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    Complex regional pain syndrome in stroke patients
    (LIPPINCOTT WILLIAMS & WILKINS, 2007) Kocabas, Hilal; Levendoglu, Funda; Ozerbil, Onder Murat; Yuruten, Betigul
    The objective of this study was to investigate the incidence, and the factors influencing the development, of complex regional pain syndrome-1 in the upper extremity in herniplegic patients within the first 28 weeks following a stroke. We followed up 82 stroke patients. All patients were evaluated at weeks 2, 6, 14 and 28 after suffering a stroke. Outcomes were assessed using passive range of motion of shoulder, presence of subluxation, Ashworth score, Motricity index arm score, Brunnstrorn stages and depression score. The incidence of complex regional pain syndrome-I was 48.8% in the first 28 weeks. Significant correlation was found between complex regional pain syndrome-1 and the presence of subluxation, Ashworth score, Motricity index arm score, Brunnstrom stage and depression score (r= 0.259, P= 0.019; r= 0.271, P= 0.014; r= - 0.393, P < 0.001; r= - 0.385, P < 0.001; r= 0.293, P=0.008, respectively). In this study, there was a relationship between complex regional pain syndrome-I and subluxation, loss of range of motion, spasticity of shoulder muscles and muscle strength. In order to prevent the development of complex regional pain syndrome-1, exercises directed at increasing the range of motion for the glenolhumeral joint, strengthening shoulder muscles and reduction of spasticity will establish the integrity of the shoulder joint.
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    Digital Neuropathy of the Median and Ulnar Nerves Caused by Dupuytren's Contracture Case Report
    (LIPPINCOTT WILLIAMS & WILKINS, 2009) Guney, Figen; Yuruten, Betigul; Karalezli, Nazim
    Introduction: Digital neuropathy is a pure sensory neuropathy of a digital nerve. It may be caused by acute or chronic local trauma or pressure, or accompany systemic illnesses such as rheumatoid disease, leprosy, Raynaud disease, dysproteinemia, or diabetes mellitus. We describe an extraordinary case of digital neuropathy of the median and ulnar nerves caused by Dupuytren contracture. Case Report: A 56-year-old right-handed man was presented with numbness and tingling of the little finger of the right and ring finger of the left hand. The clinical and EMG findings in this patient were consistent with a lesion of the median and ulnar palmar digital nerves of the right and left ring and little fingers. Conclusion: Dupuytren tissue usually affects: the palmar fascia, superficial to the digital nerves, and it may rarely affect the spiral cord in the digits. A spiral cord may cause sensory loss due to impingement of digital nerves or Dupuytren tissue may have been compressing the palmar digital nerves against the relatively inelastic deep transverse metacarpal ligament. As a result, digital neuropathy can develop in those with Dupuytren's contracture, and nerve conduction studies should also be performed to determine the condition. New Studies are needed to provide better diagnostic criteria for the condition.
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    Lumboperitoneal shunt in a patient with Behcet's disease with medically refractory intracranial hypertension
    (ELSEVIER SCI LTD, 2011) Dogan, Ebru Apaydin; Ozturk, Banu Turgut; Mutluer, Muzaffer; Yildiz, Gulce Unal; Genc, Emine; Yuruten, Betigul; Kocaogullar, Yalcin
    A 21-year-old male presented with severe throbbing headache, nausea, vomiting and progressive visual loss. Clinical examination revealed bilateral papilledema and left abducens nerve palsy. MRI showed findings consistent with ducal sinus thrombosis. Combinging the clinical findings, MRI and a positive pathergy test, the patient was diagnosed with dural sinus thrombosis associated with Behcet's disease (BD). Despite acetazolamide, prednisone, azathioprine and repeated lumbar punctures, his signs and symptoms of intracranial hypertension gradually worsened. Therefore, lumboperitoneal shunting was planned after which rapid resolution of intracranial hypertension was observed. After reviewing similar reports, we suggest that lumboperitoneal shunt placement can be an effective treatment for patients with BD with medically refractory intracranial hypertension associated with dural sinus thrombosis. (C) 2010 Elsevier Ltd. All rights reserved.
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    Spinal myoclonus associated with vitamin B12 deficiency
    (ELSEVIER, 2007) Dogan, Ebru Apaydin; Yuruten, Betigul
    We report a 85-year-old female patient with involuntary and regular movements restricted to abdominal muscles, resembling belly dance, with additional clinical features; ataxia, impaired cognition, neuropathy and glossitis. We initially excluded the possible cortical and spinal structural abnormalities with magnetic resonance imagings and performed routine blood analysis which revealed that serum vitamin B12 (vB12) level was under normal ranges. The relation of low serum vB12 level and myoclonus is speculative and very few studies have demonstrated such patients. In this case report, serum vB 12 deficiency is discussed in the context of its probable role in the generation of spinal myoclonus. (C) 2007 Elsevier B.V. All rights reserved.