Sleep bruxism (SB) is a stereotyped movement disorder characterized by grinding or clenching of the teeth during sleep. We aimed to understand the abnormal networks related to the excitability of masticatory pathways in patients with SB. Eleven patients with SB and age- and gender-matched 20 healthy subjects were prospectively enrolled in our study. The masseter inhibitory reflex (MIR) after electrical stimulation and auditory startle reaction (ASR) were examined. For MIR responses, durations of early and late silent period (SP) were shorter and the degree of suppression of SPs was significantly lower in SB group in comparison to those obtained in healthy subjects. The ASR responses even of the masseter muscle, however, were similar between patients with SB and healthy individuals. Abnormal MIR provides support for the decreased inhibitory control of the central masticatory circuits in SB whereas normal ASR suggests the integrity and normal functioning of brainstem pathways mediating startle reaction. Although the sample size is small, our results are in line with previous findings and suggest an abnormally decreased inhibition in trigeminal motoneurons to masseter muscle rather than reticulobulbar pathways in patients with SB.
Objectives: Schizophrenia is a disorder with different clinical features. Schizophrenia may start insidiously and slow and go on for many years. But the negative symptoms and deficiency symptoms leading to social deterioration may come to the forefront. All these factors are taken into consideration, our aim in this study was to examine the demographic and clinical effects of symptoms on schizophrenic patients who have not yet been treated. Methods: Eighty patients who were admitted to the Ankara Numune Training and Research Hospital Psychiatry Outpatient Clinic, who did not have any previous antipsychotic medications and who did not use medications at the time of admission and who met the criteria for schizophrenia according to the DSM-5. Sociodemografic Data Form and the PANSS scale were used to assess the clinical status of the patients. Results: When the demographic characteristics of the participants were examined, 33 (41.2%) were female and 47 (58.8%) were male. The mean age of the patients was 31.08±9.37; mean education year was 8.76±3.53. When the patients participating in the study were evaluated in terms of gender, marital status, working status, smoking status, and family history, no statistical differences were found between the groups in terms of their PANSS scores (p>0.05). However, the PANSS Negative subscale scores (p<.001), general psychopathology scores (p=0.006), and total PANSS scores (p=0.003) were statistically significantly different between the three groups when the patients were untreated for 0-1 years, 1-5 years, and 5 years. Conclusions: In this study none of the sociodemographic factors we assessed had any effect on symptom severity. However, there are different results in the literature regarding gender, age, marital status and working status. Besides, it has been determined that the most important clinical manifestation in our study is the period without treatment. Further studies should identify demographic and clinical features that affect schizophrenic symptom changes.
Objective: It has been proposed that anything does not kill you make you stronger. Although it might be true in adult cases, children whose psychological life begin in the parental mind and shaped by the experiences during the early period of life are not as strong as adult against adverse effects of stressful events. Internalization of objects and emerging of internally working models, concept of normality and abnormality that will be the main ground for the understanding of the world in later life are emerged during childhood. That is why anything does not kill a child will shape its mind that might have everlasting effects on child. The clinical characteristics and pharmacological treatment process of a 10-yearold boy with Autism Spectrum Disorder who had drug refractory self-injurious behaviour Hasan Cem Aykutlu and Işık GörkerDepartment of Child and Adolescent Psychiatry, Trakya University School of Medicine, Edirne, Turkey E-mail address: hasancemay@hotmail.com ABSTRACT Objective: Irritability is the most common co-occurring symptom and common target of pharmacotherapy in children with Autism Spectrum Disorders (ASD) [1][2][3]. FDA-approved agents risperidone and aripiprazole are commonly used in irritability and became the firstline treatment, but the growing evidence has shown that a group of children with ASD comorbid, especially with intellectual disability, do not respond to the treatment [1,3]. In a recent research, drug refractory behaviours in children with ASD defined as aggression, selfinjury, and tantrums requiring medication adjustment despite trials of risperidone and aripiprazole or three or more psychotropic drugs targeting irritability [1]. In this presentation, it is aimed to review current literature with the case report of a child with ASD who had drug refractory self-injurious behaviour. Case presentation: Ten-year-old boy, who diagnosed with ASD and attention-deficit/hyperactivity disorder (ADHD) and intellectual disability, has been followed in our outpatient clinic since he was 3 years old. He had been prescribed risperidone up to 2 mg/day for irritability and hyperactivity between 3 and 9 years old, and had responded well to the treatment. At age 10, his family described the increase in irritability, aggression, tantrums, and severe self-injurious behaviour with his ongoing treatment. His Clinic Global Impression (CGI)-Severity score was 7/7, Aberrant Behaviour Checklist (ABC)-Irritability score was 41/45 and ABC-Hyperactivity score was 40/48. Neurological and medical comorbidities were not detected in the examination. There was limited or no response to the treatment with various trials of risperidone, aripiprazole, haloperidol, zuclopenthixol, benzodiazepines, methylphenidate, atomoxetine, valproate, and PSYCHIATRY AND CLINICAL PSYCHOPHARMACOLOGY, 2018 VOL. 28, NO. S1, 297-391 https://doi.org/10.1080/24750573.2018 naltrexone. After the combined treatment of risperidone 2 mg/day with clonidine 0.3 mg/day, well and sustainable treatment response of irritability and self-in...
Background and purpose – Haematopoietic stem cell transplantation (HSCT) is one of the most effective treatment methods for many malignant and non-malignant diseases. In this study, we aimed to detect electroencephalographic (EEG) anomalies at an early stage in patients who underwent allogeneic and autologous HSCT and required the management of potentially lifethreatening non-convulsive seizures. Methods – The study was conducted with 53 patients. The age, gender, HSCT type (allogeneic or autologous), and treatment regimens applied before and after HSCT were recorded. All patients underwent EEG monitoring twice, once on the first day of hospitalization and again one week after conditioning regimens began and HSCT was performed. Results – When the pre-transplant EEG findings were examined, 34 (64.2%) patients had normal EEGs and 19 (35.8%) had abnormal EEGs. After transplantation, 27 (50.9%) had normal EEG findings, 16 (30.2%) had a basic activity disorder, 6 (11.3%) had a focal anomaly, and 4 (7.5%) had a generalised anomaly. In the allogeneic group, the anomaly rate in post-transplant EEGs was significantly higher than that in the autologous group (p<0.05). Conclusion – It is important to consider the likelihood of epileptic seizures in the clinical follow-up of HSCT patients. EEG monitoring is crucial for the early diagnosis and treatment of such non-convulsive clinical manifestations.
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