Gulcin Benbir

Istanbul University, İstanbul, Istanbul, Turkey

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Publications (43)71.12 Total impact

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    ABSTRACT: Willis-Ekbom disease (restless legs syndrome, WED/RLS) is the most common sleep-related movement disorder in pregnancy. We designed a prospective longitudinal study to investigate the correlates of WED/RLS during and after pregnancy.
    Sleep Medicine 05/2015; DOI:10.1016/j.sleep.2015.01.026 · 3.10 Impact Factor
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    ABSTRACT: Background: The differentiation of narcolepsy without cataplexy from idiopathic hypersomnia is based on the number of sleep onset REM periods (SOREMP) observed by multiple sleep latency test (MSLT) and nocturnal polysomnography (PSG). The main aim of this study was to investigate the utility of SOREMP in differential diagnosis of central hypersomnias. Methods: We retrospectively evaluated consecutive 101 patients with a normal PSG other than the presence of SOREMP and/or REM without atonia, and a latency of <8 minutes in MSLT. Results: We classified patients as follows: 52 patients had at least 2 SOREMPs (narcolepsy group), 23 had no SOREMPs (idiopathic hypersomnia group), and 26 patients had only one SOREMP (intermediate group). In PSG recordings, both mean sleep latency (SOL) and REM latency (REML) were significantly shorter in the narcolepsy (p=0.012, p<0.001, respectively) and intermediate groups (p=0.005 and p=0.035, respectively) compared to the idiopathic hypersomnia group. In MSLT recordings, SOL was 2.7+2.2 minutes in narcolepsy group, 3.6+1.4 minutes in intermediate group, and 5.2+2.7 minutes in idiopathic hypersomnia group (p<0.001). The mean REM latency and sleep stages SOREMPs arised from was similar between narcolepsy and intermediate groups. Conclusion: To date, SOREMPs in MSLT and PSG remain the sole electrodiagnostic feature that discriminates narcolepsy without cataplexy from idiopathic hypersomnia. Different parameters or combined criteria are being increasingly investigated to increase the sensitivity and specificity of MSLT. Our findings showed an altered instability of REM sleep not only in patients with 2 or more SOREMPs in MSLT, but also in patients with one SOREMP.
    Journal of Clinical Neurophysiology 05/2015; DOI:10.1097/WNP.0000000000000192 · 1.60 Impact Factor
  • Sinem Yazici, Gulcin Benbir, Birsen Ince
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    ABSTRACT: Ulcerative colitis (UC) is characterized by an inflammatory disorder of the gastrointestinal tract. Immune-mediated extraintestinal manifestations of UC have increasingly attracted attention in the literature recently, for which UC is now considered as a systemic disease. Neurologic involvement associated with UC is probably under-reported because of the unawareness of many physicians, although early recognition and treatment are crucial in preventing major morbidity and sequel. In this case report is presented a patient newly diagnosed as UC, who developed both sensorineural hearing loss and intractable status epilepticus that we suggest to have resulted from immune-mediated mechanisms.
    01/2015; 6(1):77-9. DOI:10.4103/0976-3147.143205
  • 01/2015; 53(1):11. DOI:10.5455/NYS.20141112110225
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    ABSTRACT: Recurrent hypersomnias are very rare with two subtypes as Kleine-Levin syndrome and menstruation-related hypersomnia, which is very rarely encountered worldwide. Here, we report a young girl with menstruation-related recurrent hypersomnia, who was misdiagnosed as epilepsy due to co-existing generalized epileptic discharges. The importance of this comorbidity in terms of differential diagnosis of the attacks is discussed.
