Arrhythmia is not uncommon in the etiology of syncope which mimics epilepsy. Data about the epilepsy induced vagal tonus abnormalities have being increasingly reported. So we aimed to evaluate what a neurologist may gain by a simultaneous electrocardiogram (ECG) and electroencephalogram (EEG) recording in the patients who underwent EEG testing due to prediagnosis of epilepsy. We retrospectively evaluated and detected ECG abnormalities in 68 (18%) of 376 patients who underwent EEG testing. A minimum of 20 of minutes artifact-free recording were required for each patient. Standard 1-channel ECG was simultaneously recorded in conjunction with the EEG. In all, 28% of females and 14% of males had ECG abnormalities. Females (mean age 49 years, range 18-88 years) were older compared with the male group (mean age 28 years, range 16-83 years). Atrial fibrillation was more frequent in female group whereas bradycardia and respiratory sinus arrhythmia was higher in male group. One case had been detected a critical asystole indicating sick sinus syndrome in the female group and treated with a pacemaker implantation in the following period. Simultaneous ECG recording in conjunction with EEG testing is a clinical prerequisite to detect and to clarify the coexisting ECG and EEG abnormalities and their clinical relevance. Potentially rare lethal causes of syncope that mimic seizure or those that could cause resistance to antiepileptic therapy could effectively be distinguished by detecting ECG abnormalities coinciding with the signs and abnormalities during EEG recording.

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Background: This study investigated the efficacy and safety of transnasal sphenopalatine ganglion block (SPGB) for treatment of postural puncture headache (PDPH) in non-obstetric patients.Methods: This retrospective study was conducted at the Ankara Research and Educational Hospital, in Turkey, and included 26 non-obstetric patients (age, "18 years) who were diagnosed with PDPH and unresponsive to conservative therapy or unable to continue it because of side effects. Transnasal SPGB was performed in each nostril. Pain severity was assessed with the Visual Analogue Scale (VAS) at 15 min, 30 min, 24 h, and 48 h after the procedure, while patients were seated. The patients were monitored for 48 h for adverse effects (AEs). Patient treatment satisfaction was assessed at 48 h after the procedure by using the Patient Global Impression of Change (PGIC) scale.Results: Headache at 15 min post-procedure was relieved rapidly. At 24 h post-procedure, nearly half of patients (42.3%) had no pain, and all patients (100%) had a VAS score of <3. Nasal discomfort, throat numbness, and nausea were AEs reported after SPGB; however, these AEs were completely relieved at 24 h after the procedure. According to the PGIC scale scores at 48 h post-procedure, 73.1% of patients evaluated themselves as "much improved" and 26.9% evaluated themselves as "very much improved". Conclusion:When PDPH does not respond to conservative treatment, it may be treated effectively with transnasal SPGB, which is a noninvasive, safe, well-tolerated, and straightforward method with a low complication rate.

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Aim: Electroneuromyography (ENMG) is an electrophysiological method of examination for neurophysiological state of motor neuron, peripheral nerve and muscle functions. This study was aimed to investigate the concordance of between referral diagnosis and ENMG diagnosis in patients referred to the electrophysiology laboratory. Methods: A retrospective cohort study is planned. Patients, whose evaluations of ENMG were requested by the orthopedic, neurology and physical therapy and rehabilitation physicians between June 2015 and December 2018, were included in this study. Descriptive statistics and Cohen's Kappa Test were run for data set analysis. Results: A total of 486 patients are included in the study. Of the 486 patients undergoing ENMG examination, 362 were female (74.5%) and 124 were male (25.5%). The mean age was 46.71±12.41. 35.2% (n=171) of the referral diagnoses were requested by orthopedics, 32.7% (n=159) by physical therapy and rehabilitation and 32.1% (n=156) by neurology clinics. When the consistency between the preliminary diagnosis and post-ENMG diagnosis was examined; 65.4% of the results were found to be compatible. According to the clinics; 76.3% of the requests referred by the neurology clinic and 64.8% of the requests referred by the physical therapy and rehabilitation clinic, 56.1% of the requests referred by the orthopedic clinic were confirmed by ENMG. As a result of the Cohen's Kappa test, the total (κ) correlation between clinical preliminary diagnosis and ENMG diagnosis was found to be 0.574 (p<0.001). These findings demonstrated a moderate (0.41-0.60) concordance. When examined according to the clinics, compliance values; for the orthopedic clinic were 0.484 (p<0.001), 0.571 for the physical therapy and rehabilitation clinic (p<0.001) and 0.685 for the neurology clinic (p<0.001). Conclusion: This study confirmed that ENMG should be considered as an extension of neurological examination.

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