No abstract

The occurrence of sciatic neuropathy after gluteal injection causing permanent sequelae and leading to medicolegal problems is relatively rare. We suggest a double quadrant drawing technique in each gluteal region. We also draw attention to this issue with postgraduate and in-service training programs of medical staff, and providing continuity in education can reduce this serious complication.

The aim of this study was to evaluate whether retinal neural network was impaired and cognitive functions were disturbed in restless legs syndrome (RLS) considering the hypothesis that there may be a dysfunction in dopaminergic pathways in RLS like in Parkinson's disease. Therefore, we evaluated retinal neural network with optical coherence tomography (OCT) and presence of cognitive impairment with Montreal Cognitive Assessment (MOCA). Methods: OCT evaluations were performed for 30 RLS patients and 30 healthy controls. Ganglion cell complex was segmented to retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) automatically by the device, and recorded. Additionally, all the patients and the controls were evaluated using MOCA. Results: No statistically significant difference was detected between RLS and controls in RNFL, GCL, IPL, and choroidal thicknesses. However, total MOCA score and all of its subscale scores were significantly lower in the RLS patients compared with the controls. No significant correlation was detected between OCT and MOCA parameters. Conclusion: No degeneration was detected in retinal neurons (RNFL, GCL, and IPL) of RLS patients. However, impairments were seen in MOCA total and subscale scores of these patients. On the other hand, no significant correlation was detected between MOCA scores and RNFL, GCL, or IPL thicknesses. These findings suggest decrease in cognitive functions of RLS patients probably due to dopaminergic dysfunction regardless of anatomical neural degeneration. Longitudinal follow-up studies are warranted to evaluate whether neuronal degeneration will develop.

Araştırma Makalesi / Research Article 34Ya z›fl ma Ad re si/Cor res pon den ce Ad dress: Dr. Murat Kuloğlu, Fırat Üniversitesi Hastanesi, Ruh Sağlığı ve Hastalıkları Kliniği, Elazığ, Türkiye Gsm: +90 533 413 9 897 E-posta: kuloglum@yahoo.com Ge liş ta ri hi/Re cei ved: 15.08.2011 Ka bul ta ri hi/Ac cep ted: 08.03.2012 © Nö rop si ki yat ri Ar şi vi Der gi si, Ga le nos Ya yı ne vi ta ra f›n dan ba s›l m›fl t›r. / © Arc hi ves of Neu ropsy chi atry, pub lis hed by Ga le nos Pub lis hing. ÖZET Amaç: Bu çalışmada bir grup Multipl Skleroz (MS) hastası ve kontrol bireyinin mizaç ve karakter özellikleri ile aleksitimi düzeyinin karşılaştırılması amaçlandı. Yöntem: Çalışmaya Fırat Üniversitesi Hastanesi Nöroloji Kliniğine başvuran ve çalışma ölçütlerini karşılayan 60 MS hastası ile yaş ve cinsiyet açısından eşleştirilmiş 60 sağlıklı birey kontrol grubu olarak alındı. Hasta ve kontrol grubuna Mizaç ve Karakter Envanteri (MKE), Toronto Aleksitimi Ölçeği (TAÖ-20) ve Genişletilmiş Özürlülük Durum Skalası (GÖDS) ile klinik-sosyodemografik özellikleri sorgulayan yarı yapılandırılmış görüşme formu uygulandı. Bulgular: Mizaç ve karakter bileşenleri açısından MS grubunda; zarardan kaçınma (ZK) skoru yüksek, kendi kendini yönetme (KY) ve sebat etme (SE) skorları ise düşük saptandı. Alt ölçek analizinde ise MS grubunda düzensizlik ve çabuk yorulma skorları yüksek, beceriklilik ve sosyal onaylama skorları ise düşük saptandı. Aleksitimi düzeyi açısından ise MS grubunda; duygularını tanıma zorluğu, dışa dönük düşünce ve aleksitimi toplam skorları yüksek saptandı. MS grubunun TAÖ toplam skorları KY ile negatif (r=-0,307, p=0,017), kendini aşma (KA) ile pozitif (r=0,291, p=0,024) korelasyon gösterdi. Sonuç: Araştırmamızın sonuçları MS hasta grubu ile kontrol grubu arasında MKE parametreleri ve aleksitimi düzeyi açısından farklılıklar gösterdiğini ortaya koymuştur. Bu farklılıkların MS hastalığıyla nedensel ilişkisini saptamaya yönelik daha fazla sayıda çalışmaya gereksinim vardır. (Nö rop si ki yat ri Ar fli vi 2013; 50: 34-39) Anah tar ke li me ler: Multipl Skleroz, aleksitimi, mizaç, karakter, kişilik Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir. ABS TRACTObjective: In this study, we aimed to compare temperament and character traits and levels of alexithymia between multiple sclerosis (MS) patients and healthy individuals. Methods: Sixty patients with MS who were admitted to Fırat University Hospital, Neurology Clinic and sixty age-and sex-matched healthy controls were enrolled in the study. Each participant met the inclusion criteria. The Temperament and Character Inventory (TCI), Toronto Alexithymia Scale (TAS-20), the Expanded Disability Status Scale (EDSS), and a semi-structured interview which investigated the clinical and socio-demographic features of the participants were administered to both patients and healthy individuals. Results: In terms of temperament and character components, scores of harm avoidance (HA), self-directedness (SD) and persistence (P) were found to b...

