Person: OKAN, MEHMET SAİT
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Publication Evaluation of patients admitted to pediatric emergency outpatient clinic with non-traumatic neurological complaint(Bursa Uludag Univ, 2020-12-01) Toker, Rabia Tutuncu; TÜTÜNCÜ TOKER, RABİA; Bodur, Muhittin; BODUR, MUHİTTİN; Özmen, Abdullah Hakan; ÖZMEN, ABDULLAH HAKAN; Okan, Mehmet Sait; OKAN, MEHMET SAİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0002-3129-334X; 0000-0002-2588-8195; 0000-0002-9303-5768; JAN-9435-2023; AAH-2684-2021; AAE-2163-2022; IZP-6290-2023; AAF-8981-2020INTRODUCTION: Pediatric Emergency Outpatient Clinic are the units where treated the entire range of emergent and urgent medical conditions. Patients present with a wide range of complaints. Determining the general distribution, frequency and density of Pediatric Emergency Outpatient Clinic applications is of great importance in order to make appropriate future plans. In this study, it was aimed to evaluate the clinical features of patients presenting with non-traumatic neurological complaints.MATERIALS and METHODS: The files of the patients who applied to the Pediatric Emergency Outpatient Clinic within one year were evaluated retrospectively. Patients with a known neurological disease who presented to the Pediatric Emergency Outpatient clinic with non neurological complaints, those in the neonatal and trauma patients were not included in the study.RESULTS: It was found that the main complaint of 628 of the patients who applied to the Pediatric Emergency Outpatient Clinic within a year was neurological symptoms. % 50,3 of the patients were found as girls and %49,7 as boys. Seizure was the most common neurological complaint. It was found that %83,1 of the patients who presented with seizures for the first time presented with a febrile seizures and %16,9 with febrile seizures. Status epilepticus rate was found to be %4,5 in patients presenting with seizuresCONCLUSIONS: Seizure was the most common non-traumatic neurological presentation to Pediatric Emergency Outpatient Clinic. We believe that updating knowledge and skills on emergency approach to seizures in Pediatric Emergency Outpatient Clinic will increase the quality of healthcare services to be provided.Publication Evaluation of magnetic resonance (MR) findings in patients with refractory epilepsy(Kare, 2020-01-01) Çat, Fatma Çetinkaya; Okan, Mehmet Sait; OKAN, MEHMET SAİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Nörolojisi Anabilim Dalı.; 0000-0002-7155-6634; DKC-6496-2022Objectives: Epilepsy is characterized as a tendency towards recurrent seizures and it is a significant health problem in the world and one of the most common severe neurologic disorders among children. This study aims to evaluate the outcome of magnetic resonance imaging in determining the etiology in patients with refractory epilepsy and to reveal pathologies that may have the potential to be treated with methods, such as epileptic surgery.Methods: Data were obtained from the patient files of the patients diagnosed with epilepsy and monitored for at least two years between 01.01.2009-12.31.2012 in the Uludag Faculty of Medicine, the Division of the Pediatric Neurology. File records of the patients, age, sex and MRI findings of the patients were recorded.Results: One hundred twenty were girls (49%) and 125 were male (51%) of the cases. The age range ranged from 1 to 18 years and the median value was 8.3 (1-18) years. One hundred twenty of the 245 patients who met the diagnostic criteria for resistant epilepsy was found as well controlled. In patients with resistant epilepsy, the findings of these two groups of patients were compared concerning MR findings. Among all patients, 154 (62.8%) patients were found to have MR pathology. Of these patients, 83 (53.9%) were in the resistant group and 71 (46.1%) were in the well-controlled group. There was no significant difference in the presence of MR findings between the two groups (p=0.354). The highest incidence (24.8%) of the encephalomalacia in patients in the resistant group may explain the association of perinatal hypoxia