Araştırma Çıktıları
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Item Cluster Analysis Revealed Two Hidden Phenotypes of Cluster Headache(FRONTIERS MEDIA SA, 2022-01-01) Dikmen, Pinar Yalinay; Ari, Cagla; Sahin, Erdi; Ertas, Mustafa; Domac, Fusun Mayda; Aydinlar, Elif Ilgaz; Sahin, Aysenur; Ozge, Aynur; Ozguner, Hilal; Karadas, Omer; Shafiyev, Javid; Vuralli, Doga; Aktan, Cile; Oguz-Akarsu, Emel; Karli, Necdet; Zarifoglu, Mehmet; Bolay, Hayrunisa; Ekizoglu, Esme; Orhan, Elif Kocasoy; Tasdelen, Bahar; Baykan, BetulObjectiveTo investigate the possible subgroups of patients with Cluster Headache (CH) by using K-means cluster analysis. MethodsA total of 209 individuals (mean (SD) age: 39.8 (11.3) years), diagnosed with CH by headache experts, participated in this cross-sectional multi-center study. All patients completed a semi-structured survey either face to face, preferably, or through phone interviews with a physician. The survey was composed of questions that addressed sociodemographic characteristics as well as detailed clinical features and treatment experiences. ResultsCluster analysis revealed two subgroups. Cluster one patients (n = 81) had younger age at diagnosis (31.04 (9.68) vs. 35.05 (11.02) yearsItem A Case with Cramp-Fasciculation Syndrome(DERMAN MEDICAL PUBL, 2016-01-01) Dikmen, Pinar Yalinay; Aysevener, Elif OnurCramp-fasciculation syndrome is one of the peripheral nerve hyperexcitability disorders and presents muscle aching, cramps, stiffness and exercise intolerance. Fasciculation and cramps can be seen both in healthy individuals and in those with fatal diseases, such as Amyotrophic Lateral Sclerosis. We present a 27-year-old male patient, professional soccer player with fasciculations and cramps in bilateral gastrocnemius-soleus complex. The patient complained about having to stop playing soccer because of muscle cramps and twitches in both calves, which had started 3 years earlier. After completing all laboratory and electrophysiological examinations, the patient was diagnosed as cramp-fasciculation syndrome. The aim of this paper was to present a rare case of cramp-fasiculation syndrome and discuss if the syndrome is benign or pioneer of a severe pathological process.Item Intraoperative Neurophysiological Monitoring to Prevent New Neurological Deficits in Spinal Tumor Cases(TURKISH NEUROLOGICAL SOC, 2014-01-01) Aydinlar, Elif Ilgaz; Dikmen, Pinar Yalinay; Silav, Gokalp; Berkman, Mehmet Zafer; Elmaci, Ilhan; Ozgen, SerdarObjective: Intraoperative neurophysiological monitoring was carried out in patients with spinal cord tumors. These patients were retrospectively evaluated for new postoperative neurological deficits. Materials and Methods: A total of 32 spinal tumor cases (8 cervical, 14 thoracic, 10 lumbosacral), 17 male and 15 female, patients between 2-66 years of age (mean 44.1 +/- 20) operated in our center were evaluated. All of our cases were monitored with somatosensory evoked potentials (SEP) muscular motor evoked potentials (MEP) and free run electromyography. Spinal MEP (D wave), bulbocavernosus reflex (BCR) and pudendal SEP were obtained in appropriate cases. Results: Five cases presented with temporary new postoperative neurological deficits in the form of strength loss. Neurophysiological recordings of all of these patients showed either temporary or permanent deterioration during surgery. The tumor was removed completely or almost completely in 26, near-completely in 4 and partially in 2 cases and none of our cases had a new permanent deficit. Conclusion: The functional integrity of the lateral and dorsal columns of the spine can be assessed by SEP and muscular MEP recording. Additional information about the neurological tissue is given by spinal MEP, BCR and pudendal SEP in suitable cases. We did not experience any false positive or negative results in our cases and we believe that the combined use of intraoperative spinal and MEP in spinal column located tumors gives reliable information about postoperative neurological outcome.Item A Review on Cutaneous and Musculoskeletal