy who were taking ASMs were included. All patients underwent a neuropsychiatric assessment, Beck Depression and Anxiety Inventories, Positive and Negative Syndrome Scale, and general psychopathological tests. The patients were divided into polytherapy and monotherapy groups. Subgroups were categorized according to the type of ASMs, dosage, and duration of monotherapy. Results. Ninety-seven patients were included in this study. The polytherapy group showed a significant decrease in attention, total learning, and interpretation of proverbs compared to the monotherapy group. In the monotherapy group, carbamazepine use had a moderate positive correlation with working memory (r = .669; P = .034), and a strong negative correlation with maintaining attention (r = -.740; P = .014). The duration of levetiracetam monotherapy was negatively correlated with verbal memory (immediate recall r = -.436, P = .038; free recall r = .426, P = .043) and negatively weakly correlated with naming performance (r = -.488, P = .025). Conclusion. The study showed polytherapy may affect verbal and working memory. Carbamazepine may affect working memory and the maintenance of attention in a dose-dependent manner. Levetiracetam may cause impairments in verbal memory and naming, depending on the duration of usage.

Keywords

Author Keywords

antiseizure medications cognition epilepsy mood psychopathology
 

Keywords Plus

CARBAMAZEPINE PHENYTOIN INTERFERENCE MONOTHERAPY

Exploring shared triggers and potential etiopathogenesis between migraine and idiopathic/genetic epilepsy: Insights from a multicenter tertiary-based study

By

Türk, BG (Turk, Bengi Gul) [1] ; Yeni, SN (Yeni, Seher Naz) [1] ; Atalar, AC (Atalar, Arife Cimen) [2] ; Ekizoglu, E (Ekizoglu, Esme) [3] ; Gök, DK (Gok, Duygu Kurt) [4] ; Baykan, B (Baykan, Betul) [3] ; Ozge, A (Ozge, Aynur) [5] ; Ayta, S (Ayta, Semih) [6] ; Erdogan, FF (Erdogan, Fuesun Ferda) [4] ; Tasdelen, B (Tasdelen, Bahar) [7] ; 

Group Author

IDEM Study Group (IDEM Study Group)

 (provided by Clarivate) 

Source

CLINICAL NEUROLOGY AND NEUROSURGERY

Volume

237

DOI

10.1016/j.clineuro.2024.108146

Article Number

108146

Published

FEB 2024

Early Access

FEB 2024

Indexed

2024-03-30

Document Type

Article

Abstract

Introduction: Migraine and epilepsy are two episodic disorders that share common pathophysiological mechanisms. The aim of our research was to assess the possible shared etiopathogenesis by analyzing the relations of headache, and seizure triggers, based on information obtained from a national cohort surveying the headache characteristics of 809 patients who had been diagnosed with idiopathic/genetic epilepsy. Material and methods: Our study utilized data from a multi -center, nationwide investigation of headaches in 809 patients with idiopathic/genetic epilepsy. Out of these, 508 patients reported complaints related to any type of headache (333 Migraines, 175 Headaches of other types). In the initial phase of the study encompassing the entire sample of 809 epilepsy patients, differences in seizure triggers were assessed between the migraine group (n = 333) and the non -migraine group (n = 476). Additionally, the subsequent part of the study pertains to a subgroup of the entire patient group, namely those affected by all types of headaches (n = 508), and differences in headache triggers were assessed among migraine patients (n = 333) and those with other types of headaches (n = 175). Similar differences were observed between epilepsy patients with and without a family history of epilepsy. Results: The most frequently reported seizure triggers in all I/GE group (n = 809) were stress (23%), sleep deprivation (22%) and fatigue (18%), respectively. The most frequently reported headache triggers in migraine patients were stress (31%), sleep deprivation (28%), and noise (26%). The occurrence of menstruation -triggered seizures in individuals with migraine and I/GE was found to be considerably higher than those without migraine. The most common triggers for seizure and headache among the individuals with a positive family history of epilepsy were determined to be light stimuli and sleep deprivation. Conclusion: In conclusion, our study provides valuable insights into the overlapping triggers including sleep patterns, stress levels, and menstrual cycles, etc. and potential shared etiology of migraine and I/GE. Recognizing these connections may facilitate the development of more precise therapeutic strategies and underscore the significance of adopting a holistic, multidisciplinary approach to the management of these intricate neurological conditions. Further research is essential to explore in greater depth the shared mechanisms underpinning these associations and their implications for clinical practice.