    Journal of Pediatric Neurosciences 01/2015; 10(1):28-30. DOI:10.4103/1817-1745.154325
  • La Presse Médicale 12/2014; 44(1). DOI:10.1016/j.lpm.2014.05.022 · 1.17 Impact Factor
  • Gulcin Benbir, Meral E Kiziltan
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    ABSTRACT: The somatosensory-evoked blink reflex (SBR) is one of the release phenomena of blink reflex, possibly resulting from increased excitability of brainstem reticular formation. The authors investigated trigeminal blink responses and SBR in 26 patients with postparalytic facial syndrome (PFS) with synkinesia, 18 patients with essential blepharospasm, and 36 healthy volunteers (control participants). Trigeminal blink reflex responses were elicited in all participants, whereas SBRs were elicited in 44.4% of control participants, 38.9% of patients with essential blepharospasm, and 65.4% of patients with PFS. The mean R2 amplitude and duration and the mean amplitude and duration of SBR were highest in patients with essential blepharospasm. The mean latency of SBR was shorter on the symptomatic side of patients with PFS when compared with the asymptomatic side. The mean R2 duration on the symptomatic side of the patients with PFS was longer than the control participants. These results showed that somatosensory stimulation could be used as an alternative method to demonstrate increased excitability in facial motor neuron in patients with PFS and essential blepharospasm. Disease states relating to different peripheral and/or suprasegmental structures could also influence blink reflex and change its basal excitability and manner in which the reflex responds to modulatory factors.
    Journal of clinical neurophysiology: official publication of the American Electroencephalographic Society 12/2014; 31(6):535-40. DOI:10.1097/WNP.0000000000000095 · 1.60 Impact Factor
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    ABSTRACT: Creutzfeld-Jacob disease (CJD) is a rare, progressive disease that has a vast clinical manifestation range. Cranial magnetic resonance imaging (MRI), electroencephalography (EEG), and measurement of 14-3-3 in cerebrospinal fluid (CSF) may offer a pragmatic approach in the diagnosis of CJD as an alternative to histopathological confirmation. To present the symptoms and signs of the CJD patients in regard to radiological and neurophysiological findings. We collected all cases with the diagnosis of probable CJD admitted to our neurology department between June 2010 and June 2014. The medical records and laboratory data, clinical features, results of MRI (including diffusion weighted images), EEG and CSF evaluations, and other laboratory data to exclude other possible diagnoses were recorded. None of the patients underwent biopsy or autopsy for histological diagnosis. Of 20 patients, 11 (55%) were men and nine (45%) were women. The mean age at disease onset was 60.0 ± 9.5 years (age range, 47-80 years). All patients without exception had characteristic abnormalities in DWI and/or FLAIR on admission, about 4 months after the initial symptom. Periodic complexes on EEGs characteristic for CJD were detected only in 10 patients (50%) on admission and in 13 patients (65%) during disease course. Out of 14 patients who underwent CSF examination, 11 (78.5%) were positive for 14-3-3 protein. Although the definite diagnosis of CJD is made histopathologically, we aimed to discuss the value of magnetic resonance imaging in the diagnosis of CJD in respect to EEG findings and protein 14-3-3 levels in CSF.
    11/2014; 3(10):2047981614552218. DOI:10.1177/2047981614552218
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    ABSTRACT: AimThe prevalence of insomnia is influenced by environmental factors. This study aimed to investigate the prevalence of insomnia and its sociodemographic and clinical correlates in a general population-based survey in Turkey.Methods This population-based study included 4758 subjects among 5021, who participated in TAPES (Turkish Adult Population Epidemiology of Sleep Disorders) study. Questionnaire items evaluating insomnia were adapted from International Classification of Sleep Disorders (ICSD)-II and DSM–IV–TR. Subjects with restless legs syndrome were excluded.ResultsInsomnia was found to be associated with older age (18-24 years: 9.8%, 25-44 years: 11.7%, 45-64 years: 13.8%, 65 years or older: 13.9%), lower income level (<500 USD: 16.5%), time spent watching TV (6-8 hour or more: 18.4%), tea consumption in the evening (≥6 glasses: 14.5%) and smoking status (current and ex-smoker both: 14.2%) in multiple logistic regression analysis. In respect to other medical disorders, insomnia was significantly associated with the presence of hypertension, diabetes and heart diseases after the adjustment for relevant risk factors for each disease, across all age and gender groups.Conclusions Insomnia is a major health problem in our population, affecting subjects in working age group and lower socioeconomic status. It should especially be screened in patients with chronic diseases. Relatively low proportion of insomnia diagnosed as a sleep disorder suggests the possibility of under-recognition of this condition and its clinical correlates.
