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Öğe Bilateral Thalamic Infarct: Occlusion of the Percheron Artery(Aves, 2013) Altunrende, S. Sevil; Canan, Arzu; Yildiz, Serpil; Yildiz, NebilÖğe Evaluation of autonomic nervous system dysfunction in fibromyalgia(2011) Şahin, Özlem; Yildiz, Serpil; Yildiz, Nebil; Yaşar, Mustafa Fatih; Kaptanoğlu, EceAmaç: Fibromyaljide (FM) otonom sinir sistemi (OSS) disfonksiyonu hakkındaki çalışmaların farklı sonuçları vardır. Bu çalışmadaki amacımız sempatik deri yanıtı (SDY) cevaplarını kullanarak FM hastalarında sempatik sinir sistemi disfonksiyonunu değerlendirmektir. Gereç ve Yöntem: Çalışmaya 27 fibromyaljili kadın hasta ve 18 sağlıklı gönüllü kadın kontrol alındı. FM hastaları ve sağlıklı kişiler Beck Depresyon Envanteri (BDE), Beck Anksiyete Envanteri (BAE) ve FM için karakteristik olan kronik semptomlar yönünden sorgulandı. Sağ el palmar SDY, median sinirin bilek hizasında elektriksel olarak uyarılması ile elde edildi. Bulgular: FM hastalarında kronik semptomların çoğu yüksek orandaydı. Hastaların ve kontrollerin SDY amplitüd ve latansları arasında istatistiksel olarak anlamlı bir fark yoktu (p>0,05). BDE ve BAE ortalama değerlerine göre FM hastalarında anksiyete ve depresyon yoktu. Sonuç: Bu çalışmada FM’de OSS disfonksiyonu tesbit edilmedi. SDY sadece sudomotor aktiviteyi gösterdiği için OSS’nin tamamını değerlendirmede yetersiz bir yöntem olabilir. OSS disfonksiyonu FM’nin etyopatogenezinden ziyade FM’de gözlenen bazı kronik semptomlardan, eşlik eden depresyon ve anksiyeteden sorumlu olabilir. FM hastalarının kronik semptom, anksiyete ve depresyon durumları da gözönünde bulundurularak, OSS’nin alt sistemlerini (kardiyovasküler refleks yol, sempatik kolinerjik aktivite gibi) inceleyen çalışmalar ile OSS’nin FM etyopatogenezindeki rolünü belirlemek mümkün olabilir.Türk Fiz Tıp Rehab Derg 2011;57:62-5.Öğe The Evaluation of Small Nerve Fiber Dysfunction with Quantitative Sensory Testing in Patients with Type II Diabetes Mellitus without Large Fiber Neuropathy, and Normal Values for Thermal Thresholds(Aves, 2010) Yildiz, Nebil; Dogan, Nazile; Yildiz, Serpil; Altunrende, Burcu; Dikbas, OguzObjective: Quantitative sensory testing (QST) thermal threshold evaluation is used in order to determine small fiber neuropathy, and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale is used in diagnosing neuropathic pain. The aim of this study is to find out the normal QST thermal threshold values, and to compare the QST values of normal controls and patients with type II diabetes mellitus, who do not have large fiber neuropathy. With this comparison, the study also aims to determine whether QST abnormalities are present in patients without neuropathic pain. Methods: A total of one hundred normal subjects between the ages of 20 and 69, and 50 patients with type II diabetes mellitus aged 40 to 69 years with no sign of large fiber neuropathy were recruited. The normal subjects were divided into 5 subgroups according to their ages. The mean values of the QST thermal detection and thermal pain thresholds were determined. Sixty normal subjects between the ages of 40-69 were defined as a control group for comparison with the diabetic group. The patients were divided into subgroups according to their LANSS points and their data were compared with the data of age-matched controls. Results: The mean ages of total normal subjects and the control group were 44.8 +/- 14.4 and 57.4 +/- 8.4, respectively. In diabetic group, according to LANSS, 10 patients (mean age, 55.1 +/- 8.5 years) scored above 12 (14.6 +/- 3.5), and 40 patients (mean age, 55.5 +/- 8.4 years) scored under 12 points (6.8 +/- 3.4). In the LANSS>12 group, the least abnormality rate was 100%, and the most frequently detected abnormality was in the foot cold pain threshold (70%). In the LANSS<12 group, the least abnormality rate was 67.5%, and the most frequently detected abnormality was in the hand cold pain threshold (45%). Conclusion: It was demonstrated that QST was successful in determining thermal detection abnormalities in all patients with probable neuropathic pain according to LANSS Pain Scale. QST is a test, which gives reliable and reproducible results in the diagnosis of small fiber sensory neuropathy. Because of its subjectivity and inefficacy in differentiation of peripheral and central causes, QST findings should be evaluated together with findings of neurological examination and nerve conduction studies. (Archives of Neuropsychiatry 2010;47:223-9)Öğe Multiple Sclerosis and Hashimoto's Thyroiditis: A Case Report(Aves, 2011) Altunrende, Burcu; Yildiz, Serpil; Yildiz, Nebil; Gurel, KamilIt