Person: BORA, İBRAHİM HAKKI
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BORA
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İBRAHİM HAKKI
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Publication A rare cause of epilepsy: Ulegyria revisited in a series of 10 patients(Sage Publications, 2021-09-17) Demir, Aylin Bican; Eser, Pınar; Bekar, Ahmet; Hakyemez, Bahattin; Bora, İbrahim; BİCAN DEMİR, AYLİN; Eser, Pınar; BEKAR, AHMET; HAKYEMEZ, BAHATTİN; BORA, İBRAHİM HAKKI; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı/Epilepsi Merkezi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-6739-8605; 0000-0003-0132-9927; 0000-0002-3425-0740; ABX-9081-2022; AAI-2073-2021; V-7170-2017; AAI-2318-2021; ENI-7759-2022Introduction. Ulegyria results from perinatal hypoxic-ischemic brain injury in term infants. The specific mushroom-shaped configuration of ulegyria results from small atrophic circumvolutions at the bottom of a sulcus underlying an intact gyral apex. Clinically, ulegyria is generally associated with epilepsy. Here, we aimed to delineate the characteristics of patients with ulegyria and the epileptic seizures they experience. Material and methods. Medical records including radiology and pathology reports, video-electroencephalographic (EEG) analysis, operative notes, hospital progress and outpatient clinic notes were reviewed retrospectively in a total of 10 ulegyria patients. Results. Patients ages ranged between 24 and 58 years (mean, 32 +/- 9.8 years). Past medical history was confirmed for neonatal asphyxia in 2 (20%). Neurological examination was remarkable for spastic hemiparesis in 1 (10%) patient with perisylvian ulegyria and for visual field deficits in 2 patients (20%) with occipital ulegyria. Ulegyria most commonly involved the temporoparietal region (n = 5, 50%) followed by the perisylvian area (n = 2, 20%). Except the one with bilateral perisylvian ulegyria, all patients had unilateral lesions (n = 9, 90%). Hippocampal sclerosis accompanied ulegyria in 2 patients (20%). All patients experienced epileptic seizures. Mean age at seizure onset was 8.8 +/- 5.4 years (range, 2-20 years). Interictal scalp EEG and EEG-video monitoring records demonstrated temporoparietal and frontotemporal activities in 5 (50%) and 2 (20%) patients, respectively. The seizures were successfully controlled by antiepileptic medication in 8 patients (n = 8, 80%). The remaining 2 patients (%20) with concomitant hippocampal sclerosis required microsurgical resection of the seizure foci due to medically resistant seizures. Discussion. Ulegyria is easily recognized with its unique magnetic resonance imaging characteristics and clinical presentation in the majority of cases. It is highly associated with either medically resistant or medically controllable epileptic seizures. The treatment strategy depends on the age at onset and extends of the lesion that has a significant impact on the severity of the clinical picture.Publication Headaches associated with seizure: A prospective comparative cohort study(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2021-03-01) Haki, Cemile; Akdoğan, Özlem; Bora, İbrahim; BORA, İBRAHİM HAKKI; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; ENI-7759-2022Introduction: The purpose of the present study is to examine the frequency of headaches based on their relationship with seizures in epileptic patients as well as types of these headaches, and their clinical characteristics. Methods: 100 patients with epilepsy (60 female, 40 male), who applied to the epilepsy outpatient clinic of Faculty of Medicine of Uludag University, were included in the study after accepting their consent forms. Patients with symptomatic epilepsy, secondary headaches and mental retardation were excluded from the study. Patients with epilepsy were divided into two groups as the patients with or without headaches associated with seizure. In addition, according to their temporal relationships with seizures, headaches were grouped as preictal, ictal and postictal headaches and the characteristics of headaches associated with seizure were examined and the patients with and without headache associated with seizure were compared in terms of their demographic and clinical features. Results: In this study, the prevalence of headache associated with seizure was found as 42%. Headaches associated with seizure were more frequent in the postictal period and they were mostly characterized as migraine-like headache. According to the seizure periods, 22 (52.3%) of the patients experienced pain during every seizure period. It was determined that preictal headache was frequently migraine-like compared to postictal headache and this headache was more frequently accompanied by aura.Conclusion: Headache and epilepsy are the most frequent paroxysmal neurological conditions. However, because the symptoms of epilepsy are more remarkable, and its clinical presentation has a more dramatic picture, additional neurological conditions may be overlooked. Since both epilepsy and headache symptoms decrease the quality of life, it is important to treat both conditions. Examination of the