Cagri Mesut Temucin

Hacettepe University · Department of Neurology

Background and aims: The autonomic system is frequently affected in Sjogren’s syndrome (SS), but presentation with severe autonomic neuropathy is very rare. This report presents a patient with SS-associated severe autonomic neuropathy, which is significant clinical and electrophysiological responsive to immunotherapy. Methods: N/A Results: A 29-yea...

Introduction Isolated spinal cord angiitis (ISCA) is very rare disease. But, it is frequently encountered in the differential diagnosis of atypical spinal cord syndromes. Case presentation and review of the literature We present a 31-year-old male who presented with progressive paraparesis, and diagnosed with pathologically confirmed ISCA. Longitu...

Background: Preclinical and clinical studies reported cortical inhibition deficits in schizophrenia. There are few studies evaluating the effects of antipsychotics on cortical inhibition. The purpose of this study is to investigate the effects of 90-120 days of clozapine treatment on TMS parameters and to compare them with healthy controls. There i...

Background Since December 2019, coronavirus disease 2019 (COVID-19) has become a global pandemic caused by highly transmissible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although respiratory disease and multisystem inflammatory syndrome in children (MIS-C) are main clinical presentations in children, numerous neurological manife...

Amaç: Sjögren sendromu (SS)’na sekonder şiddetli otonom nöropatiye sahip bir hastanın intravenöz immünoglobulin (IVIg) tedavisine verdiği olumlu klinik ve elektrofizyolojik yanıtı vurgulamak. Giriş: SS, ekzokrin bezleri etkileyerek keratokonjonktivit sikka ve kserostomiye yol açan otoimmün bir hastalıktır. SSde otonom sistem sıklıkla etkilenmekle b...

Giriş: Herediter lökodistrofiler; bilateral diffüz simetrik beyaz cevher tutulumu ile giden kalıtımsal ilerleyici seyirli nadir bir hastalık grubudur. Kimi alt tiplerinde spesifik bazı görüntüleme bulguları olmasıyla birlikte çoğunlukla sadece görüntüleme tanıda yeterli olmaz. Olgu: 34 yaşında kadın hasta beş yıldır olan yavaş ilerleyici seyirli ko...

Giriş: Charcot-Marie-Tooth (CMT), ekstremite distallerinde kuvvetsizlik, atrofi, duyusal yakınmalarla seyreden herediter bir nöropatidir. Her ne kadar periferik sinir sistemi tutulumu ile prezente olsa da nadiren santral sinir sisteminde (SSS) de demiyelinizasyonla birlikte karşımıza çıkmaktadır. Bu bildiride sağ taraflı ilerleyici güçsüzlük yakınm...

Brief summary of case 34 years old female patient was admitted with the complaints of speech difficulty, cognitive impairment, restlessness, and slow deterioration of daily life activities. She firstly had change in speech characteristics 5 years ago with an increase in the amount and speed of speech. After that, she started to have akathisia and d...

Autosomal recessive intermediate Charcot Marie Tooth (CMT) disease type C is a very rarely-seen neurogenetic disorder. Homozygous or compound heterozygous mutation in the Pleckstrin homology domain-containing family G member 5 (PLEKHG5) gene on chromosome 1p36 was recently reported in patients with CMT. From the first description of the disease to...

Electromyography (EMG) is a technique that gives information about the neuromuscular pattern and function which is commonly-used in the practice of neurology. With this method, the signals obtained from the muscle cells using an amplificatore are enhanced to an amount enough to study on. The potentials monitored are called Motor Unit Action Potenti...

Introduction In diabetes mellitus (DM) myelin-sheath dysfunction has been suggested as the earliest response to abnormal glucose metabolism. Aim of our study is the early electrophysiological detection of this dysfunction in DM patients with normal nerve conduction studies (NCS) despite having neuropathic symptoms. Methods Fourteen DM patients wi...

Introduction Oxaliplatin is a commonly used effective platinum analogue for gastrointestinal tumors. Oxaliplatin induced peripheral neuropathy(OXAIPN) is an most common, dose limiting and disabling adverse effect of the chemotherapy. The presentation of neuropathy induced by OXA is different from other platinum compounds, consists of acute and chro...