    Psychiatry and Clinical Neurosciences 11/2014; DOI:10.1111/pcn.12252 · 1.62 Impact Factor
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    ABSTRACT: Cerebellum is highly vulnerable in the prenatal period. Increasing experience with fetal imaging studies has demonstrated that unilateral cerebellar hypoplasia (UCH) is mainly prenatally acquired, representing disruption rather than a true malformation. Here, we report the case of a 17-month-old boy presented with a sudden onset of abnormal eye movements, who was diagnosed during routine fetal screening with UCH and brain stem hypoplasia and suffered from cerebral palsy; however, no posterior arterial system pathology was detected on cranial magnetic resonance images at that time. Following this acute event, diagnostic neuroradiological interventions revealed a dissecting aneurysm with a saccular component in midbasilar arterial segment and hypoplastic left posterior cerebral artery, which may support the ischemic disruptive mechanism in the development of prenatally detected UCH in this child. The pathogenetic mechanisms for cerebellar disruption are certainly multifactorial in origin, although ischemic arterial etiologies were often undervalued.
    Neuropediatrics 08/2014; DOI:10.1055/s-0034-1387168 · 1.10 Impact Factor
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    Hulya Apaydin, Gulcin Benbir
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    ABSTRACT: Background: The diversity of clinical presentation and neuroimaging findings of CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) from different regions of the world has not yet been studied in depth. Here we investigated the variability of clinical, radiological and genetic data of 48 patients analyzed for NOTCH3 mutation in Turkey. Methods: Clinical evaluation was made according to a preformed questionnaire. Cranial neuroimaging findings were determined on the basis of T1, T2, FLAIR and proton-density magnetic resonance scans. For genetic analysis, polymerase chain reaction was performed with primers flanking exons 2-6 and 11 of NOTCH3 gene. Results: Twenty-five patients (52.1%) were diagnosed as CADASIL with NOTCH3 mutation, while 23 patients (47.9%) had no mutation (NOTCH3-negative patients). The mean age and age at stroke onset were lower in male CADASIL patients (p < 0.03). A family history of migraine (p = 0.012), stroke (p < 0.001), recurrent strokes (p = 0.020) and dementia (p = 0.012) was more common in CADASIL patients. Temporal pole involvement was more common in CADASIL patients (p = 0.004). Conclusion: It is of clinical importance to identify the heterogeneity of CADASIL from different countries due to a low correlation of clinical and radiological data with respect to NOTCH3 mutation. © 2014 S. Karger AG, Basel.
    European Neurology 07/2014; 72(3-4):125-131. DOI:10.1159/000360530 · 1.36 Impact Factor
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    ABSTRACT: Many efforts have been made to develop decision-support tools and bleeding prediction schemes to start or resume anticoagulation after intracerebral hemorrhage, related with anticoagulation use or not, such as CHA2DS2-VASc or HAS-BLED scoring. HAS-BLED is a validated scoring system to predict the risk of major bleeding in a patient with atrial fibrillation; some current scientific guidelines suggest its use in ‘risk–benefit’ reasoning when deciding whether to start long-term oral anticoagulation. Here the authors present a patient with atrial fibrillation and intracerebral hemorrhage, and aim to discuss the use of HAS-BLED, suggesting that some revisions may help better management of these patients for major bleeding risk.
    Expert Review of Cardiovascular Therapy 07/2014; DOI:10.1586/14779072.2014.931225
  • Hulya Apaydin, Gulcin Benbir
    The Journal of neuropsychiatry and clinical neurosciences 07/2014; 26(3):E46. DOI:10.1176/appi.neuropsych.13080191 · 2.77 Impact Factor
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    ABSTRACT: A 37-year-old male, previously diagnosed with GAPO syndrome, was admitted to our hospital complaining of recurrent episodes of transient weakness and numbness in his left arm for 3 months, and severe headache with progressive dysphagia for 15 days. His cranial magnetic resonance (MR) images showed multiple ischemic foci in the bilateral periventricular and supraventricular white matter. Cerebral MR-angiography showed total occlusion of the right internal carotid artery and moderate stenosis in the left internal carotid. We also detected chronic thrombotic changes in the distal left sigmoid sinus, proximal right sigmoid sinus, and bilateral jugular veins on cerebral MR-venography. He was diagnosed with dilated cardiomyopathy at age 31 years, which was reported as a novel association; and later he had a myocardial infarction at age 34 years. To the best of our knowledge, this is the first patient with GAPO syndrome and arterial atherosclerosis in cerebral-as well as coronary-arteries and intracranial venous thrombosis. We report the evolution of the disease in this patient, who died at age 38 years due to respiratory failure secondary to lower respiratory tract infection. © 2014 Wiley Periodicals, Inc.