has been suggested that multiple sclerosis (MS) is an immune-mediated disease directed against central nervous system (CNS) myelin, although the exact pathogenesis is still unclear. There are a lot of reports regarding the coincidence of MS with other immune-mediated diseases. In recent years, there have been only few case reports of MS associated with Hashimoto's thyroiditis. This coincidence is especially important from both clinical and therapeutic standpoints. In this case report, we present a patient with MS and Hashimoto's thyroiditis and summarize the clinical features. (Archives of Neuropsychiatry 2011; 48: 224-6)Öğe Presynaptic Inhibition and Disynaptic Reciprocal 1a Inhibition in Parkinson's Disease, The Effect of The Dopaminergic Treatment(Journal Neurological Sciences, 2010) Yildiz, Nebil; Turkoglu, Sule Aydin; Yildiz, Serpil Kuyucu; Altunrende, BurcuObjective: In recent years, increasing number of studies about the spinal cord pathology in Parkinson's disease had been conducted. H reflex investigation is an important choice in the studies dealing with neurophysiological and interneuronal alterations of the spinal cord. The effect of the dopaminergic treatment on the spinal interneuronal reflex pathways is a relatively less investigated issue. This study has been adressed to assess the presynaptic and disynaptic inhibition levels in Parkinson's disease, and the effect of dopaminergic treatment. Methods: Presynaptic inhibition and dysynaptic reciprocal 1a inhibition is investigated by double stimulation of the tibial nerve at the popliteal fossa and peroneal nerve at the fibular head in patients with Parkinson's disease and also in control subjects for the 1-100 ms conditioning test intervals. The amplitude changes of the test and the conditioned H reflex responses were calculated and compared in the affected and less affected sides in both before and under dopaminergic treatment. Results: Disynaptic and presynaptic inhibitions existed in all subjects. Disynaptic reciprocal 1a inhibition was shortened only at 2 ms conditioning interval. The conditioned and test H reflex ratio (Hc/Ht) for the 20 ms conditioning test interval (presynaptic inhibition) was significantly smaller in the affected side than the controls (p: 0.046). The percentages of the inhibitions for the 20-10-5-3-2 ms conditioning intervals significantly increased in the affected side under treatment when compared with the ones obtained in the pretreatment period (p: 0.031, 0.027, 0.014, 0.026, 0.037). Conclusion: Presynaptic inhibition was decreased and disynaptic inhibition duration was shortened in the affected side of the patients with Parkinson's disease, dopaminergic treatment caused significant increases in both periods of inhibition. These findings indicate an abnormal supraspinal influence on the spinal cord in Parkinson's disease, and also the role of some dopa responsive neural mechanisms.Öğe Sympathetic Skin Responses from the Neck Area in Patients with Unilateral Migraine(Aves, 2015) Korkmaz, Bektas; Yildiz, Serpil; Yildiz, NebilIntroduction: In this study, in patients with unilateral migraine headache and in normal controls, it was aimed to assess the sympathetic function during attack, post attack, and interval periods and to compare these findings by recording sympathetic skin responses from the neck area, which was not studied before. Methods: A total of 37 unilateral patients with migraine (30 women, seven men) who fulfilled the criteria of International Headache Society (2004) were recruited from our outpatient clinic. The control group consisted of 21 healthy individuals (16 women, five men) who are employees or students of our Medical Faculty. Mean latency and maximum amplitude values of sympathetic skin responses obtained from neck areas of the patients during attack, post attack, and interval periods were calculated. We compared the mean latency and the maximum amplitude values of the symptomatic side with the data of the asymptomatic side and with the data of the control group. We also compared the responses of the patients with right-sided headache with the responses of the patients with left-sided headache. All statistical analyses were performed using SPSS. Results: On the neck area, we observed sympathetic hypo-function in the attack and interval periods and a relative hyper-function in the post attack period bilaterally, regardless of the symptomatic side. Conclusion: These findings suggest that there is ongoing bilateral sympathetic hypo-function in the neck area and there occurs a temporary increase in the function of sympathetic sudomotor activity in the recovery period of headaches.