Keywords

Author Keywords

Migraine Idiopathic generalized epilepsy Genetic generalized epilepsy Trigger factors Comorbidity
 

Keywords Plus

SEIZURE PRECIPITANTSPHOTOSENSITIVITYSLEEP

AEROBIC EXERCISE IN INDIVIDUALS WITH RESTLESS LEGS SYNDROME: A CASE SERIES STUDY

By

Aktar, B (Aktar, Burcin) [1] , [2] ; Balci, B (Balci, Birgul) [2] ; Buran, S (Buran, Sinan) [3] ; Aslantas, BN (Aslantas, Beyza Nur) [1] ; Dibek, DM (Dibek, Dilara Mermi) [4] ; Oztura, I (Oztura, Ibrahim) [5] ; Baklan, B (Baklan, Baris) [5]

 (provided by Clarivate) 

Source

JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES

Volume

8

Issue

2

Page

511-515

DOI

10.30621/jbachs.1277737

Published

2024

Indexed

2024-07-20

Document Type

Article

Abstract

Purpose: Exercise has been demonstrated to alleviate symptoms of restless legs syndrome (RLS) in individuals with RLS, but there are few studies on physical health in primary RLS. This case series aims to describe the outcome of supervised aerobic exercise training in individuals with RLS. Case Report: Five individuals with RLS were given supervised aerobic exercise training 2 days a week for 12 weeks. The International Restless Legs Syndrome Study Group Rating Scale (IRLS) was used to detect the severity of RLS. The Turkish version of the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. The functional effect of fatigue was assessed using the Fatigue Impact Scale (FIS). The Six-Minute Walk test (6MWT) was used to determine the functional exercise capacity. All assessments were taken at baseline and post -intervention. Conclusion: Following aerobic exercise, clinically meaningful changes in RLS severity, PSQI, and 6MWT were reported in all individuals with severe RLS. Four out of 5 patients improved their FIS at postintervention. These results suggest that 24 -session supervised aerobic exercise training might help to improve RLS severity, sleep quality, fatigue, and exercise capacity in an individual with RLS.

Keywords

Author Keywords

aerobic exercise restless legs syndrome sleep

THE TEST-RETEST RELIABILITY AND MINIMAL DETECTABLE CHANGE OF THE SIX-MINUTE WALK TEST, TIMED UP AND GO TEST, AND 30-SECOND CHAIR STAND TEST IN PEOPLE WITH EPILEPSY

By

Aktar, B (Aktar, Burcin) [1] , [2] , [4] ; Balci, B (Balci, Birgul) [2] ; Oztura, I (Oztura, Ibrahim) [3] ; Baklan, B (Baklan, Baris) [3]

 (provided by Clarivate) 

Source

PHYSIOTHERAPY THEORY AND PRACTICE

Volume

40

Issue

10

DOI

10.1080/09593985.2023.2237566

Published

OCT 2 2024

Early Access

JUL 2023

Indexed

2023-08-21

Document Type

Article

Abstract

Background: The available evidence suggests that people with epilepsy have reduced cardiorespiratory fitness and muscle strength endurance, and impaired balance and mobility. The 6-minute walk test (6MWT), Timed Up and Go (TUG), and 30-second chair stand test (30CST) are physical performance tests frequently used in clinical practice.

Objective: To establish the test-retest reliability and minimal detectable change of the 6MWT, TUG, and 30CST in people with epilepsy.

Methods: The study was designed as an observational study. Forty-one people with epilepsy (23 females, 18 males; mean age 34.7 +/- 10.4 years) participated. The 6MWT, TUG, and 30CST were tested by a trained physiotherapist during two sessions, which were conducted 7-14 days apart. The test-retest reliability of measures was assessed using the intra-class correlation coefficients (ICC) using two-way random effects and absolute agreement methods. The 95% limits of agreement, standard error of measurement (SEM), and minimal detectable change (MDC95) were calculated.

Results: The 6MWT (ICC = 0.92, SEM = 15.8, MDC95 = 43.8), TUG (ICC = 0.95, SEM = 3.2, MDC95 = 0.5) and 30CST (ICC = 0.92, SEM = 1.0, MDC95 = 2.8) performance measurements demonstrated excellent test-retest reliability. The 95% limits of agreement was calculated, as illustrated in a Bland-Altman plot.

Conclusion: The 6MWT, TUG, and 30CST are reliable for measuring physical performance. The findings of this study can support researchers and clinicians to decide if a change score of a person with epilepsy is likely to be measurement error or true change.

