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Article ; Online: The correlation of non-motor symptoms and sleep on balance in Parkinson's disease patients with normal cognition and mild cognitive impairment.

Saricaoglu, Mevhibe / Yilmaz, Nesrin Helvaci / Ozer, Fahriye Feriha / Hanoglu, Lutfu

2021 Volume 190, Issue 4, Page(s) 1577–1584

Abstract: Background: Parkinson's disease (PD) is characterized by non-motor symptoms (NMS) as well as by motor symptoms. Together with the impairment of cognitive functions, NMS and sleep also affect motor symptoms negatively. The aim of our study is to examine ... ...

Abstract	Background: Parkinson's disease (PD) is characterized by non-motor symptoms (NMS) as well as by motor symptoms. Together with the impairment of cognitive functions, NMS and sleep also affect motor symptoms negatively. The aim of our study is to examine the correlation of NMS and sleep on balance in PD patients with normal cognition (PD-NC) and with mild cognitive impairment (PD-MCI). Methods: A total of 69 patients were included in our study. Using the Standardized Mini-Mental State Examination, participants were divided into 2 groups, PD-NC and PD-MCI. Patients were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS), the Berg Balance Scale (BBS), the Tinetti Balance Assessment Tool (TBAT), the Non-Motor Symptoms Questionnaire (NMSQ), and the Parkinson's Disease Questionnaire (PDQ-39). Results: PD-MCI patients had statistically significant worse motor symptoms and more balance disorder compared to PD-NC (UPDRS: p = 0.009; BBS: p = 0.010; TBAT: p = 0.004). PD-MCI patients had greater severity of non-motor symptoms and worse sleep quality than the PD-NC group (NMSQ-total: p = 0.02; NMSQ-sleep total: p = 0.01). The evaluation has shown that with a diagnosis of MCI, NMS, and sleeping problems were correlated, and the correlation was associated with impairment of the balance function. While being more pronounced in the PD-MCI group, quality of life was affected in both groups (p < 0.05). Conclusion: Our data demonstrate a negative effect on the balance function in patients with cognitive impairment suffering increased NMS and sleeping disorders. Treatment of these patients needs to concentrate on NMS and cognitive functions as much as on motor symptoms.
MeSH term(s)	Cognition ; Cognitive Dysfunction/etiology ; Humans ; Parkinson Disease/complications ; Quality of Life ; Sleep
Language	English
Publishing date	2021-01-15
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-020-02462-6
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Article ; Online: How Does Entacapon Affect Homocysteine Levels?

Gönül Akdağ / Feriha Özer / Mithat Bedir / Özlem Çokar / Belgin Petek Balcı / Gülsün Gül

Türk Nöroloji Dergisi, Vol 27, Iss 2, Pp 145-

2021 Volume 150

Abstract: Objective: To determine homocysteine, vitamin B12, and folate levels in patients with Parkinson’s disease and to investigate the effect of entacapone use on homocysteine levels. Materials and Methods: The records of patients who were followed up in our ... ...

Abstract	Objective: To determine homocysteine, vitamin B12, and folate levels in patients with Parkinson’s disease and to investigate the effect of entacapone use on homocysteine levels. Materials and Methods: The records of patients who were followed up in our outpatient clinic between 2009 and 2010 were reviewed retrospectively. The demographic, clinical characteristics, and laboratory findings of the patients were recorded. The control group consisted of healthy subjects with similar demographic characteristics. The patients were divided into two groups according to the treatment they received. Results: The control group consisted of 22 healthy subjects (group 1), group 2 comprised 22 patients [entacapone (+)], and group 3 constitued 50 patients [entacapone (-)]. The homocysteine levels of the control group were significantly lower than the entacapone (-) and entacapone (+) groups. The vitamin B12 level of the control group was significantly higher than in the entacapone (-) group. The folate levels of the control group were significantly higher than those of the entacapone (-) group. There was no significant difference between the entacapone (-) and entacapone (+) groups in terms of homocysteine, vitamin B12, and folate levels. Conclusion: Levodopa treatment affects homocysteine levels in patients with Parkinson’s disease. The effect of levodopa + entacapone on plasma homocysteine levels should be evaluated together with basal vitamin B12 and folate levels and genetic features.
Keywords	idiopathic parkinson’s disease ; entacapone ; homocysteine ; Medicine ; R ; Neurology. Diseases of the nervous system ; RC346-429
Subject code	610
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
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Article: The Relationship Between Pain, and Freezing of Gait and Falls in Parkinson's Disease.

