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Öğe Effects of 12-month Antiepileptic Drug Use on Thyroid Functions in Children: A Retrospective Observational Study(Galenos Yayincilik, 2021) Hanci, Fatma; Turay, Sevim; Bala, Keziban Asli; Tunclar, Aslian; Dilek, Mustafa; Kabakus, NimetAim: The purpose of this study was to examine the effects of antiepileptics on thyroid function tests and to compare these effects among different antiepileptics. Materials and Methods: Two hundred and twenty patients (102 female and 118 male) aged 1-17 years indicated for antiepileptic drug (AED) therapy for epilepsy were enrolled in this study which was performed in a child neurology clinic between January 2014 and January 2018. Those patients using a single AED and with complete seizure control were included. In this study period, according to the local protocol, we measured free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels at the beginning of treatment and at the 12th month of AED therapy. Results: The mean age of the patients was 10.2 +/- 4.4 years. TSH elevation was observed in only eight patients. These eight patients' thyroid autoantibodies were negative and their thyroid ultrasonography were normal. Subclinical hypothyroidism (TSH: 5-10, fT4 normal) was present in three of these eight patients, and they were therefore not started on medication. The other five were started on L-thyroxine. Four of these were using valproic acid and one was using carbamazepine. We found no significant difference between TSH and fT4 levels measured before the start and at the 12th month of drug therapy, nor among the different AEDs used. Conclusion: AEDs have no marked effects on thyroid function, and may therefore be safely used from that perspective.Öğe Electroencephalogram Abnormalities and Epilepsy in Autism Spectrum Disorders: Clinical and Electroencephalogram Findings(Georg Thieme Verlag Kg, 2021) Hanci, Fatma; Turay, Sevim; Ozturk, Yusuf; Kabakus, NimetIt has been known for several decades that epilepsy and autism spectrum disorders (ASD) are related to each other. Epilepsy frequently accompanies ASD. The purpose of this study was to investigate relationship between clinical and electroencephalogram (EEG) findings in ASD patients and to identify EEG characteristics that may create a disposition to epilepsy in ASD by examining differences in clinical and EEG findings between patients diagnosed with ASD without epilepsy and ASD with epilepsy. A total of 102 patients aged 2 to 18 years and diagnosed with ASD based on Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria between January 2017 and June 2019 were included in the study. Patients were assigned into two groups: (1) ASD with epilepsy and (2) ASD without epilepsy. Clinical findings were retrieved from patients' files, and EEG findings from first EEG records in the EEG laboratory at the time of diagnosis. EEG findings were defined as central, parietal, frontal, temporal, or generalized, depending on the location of rhythmic discharges. The incidence of epilepsy in our ASD patients was 33.7% and that of febrile convulsion was 4%. Generalized motor seizures were the most common seizure type. Epileptic discharges most commonly derived from the central and frontal regions. These abnormalities, especially frontal and central rhythmic discharges, may represent a precursor for the development of epilepsy in ASD patients.Öğe Epilepsy and drug-resistant epilepsy in children with cerebral palsy: A retrospective observational study(Academic Press Inc Elsevier Science, 2020) Hanci, Fatma; Turay, Sevim; Dilek, Mustafa; Kabakus, NimetPurpose: The objective of this study was to determine risk factors for epilepsy and drug-resistant epilepsy (DRE) development in children with cerebral palsy. Method: Two hundred twenty-nine patients presenting to the pediatric neurology clinic and diagnosed as having cerebral palsy between November 2016 and November 2019 were included in the study. Medical histories and clinical, laboratory, and radiological findings were examined retrospectively from patient records in the hospital data system. Results: Girls represented 103 patients (45%) and boys 126 (55%). The patients' mean age was 8.39 +/- 4.54 years. Epileptic seizures were present in 120 (52.4%) patients and drug-resistant seizures in 64 (27.9%). The risk of epilepsy was significantly higher in patients with motor or speech impairment, with hearing impairment, or undergoing first seizure in the neonatal period. We also observed a higher risk of epilepsy in patients with psychiatric comorbidity, particularly autism spectrum disorder. The risk of epilepsy was also higher in patients with microcephaly or quadriplegic cerebral palsy and in patients with focal and generalized epileptiform abnormality on electroencephalograms (EEGs). However, no significant difference was identified when all these factors were evaluated in terms of the risk of developing DRE. Conclusion: Patients with cerebral palsy have high comorbid epilepsy rates. We think that the risk of epilepsy may be higher in patients undergoing first seizure in the neonatal period, with microcephaly, with quadriplegic type cerebral palsy, and with additional psychiatric comorbidity. The rate of DRE development was very low in patients with normal EEG findings or with only background rhythm abnormalities on first EEGs during neonatal seizures. This may be regarded as a good prognostic factor for nondevelopment of DRE. (C) 2020 Elsevier Inc. All rights reserved.