Keywords

Author Keywords

test-retest reliabilitysix-minute walk teste pilepsies seizure disorders
 

Keywords Plus

CARDIORESPIRATORY FITNESSPHYSICAL-EXERCISEMEASUREMENT ERRORSTATISTICS NOTESINDIVIDUALSGUIDELINESSTATEMENTMOBILITYBALANCEREHABILITATION

Yoga and aerobic exercise in epilepsy: Study protocol for a randomized controlled trial

By

Aktar, B (Aktar, Burcin) [1] , [2] , [6] ; Balci, B (Balci, Birgul) [2] ; Boz, HE (Boz, Hatice Eraslan) [3] , [4] ; Oztura, I (Oztura, Ibrahim) [5] ; Baklan, B (Baklan, Baris) [5]

 (provided by Clarivate) 

Source

PHYSIOTHERAPY RESEARCH INTERNATIONAL

Volume

28

Issue

4

DOI

10.1002/pri.2013

Published

OCT 2023

Early Access

MAY 2023

Indexed

2023-06-12

Document Type

Article

Abstract

Background: There has been a growing interest in demonstrating the health benefits of exercise among people with epilepsy in recent years. Although exercise is recommended for people with epilepsy, there is uncertainty concerning the effects of yoga and aerobic exercise on multiple health outcomes in epilepsy. Purpose: The aim of this trial was to examine the effects of yoga and aerobic exercise training on physical activity, seizure frequency, health-related physical fitness, mental, emotional, and psychological health status, and quality of life. Methods: This study was designed as a single-center, 8-week, randomized controlled trial in a three-arm parallel group. Participants will be randomly allocated to yoga, aerobic exercise, or wait-list control groups. The primary outcome is physical activity/sedentary behavior measured by the ActiGraph GT9X accelerometer and seizure frequency. Secondary outcomes include functional capacity, lower extremity strength, balance, body composition, waist and hip circumference, cognition, depression, anxiety, perceived stress, fatigue, sleep quality, and quality of life. The outcomes will be evaluated at baseline and at 8 weeks of follow-up. Implications of physiotherapy practice: This study is the first randomized controlled trial comparing the effects of yoga and aerobic exercise among people with epilepsy. The findings of this study could provide important information about the effects of yoga and aerobic exercise training on a variety of health conditions in people with epilepsy. Trial registration: ClinicalTrials.gov identifier: NCT05066880, registered October 4, 2021.

Keywords

Author Keywords

aerobic exercise epilepsy activity yoga
 

Keywords Plus

QUALITY-OF-LIFE PHYSICAL-ACTIVITYP SYCHOSOCIAL HEALTH THERAPY IMPACT RELIABILITY NEUROPLASTICITY ADAPTATION MECHANISMS STATEMENT

The liverpool adverse drug events profile (LAEP): Validity and reliability of Turkish version (LAEP-TR)

By

Dibek, DM (Dibek, Dilara Mermi) [1] , [2] , [4] ; Kiliç, B (Kilic, Bulent) [3] ; Oztura, I (Oztura, Ibrahim) [2] ; Baklan, B (Baklan, Baris) [2]

 (provided by Clarivate) 

Source

NEUROLOGICAL SCIENCES AND NEUROPHYSIOLOGY

Volume

40

Issue

2

Page

101-105

DOI

10.4103/nsn.nsn_83_23

Published

APR-JUN 2023

Indexed

2023-08-08

Document Type

Article

Abstract

Aim: Adverse effects should be questioned in outpatient clinics during routine visits. However, physicians have not yet had a questionnaire in Turkish for patients who take antiseizure medications (ASMs). The Liverpool Adverse Drug Events Profile "LAEP" was created to follow up on possible adverse effects of ASMs in different languages. This study aimed to assess the reliability and validity of LAEP for the Turkish-speaking population. Method: First, permission was requested from the authors of the original questionnaire. After that, English-Turkish and re-translations were made by two independent people, respectively. Finally, the questionnaire was administered to 10 people as a pilot study, and the final version was decided. Patients who were followed up at the epilepsy outpatient clinic of xxx Hospital and who had not changed antiseizure medications dosage for at least 3 months were included in the study. Cronbach's a and intraclass correlation coefficient (ICC) coefficients were calculated for internal consistency. A consistency study was performed by applying the scale to the same patient group with an interval of 2 weeks. Confirmatory factor analysis was performed for validity analyses using the questionnaire, which was divided into three subdimensions, neurologic, psychiatric, and other system adverse effects. Results: Thirty-seven [male: 16 (43.2%) and female: 21 (56.8%)] patients were included for test-retest analysis. Consistency measurements (ICCs) were performed, and high correlations of ICC >0.70 were obtained for all items. The questionnaire was administered to 168 [male: 64 (38.1%) and female: 104 (61.9%)] patients for validity by factor analysis and reliability by Cronbach's a correlation. Three dimensions were obtained in factor analysis, classified as nervous system-related, psychiatric-related, and other system-related. The Cronbach a values were found as 0.804, 0.828, and 0.484, respectively. Conclusion: The LAEP-TR scale can be used in outpatient clinics on patients who use ASMs.