Yilmaz, Nesrin Helvaci / Saricaoğlu, Mevhibe / Eser, Hale Yapici / Düz, Özge Arici / Polat, Burcu / Özer, Fahriye Feriha

Noro psikiyatri arsivi

2019 Volume 57, Issue 1, Page(s) 56–60

Abstract: Introduction: To investigate the relationship between pain, freezing of gait (FOG) and falls in Parkinson's Disease (PD).: Methods: The study included 110 PD patients. The Unified PD Rating Scale (UPDRS) and Hoehn and Yahr Scale were used to evaluate ...

Abstract	Introduction: To investigate the relationship between pain, freezing of gait (FOG) and falls in Parkinson's Disease (PD). Methods: The study included 110 PD patients. The Unified PD Rating Scale (UPDRS) and Hoehn and Yahr Scale were used to evaluate disease severity. The patients self-reported occurrence of FOG and falls, and the FOG Questionnaire was administered to evaluate the severity of FOG. A visual analog scale (VAS) was used to measure the severity of pain and pain localization was self-reported by the patients. Results: Fifty-eight of the patients had FOG and 43 experienced falls. Among the patients, 42 had no pain, whereas 35 had lower extremity pain. Higher UPDRS motor and FOG scores, and advanced-stage disease were noted in significantly more of the patients with FOG and falls. VAS scores were not affected by the presence of FOG or falls. There was a positive correlation between the severity of FOG and VAS score in the male patients (r=0.308; p=0.010). More patients with falls had lower extremity pain than those without falls (r=0.308; p=0.010). Discussion: Patients with FOG and falls had more severe motor findings. Pain is correlated with both FOG and falls. Further investigations should be done to understand the mechanism of this relationship to prevent the motor complications in advanced PD.
Language	English
Publishing date	2019-11-25
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2565770-7
ISSN	1300-0667
ISSN	1300-0667
DOI	10.29399/npa.24716
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Article ; Online: High cholesterol diet activates ER stress mediated apoptosis in testes tissue: Role of α-tocopherol.

Sozen, Erdi / Demirel-Yalciner, Tugce / Koroglu, M Kutay / Elmas, Merve Acikel / Ercan, Feriha / Ozer, Nesrin Kartal

IUBMB life

2021 Volume 74, Issue 1, Page(s) 85–92

Abstract: The seminiferous tubules where spermatogenesis occurs are enveloped and protected by the Sertoli cells to support germ cells undergoing meiosis to produce haploid gametes. Clearly, induction of apoptosis in seminiferous tubules leads to abnormalities in ... ...

Abstract	The seminiferous tubules where spermatogenesis occurs are enveloped and protected by the Sertoli cells to support germ cells undergoing meiosis to produce haploid gametes. Clearly, induction of apoptosis in seminiferous tubules leads to abnormalities in spermatogenesis and male infertility. Studies demonstrated that increased hyperlipidemia impairs male infertility and spermatogenesis by enhancing seminiferous tubules apoptosis. However, molecular mechanisms underlying high-cholesterol-mediated testicular damage remain poorly elucidated. In this scope, we established a rabbit model and investigated the role of endoplasmic reticulum (ER) stress on high cholesterol diet induced seminiferous tubule apoptosis. Histopatological examinations revealed increased seminifer tubule apoptosis in testes of rabbits fed high cholesterol diet. In addition, phosphorylated forms of IRE1 and PERK, two well-identified markers of ER stress, were significantly induced in accordance with high cholesterol diet. High cholesterol diet also exhibited CHOP induction in testes, indicating increased ER stress related apoptosis. Supplementation of α-tocopherol significantly attenuated cholesterol mediated ER stress, and restored seminiferous tubules apoptosis. Taken together, our findings suggest that α-tocopherol might be capable to reduce testicular damage via ameliorating histopatological features and inhibiting seminiferous tubules apoptosis in hypercholesterolemic rabbits.
MeSH term(s)	Animals ; Apoptosis ; Cholesterol ; Diet ; Hypercholesterolemia ; Male ; Rabbits ; Testis ; alpha-Tocopherol/pharmacology
Chemical Substances	Cholesterol (97C5T2UQ7J) ; alpha-Tocopherol (H4N855PNZ1)
Language	English
Publishing date	2021-08-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1492141-8
ISSN	1521-6551 ; 1521-6543
ISSN (online)	1521-6551
ISSN	1521-6543
DOI	10.1002/iub.2535
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Article ; Online: Validity and Reliability of the Turkish Version of The International Restless Legs Syndrome Study Group Rating Scale

