• ÖZ

Objective: Inflammation and migration of leukocytes to the brain parenchyma play a role in atherosclerosis and cerebral ischemic stroke. Migration occurs with the help of adhesion molecules on the surface of cerebral endothelial cells and leukocytes. P-selectin, an adhesion molecule, is present on the platelet and endothelial surface and allows leukocytes to loosely adhere to the endothelium, and its increase has been shown in acute ischemic stroke (AIS). Thrombin-activatable fibrinolysis inhibitor (TAFI) is a procarboxypeptidase molecule that can be another marker of AIS, which has been shown to increase the risk of thromboembolism and stroke 6-fold. Intima-media thickness (IMT) is thought to be associated with atherosclerotic diseases in carotid ultrasonography (USG) and increased risk of ischemic stroke has been found to be associated with increased carotid IMT. In this study, we investigated the relationship between P-selectin and TAFI levels, which have been shown to be effective for AIS via carotid IMT, and is considered significant for atherosclerosis. Materials and Methods: Forty patients with AIS and 22 healthy subjects were included in the study. In both groups, serum P-selectin and TAFI levels were studied at the time of presentation, and on day 7, day 14, and at one month; carotid IMT and stenosis rates were measured by Doppler USG. P-selectin and TAFI levels were compared with carotid IMT in both groups. Results: There was no significant difference between P-selectin levels and carotid IMT between the groups; TAFI levels were significantly higher in the patient group and were correlated with carotid IMT in both groups. Conclusion: TAFI increase has been suggested to be a marker of early atherosclerosis in asymptomatic atherosclerosis and ischemic stroke. A positive correlation between TAFI levels and carotid IMT and stenosis rates have been reported; however, the positive correlation between increased P-selectin levels in AIS and carotid IMT was not detected in our study.

• ÖZ

Nörolojik hastalıklar bütün dünyada en fazla sağlık yükü oluşturan hastalık gruplarındandır. Çoğu kronik ve iyi takip edilmesi gereken risk faktörlerine bağlı olan nörolojik hastalık alanına yeni koronavirüs hastalığı-19 (COVID-19) pandemisi ile yeni ve ağır bir yük daha eklenmiştir. Nörolojik sisteme etkileri giderek daha fazla yayımlanmakta olan Severe Acute Respiratory syndrome-Coronavirus-2’nin nörolojik tutulum yapma sıklığı ve mekanizmaları multidisipliner ekip içinde nörologların da yer alması ile daha iyi anlaşılabilecektir. Diğer bir önemli durum ise, COVID-19 nedeniyle yapılan olağanüstü düzenlemelerin kronik gidişli, sık ve düzenli kontrol gerektiren, akut müdahale gerektiren hastaların izlem ve tedavilerini aksatabilme durumudur. Nöroloji uzmanlarının bu dengeleri koruyarak sahadaki sorumluluklarını yerine getirecek düzenlemeler yapılması hayati önemdedir.

• ÖZ

Objective: Although Aquaporin-4 (Aqp-4) gene polymorphisms have been extensively studied in neuromyelitis optica spectrum disorder (NMOSD), there is little evidence on the involvement of Aqp-4 in the pathogenesis of relapsing optic neuritis (RON). Materials and Methods: In our study, we recruited patients who were followed by Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Multiple Sclerosis and Myelin Disorders Unit between 1979 and 2015. Blood samples of the patients were genotyped for potential variants in the exons and the nearby regions of Aqp-4 gene. Results: The Aqp-4 gene was sequenced in 15 patients with RON who were seronegative, 33 patients with NMOSD, and 30 healthy controls. None of the patients showed previously described single nucleotide polymorphisms (SNPs). Three new SNPs were identified in non-exonic regions of the gene. One intronic SNP located in close proximity to the fifth exon had a higher prevalence in patients with RON than patients with NMOSD and healthy controls. Conclusion: Aqp-4 SNPs show a considerable heterogeneous geographic distribution and might be involved in RON pathogenesis.

• ÖZ

Objective: Bell’s palsy is an acute onset, unilateral, self-limiting paresis or paralysis of the facial nerve. The objective in treatment is to increase facial functions and to accelerate recovery by suppressing this inflammatory process. Steroids and acyclovir (singly or in combination) are used in medical treatment. The objective of this study was to determine the clinical profile of Bell’s palsy in childhood and to compare the efficacy of combined acyclovir-prednisolone therapy with that of prednisolone therapy alone. Materials and Methods: Eighty-six patients diagnosed as having Bell’s palsy were enrolled in the study. All patients were assessed in terms of facial nerve dysfunction and recovery time using the House-Brackman Facial Nerve Grading scale (HBFNGS) at initial presentation and at the 15th day, and the first, third, and sixth months. Grade 4 and above was assessed as severe, and lower grades were regarded as mild. Results: The mean age of the patients was 9.5 (±2.4) years. Forty-six (57.6%) patients received prednisolone therapy only, and 34 (42.4%) were started on a combination of oral acyclovir and prednisolone therapy, 29 of whom were in the severe category. Analysis of HBFNGS at one month revealed that the addition of acyclovir to treatment had no effect on the recovery period. However, combination therapy seems more beneficial in severe cases. Conclusion: Bell’s palsy frequently resolves entirely in childhood, and an acyclovir plus prednisolone combination is not superior to prednisolone alone except in severe cases.