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Öğe Calcitonin Gene Related Peptide Gene Polymorphism in Migraine Patients(Cambridge Univ Press, 2013) Guldiken, Baburhan; Sipahi, Tammam; Tekinarslan, Remziye; Kabayel, Levent; Ozkan, Hulya; Unlu, Ayhan; Yamasan, Bilge ErenObjective: Calcitonin gene related peptide (CGRP), which has a vasodilator effect, is held responsible for neurogenic inflammation and vasodilatation of the cranial vessels in migraine pathophysiology. In this study, we investigated the association between alpha CGRP gene polymorphism (CALCA T-692C) and migraine. Material and Methods: One hundred and thirty-four female migraineurs and 96 healthy female cases were enrolled in the study. The patient group was further subdivided into migraine with and without aura groups. The CALCA T-692C gene polymorphism was identified using polymerase chain reaction (PCR) technique and restriction fragment length polymorphism (RFLP). Results: The genotype and allele frequencies of CALCA T-692C gene polymorphism did not differ between the migraine and control groups. Between the migraine with and without aura subgroups, there was no difference. No association was seen between the CALCA T-692C gene polymorphisms and migraine attack severity and frequency. Conclusion: Our study did not show any association between CALCA T-692C gene polymorphism and migraine.Öğe Endothelial Nitric Oxide Synthase and Angiotensin Converting Enzyme Gene Polymorphisms in Migraine Patients(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2013) Sipahi, Tammam; Guldiken, Baburhan; Kabayel, Levent; Palabiyik, Orkide; Ozkan, Hulya; Okman Kilic, Tulay; Sut, NecdetIntroduction: In this study, we investigated the association of migraine with the Variable Number of Tandem Repeats (VNTR), repeated as 27 base pair, gene polymorphism in intron 4 of the endothelial nitric oxide synthase (eNOS) and the insertion/deletion of angiotensin converting enzyme (ACE) gene polymorphisms. Methods: One hundred and five migraine and ninety seven healthy female control subjects were enrolled in the study. The patients were subdivided as migraine with aura and without aura, and the frequency and severity of migraine headaches were recorded. The eNOS VNTR (eNOS 4 a/b) and ACE insertion/deletion gene polymorphisms (ACE I/D) were assessed by polymerase chain reactions. Results: The allele and genotype frequencies of eNOS 4 a/b gene polymorphism showed no difference between the migraine and control groups. The genotypic distribution of the ACE I/D gene polymorphism in the migraine group significantly differed from that in the control group. The DD and ID genotype increased the risk of migraine as much as 2.571 (95% CI-1.138-5.811) and 4.453 (95% CI-2.006-9.883) compared to the II genotype. The same increased risk sustained for both genotypes in the migraine with aura subgroup, but only the ID genotype remained as the risk factor in the migraine without aura subgroup (OR-3.750, 95% CI-1.493-9.420). No association of gene polymorphisms with migraine frequency and severity was observed. Conclusion: Our findings support the relationship between migraine and the ACE I/D gene polymorphism. However, no association was found between migraine and the eNOS 4 a/b gene polymorphism.Öğe Factors affecting long-term prognosis in adult patients with psychogenic non-epileptic seizures(Literatura Medica, 2024) Turksever, Meliha; Guldiken, Baburhan; Ozkan, Hulya; Cakar, Merve MelodiBackground and purpose - Among epileptic patients who are monitored using the video-electroencephalography monitoring (VEM) technique, in some patients a psychogenic non-epileptic seizure (PNES) can be identified as a definitive diagnosis. The long-term prognosis of these patients is not well known. In this study, we aimed to determine the factors that affect the prognosis of PNES. Methods - Forty-one PNES patients diagnosed using VEM between 2012 and 2022 were questioned about their PNES frequencies in the last 12 months. According to their semiological characteristics, PNES types were divided into motor and non-motor seizures. The effects of clinical characteristics (e.g. age, gender, marital status, education level and PNES type) on the prognoses were identified. Results - Twenty-one PNES patients (51.2%) had long-term seizure freedom after VEM. Thirteen of them (31.7%) entered the seizure-free period immediately after VEM, and the other eight (19.5%) continued suffering from PNES for several years and became seizure free in the last 12 months. In the poor-prognosis group, female cases showed worse prognoses than male cases. The prognoses of motor and non-motor PNES types did not show significant differences. Conclusion - This study showed that 51.2% of the PNES patients examined had long-term seizure freedom and that female patients had worse prognoses than male patients.