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Öğe Breath-holding Spells: Etiological Factors, Laboratory Findings, and Rates of Response to Iron Therapy(2021) Kabakuş, Nimet; Tırınk, Ömer Faruk; Türay, Sevim; Hancı, FatmaAim: In this study, we aimed to investigate the etiological factors, electroencephalographic (EEG) findings, rates of response to iron therapy, and factors affecting response to iron therapy in children diagnosed with breath-holding spells (BHS). Methods: The study included 136 children aged 1 to 48 months who received iron therapy after a BHS diagnosis at our pediatric neurology clinic between November 2015 and No¬vember 2019. Patient medical records (physical examination, laboratory and EEG findings, medical history, and effectiveness of iron therapy) were reviewed retrospectively. Results: Of all patents, 81 (59.6%) exhibited partial response (partial remission) to iron therapy (50% decrease in BHS frequency), 52 (39%) responded completely (complete remission), and 2 were unresponsive. Comparison of the patients with complete and partial remission revealed a higher rate of complete remission in girls. In addition, patients with complete remission had higher levels of hemoglobin, MCV, and ferritin than those with partial remission. Complete remission rates were also higher in patients with normal EEG findings. Conclusion: BHS in childhood is a benign, recurring, and non-epileptic disorder and its differentiation from epilepsy is important. Children with BHS respond well to iron therapy, which can be recommended even if the serum iron and ferritin levels are normal.Öğe Evaluation of sleep habits, sleep chronotype, and quality of life in children with drug-resistant epilepsy in Turkey(Academic Press Inc Elsevier Science, 2022) Öz, Büşra; Şahin, Ayşenur Kübra; Türay, Sevim; Sungur, Mehmet AliBackground/Aim: Drug-resistant epilepsy (DRE) is a condition that affects sleep habits and the quality of life of children unfavorably. The aim of our study was to evaluate the relationship of sleep habits and sleep chronotype with the quality of life and behavioral problems in children with DRE. Materials and methods: In our study, 2-11-year-old children, who were either healthy or diagnosed with DRE, were evaluated. A sociodemographic data form was filled out to evaluate the general characteristics of children. The Children's Sleep Habits Questionnaire (CSHQ) and the Children's Chronotype Questionnaire (CCTQ) for sleep habits, the Pediatric Quality of Life Inventory (PedsQL) for the quality of life, and the Aberrant Behavior Checklist (ABC) for behavioral problems were filled out through face-to-face interviews with parents. Results: Thirty children with DRE and 31 healthy children were included in our study. Statistically significant differences were found in children with DRE compared to the control group in terms of the total and the subscale scores of CSHQ, including sleep onset delay, sleep duration, sleep anxiety, parasomnias, and sleep-disordered breathing (p < 0.001). There were no significant differences between the groups in terms of CCTQ total scores and sleep patterns (p > 0.05). Significant differences were found in PedsQL total and subscale scores, and ABC scores in children with DRE compared to the control group (p < 0.001). Children's Sleep Habits Questionnaire, PedsQL, and ABC scores were significantly correlated with each other in children with DRE. Conclusions: Our results have shown that sleep habits and the quality of life are poor in children with DRE. Our study has shown that sleep disturbances, quality of life, and behavioral problems are strongly associated with each other in DRE. The recognition and appropriate treatment of sleep disturbances are important for improving the quality of life in children with DRE. (c) 2022 Elsevier Inc. All rights reserved.