Papers by Prof.Dr. Burhanettin Uludağ
Turkish Neurosurgery, 2021
In this report, we present the case of a 21-year-old female with midbrain tremor involving atypic... more In this report, we present the case of a 21-year-old female with midbrain tremor involving atypical features, treated using a pedinculopontine nucleus lesion. Different targets for the treatment of midbrain tremor using radiofrequency lesion have been reported. In this case, stimulation of the thalamic ventralis intermedius nucleus and subthalamic nucleus produced no satisfactory improvement in tremor frequency and amplitude. A third goal was to obtain a significant response in terms of these outcomes with pedinculopontine nucleus stimulation. According to the literature, this is the first case of midbrain tremor treated with a pedinculopontine nucleus radiofrequency thermocoagulation lesion.
An Unusual Case Presenting with New Onset Epileptic Seizure and Unilateral Temporal Lobe Lesion Diagnosed as Influenza Type A Associated Encephalitis
PubMed, Jul 23, 2022
Influenza A viruses, known etiological agents of seasonal outbreaks, epidemics, and pandemics, ar... more Influenza A viruses, known etiological agents of seasonal outbreaks, epidemics, and pandemics, are RNA viruses of the Orthomyxoviridae family. They can manifest with a wide range of neurological complications. Influenza related encephalitis is rarely reported and poorly characterized in adults. Its diagnosis is hampered by significant variation in clinical presentation and difficulties in virus detection in the cerebrospinal fluid. Diffuse brain edema, symmetric involvement of thalamus, brain stem, and cerebellum, or normal findings in the acute phase followed by the appearance of diffuse low attenuation and mild brain atrophy are reported cranial magnetic resonance imaging findings, but unilateral temporal lobe involvement has not been observed before. Here we describe an unusual adult case who presented with new-onset epileptic seizures and unilateral temporal lobe lesion mimicking herpes simplex encephalitis but a polymerase chain reaction of cerebrospinal fluid confirmed influenza type A associated encephalitis.
Neurological Sciences, Jan 5, 2016
The head stabilization reflex (HSR) is a brain stem reflex which appears in the neck muscles in r... more The head stabilization reflex (HSR) is a brain stem reflex which appears in the neck muscles in response to sudden head position changes and brings the head to its previous position. The reflex mechanism has not been understood. The afferent fibers come from cervical muscle spindles, vestibular structures, and the accessory nerve, the efferents from the accessory nerve. In this study, we aim to investigate the roles of supraspinal neural structures and the vestibular system on the HSR. The patient group consisted of 86 patients (33 cerebral cortical lesion, 14 cerebellar syndrome and 39 vestibular inexcitability or hypoexcitability); the control group was composed of 32 healthy volunteers. Concentric needle electrodes were inserted into the sternocleidomastoid muscle (SCM) and the accessory nerves were stimulated with the electrical stimulator. A reflex response of about 45-55 ms was obtained from the contralateral SCM muscle. 50 % of cases had bilateral loss whereas 37 % of cases with unilateral cerebellar lesions had an ipsilateral reflex loss. Bilateral HSR loss was detected in 84 % of cases with bilateral cerebellar lesions. Bilateral reflex loss was observed in 70 % of patients with unilateral cortical lesions and 94 % of those with bilateral vestibular dysfunction. Ipsilateral HSR loss was observed in 55 % of cases with unilateral vestibular dysfunction. It was discovered that supraspinal structures and the vestibular system may have an excitatory effect on HSR. This effect may be lost in supra-segmental and vestibular dysfunctions. The localization value of HSR was found to be rather poor in our study.
Reply to Josef Finsterer about the article ‘What does epileptic nystagmus show us in cases presenting acute neurological symptoms?’
Seizure
What does epileptic nystagmus show us in cases presenting acute neurological symptoms?
