Analysis of YouTube videos as a source of information for reliability and effectiveness of cannabidiol oil in treatment of epilepsy.

OBJECTIVE: Cannabidiol (CBD) oil has been used for the treatment of refractory epilepsy for a long time. In this study, we aimed to investigate the quality and reliability of YouTube videos pertaining to the use of CBD oil in the treatment of epilepsy. METHODS: A total of 100 videos were reviewed. Evaluation of the videos were performed by two experienced neurologists at the same time, but in different settings in order to prevent bias. Videos' image type, video content, video length, upload date, daily view count, comment and like counts, qualification of uploaders, DISCERN, and GQS scores were recorded. RESULTS: The videos were found to be uploaded by physicians (46 %), health channels (33 %), TV channels (7 %), patients (2 %), and other persons (12 %). The mean DISCERN score was found as 3.71 ± 1.17 and the mean GQS score was found as 3.21 ± 1.05 in all videos. According to the DISCERN scale, the videos uploaded by doctors were scored as 3.82 ± 1.02 and the videos uploaded by non-doctors as 3.07 ± 1.12 (p < 0.001). According to the GQS scale, the videos uploaded by doctors were scored as 3.51 ± 1.02 and the videos uploaded by non-doctors as 3.01 ± 1.17 (p < 0.001). CONCLUSION: Thirty-two (32%) videos were poor, 43 (43%) videos were moderate, and only 25 (25%) videos were good in terms of quality and reliability. YouTube videos related to health issues need to be audited strictly before they can become publicly accessible.

Impact of obstructive sleep apnea on neuromuscular transmission- a descriptive study.

Objective: Obstructive sleep apnea (OSA) is a sleep disorder accompanied by intermittent hypoxia. Neuromuscular transmission (NT) is known to be disturbed under chronic hypoxia. In this descriptive study, it has been aimed to test NT under intermittent hypoxia in OSA. Methods: Thirty-nine newly diagnosed OSA patients without any comorbidities or conditions that alter NT were included in the study. Jitter analysis was performed using a concentric needle electrode. Results: The mean jitter value of 39 OSA patients was 25.9 ± 3.7 µs. When compared to the mean reference jitter values, patients in the present study had significantly higher jitter (p < 0.001). Seven (17.9%) patients met the electrophysiological criteria for NT failure. Conclusion: The authors propose that intermittent hypoxia can be the trigger for NT failure in OSA. The interaction between increased oxidative stress and disturbed mitochondrial functions may also contribute.

Ulnar nerve entrapment at elbow in obstructive sleep apnea patients: a randomized controlled trial.

PURPOSE: Obstructive sleep apnea (OSA) is a highly prevalent disease. For diagnostic and therapeutic purposes, OSA has been divided into several subgroups. Positional OSA (POSA), the most frequent subgroup (56 %), is described as overall apnea hypopnea index (AHI) ≥5 and supine AHI at least twice as high when compared to non-supine AHI. We aimed to investigate the frequency of ulnar nerve entrapment neuropathy at the elbow (UNEE) in OSA patients without clinical signs and symptoms of ulnar neuropathy and intended to find if sleeping position in OSA had an impact on UNEE development. METHODS: Fifty POSA, 48 non-positional OSA (NPOSA) patients, and 45 healthy controls without diabetes mellitus, hypothyroidism, rheumatic diseases, and cervical radiculopathy underwent nerve conduction studies. RESULTS: We found that UNEE was highly frequent in OSA patients (42.9 %) and significantly more frequent in moderate to severe POSA patients than mild POSA patients (65.4 vs. 33.3 %, p < 0.05). Furthermore, when compared to non-positional ones, UNEE was significantly more frequent in moderate to severe POSA patients (65.4 vs. 36.4 %, p < 0.05). CONCLUSIONS: Our results showed that the severity of OSA in positional patients was correlated with increased frequency of UNEE. OSA patients should be informed about the predisposition of UNEE and questioned for the symptoms in periodical controls. POSA patients should be alerted about the additional effect of sleeping position on UNEE and the necessity of OSA treatment should be emphasized.

EEG in Sarcoidosis Patients Without Neurological Findings.

Sarcoidosis is a multisystem granulomatous disease affecting nervous system in 5% to 10% of patients. Magnetic resonance imaging (MRI) is accepted as the most sensitive method for detecting neurosarcoidosis. However, the most common findings in MRI are the nonspecific white matter lesions, which may be unrelated to sarcoidosis and can occur because of hypertension, diabetes mellitus, smoking, and other inflammatory or infectious disorders, as well. Autopsy studies report more frequent neurological involvement than the ante mortem studies. The aim of this study is to assess electroencephalography (EEG) in sarcoidosis patients without neurological findings in order to display asymptomatic neurological dysfunction. We performed EEG on 30 sarcoidosis patients without diagnosis of neurosarcoidosis or prior neurological comorbidities. Fourteen patients (46.7%) showed intermittant focal and/or generalized slowings while awake and not mentally activated. Seven (50%) of these 14 patients with EEG slowings had nonspecific white matter changes while the other half showed EEG slowings in the absence of MRI changes. We conclude that EEG slowings, when normal variants (psychomotor variant, temporal theta of elderly, frontal theta waves) are eliminated, may be an indicator of dysfunction in brain activity even in the absence of MRI findings. Hence, EEG may contribute toward detecting asymptomatic neurological dysfunction or probable future neurological involvement in sarcoidosis patients.

Carpal Tunnel Syndrome in Obstructive Sleep Apnea Patients.

INTRODUCTION: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. It is usually associated with the compression of the median nerve in the median groove. Because the main symptoms of CTS pain and numbness worsen at night, sleep disorders in CTS patients and the impact of preferred sleeping position on CTS development have been formerly studied. However, to the best of our knowledge, this is the first study assessing the frequency of CTS in obstructive sleep apnea (OSA) patients. This study aimed to determine the frequency of CTS in OSA patients and evaluate the causative relation between the two diseases. METHODS: Records of individuals who were admitted to our sleep laboratory were retrospectively scanned. Eighty patients who were diagnosed with OSA and did not have comorbidities that might cause OSA (e.g., diabetes mellitus, hypothyroiditis, rheumatic diseases, and cervical radiculopathy) were included in the study along with 80 healthy controls who matched for age, sex, and BMI of OSA patients. To maintain observer blindness, patients were not questioned regarding their symptoms or the clinical data that would be used in the study. All participants underwent nerve conduction studies. Those who were diagnosed with CTS were questioned regarding CTS symptoms and the preferred sleeping position. Subsequently, patients were given the Boston CTS questionnaire. RESULTS: CTS frequency in OSA patients was found to be 27.5%. There was no significant relation between preferred sleeping position or being a manual worker and having CTS. CONCLUSION: CTS frequency in OSA patients is significantly higher than that in healthy individuals. In contrast to previous studies that have been performed in the absence of polysomnographic and electrophysiological data, in our study biomechanical factors were not associated with CTS presence. Therefore, we conclude that intermittent hypoxemia is the main etiological factor for CTS in OSA patients. Inflammation may be a common factor for etiopathogenesis for both diseases, but this hypothesis needs further investigation.

Executive functions in sarcoidosis: a neurocognitive assessment study.

Not available.