    American Journal of Medical Genetics Part A 05/2014; 164(5). DOI:10.1002/ajmg.a.36440 · 2.05 Impact Factor
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    ABSTRACT: Brainstem is the most common site of involvement in neuro-Behçet syndrome (NBS). On the other hand, the critical importance of this anatomical region in the regulation of sleep has been disregarded in the literature. We aimed to investigate the microstructure of sleep in patients with Behçet syndrome (BS) and NBS. Patients were allocated to 2 groups: (1) BS without any neurological involvement and (2) NBS with brainstem lesions only. A control group was also enrolled in this study. The comparison of polysomnographic parameters between all patients (BS and NBS) with the control group showed that sleep onset was longer (p = 0.006), the duration of superficial NREM sleep stage (N2) was significantly longer (p = 0.018), and the respiratory disturbance index was significantly higher (p = 0.034) in patients. Sleep apnea and restless legs syndrome are more commonly observed in BS and NBS. Our findings emphasize the importance of questioning the quality of sleep and its disorders in patients with BS in order to better handle the common somatic complaints in these patients, such as fatigue or daytime sleepiness. © 2014 S. Karger AG, Basel.
    European Neurology 01/2014; 71(3-4):115-119. DOI:10.1159/000355277 · 1.36 Impact Factor
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    ABSTRACT: While previous studies have investigated the prevalence of restless legs syndrome (RLS) in patients with migraine, we aimed to explore the prevalence and characteristics of migraine in adult patients diagnosed with RLS. The association of primary headaches, especially of migraine, with RLS has recently attracted much attention. Migraine prevalence was reported to be higher in patients with RLS than in the general population, and the role of dopamine was strengthened. We evaluated 265 consecutive adult RLS patients (137 males and 128 females) followed up in a Sleep Disorders Unit and diagnosed according to criteria defined by the International Restless Legs Syndrome Study Group (IRLSSG). RLS characteristics, and the severity, were performed by using the IRLSSG severity scale. The diagnosis of headache subtypes was defined by the International Classification of Headache Disorders. Gender, age, age at RLS onset, duration of RLS, family history of RLS, family history of headache, presence of depression, any treatments given for RLS, and the change in headache following RLS treatment were questioned. The mean age of the study population was 50.4 ± 12.8 years, mean age at RLS onset was 41.6 ± 13.2 years, and mean disease duration was 8.40 ± 8.6 years. Of these, 163 patients had headache; 40 of them were diagnosed to have migraine-type headache (15.1%). The presence of migraine-type headache was 9.4% in males with RLS, and 21.1% in female RLS patients. In RLS patients with migraine, 67.5% were females, while 48.0% of RLS patients with other types of headache were females (P = .032), and only 41.2% of RLS patients without headache were females (P = .005). The severity of RLS was significantly higher in patients with migraine compared with those without headache (P < .001). The presence of depression, the family history of RLS, and headache were also higher in patients with migraine compared with RLS patients with other types of headache or those without headache. Thirty-six patients with headache reported partial or substantial benefit from RLS treatment. Our results did not suggest higher rates of migraine-type headache in RLS patients when compared with population-based prevalence studies from Turkey. Alternatively, the severity of RLS was significantly higher in patients with migraine. Although the increase in these scores does not constitute a relationship etiopathogenetic, it suggests a correlation between the type cross-model nociceptive systems. Moreover, the family history of RLS was higher in patients with migraine. The prevalence of migraine in patients with RLS, however, waits to be better demonstrated.