Keywords

Author Keywords

Anti-seizure medications epilepsyLAEP-TR scale side effects

Peri-ictal headache: An underestimated prognostic finding associated with idiopathic epilepsies

By

Ekizoglu, E (Ekizoglu, Esme) [1] ; Baykan, B (Baykan, Betul) [1] ; Atalar, AÇ (Atalar, Arife Cimen) [2] ; Türk, BG (Turk, Bengi Gul) [3] ; Gök, DK (Gok, Duygu Kurt) [4] ; Topaloglu, P (Topaloglu, Pinar) [5] ; Özge, A (Ozge, Aynur) [6] ; Ayta, S (Ayta, Semih) [7] ; Erdogan, FF (Erdogan, Fuesun Ferda) [4] ; Yeni, SN (Yeni, Seher Naz) [3] ; 

Group Author

Idem Study Grp (Idem Study Grp)

 (provided by Clarivate) 

Source

EPILEPSY & BEHAVIOR

Volume

141

DOI

10.1016/j.yebeh.2023.109136

Article Number

109136

Published

APR 2023

Early Access

FEB 2023

Indexed

2023-03-31

Document Type

Article

Abstract

Objective: There are a handful of studies investigating peri-ictal headache (PIH) and its clinical associa-tions in patients with idiopathic/genetic epilepsies (I/GE). This multi-center study aimed to investigate PIH, which is an ignored comorbid condition in patients with I/GE, by headache experts and epileptolo-gists working together.Methods: The data were collected from a cross-sectional large study, using two structured questionnaires for headache and epilepsy features, fulfilled by neurologists. Headaches were classified according to the International Classification of Headache Disorders, third edition, whereas seizure and syndrome types were diagnosed according to International League Against Epilepsy criteria. The patients with a headache starting 24 hours before the onset of the seizure (preictal) or within 3 hours after the seizure (postictal) were defined as patients with PIH. We compared demographic and clinical differences between two groups of patients with and without PIH statistically and used ROC curves to determine a threshold of the total number of seizure triggers associated with the occurrence of PIH.Results: Among 809 (531 females, 65.6%) consecutive patients with I/GE, 105 (13%) patients reported PIH (22 preictal, 82 postictal headaches, and one with both types). Peri-ictal headache was more frequently reported by females and those having a family history of migraine or epilepsy, and it was significantly associated with lower rates of seizure freedom for more than five years, drug resistance, and use of poly -therapy, remarkably. Moreover, ROC curves showed that having more than 3 seizure triggers was asso-ciated with the presence of PIH.Conclusion: Our findings revealed that PIH may be linked to poor outcomes in I/GEs and seems to be related to a lower ictal threshold precipitated by multiple triggers. Future prospective studies will illumi-nate the unknown underlying mechanisms and appropriate management strategies for PIH to improve the prognosis.(c) 2023 Elsevier Inc. All rights reserved.

Keywords

Author Keywords

Idiopathic epilepsy Genetic epilepsy Peri-ictal headache Postictal Headache Drug-resistance
 

Keywords Plus

ILAE COMMISSIONSEIZUREMULTICENTERMIGRAINE

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

By

Atalar, AC (Atalar, Arife Cimen) [1] ; Özge, A (Ozge, Aynur) [2] ; Türk, BG (Turk, Bengi Gul) [3] ; Ekizoglu, E (Ekizoglu, Esme) [4] ; Gök, DK (Gok, Duygu Kurt) [5] ; Baykan, B (Baykan, Betul) [4] ; Ayta, S (Ayta, Semih) [6] ; Erdogan, FF (Erdogan, Fusun Ferda) [5] ; Yeni, SN (Yeni, Seher Naz) [3] ; Tasdelen, B (Tasdelen, Bahar) [7] ; 

Group Author

Idem Study Grp (Idem Study Grp)

 (provided by Clarivate) 

Source

FRONTIERS IN NEUROLOGY

Volume

13

DOI

10.3389/fneur.2022.1103541

Article Number

1103541

Published

JAN 10 2023

Indexed

2023-02-25

Document Type

Article

Abstract

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert. MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis. ResultsLonger headache duration (<4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone. ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs.

