Obstructive sleep apnea syndrome (OSAS) in children is associated with changes in the structure of sleep. The possible effects of snoring on spindle activity have not been established. We analyzed the polysomnography recordings and sleep spindle activity in children with primary snoring and/or OSAS compared with healthy children. Fifty-one children were included; 8 had primary snoring, 16 had OSAS and snoring, 11 had OSAS without snoring, and 16 were healthy controls. The density ( P = .034) and duration ( P = .019) of sleep spindles were decreased in children with OSAS compared with controls. The sleep spindle activity did not show significant changes between children with primary snoring and healthy controls, or between OSAS with/without snoring. We conclude that it is not snoring per se but OSAS that affects sleep spindle activity. Obstructive sleep apnea syndrome with/without snoring deserves greater attention because it has different phenotypes of the disease with different pathophysiologies.
Objective The aim of this study was to evaluate patients who were hospitalized with a diagnosis of COVID-19 and were consulted by neurology during their hospital stay. Methods All files of patients with COVID-19 who were admitted to Cerrahpasa Medical Faculty Hospital between March 11th and December 31st, 2020 were retrospectively reviewed, and files of patients who consulted by neurology during their stay were included. Demographic and clinical characteristics, neurologic diagnosis, outcome and related laboratory data were extracted from electronic medical records and analyzed. Patients were categorized into the first wave and second wave according to the date of hospitalization. Results A total of 2257 patients were hospitalized for COVID-19; among them, 127 were consulted by a neurologist during their hospital stay. Fifteen patients received a consultation for possible drug interactions. Among the remaining 112 patients, the reason for neurology consultation was i. exacerbation of a neurological comorbidity vs ii. new-onset neurological manifestations. The median age was 68.5 ± 14.2 years, and 60.7% were men. Dementia and stroke were the leading neurological comorbidities. COVID-19 disease was more severe in the patients with the new-onset neurological comorbidity than in patients with exacerbation of a neurological comorbidity ( p = 0.07). Serum creatinine kinase levels were higher in the new-onset patient group ( p < 0.05). Exacerbation of previous neurological disease or new neurological impairment were jointly and severely related to high mortality (overall 35/112 vs 275/2145, p < 0.001; exacerbation 12/45 vs 275/2145 p < 0.01; new-onset 23/67 vs 275/2145, p < 0.001). Conclusion Serious neurological involvement is relatively uncommon in hospitalized patients with COVID-19 and is associated with increased mortality.
Objective SARS-CoV-2 infection commonly affects both the central and peripheral nervous systems. In this way, different neurological and psychiatric clinical pictures emerge. Whereas the effects of SARS-CoV-2 on neuronal structures in the short and long term are still controversial. Neurological involvement secondary to SARS-CoV-2 is heterogeneous in terms of both clinical presentation and treatment responses and prognosis. Method A case of autoimmune encephalitis developing after SARS-CoV-2 was presented. Results This case was admitted to the clinic with classical catatonia signs and encephalopathy together. The emergence of neuropsychiatric problems after the relief of SARS-CoV-2 symptoms, suggests that this picture was primarily related to immune processes. The presented case showed a good clinical response to symptomatic catatonia treatment and immune-modulatory agents and recovered both physically and cognitively without any sequelae. Conclusion In terms of clinical presentation and treatment response, SARS-CoV-2 infection may create a distinct encephalitic involvement after the infection itself by triggering some defined or not-yet-defined autoimmune pathways.
Objectives Rheumatoid arthritis (RA) is an autoimmune disease involving synovial joints, and it is known that extra-articular manifestations that may affect the central and peripheral nervous systems may develop during its course. Rheumatoid meningitis is very rare among all neurological involvements. In this study, cases diagnosed as rheumatoid meningitis with clinical, imaging, laboratory, and histopathological features are presented, and the aim of the study is to present current approaches in the diagnosis and treatment of rheumatoid meningitis in the light of case studies and current literature. Methods The data of the patients who were followed up with the diagnosis of rheumatoid meningitis in our clinic between 2017-2021 were reviewed retrospectively. Results Three cases diagnosed with rheumatoid meningitis are presented in detail. In the first case, the diagnosis was reached by clinical, imaging, and laboratory findings as well as treatment response, while the diagnosis was made by histopathological verification in the second case. The third case shows that spontaneous remission can be observed in the course of rheumatoid meningitis. Discussion Rheumatoid meningitis, which is one of the rarest involvements in the course of RA, may present with headache, focal neurological deficits, seizures, and altered consciousness. A meningeal biopsy is recommended when the differential diagnosis cannot be ruled out with imaging and laboratory findings. In the differential diagnosis TBC, syphilis, neuro-sarcoidosis, IgG4-related disease, lymphoproliferative diseases, and systemic metastasis should be kept in mind. Aggressive RA management is recommended for treatment.
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