No abstract

Objective:The objective of the study is to compare the socio-demographical characteristics of patients with psychotic disorders that engage or dont engage in violent behavior against individuals, and to conduct a research on the degree of affinity of the victims of violence with the patient and on factors that could affect violence. Methods: All patients (151 patients) that were treated during the last year, diagnosed with psychotic disorder. The patients were compared in two groups; these who engaged in violent acts and these who did not. Furthermore, patients in the violent group were separated into two groups; one consisting of the patients who engaged in violent behavior against immediate family members, hence the immediate violence group, and the patients who didn't engage in violence against immediate family members, hence the distant violence group. Results: It was determined that 56% of the patients with psychotic disorder have attempted violence, out of which 75% were engaged in violent behavior against their immediate relatives. It was determined that patients who attempted violence were primarily those diagnosed with paranoid schizophrenia and chronic schizophrenia. It was observed that patients that did not receive regular psychiatric therapy attempted in violence more than others. Conclusion:Patients with active psychotic symptoms should be treated in early stages and precautions should be taken against to decrease attempts at violence.

No abstract

Bathing-related epilepsy (BRE), which is also known as water immersion epilepsy, is a rare, benign, reflex epilepsy. It presents with focal seizures that occur during bathing with hot water and has a favorable prognosis (1). The exact mechanism underlying these seizures is unknown (1). This epilepsy is frequently confused with hot water epilepsy (HWE) and is generally seen during childhood and in males (2,3). The most common seizure type is partial complex, and the seizures are often non-convulsive and autonomic (4).A 24-year-old male was admitted to our clinic due to seizures that occur while bathing with warm water since early childhood. These seizures start approximately 10 min after contact with water in the bathroom. Frequent and difficult breathing are the initial symptoms, followed by paleness, teeth squeezing, and purple discoloration of the lips, which last for 1-2 min. The patient becomes irritable before seizure and anticipates seizure. Consciousness becomes blurred, oral automatisms initiates, and seizures ends with a sleeping period. This state of blurred consciousness lasts for approximately 2 h. The patient' s seizures are partial complex and start with an aura presenting with irritability and absenteeism and end with blurred consciousness. His relatives reported that incontinence sometimes occurs. He poured water over his head from a plastic can while sitting. He did not have seizures when the water came from a shower. He had seizures 5-6 times a month, and the number of seizures had not changed in years. His medical history was unremarkable. He was born via normal vaginal delivery, and he did not have convulsions or any significant disease as a newborn. He was the third child in a family of three children, and his parents were second-degree relatives. Results of systemic and neurological examinations as well as hemogram, biochemistry tests, urine analysis, and cranial magnetic resonance imaging (MRI) were normal. Electrocardiography showed normal QT interval with sinus rhythm. Electroencephalography (EEG) was performed three times using the standard 10-20 system. It was rhythmic with an 8-9-Hz alpha rhythm, and no abnormalities were found. Psychiatric interview to exclude somatization and cardiologic examination to evaluate syncope were normal.Bathing-related epilepsy was diagnosed after somatoform disorder and syncope diagnoses were excluded. Seizures in this case were accepted as partial complex and sodium valproate was initiated at a dose of 10 mg/kg. Control EEG performed 1 month later was normal with the same results as the previous EEG. Patient and his relatives did not report any reflex seizures. The patient gave written consent for the publication of this case report.Although the exact pathophysiology of HWE is unknown, an abnormal thermoregulation is suspected. When the scalp comes into contact with hot water, a special region of the brain is believed to be stimulated resulting in seizures (2). There are many differences among HWEcases. The body surface area to come in contact with wate...