Elif Ay / Nesrin Helvacı Yılmaz / Özge Arıcı Düz / Fahriye Feriha Özer

Acta Medica Alanya, Vol 3, Iss 2, Pp 105-

2019 Volume 110

Abstract: Aim: The purpose of this study is to prepare the Turkish version of the International Restless Legs Syndrome (RLS) Study Group Rating Scale and to investigate its validity and reliability. Materials and Methods: A total of 89 individuals with RLS were ... ...

Abstract	Aim: The purpose of this study is to prepare the Turkish version of the International Restless Legs Syndrome (RLS) Study Group Rating Scale and to investigate its validity and reliability. Materials and Methods: A total of 89 individuals with RLS were included. These subjects were divided into two groups: A pilot study group (n=20) and a study group (n=69). The scale was translated into and adjusted for Turkish was applied to the groups. Results: In the analysis conducted to test the factor structure of the scale, it was clearly seen that the items were collected under two factors and that the two factors in total accounted for 68.19% of the variance. The Kaiser-Meyer-Olkin (Kaiser-Meyer-Olkin) coefficient for validity of the scale was 0.84 and Bartlett Sphericity index was significant with p <0.005. The Cronbach's Alpha coefficient, which determined the reliability of the scale, was 0.0896. Conclusions: This study demonstrated that the Turkish version of this scale that is frequently used for scientific and clinical trials is valid.
Keywords	restless legs syndrome ; validity ; reliability ; huzursuz bacak sendromu ; geçerlilik ; güvenirlilik ; Medicine ; R
Subject code	150
Language	English
Publishing date	2019-08-01T00:00:00Z
Publisher	Alanya Alaaddin Keykubat University
Document type	Article ; Online
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Article ; Online: Effect of bladder dysfunction on development of depression and anxiety in Parkinson's disease.

Benli, Erdal / Ozer, Fahriye Feriha / Helvacı Yılmaz, Nesrin / Arici Duz, Ozge / Yuce, Ahmet / Cirakoglu, Abdullah / Ozcan, Tuba Saziye

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica

2021 Volume 93, Issue 3, Page(s) 336–340

Abstract: Objectives: Parkinson's disease (PD) often presents with movement disorder. However, besides motor complaints, there are many complaints such as anxiety, depression, urinary complaints and constipation. The aim of this study was to investigate whether ... ...