correlation between these two situations can guide the physicians for selecting the treatment type, as well as helping them to improve the quality of life.Publication Two cases of lafora disease diagnosed by genetical tests(Kare Publ, 2021-04-06) Bican Demir, Aylin; Hakkı Bora, İbrahim; BİCAN DEMİR, AYLİN; BORA, İBRAHİM HAKKI; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; KHB-9765-2024; ICC-2353-2023Epilepsy develops related to a complex genetic heredity as many diseases in society. Lafora disease (LD) is an autosomal recessive inheritance. It is localized at EPM2A gen 6q23-25 and encodes tyrosine phosphatase (Laforin protein). About 80% of the patients have mutations in this gene. In a case of LD, rapid and progressive dementia and frequent occipital seizures are clinical symptoms. For definitive diagnosis, through genetical study, EPM2A and EPM2B genes should be analyzed. A male at the age of 18, with a medical history of meningitis and seizures with high temperature. Starting from the age of 10, there have been symptoms such as generalized tonic-clonic (GTC) seizures, startles in the whole body, and forgetfulness. In genetical tests, homozygote deletion of adenine nucleotide in the position of 468 at codon 156 and guanine nucleotide in the position of 469 at codon 157 is found. In other words, there has been dinucleotide deletion which is compatible with LD. A 20-year-old male was examined because of such symptoms as forgetfulness, myoclonia, hallucinations, and GTC clonic seizures. He was diagnosed with LD because of the heterozygote transformation of CCC to CTC at codon 111. Even though genetic disorders have many different reasons, it is advised that every society should have their own advanced studies on gene mutation. In Turkish cases, both of these genes were found mutated, each in different various studies.Publication The evaluation of psychogenic non-epileptic seizures (PNES) cases with saline injection method in video-EEG monitorization unit(Assoc, 2021-04-24) Bora, İbrahim; Demir, Aylin Bican; Ceylan, Dursun; BORA, İBRAHİM HAKKI; BİCAN DEMİR, AYLİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı/Epilepsi ve Uyku Ünitesi.; 0000-0001-6739-8605; V-7170-2017; ENI-7759-2022Background: It has been reported that 10 to 30% of patients sent to epilepsy centers with a diagnosis of refractory epilepsy are diagnosed with psychogenic non-epileptic seizure (PNES). A wide variety of provocative methods are used to assist PNES diagnosis. Objective: To investigate the effect of seizure induction on the diagnosis and prognosis of PNES. Methods: We retrospectively examined 91 patients with PNES complaints in our video-EEG laboratory. Intravenous saline was administered to all patients for induction of seizures. Results: Saline injection was performed in 91 patients referred to our EEG lab with PNES initial diagnosis, 57 of whom were female and 34 male. Saline injection triggered an attack in 82 patients (90%). Conclusions: In this study we have concluded that provocative methods are practical, cheap and, most of all, effective for patient diagnosis. In clinical practice, explaining the diagnosis is the first and most important step of the treatment, and careful patient-doctor communication has a positive impact on patient prognosis.Publication Evaluation of obstructive sleep apnea syndrome in epilepsy patients with polysomnographic data(Kare Yayınevi, 2020-01-01) Leba, Leyla Köse; Demir, Aylin Bican; Bora, İbrahim; BİCAN DEMİR, AYLİN; BORA, İBRAHİM HAKKI; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; KHB-9765-2024; ENI-7759-2022Objectives: Sleep respiratory disorders, which are more common in epilepsy patients, are treatable diseases. We have discussed the diagnosis of sleep apnea syndrome after PSG of epileptic patients with visible apnea and snoring, in light of the findings in the literature.Methods: For this study, from 1120 patients with epilepsy, 32 of them who were diagnosed with OSA in the PSG test were selected. Thirty-two patients with epilepsy that snoring and apnea who consulted sleep center. Patients with simple snoring and upper airway resistance were not selected. Epworth Sleep Scales was applied to all patients and all patients were taken.Results: In this study, the findings showed that the ratio of OUAS in patients with epilepsy was 2.9%. 21 of the 32 cases were male and 11 were female. The mean age was 53 (42-69) years. 72% had partial epilepsies and 28% generalized. The Apne-hypopnea index was 28 (14-48). PAP treatment was performed after the diagnosis of sleep apnea syndrome.Conclusion: Sleep respiratory disorders are more common in patients with epilepsy than the rest of the population and they are treatable diseases. The other study revealed that the frequency of OSAS among epilepsy was 10,2%. In this study, the findings showed that the ratio of OSAS in patients with epilepsy was 2.9%. This a risk for OSAS and the medication used for the treatment should be selected appropriately. Clinical screening of OSAS in settings of epileptic patients may be needed to diagnose to find out it maybe a potential and modifiable risk factor for epilepsy.