Öğe An overview of vitamin B12 and iron deficiencies as a risk factors in children with febrile seizure etiology(2021) Türay, Sevim; Hancı, Fatma; Özde, SukriyeAim: To determine serum iron, ferritin, folate, and vitamin B12 deficiency and associated hemoglobin (Hb),hematocrit (Hct), mean corpuscular volume (MCV), and red cell distribution width (RDW) values in childrenundergoing febrile seizure, and thus to reveal their potential etiological role.Method: The serum iron, folate, vitamin B12, and ferritin, and Hb, Hct, MCV, and RDW values of 98 patientsundergoing FS and presenting to the pediatric neurology department and of 64 control patients were retrievedretrospectively and compared. Patient group data were also compared within the group.Results: Serum iron, ferritin, and vitamin B12 values were significantly lower in the patient group than in thecontrol group. Intragroup comparison revealed higher RDW values in patients with more than three FS and inthose with complicated seizures.Conclusion: This is the first study to investigate the relationship between vitamin B12, folate, and irondeficiency and FS. It should be remembered that deficiencies in these micronutrients, which are not routinelyinvestigated in patients presenting with FS, may play a role in the etiology, and that the frequency can decreasewith treatment. It should also not be forgotten that FS patients with high RDW values may be at risk of frequentseizure recurrence.Öğe Probable Risk Factors for Epilepsy Development Following Febrile Seizure: A Retrospective, Observational Study(2021) Hancı, Fatma; Türay, Sevim; Kocabey, Hüseyin; Kabakuş, Ni?MetObjectives: The purpose of this study was to investigate the risk factors for epilepsy development following febrile seizure (FS).Methods: This study included 449 patients undergoing first FS between 2014 and 2017. The sociodemographic, clinical, and electroenceph-alography (EEG) characteristics of the patients were retrieved from hospital records. Patients followed-up for at least 3 years after FS were divided into two groups (epilepsy and FS group; FS only group).Results: Of the 449 patients followed-up due to FS (238 [53.2%] boys and 211 [46.8%] girls), 42 (9.4%) were diagnosed with epilepsy during follow-up. The mean age at the time of the first FS was 21.4±14.5 months. A positive family history of FS and epilepsy was observed in 217 (48.3%) and 66 (14.7%) patients, respectively. In terms of FS characteristics, the prevalence of complex FS was significantly higher in the sub-sequent epilepsy group. The presence of a history of perinatal asphyxia and epileptiform or background abnormality findings at first EEG was also significantly higher in the subsequent epilepsy group (p<0.001).Conclusion: The findings of this study show that a history of perinatal asphyxia, complex FS, and epileptiform discharges at initial EEG exhib-ited an increased association with epilepsy development.Öğe The Prognostic Evaluation of West Syndrome Patients: A Retrospective Observational Study(2021) Türay, Sevim; Hancı, Fatma; Dılek, Mustafa; Kabakuş, Ni?MetObjective: To determine neurodevelopmental and seizure prognoses in our patients with West syndrome receiving adrenocorticotropic hormone (ACTH) therapy, and to identify the factors affecting these.Methods: We determined the demographic factors, previous seizure histories, ACTH use and drug response times, and etiological reasons of 34 patients diagnosed with West syndrome in our clinic at 3-24 months old and receiving ACTH therapy. We also investigated their neurological development and its effect on seizure prognosis.Results: We found a significant relationship between patients experiencing seizures before diagnosis and subsequent seizure prognosis. We also defined a later response to ACTH and poorer neurodevelopment and seizure prognoses in patients with symptomatic etiologies. Global developmental delay was identified in 76% of all cases, and seizures persisted despite antiepileptic drugs in 62%.Conclusions: Symptomatic etiological factors in West syndrome adversely affect the neurodevelopmental process and subsequent seizure prognosis.