Seizure: European Journal of Epilepsy
Pathological mechanisms of oropharyngeal dysphagia in amyotrophic lateral sclerosis
Untitled - Reply
WOS: A1995QU9390001
Guillain Barre sendromu faringo-serviko brakial varyantı
İzmir Alsancak Devlet Hastanesi Tıp Dergisi, 1996
What is The Role of Frontal Intermittant Rhytmic Delta Activity (FIRDA) in The Cerebral Lesions? Evaluation of 20 Patients
WOS: 000389744200015Frontal intermittent rhythmic delta activity (FIRDA) is a frequent transient ... more WOS: 000389744200015Frontal intermittent rhythmic delta activity (FIRDA) is a frequent transient electroencephalographic finding in adults. Its pathophysiologic significance is unknown. So far clinical, laboratory and neuroimaging findings related to FIRDA have been reported in the literature but the relation between cerebral lesions and FIRDA is not clear. We want to discuss this EEG presentation and its related pathologies in the light of our patients' findings. All electroencephalograms (EEGs) with FIRDA, between January 2009 -December 2014 at our institution were identified. Demographic data, clinical history, laboratory results and neuroimaging studies were recorded. We identified 20 patients with this electrographic pattern. EEGs were performed because the possibility of seizures in 8 patients, altered state of consciousness in 10 patients, forgetfulness in 1 patient. In 1 patient there was no any complaint. Amongst the 20 patients with FIRDA, 6 had asymmetric pattern on EEG. Renal function impairment was present in 1 patient and 1 patient had elevated serum ammonia level. Cranial imaging was abnormal in 11 of 19. Intrahemispheric lesions, hemorrhage, encephalomalacia, tumor, were present in 5, and basal ganglia hemorrhage in 1. In 1 patient, hydrocephalus was detected. In conclusion, we observed that various etiologic factors can play an important role in the development of FIRDA and in our group, cerebral lesions are more common. Location and type of the lesions do not make any difference. But in acute cerebral lesions, asimetric pattern can be seen and this could give an idea about the location of pathology
NeuroRehabilitation, 2007
Hand motor representation area expands towards the area of the perioral facial motor cortex in pa... more Hand motor representation area expands towards the area of the perioral facial motor cortex in patients with peripheral facial paralysis (PFP) and in hemifacial spasm cases treated with botulinum toxin. In this current study, we aimed to investigate the changes both in the ipsilateral and contralateral facial motor cortex areas in patients with PFP with transcranial magnetic stimulation (TMS). Thirty healthy individuals and 41 patients with unilateral PFP with partial or total axonal degeneration participated in this study. Motor evoked potentials (MEPs) of perioral muscles elicited by TMS of the intracranial portion of the facial nerve and motor cortex, were recorded. TMS was delivered through a figure-of-eight coil. Mapping of the cortical representation of perioral muscles were also studied in 13 of 41 patients and in 10 of control subjects. Mean amplitude of the intact perioral MEPs elicited by the ipsilateral hemisphere TMS, was significantly higher in patients than the control subjects. There was also a mild enlargement of the mean cortical representation area of intact perioral muscles on both hemispheres though it was not significant. We have concluded that there was a cortical reorganization in the hemisphere contralateral to the paralytic side resulting in an increase at corticofugal output related to intact perioral muscles.
P199 Macro EMG findings in juvenile myoclonic epilepsy
Electroencephalography and Clinical Neurophysiology, 1996
Neurological Sciences, 2016
The head stabilization reflex (HSR) is a brain stem reflex which appears in the neck muscles in r... more The head stabilization reflex (HSR) is a brain stem reflex which appears in the neck muscles in response to sudden head position changes and brings the head to its previous position. The reflex mechanism has not been understood. The afferent fibers come from cervical muscle spindles, vestibular structures, and the accessory nerve, the efferents from the accessory nerve. In this study, we aim to investigate the roles of supraspinal neural structures and the vestibular system on the HSR. The patient group consisted of 86 patients (33 cerebral cortical lesion, 14 cerebellar syndrome and 39 vestibular inexcitability or hypoexcitability); the control group was composed of 32 healthy volunteers. Concentric needle electrodes were inserted into the sternocleidomastoid muscle (SCM) and the accessory nerves were stimulated with the electrical stimulator. A reflex response of about 45-55 ms was obtained from the contralateral SCM muscle. 50 % of cases had bilateral loss whereas 37 % of cases with unilateral cerebellar lesions had an ipsilateral reflex loss. Bilateral HSR loss was detected in 84 % of cases with bilateral cerebellar lesions. Bilateral reflex loss was observed in 70 % of patients with unilateral cortical lesions and 94 % of those with bilateral vestibular dysfunction. Ipsilateral HSR loss was observed in 55 % of cases with unilateral vestibular dysfunction. It was discovered that supraspinal structures and the vestibular system may have an excitatory effect on HSR. This effect may be lost in supra-segmental and vestibular dysfunctions. The localization value of HSR was found to be rather poor in our study.