Abstract	Objectives: Parkinson's disease (PD) often presents with movement disorder. However, besides motor complaints, there are many complaints such as anxiety, depression, urinary complaints and constipation. The aim of this study was to investigate whether neurogenic lower urinary dysfunction (NLUD), which is frequently seen in PD, has an effect on the development of anxiety and depression in these patients. Materials and methods: The study included 32 males (66.6%) and 16 females (33.3%); in total 48 subjects were registered. For the diagnosis and severity of PD, the UK Parkinson's Disease Society Brain Bank Criteria, Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn-Yahr scale were used. Urological evaluation was performed using history, physical examination, laboratory tests and standard forms such as IPSS and OAB-V8. Results: There was no difference between the genders in terms of duration, severity and NLUD (p > 0.05). The incidence of anxiety and depression in PD patients was 62.8% and 72.1%, respectively. The prevalence of NLUD was 67.4% and depression and anxiety was found to increase (1.06 and 1.28 times, respectively) in relation to NLUD. In particular, there was a relationship between storage lower urinary tract symptoms and anxiety and depression development (p < 0.05). Conclusions: As expected, it was found that the incidence of NLUD, anxiety and depression was increased in PD. In addition, NLUD was found to be a risk factor for the development of anxiety and depression. Therefore, it is concluded that NLUD, which can potentially cause important complications, as well as motor complaints, should be closely monitored and treated in PD patients.
MeSH term(s)	Anxiety/epidemiology ; Anxiety/etiology ; Depression/epidemiology ; Depression/etiology ; Female ; Humans ; Male ; Parkinson Disease/complications ; Parkinson Disease/epidemiology ; Severity of Illness Index ; Urinary Bladder
Language	English
Publishing date	2021-10-01
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1153526-x
ISSN	2282-4197 ; 1120-8538 ; 1124-3562
ISSN (online)	2282-4197
ISSN	1120-8538 ; 1124-3562
DOI	10.4081/aiua.2021.3.336
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Article ; Online: Relation of Apathy to Motor and Non-motor Findings in Parkinson’s Disease

Melek Gürbüz / Gönül Akdağ / Özge Arıcı Düz / Feriha Özer / Özlem Çokar / Lütfü Hanoğlu

Haseki Tıp Bülteni, Vol 57, Iss 2, Pp 129-

2019 Volume 134

Abstract: Aim:It has been shown that motor symptoms, as well as non-motor symptoms, significantly affect the quality of life of patients with idiopathic Parkinson’s disease. In our study, the association of apathy, one of the NMS, with motor and non-motor symptoms ...

Abstract	Aim:It has been shown that motor symptoms, as well as non-motor symptoms, significantly affect the quality of life of patients with idiopathic Parkinson’s disease. In our study, the association of apathy, one of the NMS, with motor and non-motor symptoms was investigated.Methods:Patients with stage 1-3 IPH according to the Hoehn-Yahr Scale (H&Y) were included in the study. Patients who received dementia diagnosis according to the DSM IV criteria were excluded from the study. The patients were evaluated using the Unified Parkinson’s Disease Rating Scale (UPDRS), non-motor symptoms Questionnaire (NMSQ), Geriatric Depression Scale (GDS), and the revised diagnostic criteria for apathy.Results:Apathy was found in 26 of 68 patients who were included in the study. Patients with and without apathy were compared in terms of age, clinical and demographic characteristics, L-dopa equivalent doses, depression, and NMSQ scores. The group of patients with apathy consisted of nine females and 17 males and the mean age was 64.3±7.7 years. The non-apathy group included 25 females and 17 males and the mean age was 66.8±9.1 years. There was no statistically significant difference between the groups in terms of age, education, age at onset, duration of illness and L-dopa equivalent doses. The male-to-female ratio was significantly higher in the apathy group. The mean GDS and NMSQ scores in the apathy group were significantly higher than in the non-apathy group. There was a statistically significant difference between the groups in H&Y stage and total UPDRS and subscales scores. It was noteworthy that the rate of stage 3 patients was higher in the group of patients with apathy. The number of patients having bradykinesia in the apathy group and the number of patients having tremor in the group without apathy was higher.Conclusion:Our study showed that apathy, one of the non-motor symptoms, was more prominent in male gender, associated with UPDRS scores, clinical stage and bradykinesia, and accompanied by depression.
Keywords	Parkinson’s disease ; motor symptoms ; non-motor symptoms ; apathy ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
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Article ; Online: Effects of levodopa therapy on global left ventricular systolic function in patients with Parkinson disease.

Günaydın, Zeki Yüksel / Bektaş, Osman / Karagöz, Ahmet / Özer, Fahriye Feriha

Wiener klinische Wochenschrift

2016 Volume 128, Issue 13-14, Page(s) 528–533

Abstract: Objectives: Since levodopa was identified as an efficient therapeutic option in Parkinson disease (PD), great success has been achieved in the course and treatment of the disease. However, L‑dopa-related side effects limit the therapeutic use in some ... ...