Öğe Glu298Asp polymorphism of the endothelial nitric oxide synthase gene in Turkish patients with ischemic stroke(Springer, 2009) Guldiken, Baburhan; Sipahi, Tammam; Guldiken, Sibel; Ustundag, Sedat; Budak, Metin; Turgut, Nilda; Ozkan, HulyaThe low plasma nitric oxide concentrations and reduced vascular reactivity are considered major proatherogenic mechanisms in cardiovascular diseases. The present study aimed to assess the allelic frequency and the genotypic distribution of the Glu298Asp gene polymorphism at exon 7 of endothelial nitric oxide synthase (eNOS) gene in Turkish ischemic stroke patients compared to appropriate healthy controls, and to correlate the genetic findings with stroke subtypes. The study population included 146 (75 males, 71 females) patients with ischemic stroke which were categorized according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) and 133 (34 males, 99 females) healthy subjects. The eNOS polymorphism was identified with a PCR followed by RFLP with the restriction enzyme BanII. Genotypes were defined as GG, GT, and TT according to the presence of the G and T alleles. In this case-control study, we did not find any significant difference in either the genotypic distribution or allelic frequency of Glu298Asp gene polymorphism between the patients and the controls. In addition, there was also no significant difference for the genotype distribution and the allelic frequency among the stroke subtypes. The results suggested the lack of the association between the Glu298Asp gene polymorphism and ischemic stroke or subtypes of ischemic stroke in the Turkish population.Öğe Ictal Asystole in a Patient with Right Temporal Lobe Epilepsy(Taiwan Soc Cardiology, 2022) Kaya, Caglar; Ozkan, Hulya; Yilmaztepe, Mustafa; Aksoy, Yuksel; Baysal-Kirac, Leyla; Gurses, Candan[Abstract Not Available]Öğe Insulin resistance and high sensitivity C-reactive protein in migraine(Cambridge Univ Press, 2008) Guldiken, Baburhan; Guldiken, Sihel; Demir, Muzaffer; Turgut, Nilda; Kabayel, Levent; Ozkan, Hulya; Ozcelik, EmineBackground: A relationship between migraine and vascular disorders such as hypertension, stroke, and coronary ischemia has been recently reported. Insulin resistance and endothelial dysfunction. which commonly underlies these disorders, have not been widely investigated in migraine patients. In this study. we aimed to investigate the existence of insulin resistance and endothelial dysfunction, and their relationship to vascular risk factors in patients with migraine. Methods: We evaluated insulin resistance and high-sensitivity C-reactive protein (hs-CRP), a marker of endothelial dysfunction, in 60 migraine patients and 25 healthy control subjects. Multiple analysis of covariance test was used to adjust for known confounding factors that can influence insulin metabolism and endothelial Function, Such as obesity, blood pressure. and lipid parameters. Results: Insulin resistance, as measured homeostasis model assessment (HOMA)-R levels, was significantly higher in the migraine group (p < 0.001). After adjustment for confounding variables. the relationship between migraine and the HOMA-R levels remained significant (p < 0.001). The hs-CRP levels did not differ between the migraine and control groups. Conclusions: Our data show that insulin resistance is present in migraine patients. Endothelial dysfunction is not found during the headache-free period. Further studies are needed to explain the role of insulin resistance in migraine pathogenesis.Öğe Late-Onset Generalized Myoclonic Seizure: Case Report(Kare Publ, 2021) Ozkan, Hulya; Guldiken, Baburhan; Cakar, Merve Melodi; Sunal, Asli Sert; Kehaya, SezginMost of the epileptic seizures that begin at an advanced age are focal onset seizures due to an underlying structural lesion. Generalized myoc-lonic seizures, usually seen in adolescence, are very rare in elderly patients without a history of epilepsy. In this study, we present a 60-year-old patient with generalized myoclonic seizures with electrophysiological findings. Because of the late-onset, myoclonic jerks were first evaluated with the diagnosis of non-epileptic psychogenic attack in an external health center. The patient was diagnosed with seizure recordings in Elec-troencephalography-video monitoring. The patient responded well to the antiepileptic treatment and became seizure-free.Öğe Latency of epileptic and psychogenic nonepileptic seizures(Assoc Arquivos Neuro- Psiquiatria, 2023) Ozkan, Hulya; Turksever, Meliha; Guldiken, Baburhan; Sut, NecdetBackground Due to their semiological similarities, psychogenic nonepileptic seizures (PNESs) can occasionally hardly be differentiated from epileptic seizures (ESs), and long-term video-electroencephalographic monitoring (VEM) is needed for the differential diagnosis.Objective To investigate the time of the first clinical event and its distribution on the days of VEM in ES and PNES patients.Methods In total, a consecutive series of 48 PNES and 51 ES patients matched for gender and age were retrospectively and consecutively evaluated. The time distribution of the seizures during the day was noted. Seizure latency was determined as the time in hours from the start of the video-electroencephalographic recording to the first clinical event.Results The seizure latency was significantly shorter in PNES patients compared to ES patients ( p < 0.001). Seventy-two percent of PNES patients and 49.1% of ES patients had their first seizure in the 24 hours of video-EEG recording ( p = 0.023). Recording longer than 48 hours was required for 12.5% of PNES patients and 37.3% of ES patients ( p = 0.006). While ESs were almost evenly distributed throughout the day, most PNESs occurred during the evening hours ( p = 0.011).Conclusion We observed that the PNESs appeared earlier than the ESs in the VEM and were concentrated during daylight hours. Although not strictly reliable, seizure latency can contribute to the differential diagnosis of ES and PNES.