with resistance development.Conclusion: If patients with epilepsy can be predicted early in the disease, which group of the patients will not respond well to medical treatment; unlike other patients, different treatment modalities, such as antiepileptic use, vagal nerve stimulation, ketogenic diet and epilepsy surgery, can be applied to this group of the patients. We think that clinicians can guide the planning of treatment of the MR findings.Publication Etiology, clinic and prognosis of seizures in preterm and term neonates: A retrospective study(Bursa Uludag Üniversitesi, 2021-08-01) Cakir, Salih Cagri; ÇAKIR, SALİH ÇAĞRI; Toker, Rabia Tutuncu; TÜTÜNCÜ TOKER, RABİA; Koksal, Nilgun; Ozkan, Hilal; ÖZKAN, HİLAL; Okan, Mehmet Sait; OKAN, MEHMET SAİT; Kocael, Fatma; KOCAEL, FATMA; Yoruk, Gulce; YÖRÜK, GÜLCE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dali; 0000-0001-5761-4757; 0000-0002-3129-334X; 0000-0002-9303-5768; 0000-0002-1787-6872; IZP-6290-2023; HJZ-4508-2023Introduction: The seizure is one of the most common neurological problems in neonatal intensive care units (NICU). Its frequency and etiology differ between preteen and term babies. This study aimed to investigate the properties, causes, response to treatment, and prognostic factors of neonatal seizures in term and preterm babies.Materials and Methods: The files of patients with a diagnosis of neonatal seizure in the NICU between 01/01/2014 and 01/09/2019 were analyzed retrospectively. Gross motor function classification, hearing test results and epilepsy rates were examined for neurological outcomes.Results: A total of 86 patients (43 preterm and 43 term infants) were included in this study. The most common etiological factors were hypoxic-ischemic encephalopathy (HIE) (35%) in term infants and intraventricular hemorrhage (IVH) in preterm infants (54%). The most common seizure type was subtle seizures in preterm babies and clonic seizures in term babies. The first seizure day was more on the first day and between the 4-7 days in term babies and after seventh days in preterm babies (p <0.05). The onset time of seizures in preterm babies was more after seven days at IVH, and on the first day at HIE (p<0.05). Status epilepticus frequency is higher in preterm (30%) than term (9.3%) (p = 0.015). The response rate to phenobarbital treatment was 71% in term infants and 50% in preterm infants (p = 0.06). According to the criteria (death, epilepsy, hearing loss, autism and gross motor function scale> 2) in our study, the poor prognosis rates were (52%) in term infants and (75%) in preterm infants (p = 0.051).Conclusion: In the etiology of neonatal seizures, IVH in preterm infants and HIE in term infants were the first. The neurological outcomes of patients who had convulsions in the neonatal period should be followed closely.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 Facial colliculus syndrome due to a Herpes simplex virus infection following Herpes labialis(Turkish J Pediatrics, 2021-07-01) Bodur, Muhittin; Toker, Rabia Tütüncü; Özmen, Abdullah Hakan; Okan, Mehmet Sait; BODUR, MUHİTTİN; TÜTÜNCÜ TOKER, RABİA; ÖZMEN, ABDULLAH HAKAN; OKAN, MEHMET SAİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Nörolojisi Bilim Dalı.; 0000-0002-2588-8195; 0000-0002-3129-334X; 0000-0002-9303-5768; IZP-6290-2023; AAF-8981-2020; AAH-2684-2021; AAE-2163-2022; JAN-9435-2023; DKC-6496-2022Background. The facial colliculus is an elevated area that is formed by fibers from the motor nucleus of the 7'th cranial nerve as they loop over the abducens nucleus. Clinical signs and symptoms of facial colliculus lesions occur primarily due to injury to the abducens nerve nucleus, the facial nerve fibers around the abducens nucleus, paramedian pontine reticular formation, and the medial longitudinal fasciculus. The etiology of facial colliculus lesions varies by age. While tumors, demyelinating lesions, and viral infections can be involved in young individuals' etiology, vascular ischemia is a common causative factor in older people. Case. In this paper, we present a case of facial colliculus syndrome due to its rare occurrence in a young patient; who developed the signs and symptoms after a herpes infection. Conclusion. Facial colliculus syndrome is rare and the treatment is based on etiology.