To evaluate the clinical, electrophysiological, and laboratory features and to examine muscle mitochondrial respiratory complex activities in severe acute stroke patients developing intensive care unit-acquired weakness (ICUAW). ICUAW defines generalized muscle weakness seen in critically ill patients in the absence of causative factors other than...

Background: Cystinosis is a multisystemic disease resulting from cystine accumulation primarily in kidney and many other tissues. We intended to study the evolution of less commonly seen extrarenal complications of cystinosis in a group of patients who have periods without cysteamine treatment. Methods: Gastrointestinal and muscular complication...

Trigeminal neuropathy is an infrequent condition, usually limited to the sensorial component of the nerve, and it is one of the most common neurologic manifestations of mixed connective tissue disease (MCTD). However, to the best of our knowledge, no cases have been reported with MCTD presenting as trigeminal sensory and motor neuropathy. Herein, w...

Otoimmünensefalitlerden yüzey antijenlerine karşı gelişen antikor aracılı olanlar, özgün klinik tabloları ve tedavi edilebilir özellikleri ile nöroloji pratiğinde önemli bir yere sahiptir. Son 10 yıl içinde hızlı bir şekilde bu hastalıklarla ilgili bilgi ve tecrübelerimiz artmaktadır. Bu çalışmada 2007-2019 tarihleri arasında Hacettepe Üniversitesi...

Purpose This study analyzes the effect of oxaliplatin treatment on the facial nerve. The facial nerve is the most commonly paralyzed cranial motor nerve because it advances through a long, curved bone canal. Electroneurography and blink reflex are the electrophysiological measurements used for evaluating facial nerve function. Oxaliplatin is a cyto...

Repetitive transcranial magnetic stimulation (rTMS) is one of the non-invasive techniques, which is used to modulate cortical regions in patients with stroke. The aim of this single blind, controlled study was to investigate the effect of rTMS on swallowing function and quality of life of mono-hemispheric post-stroke patients with dysphagia. Twenty...

Cardiac autonomic dysfunction has been examined in myasthenia gravis but not in congenital myasthenic syndromes (CMS). We aimed to evaluate cardiac autonomic functions in genetically defined CMS. Patients diagnosed with and under treatment for CMS were reviewed for 24-hour cardiac rhythm monitoring. Heart rate variability (HRV) measures were define...

In this study, the emergences of postsynaptic action potentials are investigated using simulation study which is depended on the statistical model of acetylcholine-quantal (Ach) release theory at motor end-plate. It is supposed that the end-plate potentials (EPP) are sum of miniature end-plate potentials (MEPP) which are released as quantal and ran...

Whereas the amplitude of the startle reflex varies with stimulus valence in the normal population, a lack of this affective modulation has been reported in patients with major depressive disorder. The present study sought to clarify blunted startle modulation as a feature of depression by comparing 16 patients diagnosed with major depression prior...

We evaluated the reversible electrophysiologic abnormalities of two cases of hypokalemia paralysis (HypoPP) because of its similar findings in acute motor axonal neuropathy (AMAN). Nerve conduction studies (NCS), repetitive nerve stimulation, and exercise tests were performed in both patients. Adding a 15 minute-exercise test to routine NCS may hel...

Introduction: Chronic pain is associated with maladaptive plastic changes in the brain. It is usually more prominent in acquired pathologies of nerve fibers as in diabetic neuropathy despite less severe degeneration than hereditary neuropathies. Based on clinical differences concerning pain perception, we hypothesized that functional connectivity...

Inherited CD59 deficiency is a rare autosomal recessive disorder characterized by chronic hemolysis, recurrent ischemic central nervous system strokes, and early-onset relapsing peripheral demyelinating neuropathy mimicking recurrent Guillain–Barré syndrome (GBS) or chronic inflammatory demyelinating polyneuropathy (CIDP). We report a 7-year-old gi...

Objective: This study aims at modulating the altered cerebellar-cortical interactions in patients with multiple system atrophy-cerebellar subtype (MSA-C) by using cerebellar repetitive transcranial magnetic stimulation (rTMS). We hypothesized that cerebellar modulation by low-frequency rTMS can resolve the abnormal cortical excitability in multipl...

The genetic work-up of arthrogryposis is challenging due to the diverse clinical and molecular etiologies. We report a-18(3/12)-year-old boy, from a 2nd degree consanguineous family, who presented at 3(6/12) years with hypotonia, distal laxity, contractures, feeding difficulties at birth. He required surgery for progressive scoliosis at 16 years of...