Abstract	Objectives: Since levodopa was identified as an efficient therapeutic option in Parkinson disease (PD), great success has been achieved in the course and treatment of the disease. However, L‑dopa-related side effects limit the therapeutic use in some patients. The aim of this study was to evaluate the effects of L‑dopa therapy on left ventricular global systolic function via speckle tracking method. Methods: In this study, 55 patients with PD under L‑dopa/dopa decarboxylase inhibitor therapy were compared with 30 age- and sex-matched control subjects. Conventional transthoracic echocardiography was performed in the left lateral position by two experienced operators in accordance with generally accepted guidelines. Left ventricular systolic function was analyzed by speckle tracking method using global longitudinal strain (GLS) and global circumferential strain (GCS) imaging. Results: Adequate echocardiographic imaging for the evaluation of global longitudinal strain and global circumferential strain could be achieved in 55 of the patients. LVEF (left ventricular ejection fraction), GLS and GCS values were found to be similar between the patients with PD under L‑dopa therapy and the control group (62 ± 3.5 % vs 61 ± 4 %, p < 0.05; -19.46 ± 2.3 vs -19.4 ± 3.2, p < 0.05; and -18.60 ± 3.5 vs -18.22 ± 3.2, p < 0.05 respectively.) Conclusion: Levodopa therapy has no unfavorable effect on left ventricular systolic function in patients with PD.
MeSH term(s)	Aged ; Aged, 80 and over ; Antiparkinson Agents/adverse effects ; Antiparkinson Agents/therapeutic use ; Female ; Humans ; Levodopa/adverse effects ; Levodopa/therapeutic use ; Male ; Middle Aged ; Parkinson Disease/complications ; Parkinson Disease/drug therapy ; Parkinson Disease/physiopathology ; Stroke Volume/drug effects ; Treatment Outcome ; Ventricular Dysfunction, Left/chemically induced ; Ventricular Dysfunction, Left/physiopathology
Chemical Substances	Antiparkinson Agents ; Levodopa (46627O600J)
Language	English
Publishing date	2016-07
Publishing country	Austria
Document type	Clinical Trial ; Journal Article
ZDB-ID	200462-8
ISSN	1613-7671 ; 0043-5325 ; 0300-5178
ISSN (online)	1613-7671
ISSN	0043-5325 ; 0300-5178
DOI	10.1007/s00508-016-1026-5
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Article ; Online: Cholesterol induced autophagy via IRE1/JNK pathway promotes autophagic cell death in heart tissue.

Sozen, Erdi / Yazgan, Burak / Tok, Olgu Enis / Demirel, Tugce / Ercan, Feriha / Proto, Jonathan D / Ozer, Nesrin Kartal

Metabolism: clinical and experimental

2020 Volume 106, Page(s) 154205

Abstract: Background: Cardiovascular diseases (CVDs), with highest mortality and morbidity rates, are the major cause of death in the world. Due to the limited information on heart tissue changes, mediated by hypercholesterolemia, we planned to investigate ... ...

