Introduction: To investigate the prevalence and characteristics of Restless Legs Syndrome (RLS) in patients with Behçet's Disease (BD) and Multiple Sclerosis (MS).Methods: Consecutive patients with BD and MS seen in the outpatient clinic were included in the study. As a control group, volunteer subjects without a known peripheral or central nervous system disorder were included. The BD group was divided into two sub-groups as BD with neurological involvement [Neuro-Behçet' s Disease (NBD)] and BD without any neurological involvement (other BD) for further evaluation. Data on demographic characteristics, medical history and family history were collected, and all patients underwent neurological examination. The patients were evaluated for the presence of diagnostic criteria for RLS. The features and severity of RLS were evaluated in patients with RLS using Restless Legs Syndrome Identification Form, and the International Restless Legs Syndrome Study Group (IRLSSG) Rating Scale. The clinical and radiological findings of patients with BD and MS were retrieved from their medical files. Results:The study included a total of 96 patients with BD (mean age 39.9±11.8; 51 males; 41 patients with NBD) and 97 patients with MS (mean age 34.97±4.1 years; 24 males). There were 100 healthy control subjects (mean age 36.18±11.10 years; 46 males). RLS was more prevalent in MS (22.8%) and NBD (22%) groups compared to the control group (10%; p=0.004 and 0.029, respectively) with a statistically significant difference. The prevalence of RLS was higher in MS patients with less disability. Most severe RLS symptoms were observed in the MS group. The rate of sleep disorders was also higher in MS group. Although stress appeared to be a factor worsening RLS in all groups, its prevalence was higher in the MS group (p=0.011). There was no correlation between the distribution of magnetic resonance imaging lesions and RLS in both MS and NBD groups.Conclusions: It is well established that RLS can accompany disorders involving the peripheral and central nervous systems such as all types of peripheral neuropathy, myelopathy, and Parkinson's disease. The present study showed that MS and NBD also seem to be a risk factor for RLS, being associated with more severe symptoms.
Objective: Stroke ranks second among the diseases that cause death and third among the causes of disability in Turkey. An average of 1.9 million neurons die every minute due to acute ischemic stroke and therefore 'time is brain'. Intravenous thrombolytic treatment (ITT) and, if possible, endovascular treatment should be initiated quickly. We aimed to share our ITT experience in Sanliurfa with this study. Materials and Methods: We recorded the clinical and demographic characteristics, risk factors, and three-month follow-up of 21 patients with acute ischemic stroke who were given ITT between June 2015 and July 2017. Results: Of the 21 patients, nine were male and 12 were female, and the mean age was 72.1±11.8 (range, 48-87) years. Large vessel occlusion was found in five (23.8%) patients, cardioembolism in 9 (42.9%), and small vessel occlusion in 2 (9.5%) patients; etiology was not determined in five (23.8%) patients. Atrial fibrillation was found in 38.1%, hypertension in 57.1%, diabetes mellitus in 23.8%, coronary artery disease in 33.3%, hyperlipidemia in 19%, and smoking in 33.3% of the patients.The NIHSS score was 11.7±6.7 (range, 2-24) prior to treatment. The symptom-onset to needle time was 185±55.8 minutes when 19 patients were evaluated. Intracerebral hemorrhage was observed in two (9.5%) patients after treatment. One patient was asymptomatic and the symptomatic patient (4.75%) died despite decompression surgery. Ten patients died and the mortality rate was 47.6% at the end of the three-month follow-up period. The modified Rankin scale score was 0-2 in eight patients (38.1%) and was 0-1 in seven patients (33.3%). ITT was given to seven patients aged ≥80 years, five patients with NIHSS <5, and two patients in whom the treatment window was exceeded, which was non-adherent to the label. Conclusion: ITT is effective and safe. It increases the number of independent living patients. We must strive to perform this treatment all over Turkey and encourage our colleagues.
Background Chronic venous disorders (CVD) that conventionally refers to disease of lower and upper extremity venous system encompass a large spectrum of abnormalities in the venous system. Recently, various venous disorders such as hemorrhoids, varicocele and lower extremity varicose veins have been gathered under the term of dilating venous disease (DVeD). So, vascular wall pathology itself has been supposed to be the underlying mechanism of DVeD in different vascular systems. Migraine is a neurovascular disorder which cerebral venous congestion might have role in pathogenesis. Both vascular and neurogenic theories have been postulated for the pathophysiology of migraine. We hypothesized that pathophysiology of migraine might related with DVeD due to vascular theory. Purpose The objective was to assess the association between venous disease and migraine by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in migraineurs and non-migraineurs. Methods The study was designed as a non-randomized, prospective cohort study and consisted of patients diagnosed with migraine. The control group included age- and sex-matched healthy subjects. All participants were examined for the presence of CVD. Presence of lower extremity venous system disease and subsequent classification has been assessed and categorized according to clinical component of clinical, etiological, anatomical and pathological (CEAP) classification. VEINES-Sym questionnaire was applied to assess venous symptoms. The Migraine Disability Assessment (MIDAS) questionnaire was used to assess the severity of disease in migraineurs. Results Participants were classified into two groups as migraine (+) group (n=130) and migraine (−) group (n=130) (Figure 1). Migraine patients and control group were comparable in terms of clinical status and demographic parameters. The mean score of night cramps, burnings, itching, tingling and throbbing were found to be lower in migraineurs than those of non-migraineurs. In addition, the presence of venous symptoms, aching legs, night cramps, heat/burning sensation, throbbing and tingling were found to be significantly higher in patients with migraine compared with those without migraine (Figure 2). Also, total VEINES-Sym score was lower in patients with migraine compared to control group (34.4±8.7, 37.6±8.12, p=0.003, respectively). Additionally, there was a significant negative correlation between VEINES-Sym score and total MIDAS disability score (r=−0.33, p<0.001) and MIDAS severity levels (r=−0.266, p=0.003) of the migraineurs. Logistic regression analysis revealed that VEINES-Sym score is an independent and statistically significant associate of migraine (OR: 0.95, 95% CI: 0.92–0.98, p=0.001). Conclusions We have documented an independent association between migraine and VEINES-Sym score indicating possible pathophysiological link between migraine and CVD. FUNDunding Acknowledgement Type of funding sources: None.
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