Person: BİCAN DEMİR, AYLİN
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BİCAN DEMİR
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AYLİN
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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 Fluoxetine-associated sleep disorders-report of two cases and literature review(Galenos Yayıncılık, 2021-09-01) Leba, Leyla Köse; Demir, Aylin Bican; BİCAN DEMİR, AYLİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı; 0000-0001-6739-8605; V-7170-2017Narcolepsy is a condition characterised by excessive daytime sleepiness, cataplexy, hypnogogic hallucination and sleep paralysis. Sleep-related eating disorder (SRED) is a parasomnia that occurs while sleeping and manifests itself as paroxysmal episodes of involuntary eating and/or drinking. Both sleep disorders often occur as primary conditions. Sleep disorders secondary to medical treatment less often occur. This report presents the case of a patient with narcolepsy and another with SRED as a result of anamnesis and polysomnography. These sleep disorders are due to recently initiated fluoxetine treatment. Sleep disorder occurring as secondary to medication has been ignored because it has eluded the clinicians.Publication Hypersomnia in gulllain-barre syndrome: A co-incidental or an aetiological association?(Galenos Publ House, 2021-06-01) Demir, Aylin Bican; Dinc, Yasemin; DİNÇ, YASEMİN; BİCAN DEMİR, AYLİN; Bakar, Mustafa; BAKAR, HACI MUSTAFA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605Increased daytime sleepiness, hypersomnia, is a very common symptom in the general population and may cause serious problems in their lives. Hypersomnia may be idiopathic or may occur secondary to other aetiologies. Infections and vaccinations may also be related to hypersomnias. A 74-year-old man complaining of muscle weakness after severe diarrhoea was admitted and diagnosed with Guillain-Barre syndrome (GBS). He also complained of increased daytime sleepiness since the emergence of his weakness, for which all metabolic and endocrine aetiologies were excluded. A full night polysomnography and multiple sleep latency test revealed objective daytime sleepiness and tree episodes of rapid eye movements during sleep periods. Because of the temporal association, the patient was diagnosed with secondary narcolepsy secondary to post-infectious GBS.Publication Neuro-behcet is a rare disease but should be considered in all kinds of neurological findings, even in childhood(Clinical & Exper Rheumatology, 2022-08-01) Toker, Rabia Tütüncü; Bodur, Muhittin; Demir, Aylin Bican; Okan, Mehmet Sait; TÜTÜNCÜ TOKER, RABİA; BODUR, MUHİTTİN; BİCAN DEMİR, AYLİN; OKAN, MEHMET SAİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Nörolojisi Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0002-3129-334X; 0000-0002-2588-8195; 0000-0001-6739-8605; 0000-0002-9303-5768; IZP-6290-2023; JAN-9435-2023; KHB-9765-2024; DKC-6496-2022Objective: Behfet's disease (BD) is a vasculitis characterised by eye, musculoskeletal, neurological and gastrointestinal involvement, in addition to recurrent oral ulcers. Neuro-Behvet is the term used to define the nervous system involvement in BD and is very rarely seen in childhood. This study aims to show that neuro-Behret can manifest a clinical course involving all kinds of neurologic findings in the paediatric population.MethodsThe Clinic of Paediatric Neurology at Uludag University provides tertiary treatment for children up to eighteen years of age in Bursa, Turkey. Five patients who were clinically diagnosed with Neuro-Beket in the last 5 years were included in the study. Results: Seizure, myopathy, transverse myelitis, polyneuropathy, venous thrombosis and facial nerve paralysis were respectively seen in the patients. ConclusionNeuro-Behfet is rare in children, but it is important to know that it can cause various neurological findings, and also systemic findings should be taken into consideration in the diagnosis of neurological diseases. Studies on the neurological involvement of BD in children are inadequate. We believe that paediatric neurologists should be more aware of the neuro-Behfet condition.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 Obstructive sleep apnea syndrome and cardiovascular diseases; the role of hypertension(Galenos Yayınevi, 2022-09-01) Dinç, Yasemin; Demir, Aylin Bican; DİNÇ, YASEMİN; BİCAN DEMİR, AYLİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0003-0342-5939; IUQ-6999-2023; JZV-0986-2024Objective: Obstructive sleep apnea syndrome (OSAS) is a common disorder that results from the collapse of the upper airways during sleep and causes temporary hypoxia. OSAS and hypertension are common and multifactorial diseases. aim This study aimed to determine the clinical, demographic, polysomnographic and prognostic features of OSAS patients with hypertension.Materials and Methods: In this study, 364 patients diagnosed with OSAS in the sleep laboratory of the Department of Neurology, Bursa Uludag University Faculty of Medicine between 2016 and 2021 were retrospectively scanned and included. The patients were analyzed by comparing them with and without hypertension.Results: When