Objective: Hereditary neuropathy with liability to pressure palsy (HNPP) needs to be differentiated from entrapment neuropathies due to differences in the treatment management. Materials and Methods: Among 5075 patients with entrapment neuropathy, we retrospectively evaluated the neurophysiologic results of 20 patients with three or more entrapment...

Chronic inflammatory demyelinating neuropathy, a treatable immune-mediated disease of the peripheral nervous system is less common in childhood compared to adults. Despite different sets of diagnostic criteria, lack of a reliable biologic marker leads to challenges in diagnosis, follow-up and treatment. Our first aim was to review clinical presenta...

Sensory neuronopathy is a well-established presentation in paraneoplastic neurological syndromes that is mostly associated with small cell lung cancer and anti-Hu antibodies. Motor neuronopathy, on the other hand, is an extremely rare observation in this syndrome. A 56-year-old man presented with asymmetric brachial diparesis and sensory ataxia. El...

Background: Aberrant reinnervation after brachial plexus injuries may produce co-contractions between diaphragm and upper limb muscles. This syndrome is known as ‘Breathing Arm'. Methods: In the current study among 138 brachial plexopathy patients we retrospectively investigated the electrophysiological studies of 20 patients with severe brachial p...

Congenital mirror movements are rare conditions that define the inability to perform unimanual movements. Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, is a genetic disorder with multiple nevi predisposing to basal cell carcinoma, odontogenic keratocysts, and skeletal malformations. Herein we report on an adolescent patient w...

Objective: Neuropathy caused by vincristine toxicity can be diagnosed by electrophysiological examination. The purpose of this study is to demonstrate the electrophysiological features of vincristine toxicity. Methods: Electrophysiological data from 25 children receiving vincristine treatment and 25 normal controls were evaluated retrospectively...

Objective: Transcranial magnetic stimulation (TMS) studies show cortical inhibition (CI) abnormalities in patients with schizophrenia. However, the relationship between the changes in CI and the changes in psychopathology and cognition caused by antipsychotic treatment is not known. This is an 8 week follow up study which aims to evaluate the rela...

Multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy is characterized by asymmetric multifocal motor and sensory loss and conduction blocks in peripheral nerves. Peripheral demyelinating diseases may be accompanied by demyelination in central nervous system (CNS). In this report, a MADSAM patient with a solitary tumefactive demye...

Combined central and peripheral nervous system demyelination is a rare and poorly described phenomenon. Recently, anti-neurofascin antibodies were reported to be positive in 86% of these patients in a Japanese cohort. Yet, there seems to be a clinical, radiological, and serological heterogeneity among these patients. In this report, our aim is to d...

Concomitant involvement of peripheral nerve system in dermatomyositis and polymyositis defined as ‘Neuromyositis’ is a very rarely reported entity. Clinical presentations and pathogenesis of this entity is not well known. In addition, definite diagnostic criterias as well as even occurrence of this entity is still an argument subject for some autho...

A 48-year-old man, who had subsisted on animal husbandry and consumed unpasteurized milk for many years, presented with lowerextremity paraparesis, urinary retention,and hypoesthesia below T7 for 2 months. Spinal magnetic resonance imaging revealed edematous, homogenously T2-hyperintense, minimally enhancing lesion extending between C4 and T12 (Fig...

To identify the underlying etiology of 3 patients in a multiplex family with strokes, chronic immune-mediated peripheral neuropathy, and hemolysis. All had onset in infancy. We performed genome-wide linkage analysis followed by whole exome sequencing (WES) in the proband, Sanger sequencing, and segregation analysis of putative mutations. In additio...

Primary CD59 deficiency in humans has been reported only recently. The original patient had cerebral infarction and elements of paroxysmal nocturnal haemoglobinuria. Activation of the membrane attack complex (MAC) is responsible from the clinical events. In another family with this condition the index cases presented with chronic haemolysis and imm...

Background Cognitive dysfunction occurs in multiple system atrophy (MSA) more frequently than previously known. As a type of synucleinopathy, pathology spreads widely in cortical and subcortical areas as the disease advances. The exact anatomical and imaging substrates, and electrophysiological or biochemical indicators of cognitive impairment in M...