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 Short-term clinical outcomes of newborns who have neural tube defects(Galenos Yayincilik, 2018-01-01) ÇAKIR, SALİH ÇAĞRI; Dorum, Bayram Ali; TAŞKAPILIOĞLU, MEVLÜT ÖZGÜR; Özkan, Hilal; ÖZKAN, HİLAL; Taşkapılıoğlu, Özgür; Köksal, Nilgün; Toker, Rabia Tütüncü; TÜTÜNCÜ TOKER, RABİA; Okan, Mehmet Sait; OKAN, MEHMET SAİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0001-5761-4757; 0000-0002-2823-8454; 0000-0001-5472-9065; 0000-0002-3129-334X; 0000-0002-9303-5768; A-5375-2017; ABB-8161-2020; AEZ-2469-2022; AAG-8393-2021; IZP-6290-2023; HJZ-4508-2023INTRODUCTION: Neural tube defects (NTD) are one of the most common congenital anomalies of the newborns. The incidence of NTD in Turkey is 3/1000. Various types of NTD appear depending on the part affected by the closure of the neural tube. The etiology of NTD is multifactorial, and a significant portion of them can be prevented by folic acid supplementation. Patients with NTD need long-term medical, surgical and care support.METHODS: In this study, antenatal, natal and postnatal characteristics of NTD patients who were admitted to the NICU between 2013-2017 were examined retrospectively.RESULTS: Twenty-nine NTD patients were included in this study. Sixteen (55%) of the patients were male and 13 (45%) were female. Mean gestational age was 37.5 +/- 1.97 weeks, mean birth weight was 3050 +/- 703.29 grams. Six patients had the following maternal risk factors for NTD development: diabetes, obesity, smoking, and the use of valproic acid. None of the patients used preconceptional folic acid. Of the NTD, 23 were meningomyelocele, 1 was meningocele, 3 were encephalomyelocele, 1 was encephalocele, and 1 was acrania. NTD was the most common at the lumbosacral region (n=10) and the other regions were lomber (n=8), thoracic (n=5), occipital (n=4) and cervical (n=1). While the complete loss of leg movements was seen in eleven of the patients, partial loss was seen in nine of them. The lesion level was higher than L4 in all of those with complete motor dysfunction and in 4 (44%) with partial motor dysfunction. Meningomyelocele sacs were ruptured in seven patients. Shunt procedures were required in 18 of 19 patients with hydrocephalus. Shunt placement and meningomyelocele operations were performed simultaneously in 11 patients.DISCUSSION and CONCLUSION: The preventable etiologic risk factors of NTDs should be known especially by the parents who are considering having a child.Publication Etiologies of convulsive status epilepticus in children(Galenos Yayınevi, 2023-08-01) Toker, Rabia Tütüncü; Bodur, Muhittin; Okan, Mehmet Sait; TÜTÜNCÜ TOKER, RABİA; BODUR, MUHİTTİN; OKAN, MEHMET SAİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Nörolojisi Bilim Dalı.; 0000-0002-3129-334X; 0000-0002-2588-8195; 0000-0002-9303-5768; IZP-6290-2023; JAN-9435-2023; DKC-6496-2022Introduction: Convulsive status epilepticus (CSE) is one of the neurologic emergencies of childhood with varying degrees of impaired consciousness and motor symptoms. The aim of this study was to try to define the etiology of patients with CSE.Materials and Methods: Children aged 1 month to 18 years with CSE were included in the study. The demographic characteristics of the patients, seizure type, seizure etiology, epilepsy history, drugs used, and complications were recorded.Results: One hundred forty-five patients who were diagnosed as having were included in the study, 60.7% of whom were male. The seizure type was focal onset in 55.9% of the patients. According to the etiology of CSE, the most common group was found as unknown group (48%), and 72.9% of those had a history of epilepsy. Febrile (17%) and central nervous system infections (8.3%) were found to be the most common in acute etiology, respectively. Pulmonary complications developed most frequently. The mortality rate was 0.7%.Conclusion: The "unknown etiology" is found as the most common etiology of CSE