In spite of the fact that migraines are one of the major problems seen by primary care providers, almost half of people with migraines do not obtain appropriate diagnosis or treatment. Migraine occurs in about 18% of women, and is often aggravated by hormonal shifts occurring around women's menses, during pregnancy, and during perimenopause. Quality of life with migraines is often greatly diminished, and many women miss work days with migraines. In women, the hormonal fluctuations seen during pregnancy and lactation can affect migraine frequency and magnitude. Understanding the evaluation of headache in pregnancy is important, especially given the increased risk of secondary headache conditions. Pregnancy and lactation can complicate treatment options for women with migraine because of the risk of certain medications to the fetus. This review includes details of the workup and then provides treatment options for migraine during pregnancy and lactation.
Hot water epilepsy (HWE) is a reflex epilepsy that develops after pouring hot water on the head; seizures are induced through tactile and temperature-related stimuli. The number of cases reported worldwide is low, with most cases in Turkey and India. The exact pathophysiology of HWE is unknown but patients are thought to have abnormal thermoregulation systems with seizures that emerge due to the stimulation of a particular region in the brain cortex via contact of hot water on the skin of the head. We investigated the pathogenesis of this disorder through a literature review and by presenting the clinical and laboratory findings of three patients with HWE. Fortunately, HWE can largely be prevented; however, if non-reflexive seizures co-occur with HWE, proper medical treatment can be added to ensure seizure-free follow-up.Keywords: Hot water, epilepsy, reflex epilepsy Sıcak suyun baştan aşağı dökülmesi ile oluşan, taktil ve sıcaklığa bağlı stimuluslarla uyarılan nöbetlerin ortaya çıktığı refleks epilepsi tipi sıcak su epilepsisi (SSE) olarak tanımlanmıştır. Literatürde en çok Türkiye ve Hindistan'dan olgu bildirilmesine rağmen tüm dünyada bildirilmiş olgu sayısı azdır. SSE'nin patofizyolojisi tam olarak bilinmemektedir, ancak hastaların anormal bir termoregülasyon sistemlerinin olduğu, kafa derisinin sıcak suyla teması ile beyin korteksindeki belirli bir bölgenin uyarılması nedeniyle nöbetlerin ortaya çıktığı düşünülmektedir. Çalışmamızda, SSE olan üç hastanın klinik ve laboratuvar bulguları sunularak hastalığın patogenezi literatür eşliğinde incelenmiştir. SSE, gerekli önlemler alındığında çoğunlukla önlenebilen bir refleks epilepsi tipidir. Ancak hastalarda SSE ile birlikte non-refleksif nöbetler de eşlik ediyorsa, uygun medikal tedavi alınan önlemlere eklenerek nöbetsiz başarılı takip sürelerine ulaşılabilir.
ÖzetBehçet hastalığı (BH) etyolojisi tam olarak bilinmeyen, kronik, tekrarlayıcı, sistemik bir vaskülittir. Nöro-Behçet hastalığı (NBH), tüm BH tanısı koyulmuş olguların %20'sinde görülür ve erkekleri kadınlardan daha çok etkileme eğilimi sergiler. Bu yazıda, daha önce BH tanısı almamış, akut menenjiti taklit eden ancak antibakteriyel tedaviye yanıt alınamaması sonucu NBH tanısı konulan 27 yaşında bir olgu sunuldu. Hastanın bir yıllık izleminde nörolojik relaps görülmedi. NBH, daha önceden BH öyküsü olmayan, akut menenjite benzer santral sinir sistemi tutulumu olan hastalarda akılda tutulmalıdır. AbstractBehçet's disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. Neuro-Behçet's disease (NBD) is seen in more than 20% of all cases diagnosed with BD and has an increased tendency to affect men more than women. A 27-year-old man presenting with a clinical picture of acute meningitis unresponsive to the antibacterial treatment, subsequently diagnosed as NBD, was presented. No neurological relapse was observed during the one-year follow-up. In cases with central nervous system involvement resembling acute meningitis without a history of BD, NBD should be kept in mind.
Multiple sclerosis (MS) is the most common chronic neurologic disability in young adults in their childbearing ages of 20 to 45 years. The disease affects especially women that is worthy of discussion among pregnancy-related conditions in a woman with MS. Prenatal counseling to discuss the safety of medications in pregnancy, the antepartum period, along with what the patient can expect during birth, and the postpartum period will be discussed.
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