The conventional method of peripheral nerve gap treatment is autografting. This method is limited. In this study, an aligned nanofibrous graft was formed using microbial polyester, Poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV). The regenerative effect of the graft was compared with that of autografting in vivo. To determine the regenerative...

Introduction: In this study we investigated the clinical utility of single fiber conduction velocity (SF-CV) testing in the evaluation of motor nerve function in diabetic patients with signs and symptoms of symmetrical distal sensory polyneuropathy (DSP). SF-CV findings were compared with conventional nerve conduction studies (NCS). Methods: Twe...

Abstract This study is designed to evaluate the treatment effect of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) and human mesenchymal stem cells (hMSC) on axonal regeneration in experimental rat sciatic nerve damage, and compare the results of this modality with autologous nerve grafting. In Spraque-Dawley albino rats, 10mm long experime...

Segmental stabilization training and electrical stimulation are used as a treatment for patients with low back pain. There is limited information on the efficacy of two interventions in the literature. In this study, the efficacy of the two interventions on the multifidus muscle activation and fatigue, segmental stabilization training and electrica...

poster presentation- preliminary

Background and purpose: Extension and characteristics of WM involvement other than the brain stem remain inadequately investigated in ARSACS. The aim of this study was to investigate whole-brain WM alterations in patients with ARSACS. Materials and methods: Nine Turkish unrelated patients with ARSACS and 9 sex- and age-matched healthy control pa...

Neuropathic pain is caused by a lesion or a disease of the somatosensory system itself. It’s usually more prominent in acquired pathologies of nerve fibers like diabetic neuropathy (DNP) despite less severe degeneration than hereditary neuropathies (HNP). On the basis of differences in etiopathogenetic mechanisms, we hypothesized that grey and whit...

Cortical cholinergic deficiency occurs in Parkinson's disease (PD) and is more severe in PD dementia (PDD). Short-latency afferent inhibition (SAI) can be used as an in vivo test for the evaluation of the cholinergic circuit in the cerebral motor cortex. SAI and neuropsychological profile were studied in nondemented PD, PDD, Alzheimer's disease (AD...

Whole exome sequencing combined with homozygosity mapping comprises a genetic diagnostic tool to identify genetic defects in families with multiple affected members, compatible with presumed autosomal recessively inherited neurometabolic/neurogenetic disease. These tools were applied to a family with two individuals manifesting ataxia, associated w...

Purpose: We aimed to investigate white matter diffusivity abnormalities in hereditary spastic paraplegia with thin corpus callosum (HSP-TCC) patients in relation with electrophysiological findings. Materials and methods: Brain magnetic resonance imaging (MRI) and diffusion tensor imaging were performed on four HSP-TCC patients and 15 age-matched...

Wernicke’s encephalopathy (WE) is classically known as a disease which presents with encephalopathy, ataxia and ophtalmoparesis and is commonly observed in alcoholics due to nutritional deficiency. Recently, an increasing number of case reports and research articles in the literature has shown that this disease may be seen in nonalcoholics much mor...

To examine the effects of High Voltage Pulsed Galvanic Stimulation (HVPGS), that was applied to the spasticity associated weakness in knee flexors and ankle dorsiflexors, on strength and fatigue, in Multiple Sclerosis (MS) patients, in a non-randomized controlled trial. A total of 33 MS patients were included. Fatigue and strength were analyzed wit...

As they are mainly performed at distal nerve parts, routine electrophysiological examinations can fail to detect the abnormalities at the early stage of Guillain-Barre syndrome (GBS) because of predominant involvement of proximal nerve segments. Measurements focused on proximal conduction can provide additional findings. We investigated the diagnos...

Carpal tunnel syndrome and benign recurrent intrahepatic cholestasis are rare conditions in childhood. Benign intrahepatic cholestasis is characterized by repeated self-limited attacks of cholestasis that can start at any age and last from weeks to months. The patients are asymptomatic between these attacks. We report a 16 year-old male patient wit...

Background and purpose: Sclerotherapy with bleomycin sulfate (BS) is currently used in the management of cervicofacial cystic lymphatic malformations in children. Neurotoxic adverse effects of BS after intraventricular or intracavitary administration have been reported; however, the effects of intralesionally administered BS on the adjacent periph...