Objectives: Type 2 Diabetes Mellitus (DM) is a risk factor for mild cognitive impairment (MCI), Alzheimer's disease and vascular dementia. However, it is not known which pathophysiological mechanisms lead to impairment in cognitive functions in Type 2 DM. This study aims to compare the cognitive functions of diabetic patients with and without polyneuropathy using standardized Mini-Mental Test (MMSE) and the Montreal Cognitive Assessment Scale (MoCA) and to assess whether the presence of polyneuropathy is a predictive factor for the development of cognitive impairment. Methods: Patients with DM who underwent our EMG laboratory for polyneuropathy between January 2014 and January 2015 were included in this study. Patients who underwent electrophysiological examinations were evaluated for polyneuropathy. Patients with polyneuropathy were classified as a patient group and other patients as a control group. In all cases, MMSE and MoCA were administered. The demographic data and educational status of the patients were recorded. Hypertension, coronary artery disease, smoking and alcohol use were questioned. Their complaints, duration of illness and the treatment they were receiving were questioned. Glycosylated hemoglobin (HBA1C) values in the last three months and physical examination findings of patients were recorded. Patients with and without polyneuropathy were compared with statistical methods. Results: Polyneuropathy was detected in 34 (42%) of the 81 patients who participated in our study. The age, disease duration and HBA1C levels were statistically higher in the polyneuropathy group than in the control group (p=0.024, p=0.000, p=0.016). However, there was no statistically significant difference between MMSE and MoCA scores of these groups. In both groups, there were no patients scoring below the MMSE cut-off value of 24. Seventeen of the 34 patients (50%) in the polyneuropathic group and 19 (40,4%) of the 47 patients in the control group had scores below the MoCA cut-off value 21. However, there was no statistically significant difference between the two groups. We also found that the mean MoCA value of all DM patients was 21, which was the MoCA cut-off value. Also, factors affecting cognitive functions in all Type 2 DM patients were evaluated by logistic regression analysis, and it was found that duration of education was an independent factor affecting cognitive impairment (OR=8.167; p=0.001). Conclusion:In our study, we did not observe significant differences between MMSE and MoCA scores of Type 2 DM patients with and without polyneuropathy. However, the cross-sectional nature of our study makes it impossible to comment on this issue. To clarify whether the presence of polyneuropathy is a predictive factor in the development of cognitive impairment in Type 2 DM, there is a need for a larger sample group and long-term follow-up studies. It has also been shown that patients with Type 2 DM may have low scores according to the MOBID cut-off value even though peripheral neurologic involvement findings are not obs...
In our study, we aimed to analyze electroencephalography (EEG) findings in patients with hypocalcemia and to investigate possible relationship between calcium (Ca) level and EEG abnormalities and whether there was any change in EEG findings when serum Ca level returns to normal. Methods: Seventeen consecutive patients, who were admitted to the Endocrinology, Neurology and General Surgery Clinics at İstanbul Şişli Hamidiye Etfal Training and Research Hospital with a corrected serum Ca level of <8.5 mg/dL, were included in our study. EEG examination was performed in all patients in the same day with laboratory examination. Control EEG was performed in patients who had abnormal EEG findings and in those calcium levels were normalized (>8.5 mg/dL) in follow-up. Results: EEG abnormalities were detected in nine (53%) of 17 patients. EEG examination revealed slow background activity in seven patients (41%) and epileptiform abnormalities in two (12%) patients. In follow-up, normocalcemic period was observed in seven patients. EEG findings were improved in two of eight patients who had slow background activity and one of two patients with epileptiform activity in the normocalcemic period. Conclusion: Our study showed that various EEG findings, such as slowed background activity and epileptiform abnormalities, may be seen in isolated hypocalcemia patients even in the absence of clinical findings and these EEG findings may improve in normocalsemic period.