Öğe Mitochondrial metabolism related markers GDF-15, FGF-21, and HIF-1a are elevated in pediatric migraine attacks(Wiley, 2023) Kilinc, Yasemin Baranoglu; Kilinc, Erkan; Danis, Aysegul; Hanci, Fatma; Turay, Sevim; Ozge, Aynur; Bolay, HayrunnisaObjective: The purpose of this study was to investigate the serum levels of mitochon-drial metabolism/reactive oxygen species (ROS)- related peptides (hypoxia induc-ible factor- 1a [HIF- 1a], fibroblast growth factor -21 [FGF- 21], growth differentiation factor -15 [GDF- 15]) and key migraine- related neuropeptides (calcitonin gene- related peptide [CGRP], pituitary adenylate cyclase- activating peptide -38 [PACAP- 38], sub-stance P [SP], and vasoactive intestinal peptide [VIP]) during migraine attacks and to evaluate their diagnostic value in pediatric migraine.Background: There is increasing evidence for the important role of impairment in oxidative mitochondrial metabolism in the pathophysiology of migraine. Potential biomarkers that may reflect the relationship between migraine and mitochondrial dysfunction are unclear.Methods: A total of 68 female pediatric migraine patients without aura and 20 fe -male healthy controls aged 8- 18 years, admitted to the hospital, were enrolled in this cross- sectional study. Serum concentrations of these molecules were determined by enzyme- linked immunosorbent assays, and clinical features and their possible diag-nostic value were analyzed.Results: Serum levels of HIF- 1a (252.4 +/- 51.9 [mean +/- standard deviation]) pg/mL), GDF- 15 (233.7 +/- 24.7 pg/mL), FGF- 21 (96.1 +/- 13.1 pg/mL), CGRP (44.5 +/- 11.3), and PACAP- 38 (504.7 +/- 128.9) were significantly higher in migraine patients compared to healthy controls (199.8 +/- 26.8, 192.8 +/- 20.7, 79.3 +/- 4.1, 34.1 +/- 3.5 and 361.2 +/- 86.3 pg/ mL, respectively). The serum levels of these peptides were also higher in patients with chronic migraine than in patients with episodic migraine, and higher in the ictal period than in the interictal period. A positive correlation was found between attack frequency and both HIF- 1a and FGF- 21 levels in migraine patients. Serum levels of VIP and SP were not different between the migraine patients and healthy controls.Conclusion: Migraine attacks are accompanied by elevated HIF- 1a, FGF- 21, GDF- 15, CGRP, and PACAP- 38 in medication -naive pediatric patients with migraine. Elevated circulating mitochondrial metabolism/ROS-related peptides suggest a mitochondrial stress in pediatric migraine attacks and may have potential diagnostic value in monitoring disease progression and treatment response in children. Novel approaches intervening with mitochondrial metabolism need to be investigated.Öğe Reflex Epilepsy with Hot Water: Clinical and EEG Findings, Treatment, and Prognosis in Childhood(Georg Thieme Verlag Kg, 2020) Hanci, Fatma; Turay, Sevim; Balci, Pasa; Kabakus, NimetHot water epilepsy (HWE) is a subtype of reflex epilepsy in which seizures are triggered by the head being immersed in hot water. Hot water or bathing epilepsy is the type of reflex epilepsy most frequently encountered in our clinic. We describe our patients with HWE and also discuss the clinical features, therapeutic approaches, and prognosis. Eleven patients (10 boys, 1 girl), aged 12 months to 13 years, admitted to the pediatric neurology clinic between January 2018 and August 2019, and diagnosed with HWE or bathing epilepsy based on International League Against Epilepsy (ILAE)-2017, were followed up prospectively for similar to 18 months. Patients' clinical and electroencephalography (EEG) findings and treatment details were noted. All 11 patients' seizures were triggered by hot water. Age at first seizure was between 2 months and 12 years. Seizure types were generalized motor seizures, absence, and atonic. EEG was normal in two patients, but nine patients had epileptiform discharges. Magnetic resonance imaging of the brain was performed and reported as normal (except in one case). Histories of prematurity were present in two patients, unprovoked seizures in one, and low birth weight and depressed birth in the other. Patients with HWE have normal neuromuscular development and neurological examination results, together with prophylaxis or seizure control with a single antiepileptic drug, suggesting that it is a self-limited reflex epilepsy.