[A rarely known headache: Airplane travel headache]. / Az taninan bir basagrisi: Uçak yolculugu basagrisi.

Recently, headache associated with airplane travel has gained importance with case reports and took its place in the classification of headache in 2013. This rare condition has different spesific characteristic from the primary headaches and its pathophysiology is not clear yet. In this case report, a 27-years-old female patient was diagnosed with the headache associated with airplane travel by history, examination and imaging findings. The possible pathophysiology and treatment were discussed.

MRI findings and cognitive functions in a small cohort of myotonic dystrophy type 1: Retrospective analyses.

Myotonic dystrophy type 1 (DM1) is a progressive multisystemic disease with common cognitive deficits and potential brain involvement in addition to the cardinal muscular and systemic symptoms. Impaired mental function associated with nonspecific pathological findings such as white-matter hyperintense lesions (WMHLs), ventricular enlargement and brain atrophy on brain MRI have been previously reported in DM1 patients. While some studies showed correlation of brain morphological changes with neuropsychological and clinical parameters including CTG repeat sizes and disease severity scales in DM1, others failed. The goal of this study was to retrospectively investigate cranial MR abnormalities, predominantly WMHLs, and their effects on clinical and cognitive deficits in a small, phenotypically or genotypically well-characterized cohort of DM1 patients.

Clinical and genetic features of PKAN patients in a tertiary centre in Turkey.

OBJECTIVE: Pantothenate kinase-associated neurodegeneration (PKAN) is caused by mutations of the pantothenate kinase 2 (PANK2) gene. The major clinical sign of PKAN is dystonia and the eye-of-the-tiger pattern on the MRI has been a clue for the diagnosis. We aim to discuss clinical and genetic findings of 22 PKAN patients from 13 families. METHODS: Twenty-two patients were clinically diagnosed with PKAN and screened for PANK2 mutations. The patients were classified according to their onset age and progression rate. RESULTS: Mutation screening revealed 5 novel and 7 previously reported sequence variants in PANK2. The variants identified were in the form of missense changes, small exonic deletions and intronic mutations with a probable splicing effect. The presenting features were dystonia and gait disturbance in early onset patients, whereas the presenting symptoms were variable for the late onset group. The progression rate of the disease was not uniform. CONCLUSION: The current report is the first patient series of PKAN from Turkey that expands the clinical and genetic spectrum of the disease.

Use of Game Console for Rehabilitation of Parkinson's Disease.

BACKGROUND: Parkinson's disease (PD) predisposes to falls due to postural instability and decreased coordination. Postural and coordination exercises could ameliorate the incoordination and decrease falls. AIMS: In this study, we explored the efficiency of a game console as an adjunct to an exercise program in treating incoordination in patients with PD. STUDY DESIGN: Case-control study. METHODS: In this single-blind, prospective clinical trial, rehabilitation with the Xbox (Microsoft; Washington, USA) game console was used as an adjunct to a standard rehabilitation program. Thirty-three patients with PD at stages 1-3 were enrolled in the study. All patients received the three-times weekly exercise program and electrotherapy to back and hip extensors for 5 weeks. Study patients played catch the ball and obstacle games on the Xbox in addition to the standard exercise program. Patients were evaluated based on the scores from the Timed Up-and-Go Test, the Berg Balance Scale (BBS), and the Unified Parkinson's Disease Rating Scale-II (UPDRS-II). Post-treatment scores were compared between groups. RESULTS: Thirty-three patients were enrolled in the study (15 in the game-console group, and 18 controls). Patients in both groups had improvements in all scores. The end-of-treatment scores were significantly better in the study group compared to the control group in all parameters: UPDRS (10±5 versus 16±6, p=0.002), BBS (53±4 versus 47±8, p=0.004), and TUG (11±4 seconds versus 20±8 seconds, p<0.001). CONCLUSION: Game-exercise with a game-console was noted to be a significant adjunct to the rehabilitation program in patients with PD in this study.

Skin findings related to chronic usage of anti-epileptic drugs.