Öğe The Relationship Between Clinical Phenotypes and Chromosomal Microdeletions/Duplications in Pediatric Neurology(2021) Türay, Sevim; Eröz, Recep; Habiloğlu, Esra; Sav, Nadide MelikeAim: The aim of this study was to determine the diagnostic utility of chromosomal microarrayanalysis (CMA) in daily pediatric neurology practice and to identify the guiding clinicalparameters for patients requiring this test.Material and Methods: The CMA results for 91 patients with global developmentaldelay/intellectual disability (GDD/ID) admitted to our pediatric neurology clinic for variousreasons between 2018 and 2020 were examined. Demographical and clinical data for 34patients (37.4%) in whom del/dup was determined at CMA and 57 patients (62.6%) withnormal CMA were compared.Results: There was no statistically significant difference between two groups in terms ofdemographic characteristics such as age, gender, type of delivery, gestational age, etc.Dysmorphisms, hypotonia, myelination abnormalities were significantly more frequent inpatients with del/dup than in patients with normal result. The frequency of macrocephaly andobesity was higher in the normal group, and that of generalized seizures was higher amongepileptic patients in this group. Nineteen (55.9%) of the 34 cases who have del/dup detected atanalysis were regarded as pathogenic, 15 (44.1%) as uncertain clinical significance (likelypathogenic, likely benign and no subclassification).Conclusion: Since CMA is an expensive, laborious, and time-consuming test, consideringclinical parameters when requesting CMA will yield high diagnostic efficiency. A highpossibility of copy number variants may be predicted in GDD/ID patients with dysmorphisms,hypotonia, and myelination delay. CMA should represent the genetic analysis of choice inpediatric neurology practice in case of no finding suggesting a different etiology in these patients.Öğe Yenidoğan Yoğun Bakım Ünitesinde Respiratuvar Distres Sendromu Tanısıyla Takip Edilen Prematüre Yenidoğanların Surfaktan Cevabının Retrospektif Değerlendirilmesi(2023) Özde, Sukriye; Ünal, Nurcan; Sav, Nadide Melike; Çakmak, Hatice Mine; Türay, SevimAmaç: Preterm doğum yenidoğan ölümlerinin önde gelen nedenidir. Bu ölümlerin arasında en yüksek oran solunum sıkıntısı sendromu’ na (RDS) aittir. Bu çalışmanın amacı, yenidoğanlarda RDS yönetiminin en uygun ve etkin hale getirilmesine yardımcı olmak için; RDS’nin risk faktörlerini, klinik özelliklerini ve komplikasyonlarını belirlemektir. Gereç ve Yöntemler: Çalışmaya ikinci düzey yenidoğan yoğun bakım servisimizdeki Ocak 2016 ile Haziran 2021 tarihleri arasında düşük doğum ağırlıklı bebekler alındı. Olgular geriye dönük incelenerek, demografik özellikleri, verilmiş olan tedaviler (mekanik ventilasyon, surfaktan), ve erken ve geç komplikasyonları; ölüm oranları ve sebepleri belirlendi. Bulgular: Toplam 130 olgu çalışmaya alındı. Yüzde altmış ikisi erkek, %38’i kızdı.Yüzde 85’i sezaryen doğum, % 15’inde normal vajinal yoldu. Ortalama doğum ağırlığı 2043±372 gr, ortalama gebelik haftası 32±5 hafta bulundu. Antenatal steroid (ACS), %67,6' sında uygulanmıştı.Yüzde otuzüçünde erken membran rüptürü (EMR) saptandı. Erken ve geç komplikasyonlar; %3,8’inde ventilatöre bağlı pnömoni ve %3’ünde pnömotoraks idi.Yüzde 4,6’ında ise sepsis saptandı. Bronkopulmoner displazi (BPD) %2,3, Prematür Retinopatisi (ROP) %1,5, periventriküler lökomalazi %1,7 ile intrakraniyal kanama (IKK evre III-IV) %2 olarak görüldü. Ölüm oranı %10’du. Sonuç: Ölüm oranlarımız; ülkemizden yayınlanan verilerle benzer olarak bulundu. Doğum öncesi izlemin iyileştirilmesi, gebe takiplerinin düzenli yapılması, sık görülen ölüm nedenleri için risklerin tespit edilip bunlara karşı yeterli ve etkin önlemlerin alınması durumunda ölüm oranlarımızın azalacağını düşünmekteyiz.