patients with and without hypertension were compared according to clinical, demographic and polysomnography data, age (p<0.001), sex (p=0.009), presence of diabetes mellitus (DM) (p<0.001), presence of coronary artery disease (p<0.001), presence of heart failure (p=0.020), presence of atrial fibrillation (p=0.004), ischemic stroke (p<0.001), minimum oxygen saturation (p=0.015), oxygen desaturation index (p=0.034) and body mass index (BMI) (p<0.001) were statistically significantly correlated. When the significant variables were analyzed with binary logistic regression, the most significant variables were age [p<0.001, odds ratio (OR): 1.07], DM (p<0.001, OR: 7.58), coronary artery disease (p=0.003, OR: 4.92), heart failure (p=0.041, OR: 5.53), ischemic stroke (p=0.042, OR: 3.38) and BMI (p<0.001, OR: 1.28).Conclusion: In this study, we found that cardiovascular diseases such as coronary artery disease, heart failure and ischemic stroke are more common in OSAS patients with hypertension, and this is independent of risk factors such as age, DM and BMI. OSAS and cardiovascular diseases may show ethnic and racial differences. For this reason, we suggest conducting multicenter prospective studies examining the effects on blood pressure regulation and cardiovascular diseases in our own population.Publication Awareness of sleep and narcolepsy in children(Galenos, 2020-06-01) Demir, Aylin Bican; Okan, Mehmet Sait; Tütüncü, Rabia Toker; TÜTÜNCÜ TOKER, RABİA; Demir, Aylin Bican; BİCAN DEMİR, AYLİN; Okan, Mehmet Sait; OKAN, MEHMET SAİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-3129-334X; 0000-0001-6739-8605; 0000-0002-9303-5768; IZP-6290-2023; V-7170-2017; JCE-6657-2023Objective: This study aimed to increase the awareness of narcolepsy in children and emphasize the reduction of the socioeconomic burden caused by the delayed or incorrect diagnosis.Materials and Methods: Demographic characteristics, clinical features, and electrophysiological studies of children diagnosed with narcolepsy in the Bursa Uludag University, Health Practice and Research Hospital, Clinic of Pediatric Neurology, were obtained from medical records.Results: Six children were included in the study. The average age at which the initial symptoms were observed was 11.5 years, whereas the average age of diagnosis was 13.5 years. Daytime sleep was accompanied by cataplexy in five cases and hypnogogic hallucinations in one case. Notably, the seizure was primarily considered in the differential diagnosis before diagnosing narcolepsy.Conclusion: It is crucial to increase the awareness of narcolepsy by physicians. Although families and children cannot express sleep disorders, we believe that questioning of sleep patterns during anamnesis in routine neurology practice could prevent delayed diagnosis.Publication Evaluation of ischemic stroke and risk factors of atrial fibrillation in patients with obstructive sleep apnea syndrome(Galenos Yayınevi, 2021-12-01) Dinç, Yasemin; Demir, Aylin Bican; DİNÇ, YASEMİN; BİCAN DEMİR, AYLİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; 0000-0001-6739-8605; IWC-9957-2023; KHB-9765-2024Objective: Obstructive sleep apnea syndrome (OSAS), a sleep-related breathing disorder, is characterized by apnea and hypoapnea. In patients with OSAS, ischemic stroke may have various causes such as large-vessel atherosclerosis and cardioembolism. OSAS is one of the risk factors of atherosclerosis, and it is thought to increase the risk of ischemic stroke by triggering atherosclerosis. Many studies have shown the relationship between OSAS and cardioembolic stroke. Ischemic stroke is a heterogeneous group of diseases caused by many complex mechanisms and may show ethnic and racial differences. This study aimed to determine the etiology and risk factors of ischemic stroke in the patient group diagnosed with OSAS in our population.Materials and Methods: A total of 343 patients were retrospectively screened to determine the prevalence and risk factors of ischemic stroke in patients with obstructive sleep apnea in the sleep laboratory of the Department of Neurology, Faculty of Medicine, Uludag University, between 2015 and 2020.Results: The study included 38 (11%) patients who were diagnosed with ischemic stroke. When patients with and without ischemic stroke were compared according to clinical, demographic, radiological, and polysomnographic data, a significant relationship was found in age, atrial fibrillation (AF), heart failure, hypertension, coronary artery disease, diabetes mellitus, smoking, and non-rapid eye movement 1. According to the binary logistic regression analysis, the variable most significantly related with ischemic stroke was AF. A significant relationship was found between OSAS severity and AF.Conclusion: OSAS is a treatable sleep disorder that causes cardiovascular morbidity. OSAS is an important risk factor for the development and recurrence of AF. In this study, AF is the most important variable related to ischemic stroke in patients with OSAS, and it is associated with the severity of OSAS. Thus, patients with OSAS must be evaluated for AF to prevent ischemic stroke.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.