SummaryObjectives: Psychogenic non-epileptic seizures (PNES) are reported in 10-30% of patients who are diagnosed as having refractory seizures referred to epilepsy centers. Many epilepsy centers use some sort of provocative techniques to aid in the diagnosis of PNES. In this study we aimed to determine the value of diagnostic effects of seizure induction methods. Methods: We analyzed retrospectively 66 patients who were suspected as PNES and referred by a clinician to our outpatient EEG laboratory between July 2011-January 2013. Intravenous saline was administered for seizure induction which is a routine seizure induction method used in our laboratory. Follow-up data were gathered by telephone interviews or from patient charts. Results: PNES were observed in 39 (59.1%) of 66 patients. Twenty-eight patients were thought to have pure PNES. After 3-17 months (mean: 6.9 months) of induction, 27 of 39 patients were either seizure-free or had significiant reduction in seizure frequency. Conclusion: In this study we conclude that; provocative techniques are useful, cheap and accessible for the diagnosis of PNES. If applied delicately, they may also provide a positive impact on the patient's self-recognition, and also, the prognostic consequences of the condition.Key words: Epilepsy; induction; psychogenic non-epileptic seizure. ÖzetAmaç: Epilepsi merkezlerine dirençli epilepsi tanısı ile gönderilen hastaların yaklaşık %10-30'unun nonepileptik psikojen nöbet (NEPN) tanısı aldığı bildirilmektedir. Birçok epilepsi merkezinde NEPN tanısına yardımcı olmak için bazı provokatif yöntemler kullanılmaktadır. Bu çalışmada nöbet indüksiyonun NEPN tanısı ve prognozu üzerindeki etkisini araştırmayı amaçladık. Sonuç: Bu çalışmada, provakatif yöntemlerin kullanışlı, ucuz ve hatta hastanın tanıyı kabullenmesinde etkisi olabileceği sonucuna vardık. Tanısını kabullenen hastalarda prognoz daha iyi olup, iyi iletişim bu noktada önemlidir. Gereç ve

SummaryObjectives: We aimed to examine the demographic and clinical characteristics of patients with refractory epilepsy and to question if further improvement can be achieved by re-evaluating the data. Methods: Eighty consecutive patients apparently resistent to medical anti-epileptic treatment and followed regularly throughout the last year were included in the study. Results: Mean age of the patients included in the study was 30.35±12.11 and the male to female number was 43 to 37. At the early phase of the study all patients were found to be taking more than one anti-epileptic drugs, 9 (11.3%) of whom received them in ineffective doses. Ten patients were decided to have non-epileptic psychogenic seizures as determined by clinical and EEG data. Re-handling the patients' management provided significant decrease in both complex partial and secondary generalized seizures (p<0.05). Conclusion: Even in patients with so-called refractory epilepsy, there may be a percentage responsive to treatment if evaluated and followed closely.

Bu araştırma, kanserli hastaların ağrıyla baş etmede nonfarmakolojik yöntemleri kullanma durumlarının saptanması amacıyla yapıldı. Yöntem: Tanımlayıcı nitelikte yapılan bu çalışma, 123 kanser hastası ile yürütüldü. Araştırmanın verilerinin toplanmasında "Sözel Derecelendirme Ölçeği" ve literatür doğrultusunda araştırmacılar tarafından hazırlanan "Non-farmakolojik Yöntemler Formu" kullanıldı. Bulgular: Araştırmaya katılan hastaların yaş ortalaması 58.17±15.13 olup, %53.7'si kadın, %53.7'si okuryazar-ilkokul mezunu, %29.3'ü meme kanseri tanısı almıştır. Araştırmaya dâhil edilen hastaların %54.4'ü şiddetli ağrı yaşadığını, %82.9'u ise ağrı kesici kullandığını belirtti. Hastaların %87'si ağrı durumunda geçmesi için dua ettiğini, %63.4'ü ağrı alanına masaj yaptığını, %59.3'ü Kuran okuduğunu, %58.5'i ise nefes egzersizleri yaptıklarını belirttiler. Sonuç: Kanser hastalarının büyük çoğunluğunun ağrıyla baş etmede farmakolojik yöntemlere ek olarak non-farmakolojik yöntemleri de kullandıkları, en sık kullandıkları non-farmakolojik yöntemler arasında dua etme, ağrı alanına masaj yapma, Kuran okuma ve nefes egzersizlerinin yer aldığı sonucuna ulaşıldı.