Öğe Mean platelet volume and peripheral blood count response in acute ischemic stroke(Aves Yayincilik, Ibrahim Kara, 2008) Guldiken, Baburhan; Ozkan, Hulya; Kabayel, LeventObjectives: Mean platelet volume (MPV) is a marker of the platelet activity and is reported to increase in vascular diseases. The aim of the study is to investigate the relationship between MPV and the subtypes of acute ischemic stroke. Patients and Methods: The patient group consisted of 102 acute ischemic stroke patients who were divided into the large vessel (n=43) and the small vessel (n=59) disease subgroups. Their MPV values were compared with those of 48 age/sex-matched healthy individuals. The relationship of MPV with the subtypes and severity of stroke, and other hematological parameters (platelet count, platecrit, hemoglobin, hematocrit, erythrocyte count, mean corpuscular volume, leukocyte, neutrophil, lymphocyte, monocyte) was further investigated. Results: No difference was found in terms of MPV values between the patient subgroups and control group, and no relation was found between MPV and stroke severity and other hematological parameters (p>0.05). A significant increase in the leukocyte and neutrophil count was seen in patients of the large vessel disease group when compared with the small vessel disease and control group (p<0.005). Neutrophil count is found to be a risk factor for the stroke severity (beta=0.362, p=0.01, OR=1.437, Cl %95 0.02-0.08). Conclusion: No significant change in MPV was seen in acute ischemic stroke. High leukocyte and neutrophil levels are markers for the large vessel disease subtype and severity of ischernic stroke.Öğe Nonconvulsive status epilepticus presented with wernicke aphasia: Case report(Wolters Kluwer Medknow Publications, 2020) Ozkan, Hulya; Cakar, Melodi; Akpinar, Meliha; Kehaya, Sezgin; Guldiken, Baburhan[Abstract Not Available]Öğe Posterior Reversible Encephalopathy Syndrome in the Late Postpartum Period: A Case Report(Turkish Neurological Soc, 2018) Cakar, Merve Melodi; Kehaya, Sezgin; Ozkan, Hulya; Guldiken, Baburhan Feyzullah[Abstract Not Available]Öğe Prevalence of Multiple Sclerosis in the Metropolitan Area of Edirne City, Turkey(Galenos Publ House, 2011) Celik, Yahya; Birgili, Ozlem; Kiyat, Asli; Guldiken, Baburhan; Ozkan, Hulya; Yilmaz, Hakan; Saip, SebahattinObjective: The prevalence and incidence of multiple sclerosis may vary according to the influence of the altitude of a geographical area as well as the genetic and environmental factors. This study ained to determine the incidence and prevalence of multiple sclerosis in Edirne population. Material and Methods: Patients with a definite diagnosis of MS according to McDonald's criteria, admitted to one of the three MS clinics in Edirne, were included in this two-stage study. Also the records of hospitals in Istanbul serving patients from Edirne, have been evaluated. Results: The prevalence rate of confirmed MS patients was 33.9/100000(95% CI: 32-36) in 2003. The mean annual incidence was 3.48/100000(95% CI: 2.90-4.00). Mean age of the patients was 36.5 +/- 9.6 years. Mean age at onset was 29.2 +/- 8.5 years. Mean duration of disease was 6.9 +/- 5.2 years. Overall, 69.2% had a relapsing-remitting course, 20.5% had a primary progressive course and 10.3% had a secondary progressive course. Mean Expanded Disability Status Scale score was 3.04 +/- 2.18. The prevalence and annual incidence after one year was 36.5 per 100000 (95% CI: 33.2-38.6) and 2.60 per 100000 (95% CI: 2.1-3.8), respectively. Conclusion: This is the first city-based MS prevalence study performed in Turkey. The MS prevalence in Edirne is similar to that of Greece and Bulgaria but lower than that of European countries.Öğe Soluble CD40 ligand and prolactin levels in migraine patients during interictal period(Bmc, 2011) Guldiken, Sibel; Guldiken, Baburhan; Demir, Muzaffer; Kabayel, Levent; Ozkan, Hulya; Turgut, Nilda; Hunkar, RemziyeThe relationship of migraine with cardiovascular diseases has been clarified by many studies, and currently, migraine is suggested to be a systematic vasculopathy. Inflammation, thrombosis and impaired vascular reactivity are the underlying pathophysiological mechanisms of the vasculopathy. In the present study, we aimed to investigate the relationship between prolactin levels and subclinical atherosclerosis risk factors such as soluble CD40 ligand (sCD40L) and high-sensitivity CRP (hsCRP) in migraine patients during interictal period. Fifty female migraine patients and age-matched 25 female control cases were enrolled in the study. Migraine diagnosis was settled according to the ICHD-II diagnostic criteria. A questionnaire was completed about the existence of vascular risk factors. Serum samples were used to measure sCD40L, hsCRP and prolactin levels. No difference was found between the prolactin levels of the migraine patients and the controls. The sCD40L levels were significantly higher in migraine patients (p<0.001). High-sensitivity CRP levels showed no difference between the groups. There was no correlation between prolactin, sCD40L, and hs-CRP levels in migraine patients. We consider that the migraine patients are prone to subclinical atherosclerosis, but this tendency is independent of prolactin levels.