F Wave Parameters and F-Jitter
Objective: F response is one of the late EMG responses occurring with peripheral motor nerve stim... more Objective: F response is one of the late EMG responses occurring with peripheral motor nerve stimulation. It is generated by firing of anterior horn motor neurons as a result of antidromic propagation of the stimulus on the motor nerve. The aim of this study was to evaluate the feasibility of using average variability in consecutive F response latencies (F-jitter) as a new parameter.Method: The fundamental characteristic of the F-jitter distinguishing it from other parameters is that it describes the chrono-dispersion among the neurons stimulated consecutively. The F-jitter was investigated in patients with polyneuropathy (PNP, n = 20), spasticity (SPS), ( n = 10) and in 30 healthy subjects.Results: The sensitivity of F-jitter was observed to be at least as much as of other parameters.Conclusions: It is therefore concluded that F-jitter might be a useful parameter to be included in new-generation digital EMG instruments beyond its significant contributions to physiological studies.S...
Suppression of the jaw opening reflex prior to liquid swallowing
Effects of bolus volume on oropharyngeal swallowing: an electrophysiologic study in man
The American journal of gastroenterology, 1997
Different variables of oropharyngeal swallowing change in response to bolus volume and consistenc... more Different variables of oropharyngeal swallowing change in response to bolus volume and consistency as determined by manometric/videofluoroscopic studies. But the subject is debatable especially from the physiologic point of view. No electrophysiologic studies are available on human subjects. The effects of bolus volume and viscosity on different variables of oropharyngeal swallowing were investigated using electrophysiologic methods. Mechanical upward and downward laryngeal movements and submental electromyographic (SM-EMG) activity of the laryngeal elevator muscles were recorded during dry and 3-, 10-, and 20-ml water swallowing in 14 normal subjects. Cricopharyngeus (CP) muscle was investigated during 3- and 10-ml water swallowing in 10 normal subjects. Semisolid and liquid swallowing were compared in eight normal subjects. The total duration of SM-EMG, time necessary for larynx elevation, CP-EMG pause related with upper esophageal sphincter opening and swallowing variability (jit...
Enhancement of "end-plate monophasic waves" during an attack of hypokalemic periodic paralysis
Muscle & nerve, 1996
WOS: A1996UF72700028PubMed ID: 861857
Musical Hallucination Associated With Seizure Originating From An Intracranial Arteriovenous Malformation
Journal of Neurological Sciences (Turkish), 2010
... Hastamız halen epilepsi polikliniğimizde takip edilmekte ve 800 mg/gün karbamazepin kullanmak... more ... Hastamız halen epilepsi polikliniğimizde takip edilmekte ve 800 mg/gün karbamazepin kullanmaktadır. Nöbetleri kontrol altındadır. ... References. 1) Cho JW, Seo DW, Joo EY, Tae WS, Lee J, Hong SB. Neural correlates of musicogenic epilepsy: SISCOM and FDG-PET. ...
Electrodiagnostic Pattern Approach for Childhood Polyneuropathies
Pediatric Neurology, 2006
Electrophysiologic studies play a key role in the detection and characterization of the pattern i... more Electrophysiologic studies play a key role in the detection and characterization of the pattern in childhood polyneuropathies. In this study, the etiologic profile of 74 children with polyneuropathy was prospectively evaluated based on the electrophysiologic studies. Five electrodiagnostic patterns were identified in the cohort: (1) acute axonal polyneuropathy (n: 32, 43%); (2) chronic axonal polyneuropathy (n: 16, 22%); (3) demyelinating motor and sensory polyneuropathy (n: 13, 17%); (4) pure sensory polyneuropathy (n: 11, 15%); (5) high-low syndrome (n: 2, 3%). Etiologic factors were identified in all of the patients with three electrodiagnostic patterns of polyneuropathy: acute axonal, pure sensory, and high-low syndrome. However, etiologic factors could not be determined in 5 (31%) children with chronic axonal polyneuropathy and in 3 (23%) children with demyelinating sensory and motor polyneuropathy. Among children with the acute axonal pattern, toxic causes were evident in 18 (56%), acute motor axonal neuropathy in 11 (35%), and acute motor sensory axonal polyneuropathy in 3 (9%). Nine (82%) patients with pure sensory polyneuropathy had diabetes mellitus. In conclusion, a thorough history and physical examination in conjunction with specific electrodiagnostic patterns might provide a cost-effective and rational differential diagnosis of childhood polyneuropathies.
Mycoses, 2002
ECh4M 2002 signed to have biological risk in the 61/1999 (XII. 1.) statutory rule of the Ministry... more ECh4M 2002 signed to have biological risk in the 61/1999 (XII. 1.) statutory rule of the Ministry of Welfare (EU. M). Applied methods: 1. 2. 3. 4. 5. 6. 7.
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Papers by Prof.Dr. Burhanettin Uludağ