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    An Atypic Case of Dementia with Lewy Bodies and Negative Psychotic Symptoms
    (Düzce Üniversitesi, 2012) Kuyucu, Mutlu; Aygül, Recep; Kotan, Dilcan; Demir, Recep; Ulvi, Hızır
    Dementia with Lewy bodies (DLB) which was considered as a rare cause of dementia before,is much more frequently recognized. DLB can be considered as being a member of spectrum ofdisorders which also includes dementia, parkinsonism and psychiatric disorder. Here we reporta DLB case with atypical cognitive, motor and psychiatric symptoms and discuss under the lightof current literature
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    The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection
    (2020) Kotan, Dilcan; Duman, Taşkın
    The coronavirus invades the nervous system with the spread we call neuroinvasion, and"cytokine storm" becomes an important factor affecting the course of the disease. Seriousdamage occurs in the brain and other organs as a result of cytokine storm. Evidence isaccumulating that the coronavirus, which infects millions of people all over the world, affectsboth the central and peripheral nervous system and muscles as well as the respiratory tract.Increasing evidence has revealed neurological involvement in 36-54% of the patients, whichcorresponds to almost one in every 2 or 3 patients. In severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) patients, we frequently encounter neurological symptoms suchas smell and taste disturbances, fatigue and muscle pain, headache, nausea, vomiting, impairedconsciousness, numbness in hands and feet. To a lesser extent, we encounter neurologicalhandicaps such as dizziness, inflammation of the meninges, loss of myelin in nerve tissue,muscle inflammation, and severe rhabdomyolysis. Some of the nervous system diseasesaccompanying SARS-CoV-2 disease recover with complete or partial sequelae. Observationof permanent dysfunction in patients with neurological findings draws attention to theimportance of a detailed neurological evaluation in the examination of these cases.
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    Investigating the Frequency of Stroke in SARS-CoV-2 Cases in Sakarya City, Turkey
    (2020) Kotan, Dilcan; Ateş, Ömer Faruk; Taydas, Onur; Öztürk, Mehmet
    Aim: The aim of this study is to identify the frequency of stroke among severe acute respiratorysyndrome coronavirus 2 (SARS-CoV-2) cases in Sakarya city, to find out the clinicalcharacteristics of patients diagnosed with stroke and to contribute to the national database.Material and Methods: This retrospective study was carried out with 783 cases diagnosedwith SARS-CoV-2 between April-June 2020 at the pandemic hospital in Sakarya city. Patientswere compared in terms of age, National Institute of Health Stroke Scale (NIHSS), risk factors,radiological findings, inpatient treatment, intubation, and mortality rates.Results: Out of 26 cases of ischemic stroke, 11 (42.3%) were male and 15 (57.7%) werefemale. In terms of infarction localization, the cause was medial cerebral artery (MCA) in 4(15.4%) patients, top of the basilar in 2 (7.7%) patients, basilar artery in 1 (3.8%) patient,lacunar in 9 (34.6%) patients and anterior system in 10 (38.5%) patients. There was nosignificant difference in terms of D-dimer and C-reactive protein (CRP) levels according todisease severity (both p=0.262). Three (0.38%) patients presented with stroke findings andwere diagnosed with SARS-CoV-2. Cryptogenic stroke was detected in 8 (30.8%) of theSARS-CoV-2 cases. Stroke frequency was calculated as 3.3% among the SARS-CoV-2 casesin Sakarya city.Conclusion: This is the first study to identify the frequency of stroke among SARS-CoV-2patients in Sakarya city and Turkey. Our study is important as it shows that preventing ortreating ischemic stroke in SARS-CoV-2 cases contributes greatly to the reduction ofmortality.