    Headache The Journal of Head and Face Pain 01/2014; 54(5). DOI:10.1111/head.12288 · 3.19 Impact Factor
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    ABSTRACT: Arousal parasomnias (AP) and frontal and temporal epilepsies consist of pathologic arousals originating in abnormal thalamocortical circuits, reflecting increased sleep instability and arousal oscillations-the cyclic alternating pattern (CAP). In this study, the authors aim to investigate the CAP characteristics in 27 patients with AP, 22 patients with frontal and temporal epilepsies, and age- and gender-matched 20 healthy subjects. The mean CAP sequence and cycle was significantly higher in patients than in control subjects (P < 0.003). The total CAP duration was always higher in the patients with AP than in those with frontal and temporal epilepsies, reaching statistically significant level at the first (P = 0.044), second (P = 0.024), third (P = 0.010), and sixth (P < 0.001) sleep cycles. The duration of A1 in descending branch (P = 0.062) and trough phase of sleep cycles (P = 0.038) was longer in the patients with AP. The duration of A2 subtype of CAP in ascending branch (P = 0.039) and the number (P = 0.036) and duration (P = 0.050) of A3 subtype of CAP in descending branch of sleep cycles were higher in the patients with frontal and temporal epilepsies. This difference in CAP parameters might suggest that AP are associated with milder activation in specific brain areas, showing a similar evolution with physiologic homeostatic decrease in sleep synchronization. Frontal and temporal epilepsies, however, is associated with a moderate-to-powerful activation in wider brain networks.
    Journal of clinical neurophysiology: official publication of the American Electroencephalographic Society 08/2013; 30(4):396-402. DOI:10.1097/WNP.0b013e31829dda86 · 1.60 Impact Factor
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    ABSTRACT: Brucellosis is an anthropozoonotic disease with heterogeneous clinical presentations. This study aims to investigate the peripheral nervous system (PNS) involvement in brucellosis. A total of 57 patients with brucellosis, and 42 age- and gender-matched healthy subjects were enrolled into the study. We performed motor conduction studies that included bilateral median, ulnar, tibial and peroneal nerves, and sensory nerve investigations from bilateral median, ulnar, radial, sural and medial plantar nerves. Among patients with brucellosis, 21 had neuropathic symptoms. Of these, 9 had abnormalities in nerve conduction studies. The electromyographic testing revealed abnormalities in 2 patients without neuropathic symptoms. Overall, 11 patients (4 males, 7 females) with brucellosis (19.3%) had polyneuropathy (PNP). The mean age of patients with PNP was 52.63 ± 19.06 years, being significantly higher than those without PNP (P = 0.006). The mean duration of brucellosis was also longer in patients with PNP, but not significant. The mean distal latency (DL) and nerve conduction velocity (NCV) values were almost always longer in patients with brucellosis than controls, though not statistically significant. Our results showed that brucellosis causes clinical or subclinical peripheral PNP, and should therefore be considered as a cause of PNP, especially in endemic regions.
    08/2013; 16(8):446-8.
  • Gulcin Benbir, Derya Karadeniz
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    ABSTRACT: Destructive lesions, as cerebrovascular diseases, have been shown to lead to the development of periodic leg movements in sleep (PLMS), secondary to the loss of cortical or subcortical inhibition exerting on the brainstem generators. We designed a prospective study to investigate the association of PLMS with a clinical outcome in 24 patients with acute ischemic cerebrovascular diseases. The medical history of patients and risk factors of ischemic stroke were questioned. A whole-night polysomnographic (PSG) recording was performed; detailed PSG data including PLM index and PLM-arousal index were analyzed. Stroke outcome was assessed at 3 weeks and 3 months by the National Institute of Health Stroke Scale (NIHSS) and Barthel Scale (BS). The results of NIHSS and BS were correlated with demographic parameters and PSG parameters including PLMS data. However, none of them showed a significant correlation with clinical parameters. The delta change in outcome measures was correlated with the PLMS index, which was also not significantly different at the subacute or chronic phase. On the other hand, the correlation between delta changes in mean NIHSS and BS with mean arousal-associated PLMS index showed a borderline significance at the subacute stage, and significant correlation was observed at the chronic phase. Increased sympathetic activation secondary to RLS or arousal reactions following PLMS have been suggested as the underlying pathophysiology of cardiovascular complications. PLMS, particularly with accompanying autonomic arousal, may therefore be a risk factor for stroke, and display a negative influence on stroke outcome.
    Sleep and Biological Rhythms 07/2013; 11(3). DOI:10.1111/sbr.12021 · 0.76 Impact Factor

Publication Stats

63 Citations
71.12 Total Impact Points


  • 2006–2015
    • Istanbul University
      • • Department of Neuropathology
      • • Department of Family Medicine (Cerrahpasa Faculty of Medicine)
      İstanbul, Istanbul, Turkey