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    A Rare Case of Paraneoplastic Limbic Encephalitis leading to Epileptic Seizure in a Patient with Ovarian Carcinoma
    (EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2022-01-01) Aytar, Murat Hamit; Kilickan, Levent; Ustun, Cemal; Akkilic, Elvan Cevizci
    Paraneoplastic limbic encephalitis (PLE), a rare and diagnostically-challenging encephalopathy, is frequently associated with an underlying malign neoplastic tumor. Epileptic symptoms are uncommon but can be the first sign of the disease. We present a patient admitted to our intensive care unit (ICU) unit with epileptic seizure and a Glasgow Coma Scale (GCS) of six. All tests and investigations that had been utilized for this patient's diagnosis, including blood tests, serological analyses, magnetic resonance imaging (MRI), electroencephalogram (EEG) and cerebrospinal fluid (CSF) test results were evaluated. The patient had been diagnosed with ovarian carcinoma within the last year. The patient's cancer history, her most recent complaints and MRI results were strongly suspicious for paraneoplastic limbic encephalitis. Her neurological condition improved rapidly in a few days with steroid therapy. This case showed that any neurological deterioration based on an ovarian oncologic disease can bring PLE to mind. The possibility of PLE must be taken into consideration in patients presenting with epileptic seizures after neoplastic diagnoses.
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    Evaluation of video head impulse test during vertiginous attack in vestibular migraine
    (PACINI EDITORE, 2022-01-01) Koc, Ahmet; Akkilic, Elvan Cevizci
    Objective. The aim of this study is to evaluate vestibular functions with video head impulse test (VHIT) and to understand the value of VHIT in differential diagnosis in patients with vestibular migraine (VM) during dizziness attack. Materials and methods. Two groups were enrolled in this study. The first consisted of 84 vestibular migraine patients, and second group of 74 healthy subjects. VHIT was applied to patients with VM during vertigo attack and the results were compared with the VHIT values applied to subjects in the control group. Results. The mean vestibulo-ocular reflex (VOR) in all semicircular canals in the VM group was lower than healthy individuals, but the results were not statistically significant. Refixa-tion saccades were found in 52.3\% of VM patients and in 10.2\% of healthy individuals. Conclusions. When patients with VM were evaluated with VHIT during vertiginous attack, VOR gain values were not different from healthy individuals, but the number of catch-up saccades were higher in VM patients, which indicates peripheral vestibular involvement. For differential diagnosis in patients with VM, vestibular tests should be performed dur-ing the vertigo attack. When evaluating VHIT results, the presence of refixation saccades should also be evaluated.