Person: GÖKÇAL, ELİF
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Publication Motor and Non-Motor Symptoms in Parkinson-s Disease: Effects on Quality of Life.(2017-06-01) GÖKÇAL, ELİF; GÜR, VE; SELVITOP, R; Babacan, Yildiz; ASIL, TALİP; GÖKÇAL, ELİF; BABACAN YILDIZ, GÜLSEN; ASİL, TALIPIntroduction: This study aimed to evaluate motor and non-motor symptoms in idiopathic Parkinson's disease (IPD) patients and to determine the self-reported influence of all existing symptoms on their quality of life (QoL). Methods: The sociodemographic and clinical characteristics, medical treatments, and Modified Hoehn and Yahr (mH&Y) scores of IPD patients without cognitive impairment were recorded. A survey questioning different motor and non-motor symptoms was administered to the patients. The patients were asked to rate their symptoms by number from the greatest influence to the least influence on their QoL. Subjects were divided into two groups: those suffering from IPD for ≤5 years (Group 1) and those suffering from IPD for >5 years (Group 2). These groups were compared in terms of sociodemographic and clinical characteristics, existing symptoms, and influences of these symptoms on their QoL. Results: There were 63 patients in Group 1 and 37 patients in Group 2. No statistically significant differences were detected between the groups with respect to sociodemographic characteristics or mH&Y scores. The most common motor symptoms in both of these groups were tremor and bradykinesia; meanwhile, the non-motor symptoms most frequently encountered in these groups were pain-cramps, constipation, and excessive daytime sleepiness (EDS). Again, while the symptoms that most greatly disturbed QoL in all patients were reported to be tremor and bradykinesia, the most disturbing non-motor symptom was frequent voiding/incontinence, which was a less common symptom. Pain-cramp, constipation, and EDS, which were the most frequent non-motor symptoms, were the symptoms that least disturbed QoL. Conclusion: It is widely accepted that motor symptoms determine QoL in IPD. However, non-motor symptoms are seen during all phases of the disease. The impact of non-motor symptoms on the QoL of IPD patients remains substantial. Therefore, in addition to the well-known motor symptoms, non-motor symptoms, which may be overlooked during physical examination yet may profoundly impact QoL, should be questioned and treated appropriately to improve QoL in PD patients as much as possible.Publication Treatment of Motor Symptoms in Idiopathic Parkinson-s Disease(2015-08-01T00:00:00Z) Gokcal, Elif; BABACAN YILDIZ, GÜLSEN; GÖKÇAL, ELİF; BABACAN YILDIZ, GÜLSENIdiopathic Parkinson-s disease is one of the most common neurodegenerative disorders. Idiopathic Parkinson-s disease continues to be a progressive disorder leading to severe disability caused by motor and non-motor symptoms. To date, there have been no disease-modifying or neuroprotective interventions that could stop or slow down disease progression. Treatment of motor symptoms, such as tremor, rigidity, and bradykinesia, is primarily focused on correcting dopamine deficiency. There are some medications that do not directly affect the dopaminergic system. Some invasive interventions are also available. Treatment options should be specified according to age, disease stage, functional status, and concurrent diseases of the patients. Non-motor symptoms, such as sleep disturbances and neuropsychiatric symptoms, should also be properly diagnosed and treated. This review focuses on treatment strategies for the motor symptoms of idiopathic Parkinson-s disease.Publication Assessment of Cerebral Vasomotor Reactivity in Patients With Primary Open-angle Glaucoma and Ocular Hypertension Using the Breath-Holding Index(2021-02-01T00:00:00Z) Arslan, Gurcan D.; Olgun, Ali; Ozcan, Delil; GÖKÇAL, ELİF; Guven, Dilek; ASİL, Talip; GÖKÇAL, ELİF; ASİL, TALIPPrecis: Patients with ocular hypertension (OHT) do not show impaired cerebral vasodilation responses to hypercapnia but patients with primary open-angle glaucoma (POAG) do. Impaired vasoreactivity in patients with POAG may have neuronal or vascular origins and increase stroke risk.Publication Diagnostic value of electroencephalography