in children. Febrile seizure and central nervous system infections are common in acute etiologies.Publication Qt dispersion in epileptic children and effect of antiepileptic drugs on QT dispersion(Erciyes Üniversitesi Tıp Fakültesi, 2010-09-01) Şentürk, Ebru Tayfun; Semizel, Evren; Bostan, Özlem Mehtap; Okan, Mehmet; Çil, Ergün; TAYFUN ŞENTÜRK, EBRU; Semizel, Evren; BOSTAN, ÖZLEM MEHTAP; OKAN, MEHMET SAİT; ÇİL, ERGÜN; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Nörolojisi Anabilim Dalı.; 0000-0001-7707-2174; 0000-0003-3516-0082; JMN-6038-2023; DQX-9595-2022; AAG-8558-2021; IMZ-1723-2023; AAG-9324-2021Purpose: Sudden death in epileptic patients may due to epilepsia or drug induced arrhythmia. The aim of this study is to identify changes of QT dispersion, as a predictive marker for arrhythmias, in children treated with antiepileptic drugs.Material and Methods: Ninety children treated with antiepileptic drugs and 30 healthy children as controls were involved in the study. Standard 12-lead surface electrocardiograms (ECG) of the study groups were evaluated before antiepileptic drug therapy and after 3 months. ECG of the control group was also reviewed at the beginning of the study and after 3 months. QT, JT and RR intervals were measured in both groups. The corrected QT (QTc) and JT (JTc) intervals were determined and QTc and JTc dispersions were measured.Results: QTc and JTc dispersion were found to be 85.8+/-16.5 ms and 79.8+/-15.6 ms respectively in patients group before the therapy and 43.3+/-8.2 ms and 40.8+/-5.6 ms in control group at the beginning (p<0.05). Even QTc dispersion were found to be significantly decreased after 3 months of therapy (80.5+/-12.9 ms), it was still significantly higher than the QTc dispersion in control group after 3 months.Conclusion: Determination of QTcd and JTcd values may be useful to predict the risk of sudden death in epileptic patients.Publication The efficacy and adverse effects of topiramate in Add on therapy in children with intractable epilepsy(Galenos Yayıncılık, 2009-12-01) Özdemir, Özlem; Okan, Mehmet; Beyazıt, Aysun N.; Özdemir, Özlem; OKAN, MEHMET SAİT; Beyazıt, Aysun N.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı Hastalıkları Anabilim Dalı/Çocuk Noroloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı Hastalıkları Anabilim Dalı.; FPY-3754-2022; IMZ-1723-2023; EOB-0702-2022Introduction: The aim of this study was to evaluate the efficacy and adverse effects of topiramate add on therapy in children with intractable epilepsy.Materials and Method: The efficacy and adverse events of topiramate were evaluated in 166 children (67 girls, 99 boys). The classification of the epilepsies were as follows: partial 82 (49.4%), generalized 8 (4.8%), secondarily generalized 6 (3.8%), myoclonic 24 (14.5%) and epileptic syndromes 34 (27.7%). Topiramate was initiated at a daily dose of 0.5-1 mg/kg, up to an approximate daily dose of 9 mg/kg. The patients were assessed for the seizure frequency, duration and adverse events during the follow-up. Response to treatment was classified as good (complete, > 75%), moderately (25-75%) and poor (0-25%).Results: Response to treatment among 166 patients were as follows: 85 (51.2%) good, 39 (23.5%) moderately and 42 (25.3%) poor. The efficacy rates according to the seizure types were 45 (54.9%) good, 22 (26.8%) moderately, 15 (18.3%) poor for partial seizures; 8 (100%) good for generalized whereas 10 (41.7%) good, 4 (16.7%) moderately and 10 (41.7%) poor for myoclonic seizures. Generally topiramate appeared to be more effective in partial epilepsy than generalized and myoclonic epilepsy (p=0.008 and p=0.024). Adverse events were present in 33 patients (19.9%), mostly as somnolence (n=9, 5.4%). Topiramate was discontinued because of poor response in 33 patients (19.9%), severe adverse events in 4 (2.4%), increase in the frequency of seizures in 3 (1.8%) and long term seizure free follow-up in 2 (1.2%).Conclusion: Topiramate seems to be highly effective and safe in intractable epileptic patients. However, the drug specific adverse events should always be kept in mind during the follow-up.