Manifestations of CLOVES Syndrome(DOVE MEDICAL PRESS LTD, 2022-01-01) Durmaz, Emel Ozturk; Demircioglu, Deniz; Dikmen, Pinar Yalinay; Alanay, Yasemin; Alanay, Ahmet; Demirkesen, Cuyan; Tokat, Fatma; Karaarslan, ErcanCLOVES syndrome is a novel sporadic mosaic segmental overgrowth syndrome, currently categorized under the canopy of PROS (PIK3CA-related overgrowth spectrum) disorders. All PROS disorders harbor heterozygous postzygotic activating somatic mutations involving the PIK3CA gene. As an upstream regulator of the PI3K/AKT/mTOR signal transduction pathway, activating mutations of PIK3CA gene commence in uncontrolled growth of cutaneous, vascular (capillaries, veins, and lymphatics), adipose, neural, and musculoskeletal tissues. The excessive growth is segmental, patchy, asymmetric, and confined to body parts affected by the mutation. The term `CLOVES' is an acronym denoting congenital lipomatous overgrowth, vascular malformations, epidermal nevi and spinal (scoliosis) and/ or skeletal anomalies. The syndrome is characterized by an admixture of overgrown tissues, derived mainly from mesoderm and neuroectoderm. Among PROS disorders, CLOVES syndrome represents the extreme end of the spectrum with massive affection of almost the entire body. The syndrome might judiciously be treated with medications hampering with the PI3K/AKT/mTOR signal transduction pathway. This article aims at reviewing the cutaneous and musculoskeletal manifestations of CLOVES syndrome, as the paradigm for PROS disorders. CLOVES syndrome and other PROS disorders are still misdiagnosed, underdiagnosed, underreported, and undertreated by the dermatology community.Item The relation of sexual function to migraine-related disability, depression and anxiety in patients with migraine(BMC, 2014-01-01) Eraslan, Defne; Dikmen, Pinar Yalinay; Aydinlar, Elif Ilgaz; Incesu, CemDepression and anxiety are two phenomena that affect quality of life as well as sexual function. Depression and anxiety levels are reported to be high in migraine sufferers. We aimed to understand whether sexual function in women with migraine was associated to migraine-related disability and frequency of migraine attacks, and whether this relationship was modulated by depressive and anxiety symptoms. As migraine is more commonly seen in females, a total of 50 women with migraine were included. The diagnosis of migraine with or without aura was confirmed by two specialists in Neurology, according to the second edition of International Headache Society (IHS) International Classification of Headache Disorders (ICHD-II) in 2004. Migraine disability assessment scale score, female sexual function index scores, Beck depression inventory score and Beck anxiety inventory scores. Mean MIDAS score was 19.3 +/- 12.8, and mean number of migraine attacks per month were 4.3 +/- 2.7. Mean Female Sexual Function Index score was 20.9 +/- 5.9 and 90\% of patients had sexual dysfunction. Sexual dysfunction was not related to MIDAS score or frequency and severity of attacks. No relationship between sexual function and anxiety was found, whereas severity of depressive symptoms was closely related to sexual function. Depressive symptoms affected all dimensions of sexual function, except for pain. Sexual dysfunction seemed to be very common in our patients with migraine, while not related to migraine related disability, frequency of attacks and migraine severity or anxiety. The most important factor that predicted sexual function was depression, which was also independent of disease severity and migraine related disability. While future larger scale studies are needed to clarify the exact relationship, depressive and sexual problems should be properly addressed in all patients with migraine, regardless of disease severity or disability.Item Diagnostic use of dermatomal somatosensory-evoked potentials in spinal disorders: Case series(MANEY PUBLISHING, 2013-01-01) Dikmen, Pinar Yalinay; Oge, A. EmreObjective/Context: Dermatomal somatosensory-evoked potentials (dSEPs) may be valuable for diagnostic purposes