inpatient patients: Effect on clinical decision-making Yatan hastalarda elektroensefalografinin tanısal değeri: Klinik karar verme üzerine etkisi(2020-01-01T00:00:00Z) İlgen Uslu, Ferda; Gökçal, Elif; USLU, FERDA; GÖKÇAL, ELİF© 2020, Istanbul Universitesi. All rights reserved.Objective: To evaluate the efficiency of electroencephalography (EEG) requested at the consul-tation. Methods: EEGs for which consultation was requested in one year were analyzed retrospectively. Neurology consultation notes, EEG forms, compliance with EEG findings were examined for each pa-tient. Demographic data, requested unit, pre-diagnosis, final diagnosis were recorded. EEG results were divided into 3 groups:1)normal, 2)EEG with epileptiform anomaly (EEG-EA),3)EEG with nonepilepti-form anomaly (EEG-NE). EEGs were also evaluated for their indications and contribution to diagnosis. Results: A total of 261 EEG recordings of 239 patients (133 men, average age 56.44 (18-90)) were examined. 30.5% of the registered patients had a history of neurological diseases. EEGs were requested from 36.4% intensive care units and emergency departments, 51.5% internal branches, 12.3% surgical branches. Preliminaries were seizures in 42.5%, alertness/encephalopathy in 17.2%, syncope in 5.7%, nonconvulsive status epilepticus (NCSE) in 10.3%. 55% of EEGs were considered nor-mal. 37.5% were in EEG-NE, 8.4% in EEG-EA. 91.6% of patients were imaged, 52.5% were pathological. Focal imaging pathology and EEG findings were compatible in 63% of patients with pathological EEG findings. EEG was pathological in 64.5% of the 127 patients requested with appropriate indications. 80% of EEG was thought not to contribute to the definitive diagnosis. Discussion: Male and advanced elderly people with neurological disease were preferred for EEG. Appropriate indication with a desired high probability of detection of pathological EEG. It is important that the doctor who evaluates the inpatient patient makes more careful decisions in terms of unneces-sary process, resource and time wasting.Publication Essential Tremor and Alexithymia(2018-10-01) ŞENGÜL, YILDIZHAN; ŞENGÜL, HAKAN SERDAR; GÖKÇAL, ELİF; ÜSTÜN, İSMET; ÖZTÜRK, AHMET; YILMAZ, ONUR; YILDIZ, GÜLSEN; ŞENGÜL, YILDIZHAN; GÖKÇAL, ELİF; ÜSTÜN, İSMET; ÖZTÜRK, AHMET; YILMAZ, ONURPublication Multiple Spontaneous Intracranial-Extracranial Arterial Dissections in a Patient with Osteogenesis Imperfecta(2017-01-01T00:00:00Z) KOLUKISA, MEHMET; GÖKÇAL, ELİF; GÜRSOY, Azize Esra; DENİZ, ÇİĞDEM; ARALAŞMAK, Ayşe; ASİL, Talip; KOLUKISA, MEHMET; GÖKÇAL, ELİF; GÜRSOY, AZIZE ESRA; DENİZ, ÇİĞDEM; ARALAŞMAK, AYŞE; ASİL, TALIPA 40-year-old male with osteogenesis imperfecta (OI) was admitted to the hospital with an acute right monoparesis. Diffusion-weighted MRI showed infarction in the territory of the left anterior cerebral artery (ACA) and in the left posterior cerebral artery (PCA). In his vascular imaging, occlusion of the left vertebral artery (VA) starting from V2 segment was consistent with dissection and pseudoaneurysm in the right ACA. We presented this case because of the presence of spontaneous and simultaneous occurrence of both intracranial and extracranial arterial dissections in OI.Publication Esansiyel tremor hastalarında aleksitiminin değerlendirilmesi(2017-11-30) ŞENGÜL, YILDIZHAN; YILMAZ, ONUR; ŞENGÜL, HAKAN SERDAR; ÖZTÜRK, AHMET; GÖKÇAL, ELİF; YILDIZ, GÜLSEN; YILMAZ, ONUR; ÖZTÜRK, AHMET; GÖKÇAL, ELİFPublication Progressive deficit in isolated pontine infarction: the association with etiological subtype, lesion topography and outcome(2017-09-01T00:00:00Z) GÖKÇAL, ELİF; Niftaliyev, Elvin; Baran, Gozde; DENİZ, ÇİĞDEM; ASİL, Talip; GÖKÇAL, ELİF; BARAN, GÖZDE; DENİZ, ÇİĞDEM; ASİL, TALIPIt is important to predict progressive deficit (PD) in isolated pontine infarction, a relatively common problem of clinical stroke practice. Traditionally, lacunar infarctions are known with their progressive course. However, few studies have analyzed the branch atheromatous disease subtype as a subtype of lacunar infarction, separately. There are also conflicting results regarding the relationship with the topography of lesion and PD. In this study, we classified etiological subtypes and lesion topography in