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    Myalgia Frequency in Patients with COVID-19 and Its Relationship with Creatine Kinase Levels
    (2020) Can, Nimet Uçaroğlu; Kotan, Dilcan; Kaya, Özgecan
    Aim: Many studies have showed that myalgia is a common onset symptom in coronavirusdisease 2019 (COVID-19). This study aimed to determine the frequency of muscle pain inpatients followed with COVID-19 diagnosis, and to investigate the relationship betweenmuscle pain and creatine kinase (CK), pH, lactate and lactate dehydrogenase (LDH) levels.Material and Methods: One hundred ten patients diagnosed with COVID-19 in our hospitalwere included retrospectively in this study. Presence of myalgia at the time of admission andon the 14th day of control were investigated. The first admission laboratory findings, 3rd dayCK values and 14th day control CK values of all patients were recorded retrospectively fromtheir files.Results: The study included 110 patients diagnosed with COVID-19. Fifty patients (45.5%)had muscle pain at the time of admission, and it was one of the most common musculoskeletalcomplaints. High CK results were obtained in 48 (43.6%) of the 110 patients at the time ofadmission. Thirty-two (66.7%) of 48 patients with high CK had muscle pain (p<0.001). In thepatients with muscle pain, the CK levels observed on 1st, 3rd, and 14th day of the disease werefound to be significantly higher than in those without muscle pain (p<0.001, p=0.003,p=0.029). No significant relationship was found between complaints of muscle pain andlactate, pH, and LDH values.Conclusion: Since some patients may only present with musculoskeletal symptoms such asmyalgia, it is important that clinicians consider COVID-19 in patients presenting with myalgiaand high CK levels.
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    SARS-CoV-2 Enfeksiyonunda Nörolojik Bulguların Tanısal ve Prognostik Önemi
    (Düzce Üniversitesi, 2020) Kotan, Dilcan; Duman, Taşkın
    Koronavirüsü, nöroinvazyon adını verdiğimiz yayılımla sinir sistemini tutmakta, ‘sitokin fırtınası’ hastalığın gidişatını etkileyen önemli bir faktör olmaktadır. Sitokin fırtınası sonucunda beyin ve diğer organlarda ciddi hasarlar ortaya çıkmaktadır. Tüm dünyada milyonlarca kişiyi enfekte eden koronavirüsün solunum yollarının yanı sıra hem merkezi hem de periferik sinirleri ve kas sistemini etkilediğini gösteren kanıtlar gün geçtikçe birikmektedir. Artan kanıtlar, hastaların %36-54’ünde yani neredeyse her 2 veya 3 hastanın birinde nörolojik tutulumu ortaya koymuştur. Şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) hastalarında koku ve tat bozuklukları, yorgunluk ve kas ağrısı, baş ağrısı, bulantı, kusma, bilinç bozukluğu, el ve ayaklarda uyuşma gibi nörolojik belirtilerle sıkça karşılaşıyoruz. Daha az olarak ise baş dönmesi, beyin zarı iltihapları, sinir dokusunda miyelin kaybı, kas iltihabı, ağır kas yıkımı gibi nörolojik handikaplara rastlıyoruz. SARS-CoV-2 hastalığına eşlik eden sinir sistemi hastalıklarının bir kısmı tam ya da kısmi sekel ile iyileşmektedir. Nörolojik bulgu gösteren hastalarda kalıcı fonksiyon kaybının gözlenmesi, bu olguların değerlendirilmesinde ayrıntılı nörolojik değerlendirmenin önemine dikkati çekmektedir.
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    The Frequency of Fabry Disease in Acute Stroke Patients with Renal Insufficiency in Sakarya Province
    (Düzce Üniversitesi, 2023) Sayan, Saadet; Kotan, Dilcan; Çiçekli, Esen; Alemdar, Murat
    Aim: This study aimed to investigate the frequency, clinical and genetic characteristics, and therapeutic options associated with Fabry disease (FD) in individuals with acute stroke and concomitant renal insufficiency.Material and Methods: An FD screening was performed on adult patients with renal dysfunction who were admitted to the neurology clinic due to acute stroke between 2015 and 2021. Screening was performed by a leukocyte ?-galactosidase A (?-Gal A) enzyme activity assay using dried blood spot (DBS) samples from male patients. In cases where the enzyme activity was less than 2.5 nmol/ml/h, genetic analysis was performed. Female patients underwent direct genetic analysis.Results: Renal dysfunction was detected in 39 ischemic stroke patients and 5 hemorrhagic stroke patients out of a total of 401 cases. The enzyme level was found low in only one of the male patients. The c.680G>A (p.R227Q) mutation was observed in this male patient and a female patient. In the later stages of the study, it was realized with the help of pedigree analysis that these two cases were first-degree relatives. The same mutation was also detected in 13 first-degree and 2 second-degree relatives. The frequency of FD in our study group, which included patients with cerebral and renal involvement regardless of consanguinity, was 4.54%.Conclusion: Rapid detection of FD cases can be achieved by screening individuals presenting with multiple end-organ damages. To the best of our knowledge, this study highlights the underemphasized association between renal involvement and stroke in FD.