in selected cases with spinal disorders. Design: Reports on cases with successful use of dSEPs. Findings: Cases 1 and 2 had lesions causing multiple root involvement (upper to middle lumbar region in Case 1 and lower sacral region in Case 2). Cystic lesions in both cases seemed to compress more than one nerve root, and stimulation at the center of the involved dermatomes in dSEPs helped to reveal the functional abnormality. Cases 3 and 4 had lesions involving the spinal cord with or without nerve root impairment. In Case 3, an magnetic resonance imaging (MRI)-verified lesion seemed to occupy a considerable volume of the lower spinal cord, causing only very restricted clinical sensory and motor signs. In Case 4, a cervical MRI showed a small well-circumscribed intramedullary lesion at right C2 level. All neurophysiological investigations were normal in the latter two patients (motor, tibial, and median somatosensory-evoked potentials in Case 3, and electromyography in both) except for the dSEPs. Conclusions: Objectifying the presence and degree of sensory involvement in spinal disorders may be helpful for establishing diagnoses and in therapeutic decision-making. Valuable information could be provided by dSEPs in selected patients with multiple root or spinal cord involvement.Item Determination of Anxiety, Health Anxiety and Somatosensory Amplification Levels in Individuals with Benign Paroxysmal Positional Vertigo(AVES, 2019-01-01) Ozdilek, Alper; Dikmen, Pinar Yalinay; Acar, Erkan; Aksoy, Elif Ayanoglu; Korkut, NazimOBJECTIVES: Psychiatric cornorbidities may intensify peripheral vertigo and increase the number of repositioning maneuvers required. This study was designed to examine the relationship between benign paroxysmal positional vertigo (BPPV) and anxiety and assess its association with somatic amplification and health anxiety. MATERIALS and METHODS: Sixty patients with BPPV (43 women, 17 menItem Association between somatic amplification, anxiety, depression, stress and migraine(BMC, 2013-01-01) Yavuz, Burcu Goksan; Aydinlar, Elif Ilgaz; Dikmen, Pinar Yalinay; Incesu, CemThe aim of this study is to investigate the associations between migraine related disability and somatosensory amplification, depression, anxiety, and stress. Fifty-five migraine patients who applied to the outpatient unit of the Neurology Department of Acibadem University School of Medicine, Maslak Hospital in Istanbul, Turkey, and twenty-eight subjects without migraine were recruited for the study. The participants were asked to complete a sociodemographic form, Migraine Disability Assessment Scale (MIDAS), Depression Anxiety Stress Scale, Somatosensory Amplification Scale (SSAS). Somatosensory amplification scores were significantly higher in the migraineurs than in the control group (29.85+/-6.63 vs 26.07+/-7.1Item Restless Legs Syndrome Treatments in Adults: Practice Guideline Summary of American Academy of Neurology(GALENOS PUBL HOUSE, 2017-01-01) Dikmen, Pinar YalinayRestless legs syndrome is a common neurological disorder characterized by intense restlessness, relaxed with action, disturbance in the limbs and unpleasant sensations. Treatment should be considered if restless legs syndrome symptoms lead to sleep disturbances or affect daytime functions significantly. The purpose of this review is to summarize the evidence-based recommendations of the American Academy of Neurology, published in 2016, for the treatment of restless legs syndrome in adults.Item The Acute Treatment of Migraine Attack in Adults and American Headache Society Evidence Assessment of Migraine Pharmacotherapies(TURKISH NEUROLOGICAL SOC, 2016-01-01) Dikmen, Pinar YalinayMigraine is a common, the primary debilitating and recurring headache disorder. The main purpose migraine acute pharmacology is to reduce the impact and disability caused by the attack of migraine. This review primarily reminds clinical pearls in acute treatment of migraine and also summarizes the American Headache Society Evidence Assessment of Migraine Pharmacotherapies that published last year.