Keywords

Author Keywords

migraine idiopathic epilepsy classification tree headache criteria migraineICHD-3 criteria
 

Keywords Plus

VESTIBULAR MIGRAINEMECHANISMSVERTIGO

Neurodegeneration and Epileptic Seizure: Earlier Than We Think

By

Öz, D (Oz, Didem) [1] ; Aslan, T (Aslan, Taha) [1] ; Isbitiren, YÖ (Isbitiren, Yagmur Ozbek) [1] ; Öztura, I (Oztura, Ibrahim) [1] ; Baklan, B (Baklan, Baris) [1] ; Yener, G (Yener, Gorsev) [1]

 (provided by Clarivate) 

Source

ARCHIVES OF EPILEPSY

Volume

28

Issue

4

Page

149-151

DOI

10.5152/ArchEpilepsy.2022.223663

Published

DEC 2022

Indexed

2023-01-25

Document Type

Article

Abstract

Objective: The purpose of this study is to compare demographical and cognitive features of patients who have neurodegenerative diseases with or without seizures.Methods: This descriptive retrospective study included a total of 16 348 participants, 479 with seizures and 15 869 without seizures. Independent samples t-test and chi-square tests were used to compare age, education, Mini Mental State Examination, and gender of groups.Results: There was a significant difference between patients with seizures and without seizures in age [t(3764) = 2.815, P = .005]. It is found that patients with seizures (M = 67.51, standard deviation = 9.69) were significantly younger than patients without seizures (M = 70.37, standard deviation = 9.51).Conclusion: In all neurodegenerative diseases, especially Alzheimer's disease, at an early age and regardless of cognitive status, diagnosis of seizures at the first admission and subsequent follow-ups is of great importance in terms of the patient's quality of life, prognosis of the disease, and treatment options.

Author Keywords

Cognition dementia epilepsy neurodegeneration neurology seizure
 

Keywords Plus

ALZHEIMERS-DISEASEDEMENTIADYSFUNCTION

Our reasons for converting to valproic acid treatment in female patients with genetic generalized epilepsy: a retrospective, single-centre study

By

Dibek, DM (Mermi Dibek, Dilara) [1] ; Öztura, I (Oztura, Ibrahim) [1] ; Baklan, B (Baklan, Baris) [1]

 (provided by Clarivate) 

Source

NEUROLOGICAL SCIENCES

Volume

43

Issue

1

Page

517-523

DOI

10.1007/s10072-021-05261-8

Published

JAN 2022

Early Access

APR 2021

Indexed

2021-05-04

Document Type

Article

Abstract

Introduction and Aim Valproic acid (Na valproate) is a broad-spectrum anti-seizure medication used in children and adolescents. It is thought to have fewer adverse effects; however, recent studies have restricted its use in women of reproductive age due to the teratogenic impacts on cognition. Although alternative drugs have been used to treat patients in clinical follow-up, some patients have to return to using valproic acid. Our study aimed to determine the rate of return to valproic acid treatment in female patients with follow-up in our centre and the reasons for the return. Materials and Methods Female patients with genetic generalized epilepsy who were followed up in our centre were included in the study. Patient data were retrospectively obtained from file records. The patients were grouped by seizure subgroups, antiepileptic treatment used, electroencephalography characteristics, and seizure treatment response. Results Sixty-three (31.7%) of the 199 patients had to return to VPA treatment. When the reasons for the discontinuation of other drugs were examined, non-response to treatment was found in 80.0% of patients, adverse medication effects in 18.3%, and 1.7% continued voluntarily. Patients who are JAE subtypes were more likely to return to VPA treatment than GTCS alone subtypes. A total of 7.4% of patients converted to VPA therapy had continued myoclonic seizures compared with 20.4% of patients treated with alternative drugs. Conclusion VPA treatment is not used as the first choice in females of reproductive age; however, some patients will only achieve seizure control with valproate, especially those with myoclonic seizures and JAE.

Keywords

Genetic generalized epilepsy Reproductive-age women Valproic acid

1) Türk Nöroloji Derneği  ( ve 1999-2001 Türk Nöroloji Dergisi editörü)

2) Türk EEG-EMG Klinik Nörofizyoloji Derneği

3) Türk Epilepsi İle Savaş Derneği

4) Türk Uyku Tıbbı Derneği

5) ILAE International League of Epilepsy of Turkish Society Başkanlığı 2010-2012 and 2012-2014

6) Türk Tabipler Birliği İzmir Tabip Odası Delegesi 2024-2026

Ayrıca 1977 den beri ödüllü ve çeşitli sergilerde, basında yer almış Karikatürist