OBJECTIVE: Chronic type skin reactions are defined as unwanted effects of drugs. As there are more benign conditions, skin findings related to chronic usage of anti-epileptic drugs (AEDs) have not been studied previously. In this study, we investigate the skin findings associated with the chronic usage of AEDs. METHODS: The study was conducted in the Post, Telephone and Telegraph Training and Research Hospital between May 2002 and January 2003 during a 6-month work period. Skin lesions were first assessed individually, and then their correlations with AEDs were examined. Skin findings were then divided into skin disease groups to evaluate statistical significance. The prevalence of skin findings occurring in 62 epileptics was compared with that of an age-matched group of 33 non-epileptics. RESULTS: The rate of skin findings defined in the workgroup was 85.5%, while it was 84.8% in the control group. The most common skin findings were acneiform eruptions for both groups. There were no significant differences between the work and study group for skin findings (p>0.05). Alopecia was the only skin condition related to AED usage and it was seen in 4 patients (6.5%) using valproate (p<0.05). None of the 11 patients with infectious skin findings were using valproate, and that was the only significant relationship between antiepileptic drugs and skin diseases (p=0.015). CONCLUSION: The inflammatory skin diseases were the most commonly seen problem in both patients and controls. The alopecia ratio with valproate usage in our patient group was similar to literature reports.

Relationship of age with the size of the interventricular foramina and aqueductus sylvii: a morphometric evaluation.

OBJECTIVES: The ventricular system is an essential part of the brain. Various pathologies directly or indirectly affect the size of this system. Morphometric analysis of the cerebral ventricular system is important for evaluating changes due to growth, aging, and intrinsic and extrinsic pathologies. The aim of this study was to evaluate the normative data for the interventricular foramina and cerebral aqueduct with regard to surgery and clinical situations. METHODS: Cranial magnetic resonance imaging (MRI) scans of 128 healthy subjects (63 female subjects, 65 male subjects; 2-63 years old) were individually reviewed. The right and left interventricular foramina lengths and diameters and the cerebral aqueduct length and diameter were statistically evaluated and compared between sexes and among age groups. RESULTS: There were no significant differences among the age groups in either sex (P > 0·05). Additionally, there was no correlation between age and measurement parameters (P > 0·05). DISCUSSION: We did not observe any changes in interventricular foramina or cerebral aqueduct measurements in healthy subjects from a wide range of age groups. Such changes should be useful for diagnosing diseases that affect the ventricular system and planning surgical procedures, especially those involving the ventricular system.

Characteristic and overlapping features of migraine and tension-type headache.

OBJECTIVE: 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.

Skin findings related to chronic usage of anti-epileptic drugs.

OBJECTIVE: Chronic type skin reactions are defined as unwanted effects of drugs. As there are more benign conditions, skin findings related to chronic usage of anti-epileptic drugs (AEDs) have not been studied previously. In this study, we investigate the skin findings associated with the chronic usage of AEDs. METHODS: The study was conducted in the Post, Telephone and Telegraph Training and Research Hospital between May 2002 and January 2003 during a 6-month work period. Skin lesions were first assessed individually, and then their correlations with AEDs were examined. Skin findings were then divided into skin disease groups to evaluate statistical significance. The prevalence of skin findings occurring in 62 epileptics was compared with that of an age-matched group of 33 non-epileptics. RESULTS: The rate of skin findings defined in the workgroup was 85.5%, while it was 84.8% in the control group. The most common skin findings were acneiform eruptions for both groups. There was no significant differences between the work and study group as for skin findings (p>0.05). Alopecia was the only skin condition related to AED usage and it was seen in 4 patients (6.5%) using valproate (p<0.05). None of the 11 patients with infectious skin findings were using valproate, and that was the only significant relationship between antiepileptic drugs and skin diseases (p=0.015). CONCLUSION: The inflammatory skin diseases were the most commonly seen problem in both patients and controls. The alopecia ratio with valproate usage in our patient group was similar to literature reports.