isolated pontine infarction and aimed to investigate the association of etiological subtypes, lesion topography and clinical outcome with PD. We analyzed demographics, laboratory parameters, and risk factors of 120 patients having isolated pontine infarction and admitted within 24 h retrospectively. PD was defined as an increase in the National Institutes of Health Stroke scale >= 2 units in 5 days after onset. Patients were classified as following: large artery disease (LAA), basilar artery branch disease (BABD) and small vessel disease (SVD). Upper, middle and lower pontine infarcts were identified longitudinally. Functional outcome at 3 months was determined according to modified Rankin scores. Of 120 patients, 41.7% of the patients were classified as BABD, 30.8% as SVD and 27.5% as LAA. 23 patients (19.2%) exhibited PD. PD was significantly more frequent in patient with BABD (p 0.006). PD was numerically higher in patients with lower pontine infarction. PD was associated with BABD and poor functional outcome. It is important to discriminate the BABD neuroradiologically from other stroke subtypes to predict PD which is associated with poor functional outcome in patients with isolated pontine infarctions.Publication Lambert-Eaton Myasthenic Syndrome with A Twenty-Three-Year Delay in Diagnosis(2017-06-01) Gokcal, ELİF; Gürsoy, AZİZE ESRA; Asil, TALİP; Ertas, Mustafa; GÖKÇAL, ELİF; GÜRSOY, AZIZE ESRA; ASİL, TALIPLambert-Eaton myasthenic syndrome (LEMS) is a rare neuromuscular junction disorder resulting from the development of auto-antibodies against voltage-gated calcium channels (VGCCs) in pre-synaptic terminals (1). It has tumoral and non-tumoral forms; the former is associated with small cell lung cancer. Clinically, it is characterized by proximal weakness, autonomic symptoms, and loss/reduction of deep tendon reflexes (2). Muscular weakness, frequently occurring in the lower extremities, almost always begins symmetrically in the proximal muscles, progressing to involve the distal muscles over time (3). It may be confused with myopathic disorders due to the presence of symmetrical muscular weakness involving the proximal muscles. Herein we present the case of a non-tumoral LEMS patient who was diagnosed as having myopathy due to weakness that started in the legs nearly 23 years ago. Written consent was taken from the patientPublication Genotype-phenotype Correlation in Pelizaeus Merzbacher Disease and Pelizaeus Merzbacher-like Disease(2019-07-01T00:00:00Z) GÖKÇAL, ELİF; Bilir, Birdal; BATTALOĞLU, ESRA; Aydin, Resa; Yapici, Zuhal; GÖKÇAL, ELİFObjective: Among the hypomyelinating diseases of childhood, Pellizeus Merzhachcr disease (PMD) is caused by X-linked proteolipid protein (PLP) gene mutations, whereas patients without mutations of PLP gene-called Pelizaues Merzbacher-like disease (PMLD) have recessive gap junction protein alpha 12 (gap junction alpha-12/gap junction gamma-2) gene mutations. The aim of this study was to evaluate clinical severity and progression in time in patients with PMD and PMLD. Methods: The motor developmental stages of the patients were reviewed; disease severity was classified according to the walking ability they were able to achieve. Progression pattern was determined according to comparison of neurological findings at the time of the study and at follow-up visits. Patients with PMD and PMLD were compared in terms of disease severity and progression rates as well as patient groups with a unique causative mutation were analyzed individually. Results: There were 9 patients with PMD (mean age 15.2 +/- 3.1) and 11 patients with PMLD (mean age 1 2.4 +/- 1.9). The presence of severe disease was more common in patients with PMD when compared to PMLD. In X-linked PMD, missense mutations were associated with the most severe disease and rapid progression, while deletion mutations were associated with mild disease severity and slow progression. Disease severity and progression patterns seemed to he heterogenous in different causative mutations of PMLD. Conclusion: Although PMLD might have milder disease phenotype when compared to PMD, certain causative mutations in different genetic traits may cause different disease severity and progression patterns.