Person: TÜRKDOĞAN, DİLŞAD
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TÜRKDOĞAN
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DİLŞAD
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Publication Metadata only Lipid peroxidation and antioxidative enzyme activities in childhood epilepsy(B C DECKER INC, 2002) TÜRKDOĞAN, DİLŞAD; Turkdogan, D; Toplan, S; Karakoc, YThis study aimed to investigate the relationship among lipid peroxidation, subsequent activation of scavenger enzymes (superoxide dismutase and glutathione peroxidase), and the presence of structural abnormality in 52 epileptic children receiving monotherapy (medically responsive) or polytherapy (medically intractable). Plasma lipid peroxidation in epileptic patients with abnormal magnetic resonance imaging (MRI) findings significantly increased as compared with that of 16 healthy children (P<.05), whereas antioxidant enzymes were not significantly affected. Both medically controlled and intractable children with normal MRI had higher activities of superoxide dismutase than those of controls (P<.05). The activity of superoxide dismutase in epileptic patients with structural abnormality did not significantly change as compared with controls. Activity of glutathione peroxidase in all of the epileptic children was not significantly different from controls. The activity of antioxidant enzymes or plasma malonyldialdehyde levels did not correlate with duration of epilepsy, frequency of seizures (> one seizure per month or not), and the presence or localization (focal, multifocal, or generalized) of electroencephalographic or MRI abnormalities. Increased plasma lipid peroxidation may be causally related to the presence of structural abnormality rather than ongoing epileptic activity or therapy status.Publication Metadata only Characteristic and overlapping features of migraine and tension-type headache(WILEY, 2006) TÜRKDOĞAN, DİLŞAD; Turkdogan, D; Cagirici, S; Soylemez, D; Sur, H; Bilge, C; Turk, UObjective.-This epidemiological survey was conducted to investigate comprehensive characteristic and overlapping features of migraine and tension-type headache (TTH) disorders classified based on International Classification of Headache Disorders-II. Methods.-The stratified cohort of this study was composed of 2504 schoolchildren aged 10 to 17 years. A 38-item questionnaire inquiring all characteristic features of primary headache syndromes mandatory for classification was applied to selected 483 children with recurrent headache in the last 6 months. Results.-Migraine was diagnosed in 227 (47.0%) of 483 children and TTH in 154 (31.9%). Out of 125 children with definite migraine, 73 (58.4%) reported tension-type symptoms and 94 (68.1%) of 138 children with definite TTH reported migraine-type symptoms. Pressing pain (21%) and lack of aggravation of pain by physical activity (34%) were the major tension-type features in patients with migraine. Throbbing quality (43%) and aggravation by physical activity (30%) determined the main migraine-type features in patients with TTH. Conclusion.-The frequent co-occurrence of migraine and TTH symptoms suggests the presence of a common pathogenesis.Publication Metadata only Normative data of sympathetic skin response and RR interval variation in Turkish children(1999) TÜRKDOĞAN, DİLŞAD; Akyüz, G.; Türkdoğan-Sözüer, D.; Turan, B.; Canbolat, N.; Yilmaz, I.; Us, O.; Kayhan, O.Sympathetic skin response (SSR) and RR interval variation (RRIV) are used commonly for the assessment of sympathetic and parasympathetic nervous system function, respectively. We determined the normal values of SSR and RRIV in 23 (14 females, nine males) Turkish children aged 5 to 14 (mean 9.86, SD 2.48) years. SSR was recorded on the hands and feet during the electrical stimulation of both median and posterior tibial nerves, respectively. Similar response was elicited on both feet during the stimulation of the right median nerve. RRIV testing was performed during rest on the supine position and deep inspiration at a frequency of 6 times/min. The SSR was elicited in all children. The mean SSR latencies recorded on the feet during the stimulation of median or posterior tibial nerve were significantly more prolonged than those recorded at the hands (P < 0.001). There was no significant difference between the mean latencies of SSR recorded at the ipsilateral and contralateral palms or soles. The mean latencies recorded at the sole during stimulation of the median nerve were not significantly different compared to those that recorded at the sole during the posterior tibial nerve (P > 0.05). The SSR amplitudes were not assessed because of great variability and rapid habituation. The mean RRIV (46.54+/-11.29%) during deep breathing was significantly increased as compared to that (35.90+/-10.63%) during rest (P < 0.003). As a result, SSR and RRIV are preferred non-invasive tests for evaluation of autonomic nervous system in children. The SSR is useful and reliable if it is obtained in the optimum technical conditions. Further research is necessary to establish strict criteria for abnormality.Publication Metadata only Auditory neuropathy in hyperbilirubinemia: Is there a correlation between serum bilirubin, neuron-specific enolase levels and auditory neuropathy?