Gulcin Benbir

Istanbul University, İstanbul, Istanbul, Turkey

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Publications (30)58.5 Total impact

  • [Show abstract] [Hide abstract]
    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; · 1.19 Impact Factor
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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.
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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;
  • Hulya Apaydin, Gulcin Benbir
    The Journal of neuropsychiatry and clinical neurosciences 07/2014; 26(3):E46. · 2.34 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 03/2014; · 2.30 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. · 1.50 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; · 2.94 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.
    Archives of Iranian medicine. 08/2013; 16(8):446-8.
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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. · 1.47 Impact Factor
  • 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). · 1.05 Impact Factor
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    ABSTRACT: Stroke is still a major cause of morbidity and mortality throughout the world, although better stratification and treatment modalities are being developed. As compared to ischemic stroke, intracerebral hemorrhage (ICH) possesses many unknown data and lacks guidelines for better prophylaxis. In this study, we aimed to investigate patients with ICH hospitalized in our neurology department within 5 years in terms of risk stratification. A total of 4,449 patients were hospitalized; 1,378 of patients (31 %) were diagnosed as having cerebrovascular disease and of these 165 patients (3.7 %) had ICH. The risk factors of patients with ICH were investigated and compared with age- and gender matched 75 healthy subjects. We observed that hypercholesterolemia (p = 0.002) was one of the most common risk factors in patients with ICH as compared to controls, together with hypertension (p = 0.010). On the other hand, hypolipidemia (LDL-cholesterol level < 50 mg/dl) was not present in any of the patients. As our purpose as neurologists is to reduce the occurrence and fatal outcome of cerebrovascular events, we aimed to emphasize the importance of risk factors to be well defined, for which every effort should be exhibited for both primary and secondary prevention.
    Acta neurologica Belgica. 06/2013;
  • Gulcin Benbir, Sibel Ertan, Sibel Ozekmekci
    La Presse Médicale 05/2013; · 0.87 Impact Factor
  • Stroke 03/2013; 44(3):e18. · 6.16 Impact Factor
  • Birsen Ince, Gulcin Benbir
    Stroke 03/2013; 44(3):e17. · 6.16 Impact Factor
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    ABSTRACT: Aim: Many guidelines recommend carotid endarterectomy (CEA) in symptomatic patients with carotid stenosis of greater than 70%, and carotid artery stenting (CAS) as an alternative to CEA. In our study, we evaluated the clinical characteristics of patients who underwent revascularizaton therapy. Material and Methods: We reviewed the files of 2369 patients with stroke followed in our cerebrovascular outpatient clinics since 1996. Results: 92 patients were treated by revascularization therapy. A total of 41 patients had CEA, 42 patients had CAS, and 9 patients had vertebral artery stenting; and 77 patients were followed-up for a mean period of 50.2+42.7 months (6 to 168 months). Recurrent stroke or TIA and deaths due to cerebrovascular diseases were similar between CEA and CAS patients. Myocardial infarction (including silent MI) and deaths due to cardiovascular diseases were more common in CAS group, though not significant. The deaths due to other diseases and other non-fatal complications were significantly more common in CEA patients. On the other hand, restenoses - all of which were radiological findings but asymptomatic - were more common in the CAS group. Conclusion: In this study we disclosed neither morbidity nor mortality discrepancies in long term among the patients who were treated with carotid endarterectomy (CEA) and carotid artery stenting (CAS).
    Turkish neurosurgery 01/2013; 23(4):484-490. · 0.58 Impact Factor
  • Sleep Medicine 12/2012; · 3.49 Impact Factor
  • Clinical neurology and neurosurgery 11/2012; · 1.30 Impact Factor
  • Gulcin Benbir, Derya Karadeniz
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    ABSTRACT: The pathophysiology of periodic leg movements in sleep (PLMS) is complex, and still lacks a consensus. Consecutive 35 patients with the diagnosis of acute supratentorial ischemic stroke and 35 age- and sex-matched control subjects were prospectively investigated. Clinical and sociodemographic evaluation and a whole-night polysomnographic recording were performed. In patients with supratentorial ischemic stroke, 27 patients (77.2%) had PLMS-index more than 5/h, and 19 out of 35 patients (54.3%) had PLMS-index more than 15/h; while only 10 participants (28.5%) in control group had PLMS-index more than 5/h, and 6 participants (17.1%) had PLMS-index more than 15/h (p < 0.05). None of the demographic variables showed statistically significant relationship with PLMS, such as gender (p = 0.952) and age (p = 0.435). Territorial localization of ischemic lesions showed no relation with the presence of PLMS (p = 0.867), PLMS-index (p = 0.432), or restless legs syndrome (p = 0.833). All patients demonstrated PLMS contralateral to ischemic lesion except eight patients with bilateral PLMS; these were also more prominent contralaterally. Our study supports the hypothesis that destructive lesions causing the loss of cortical or subcortical inhibition exerting on the reticular formation on spinal pathways could lead to the development of PLMS.
    Acta neurologica Belgica 03/2012; 112(1):27-32. · 0.47 Impact Factor
  • Gulcin Benbir, Derya Karadeniz
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    ABSTRACT: Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for ischemic cerebrovascular diseases, and results in worse prognosis and higher mortality. We aimed to investigate the effects of early treatment of OSAS on the prognosis of ischemic stroke. We prospectively evaluated patients with acute supratentorial ischemic stroke and OSAS on admission (acute stage), at second week (subacute stage) and at second month (chronic stage); 11 (73.3%) out of 15 patients put on the non-invasive mechanical ventilation treatment within 48 h of stroke constituted the treatment group, and 13 patients constituted the control group. Patients with OSAS treatment showed significantly better prognosis and better functioning in activities of daily living in both subacute and chronic stages. The rate of shrinkage of the ischemic lesion was higher in the treatment group, though not significant. The early and effective treatment of OSAS provides a better clinical prognosis in ischemic stroke. The beneficial effects on radiological parameters need to be further studied.
    Neurological Sciences 11/2011; 33(4):811-8. · 1.41 Impact Factor
  • Source
    Hulya Apaydin, Gulçin Benbir, Andrew Lees
    Movement Disorders 09/2011; 27(1):159-60. · 5.63 Impact Factor

Publication Stats

33 Citations
58.50 Total Impact Points


  • 2011–2014
    • Istanbul University
      • • Department of Pediatric Neurology
      • • Department of Family Medicine (Cerrahpasa Faculty of Medicine)
      • • Department of Neurology (Cerrahpasa Faculty of Medicine)
      İstanbul, Istanbul, Turkey
  • 2013
    • Kocaeli University
      Cocaeli, Kocaeli, Turkey