Evaluation of Optical Coherence Tomography Results and Cognitive Functions in Patients with Restless Legs Syndrome.

INTRODUCTION: 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.

Neuroretinal evaluation using optical coherence tomography in patients affected by pituitary tumors.

AIM: To investigate the thickness of the retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), inner plexiform layer (IPL), and choroid thickness (CT) in patients with pituitary tumours, microadenoma and macroadenoma, using spectral optical coherence tomography (OCT). METHODS: Thirty six patients who had micro and macroadenoma, and 34 healthy participants (control group) were included in the study. Spectral OCT was used to measure the RNFL, GCL, IPL, and CT values for all patients. CT measurements were performed by the same author (A.S.K). Additionally, retinal nerve fiber length, which is a sublayer of ganglion cell complex (GCC), was also measured for each patient and after segmentation oF GCC. RESULTS: No difference was detected between group according to sociodemographic data. The mean age of patients and the control group was 34.31 ± 12.47 and 33.12 ± 11.75 years, respectively. In the patient group had RNFL thinning while there was a thickening of the choroid layer. When all pituitary tumours patients (without grouping) were compared with the control group and there were significant differences on all parameters: RNFL, GCL, IPL thickness, and CT (p<0.05), while there were no significant differences in RNFL and GCL measurements between microadenoma and macroadenoma (p>0.05). All patients were significantly different from one another with respect to CT (p<0.05). CONCLUSIONS: These findings suggest that neurodegeneration occurs in the course of pituitary tumours, and this degeneration may be presented by decreased GCL at early stages, and as the disease progresses it may also affect ather layers of GCC like RNFL and IPL. RNFL and GCL were significantly thinner in the all patients as compared with the control subjects. In pituitary tumours, both microadenoma and macroadenoma, when evaluating ophthalmological findings patients' choroid thinning should be considered. KEY WORDS: Choroid thickness Ganglion cell layer thickness, Optical coherence tomographyl Pituitary tumours, Retinal nerve fiber layer thickness.

Preventing Sciatic Nerve Injury due to Intramuscular Injection: Ten-Year Single-Center Experience and Literature Review.

AIM: Sciatic nerve injury is the most frequent and serious complication of intramuscular gluteal injection. This study aims to highlight the incidence and causes of this continuing problem and to discuss the relevant literature. < p < MATERIAL and METHODS: A total of 217 subjects who were diagnosed with sciatic nerve injury in our neurophysiology laboratory between 2003 and 2013 were examined. Sensory and motor transmission studies and needle electromyography were performed by conventional methods in the two lower legs and the results were compared between each leg. RESULTS: Of the subjects who experienced a sciatic injury secondary to intramuscular injection, 59 (27.2%) were female and 158 (72.8%) were male. In all subjects, the dorsogluteal site of the buttocks was selected for intramuscular injection. Sciatica occurred on the right side in 91 subjects, on the left side in 125, and bilaterally in one. The peroneal nerve was more affected than the tibial nerve. The most used agents were non-steroidal anti-inflammatory drugs. According to follow-up electromyography findings of 103 subjects, significant sequelae remained in 2/3 of cases. CONCLUSION: 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.

Plasma nitrite levels, total antioxidant status, total oxidant status, and oxidative stress index in patients with tension-type headache and fibromyalgia.

OBJECTIVES: Tension-type headache (TTH) and fibromyalgia syndrome (FM) are worldwide seen chronic pain syndromes of unknown etiology. Despite the growing body of data on pathophysiology and generation mechanisms of pain; our knowledge on pain mechanisms in both FM and TTH is yet to be limited. PATIENTS AND METHODS: We investigated the plasma nitrite levels, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) in 35 TTH, 33 FM patients and 31 healthy controls. RESULTS: The mean plasma nitrite levels and TAS levels were significantly low and OSI was found to be significantly high in TTH and FM groups compared to the control group (p=0.001, p=0.001, p=0.001 and p=0.001, respectively). The mean serum TOS levels were also significantly higher in FM group according to the control group (p=0.034), but there was not a significant difference between TTH and control groups (p=0.066). CONCLUSION: These results indicated that; FM and TTH patients revealed higher oxidative stress index and lower total nitrite levels than healthy controls. We conclude that oxidative stress may have a role in the pathophysiological mechanisms of TTH and FM, although, whether it is the cause or the consequence, is not clear.

Galactorrhea during duloxetine treatment: a case report.

High prolactin hormone level in the blood is known as hyperprolactinemia. The most common symptom of hyperprolactinemia is galactorrhea, in which spontaneous milky discharge is seen from all ducts of the 2 mammary glands. Galactorrhea occurs due to different medical conditions, including the use of antidepressant medications. Herein we report a hyperprolactinemia case with galactorrhea due to duloxetine treatment for depression.