Abstract	Background: Cardiovascular diseases (CVDs), with highest mortality and morbidity rates, are the major cause of death in the world. Due to the limited information on heart tissue changes, mediated by hypercholesterolemia, we planned to investigate molecular mechanisms of endoplasmic reticulum (ER) stress and related cell death in high cholesterol fed rabbit model and possible beneficial effects of α-tocopherol. Methods: Molecular changes in rabbit heart tissue and cultured cardiomyocytes (H9c2 cells) were measured by western blotting, qRT-PCR, immunflouresence and flow cytometry experiments. Histological modifications were assessed by light and electron microscopes, while degradation of mitochondria was quantified through confocal microscope. Results: Feeding rabbits 2% cholesterol diet for 8 weeks and treatment of cultured cardiomyocytes with 10 μg/mL cholesterol for 3 h induced excessive autophagic activity via IRE1/JNK pathway. While no change in ER-associated degradation (ERAD) and apoptotic cell death were determined, electron and confocal microscopy analyses in cholesterol supplemented rabbits revealed significant parameters of autophagic cell death, including cytoplasmic autophagosomes, autolysosomes and organelle loss in juxtanuclear area as well as mitochondria engulfment by autophagosome. Either inhibition of ER stress or JNK in cultured cardiomyocytes or α-tocopherol supplementation in rabbits could counteract the effects of cholesterol. Conclusion: Our findings underline the essential role of hypercholesterolemia in stimulating IRE1/JNK branch of ER stress response which then leads to autophagic cell death in heart tissue. Results also showed α-tocopherol as a promising regulator of autophagic cell death in cardiomyocytes.
MeSH term(s)	Animals ; Autophagic Cell Death/drug effects ; Autophagy/drug effects ; Cells, Cultured ; Cholesterol/metabolism ; Cholesterol/pharmacology ; Endoplasmic Reticulum Stress/drug effects ; Heart/drug effects ; Heart/physiology ; Humans ; Hypercholesterolemia/complications ; Hypercholesterolemia/metabolism ; Hypercholesterolemia/pathology ; JNK Mitogen-Activated Protein Kinases/metabolism ; MAP Kinase Signaling System/drug effects ; Male ; Membrane Proteins/metabolism ; Myocardium/metabolism ; Myocardium/pathology ; Myocytes, Cardiac/drug effects ; Myocytes, Cardiac/physiology ; Protein-Serine-Threonine Kinases/metabolism ; Rabbits ; Rats
Chemical Substances	Membrane Proteins ; Cholesterol (97C5T2UQ7J) ; Ern2 protein, rat (EC 2.7.1.-) ; Protein-Serine-Threonine Kinases (EC 2.7.11.1) ; JNK Mitogen-Activated Protein Kinases (EC 2.7.11.24)
Language	English
Publishing date	2020-03-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80230-x
ISSN	1532-8600 ; 0026-0495
ISSN (online)	1532-8600
ISSN	0026-0495
DOI	10.1016/j.metabol.2020.154205
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Article ; Online: Epilepsy in the elderly

Belgin Petek Balcı / Aytül Mutlu / Feriha Özer / Özlem Çokar

Türk Nöroloji Dergisi, Vol 21, Iss 2, Pp 62-

2015 Volume 67

Abstract: OBJECTIVE: Epilepsy is a frequent disease in the elderly, but its aetiology, clinical presentation, comorbidities, and prognosis are different than younger patients. In this study, we investigated types of seizures, EEG findings and the cause of epilepsy ...

Abstract	OBJECTIVE: Epilepsy is a frequent disease in the elderly, but its aetiology, clinical presentation, comorbidities, and prognosis are different than younger patients. In this study, we investigated types of seizures, EEG findings and the cause of epilepsy in the elderly. METHODS: We analyzed retrospectively 95 patients all of whom are 65 years old and over having an epileptic seizure fort the first time. Type of epilepsy, age, EEG findings, magnetic resonans imaging and/or cranial tomography findings, aetiology, comorbidities and antiepileptic medication were evaluated. RESULTS: The average age of our patients was 75, and 50(56%) patients were males. In 95 patients, 55 (58%) had focal seizures, 36 (38%) had generalize tonic clonic seizures and 4(4%) had convulsive status epilepticus. The frequency of focal interictal epileptiform activity was 32,6% patients. Seizures were responsive to treatment as monotherapy in 81() patients and as politherapy in 14() patients. Our study showed that cerebrovascular disease was the most common (63%) aetiologic cause identified. There was no significant relationship between age and frequency of seizures and EEG abnormalities. However, a significant correlation was found between age and comorbidities. CONCLUSION: Our results supported the focal seizure is the most common manifestation of epilepsy in the elderly. Cerebrovascular disease is the most common etiological cause of epilepsy in the elderly. Monotherapy is sufficient in the majority of patients. Continuous growth of the elderly population is increasing the need for accurate diagnosis and effective treatment.
Keywords	Epilepsy ; seizure type ; EEG ; treatment ; elderly patients ; Medicine ; R ; Neurology. Diseases of the nervous system ; RC346-429
Subject code	616
Language	English
Publishing date	2015-06-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
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