SummaryObjectives: Lacosamide is a novel antiepileptic drug used in partial refractory epilepsy patients. Methods: We searched retrospectively 1100 patients who have follow up in Antalya Education and Research Hospital Epilepsy Departmant between August 2011 and December 2014 and evaluated 14 patients with refractory partial epilepsy who have been using lacosamide which has been obtained abroad by the Turkish Pharmacists' Association before placing on the market in Turkey. Reduction in seizure frequancy was divided in two groups as less than 50% and more than 50%. Results: Nine (64.2%) of 14 patients were male and the remainder were female (35.7%). Mean age was 27.14±7.7 (min. 21,max. 47). Patients were being treated for an average of four antiepileptic drugs (min.3, max.5) before the begining of lacosamide. We titrated the dosage of lacosamide from 100mg/day to 400mg/day (mean 323±30.2 mg/day).The patients had been followed up for a mean of 24 months. Lacosamide reduced the seizure frequancy in five (35.7%) patients but not the other nine (64.2%) patients.Side effects observed in five patients dizziness was the most frequent. Conclusion: Lacosamide can be effective and safe in patients with partial refractory epilepsy if it was combined appropriately with the other antiepileptic drugs. We believe that we need prospective, randomised, multicenter and longer follow up studies to evaluate the safety and effectivety profile of lacosamide on seizure control.Key words: Add-on therapy; epilepsy; lacosamide; new antiepileptic drugs. ÖzetAmaç: Lakozamid parsiyel başlangıçlı refrakter epilepsi hastalarında kullanılmaya başlanan yeni bir antiepileptik ilaçtır. Gereç ve Yöntem:Ağustos 2011 ile Aralık 2014 tarihleri arasında Antalya Eğitim ve Araştırma Hastanesi Epilepsi Polikliniği'nde takipli 1100 hasta taranarak henüz Türkiye'ye gelmeden önce Türk Eczacılar Birliği aracılığı ile yurtdışından getirilerek lakozamid tedavisi alan 14 dirençli parsiyel başlangıçlı epilepsi hastası geriye dönük olarak değerlendirildi. Nöbet sıklığındaki azalma %50'den az ve %50'den çok olmak üzere ikiye ayrıldı. Bulgular:On dört hastanın dokuzu (%64.2) erkek, beşi (%35.7) kadın idi. Yaş ortalaması 27.14±7.7 (min. 21, maks. 47) idi. Hastalara lakozamid başlanmadan evvel ortalama dörtlü (min. 3, maks. 5) antiepileptik ilaç kullanıyordu. Lakozamid 100 mg/gün ile başlanıp maksimum 400 mg/ gün'e (ort. 323±30.2 mg/gün) yükseltildi. Hastalar ortalama 24 ay takip edildi. Lakozamid beş (%35.7) hastada nöbet sıklığını azaltırken, dokuz (%64.2) hastada ise etkisizdi. Beş (%35.7) hastada yan etki gözlenmiş olup en sık sersemlik ile karşılaşıldı. Sonuç:Parsiyel epilepsilerde lakozamid uygun kombinasyonlarda kullanıldığında güvenilir efektif bir ilaç olabilir. Fakat yan etki profili ve nö-betsizlik süresi üzerine daha fazla hastanın katıldığı ve daha uzun süreli takibin yapıldığı çok merkezli geniş çaplı çalışmalara ihtiyaç olduğunu düşünmekteyiz.

The aim of the study was to determine the health literacy status of people aged 65 and over in Turkey. Methods: This study is descriptive and cross-sectional. The population consisted of people aged 65 and over living in the centre of a province. 2017 data from the Turkish Statistical Institute were used for the sample size. Following the calculations, sampling was taken from 486 people. Data were collected between January and May 2018. Ethical permission was obtained prior to the study. Participants were selected according to the improbable method among those who came to primary health institutions. A survey form was used as a data collection tool. The first part of the form determined the socio-demographic characteristics of the participants. TSOY-32 was used in the second section. A score 0 indicated the lowest HL and the score 50 indicated the highest HL in the scale. Results: The average score of the study participants in the 'Turkey Health Literacy-32' test was 24.40 ± 7.70. In this study, score means were high among people with regular health checks, those who did not use unprescribed medication, those who quit smoking, who exercised regularly and who had adequate nutrition. Conclusion: Health literacy of individuals aged 65 and over was found to be inadequate.