ÖzAmaç: Çalışmamızda hipokalsemi olan hastalardaki elektroensefalografi (EEG) bulgularını araştırmayı, kalsiyum (Ca) düzeyi ile EEG anormallikleri arasında olası ilişkiyi göstermeyi ve serum kalsiyum düzeyi normale döndüğünde EEG bulgularında değişiklik olup olmadığını göstermeyi amaçladık.Yöntemler: Çalışmamıza "xxxx" Eğitim ve Araştırma Hastanesi Endokrinoloji, Nöroloji, ve Genel Cerrahi polikliniklerine başvurmuş, düzeltilmiş serum Ca değeri <8,5 mg/dL olan ardışık 17 hasta alındı. Tüm hastalara laboratuvar tetkikiyle aynı gün içinde EEG çekimi yapıldı. Başlangıçta anormal EEG bulgusu olan hastalardan, kalsiyum değeri takiplerde normale (>8,5 mg/dl) yükselen hastalara kontrol EEG incelemesi yapıldı.Bulgular: 17 hastanın 9'unda (%53) çeşitli EEG anormallikleri saptanmıştır. EEG bulguları 7 (%41) hastada zemin aktivitesinde yavaşlama, 2 hastada ise (%12) epileptiform anormallikler gösterdi. Takiplerde 7 hastada normokalsemik dönem izlendi. Zemin aktivitesinde yavaşlama olan 5 hastanın 2'sinde, epileptiform aktivitesi olan 2 hastanın 1'inde normokalsemik dönemde EEG bulgularının düzeldiği gözlendi.Sonuç: Çalışmamız izole hipokalsemili hastalarda klinik bulgu olmasa da,zemin aktivitesinde yavaşlama ve epileptiform anormallikler gibi çeşitli EEG bulguları görülebileceğini ve bu EEG bulgularının normokalsemik dönemde düzelebileceğini göstermiştir. Anahtar Sözcükler: Hipokalsemi, elektroensefalografi, nöbetAim: In our study, we aimed to investigate electroencephalography (EEG) findings in patients with hypocalcemia, to show the possible relationship between calcium(Ca) level and EEG abnormalities and to show whether there was any change in EEG findings when serum calcium level normalized.Methods: Seventeen consecutive patients who admitted to Endocrinology, Neurology and General Surgery clinics of "xxxx" Training and Research Hospital with a corrected serum Ca level of <8.5 mg/dL were included in our study.EEG examination was performed to all patients in same day with laboratory examination.Control EEG was performed to patients who had abnormal EEG findings initially and calcium levels were normalized(> 8.5 mg / dl) in follow-up.Results: EEG abnormalities were detected in 9 (53%) of 17 patients. EEG examination revealed slow background activity in seven patients (41%) and epileptiform abnormalities in 2 (12%) patients.In follow-up the normocalcemic period was observed in 7 patients.EEG findings were improved in 2 of 5 patients who had slowed background activity and 1 of 2 patients with epileptiform activity in normocalcemic period. Conclusion:Our study showed that various EEG findings such as slowed background activity and epileptiform abnormalities may be seen in isolated hypocalcemia patients although there were no clinical findings and these EEG findings may be improved in normocalsemic period.
Dear Editor, An 18-year-old female patient was admitted to our clinic with sudden-onset horizontal binocular diplopia, marked headache on the left eyebrow, and limited abduction of the left eye that started one day ago. The patient noted that she had had similar symptoms that resolved spontaneously before, but that this time it was more severe. The patient had no history of febrile illness; trauma; regular medication use; neurologic, psychiatric or other systemic disease; and ocular surgery. A neurologic examination revealed intact visual acuity in both eyes and horizontal diplopia. In the primary position, there was left convergent strabismus (Figure 1). On light reflex examination, the left pupil was meiotic. Bilateral pathology was not observed in extraocular muscles (Figures 2A, 2B). The examination performed by the ophthalmology clinic revealed no pathology in the anterior and posterior segment of the eye, and the optic disc was normal. Visual field examination with visual achromatic perimetry was normal. No pathology was found in the remaining neurologic or ophthalmologic examinations. Cranial computed tomography (CT), CT angiography, and magnetic resonance imaging showed no pathology. Thyroid Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si:
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