(TAYLOR & FRANCIS LTD, 2004) TÜRKDOĞAN, DİLŞAD; Akman, I; Ozek, E; Kulekci, S; Turkdogan, D; Cebeci, D; Akdas, FThis study evaluated whether a correlation exists between increased serum bilirubin and neuron-specific enolase (NSE) assays (a biochemical index of neuronal damage) and auditory neuropathy. Nineteen term neonates without hemolysis whose serum bilirubin levels were above 20 mg/dl and 27 healthy term newborns with bilirubin levels <13 mg/dl were included in the study. Auditory brainstem responses (ABRs) and transient evoked otoacoustic emissions (TEOAEs) of patients with hyperbilirubinemia were obtained before discharge. This preliminary study did not show any correlation between the serum NSE and bilirubin values. However, infants who had auditory neuropathy had significantly higher NSE levels, and thus these patients, being in the high-risk group, need close follow-up.Publication Open Access Evaluation of vestibular functions in children with vertigo attacks(BMJ PUBLISHING GROUP, 2003-06-01) TÜRKDOĞAN, DİLŞAD; Uneri, A; Turkdogan, DAim: To examine vestibular system functions in children with episodic vertigo attacks. Methods: Thirty four children (20 males) aged 4-18 years with paroxysmal dizziness and/or vertigo attacks were evaluated. A medical history for vestibular symptoms and migraine was taken. Vestibular and auditory functions were assessed. Results: Chronic headache attacks consistent with migraine were reported in 12 children and motion sickness was reported in 30. Family history in first degree relatives was positive for migraine in 29 children and for episodic vertigo in 22. Electronystagmography and videonystagmography showed two types of nystagmus: spontaneous vestibular nystagmus (41%) and benign paroxysmal positional nystagmus (BPPN) (59%). The first type of nystagmus was assessed as a sign of vestibulopathy and the patients with BPPN were diagnosed as having benign paroxysmal positional vertigo (BPPV). Audiometric examination in four cases revealed bilateral sensory neural hearing loss in low frequencies. Pure tone averages in 30 cases were within normal ranges; however low frequencies in 28 of them were approximately 10 dB lower than high frequencies. Unilateral caloric responses diminished in eight children. Conclusions: Peripheral vestibular problems in childhood present in a wide spectrum, which varies from a short episode of dizziness to a typical vestibular attack with fluctuating sensory neural hearing loss or episodes of BPPV. A considerable number of these vestibular problems might be related to the migraine syndrome.Publication Open Access Familial and sporadic 15q13.3 microdeletions in idiopathic generalized epilepsy: precedent for disorders with complex inheritance(2009-10-01) TÜRKDOĞAN, DİLŞAD; Dibbens, L. M.; Mullen, S.; Helbig, I.; Mefford, H. C.; Bayly, M. A.; Bellows, S.; Leu, C.; Trucks, H.; Obermeier, T.; Wittig, M.; Franke, A.; Caglayan, H.; Yapici, Z.; EPICURE Consortium; Sander, T.; Eichler, E. E.; Scheffer, I. E.; Mulley, J. C.; Berkovic, S. F.Publication Metadata only Involvement of sympathetic reflex activity in patients with acute and chronic stroke: A comparison with functional motor capacity(W B SAUNDERS CO-ELSEVIER INC, 2004) TÜRKDOĞAN, DİLŞAD; Muslumanoglu, L; Aki, S; Turkdogan, D; Us, O; Akyuz, GObjective: To investigate sympathetic nervous system functions in patients with acute and chronic phase of stroke by measuring sympathetic skin reflex (SSR) and the relationship between sympathetic dysfunction and motor function capacity. Design: Cross-sectional, case-control study. Setting: A physical medicine and rehabilitation department in a research hospital of a university referral center in Turkey. Participants: Fifty-six patients with stroke-13 in the acute phase and 43 in the chronic phase-and 42 age- and sex-matched healthy volunteers were included. Intervention: SSR was recorded with electric stimulation of the bilateral median nerves. Main Outcome Measures: SSR was recorded to assess sympathetic reflex activity in patients in the acute and chronic phase of stroke and in controls. Motor functions was classified using the Brunnstrom stages. Results: The mean SSR latency in the acute phase was significantly prolonged and the amplitudes were decreased compared with controls. In the chronic phase, the mean amplitudes were significantly attenuated compared with controls, whereas the mean latency did not change. The mean latency of SSR in patients in Brunnstrom groups 1 and 2 was longer, and the mean amplitude was smaller than in controls (P<.05). The mean amplitude was significantly reduced in patients classified as Brunnstrom groups 3 and 4 compared with controls (P<.05), but the mean latency was not affected. Conclusions: Depression of sympathetic reflex activity was more prominent in the acute phase of stroke and was associated with moderate or highly limited motor function capacity. Improvement of motor dysfunction may parallel recovery of sympathetic reflex activity.Publication Metadata only Visual and auditory event related potentials in epileptic children: a comparison with normal and abnormal MRI findings(2003) TÜRKDOĞAN, DİLŞAD; Turkdogan, Dilsad; Us, Onder; Akyuz, GulserenVisual and auditory event related potentials (VERPs and AERPs) in 32 epileptic children with magnetic resonance imaging (MRI) abnormalities and 18 with normal MRI were recorded and compared to the data of 21 healthy children. Of all 50 epileptic children (34 male, 16 female) aged 14.42+/-4.27 (7-20) years, 21 were medically intractable and receiving polytherapy. The mean latencies of N2 and P3 components of VERPs and AERPs in all epileptic children were significantly higher than those of the controls (P<0.05). Epileptic children with structural abnormalities had more prolonged latencies of N2 and P3 components of AERPs and VERPs than those of the healthy children (P<0.05). The epileptic children with normal MRI had significantly more prolonged latency of N2 and P3 of VERPs and P3 of AERPs than those of the controls (P<0.05). The difference of the mean latency of N2 and P3 components or the mean amplitude of P3 components of ERPs between the two epileptic groups was insignificant. The type of medication (mono- versus polytherapy) did not affect the wave components of ERPs. We suggest that epileptic activity, itself, leads to prolonged N2 and P3 components of AERPs and VERPs. The presence of structural abnormality indicated by imaging is not a predictor of ERPs abnormalities.Publication Metadata only Comparison of classifications of seizures: A preliminary study with 28 participants and 48 seizures(2005) TÜRKDOĞAN, DİLŞAD; Baykan B., Ertas N.K., Ertas M., Aktekin B., Saygi S., Gokyigit A., Akyol A., Serdaroǧlu A., Bilir E., Yigit A., Mungen B., Bulut S., Genc B.O., Bingol C.A., Turkdogan D., Agan K., Arman F., Gurses C., Bebek N., Akhan G., Bozdemir H., Aslan K., Gul G., Altin U., Ozisik H.I., Misirli H., Aydogdu I., Arac N., Bora I., Taskapilioglu O., Cengiz N., Deriocioglu N., Erdinc O., Velioglu S.K.Purpose: Our aim was to compare three available seizure classifications (SCs), namely, the international classification of epileptic seizures published in 1981 (ICES; Epilepsia 1981;22:489-50); the semiological seizure classification (SSC) by H. Lüders, J. Acharya, C. Baumgartner, et al. (Epilepsia 1998;39:1006-13; Acta Neurol Scand 1999;99:137-41); and the proposal of a new diagnostic scheme for seizures (PDSS) by J. Engel, Jr. (Epilepsia 2001;42:796-803) published in 2001. The three SCs were compared with respect to diagnostic success rates, usefulness, and consistency by a large group of neurologists in this preliminary study. Methods: After a training period, 28 blindfed participants with different levels of experience with epilepsy classified videos or written descriptions of 48 randomly selected seizures according to the three SCs. Definite diagnoses of the seizures were established based on all clinical, ictal/interictal EEG, and MRI data. All the participants answered a questionnaire concerning their preferences for SCs after the study. Results: The overall diagnostic success rates were 81.4% for ICES, 80.5% for PDSS, and 87.5%, for SSC. Various parameters concerning experience with epilepsy affected success rates positively, without reaching statistical significance, whereas experience with epilepsy surgery appeared to be a parameter significantly affecting the success rate in all SCs. In reliability analysis, Cronbach's α was 0.94 for ICES, 0.88 for PDSS, and 0.70 for SSC, all showing good agreement in the group. Nineteen reviewers chose SSC, eight chose ICES, and one chose PDSS as their preference in the questionnaire, completed after the end of the study. Conclusion: The results of this preliminary study demonstrate that with proper training, physicians treating epilepsy patients can handle new SCs, and emphasize the need for revision of the current classification. © 2005 Elsevier Inc. All rights reserved.Publication Metadata only Serial MRI and MRS studies with unusual findings in Rasmussen's encephalitis(SPRINGER VERLAG, 2000) TÜRKDOĞAN, DİLŞAD; Turkdogan-Sozuer, D; Ozek, MM; Sav, A; Dincer, A; Pamir, MNRasmussen's syndrome is characterized by intractable seizures and progressive neuropsychiatric deterioration secondary to unilateral cortical inflammation and tissue destruction. Diagnosis of Rasmussen's syndrome in the early phase depends mainly on the clinical features. Neuroimaging and histopathologic examinations may not be specific during this period. We report a case of Rasmussen's syndrome followed by serial MRI and magnetic resonance spectroscopy (MRS) studies over a 3- to 16-month period. A healthy 6-year-old boy presented with focal motor seizures. An MRI study demonstrated prominent enlargement and T2 hyperintensity of the left mesial temporal lobe and perisylvian region. This early finding evolved to volume loss and later progressive atrophy of the ipsilateral hemisphere when epilepsia partialis continua occurred. Being aware of those early MRI features in a patient with increasing frequency of focal motor seizures should suggest Rasmussen's syndrome. In addition, we found prominently increased myoinositol concentration in atrophic cortex which might reflect increased gliosis in the late period of the disease.