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Çakır S, Sahin A, Gedik-Soyuyuce O, Gence Gumus Z, Sertdemir İ, Korkut N, Yalınay Dikmen P. Assessing the impact of migraine on benign paroxysmal positional vertigo symptoms and recovery. BMC Neurol 2024; 24:148. [PMID: 38698310 PMCID: PMC11064330 DOI: 10.1186/s12883-024-03606-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/18/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND During episodes of benign paroxysmal positional vertigo (BPPV), individuals with migraine, compared with individuals without migraine, may experience more severe vestibular symptoms because of their hyperexcitable brain structures, more adverse effects on quality of life, and worse recovery processes from BPPV. METHODS All patients with BPPV were assigned to the migraine group (MG, n = 64) and without migraine group (BPPV w/o MG, n = 64) and completed the Vertigo Symptom Scale (VSS), Vertigo Dizziness Imbalance Symptom Scale (VDI-SS), VDI Health-Related Quality of Life Scale (VDI-HRQoLS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) at the time of BPPV diagnosis (baseline) and on the one-month follow-up. Headache Impact Test-6 and Migraine Disability Assessment Scale were used for an assessment of headache. Motion sickness was evaluated based on the statement of each patient as present or absent. RESULTS Compared with the BPPV w/o MG, the MG had higher VSS scores at baseline [19.5 (10.7) vs. 11.3 (8.5); p < 0.001] and on one-month follow-up [10.9 (9.3) vs. 2.2 (2.7), p < 0.001]; experienced more severe dizziness and imbalance symptoms based on the VDI-SS at baseline (61.9% vs. 77.3%; p < 0.001) and after one month (78.9% vs. 93.7%, p < 0.001); and more significantly impaired quality of life according to the VDI-HRQoLS at baseline (77.4% vs. 91.8%, p < 0.001) and after one month (86.3% vs. 97.6%, p < 0.001). On the one-month follow-up, the subgroups of patients with moderate and severe scores of the BAI were higher in the MG (39.2%, n = 24) than in the BPPV w/o MG (21.8%, n = 14) and the number of patients who had normal scores of the BDI was lower in the MG than in the BPPV w/o MG (67.1% vs. 87.5%, p = 0.038). CONCLUSION Clinicians are advised to inquire about migraine when evaluating patients with BPPV because it may lead to more intricate and severe clinical presentation. Further studies will be elaborated the genuine nature of the causal relationship between migraine and BPPV.
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Affiliation(s)
- Seda Çakır
- Department of Neurology, Acıbadem University School of Medicine, İçerenköy. Kayışdağı Cad. No: 32. Ataşehir, İstanbul, 34752, Turkey
| | - Aysenur Sahin
- Department of Neurology, Acıbadem University School of Medicine, İçerenköy. Kayışdağı Cad. No: 32. Ataşehir, İstanbul, 34752, Turkey
| | | | | | - İbrahim Sertdemir
- Department of Biostatistics and Bioinformatics, Acıbadem University, İstanbul, Turkey
| | - Nazım Korkut
- Department of Otorhinolaryngology, Acıbadem Maslak Hospital, İstanbul, Turkey
| | - Pınar Yalınay Dikmen
- Department of Neurology, Acıbadem University School of Medicine, İçerenköy. Kayışdağı Cad. No: 32. Ataşehir, İstanbul, 34752, Turkey.
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Atalar AÇ, Acarlı ANÖ, Baykan B, Martelletti P, Bolay H, Ertaş M, Ekizoğlu E, Karadaş Ö, Polat B, Gençdal IY, Azorin DG, Mitsikostas D, Apostolakopoulou L, Genç H, Dikmen PY, Demirel EA, Aydınlar EI, Gözübatık-Celik RG, Shafiyev J, Taşdelen B, Özge A. COVID-19 vaccination-related headache showed two different clusters in the long-term course: a prospective multicenter follow-up study (COVA-Head Study). J Headache Pain 2023; 24:132. [PMID: 37773092 PMCID: PMC10541695 DOI: 10.1186/s10194-023-01665-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/05/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Although acute headache following COVID-19 vaccination is widely acknowledged, the long-term progression of these headaches remains poorly understood. Our objective was to identify various phenotypes of prolonged or worsened headaches associated with COVID-19 vaccination and document any changes in these phenotypes over an extended period. Additionally, we aimed to document the diverse headache presentations among patients with pre-existing primary headaches. METHODS A multinational, prospective observational study was conducted to investigate prolonged or worsened headaches associated with COVID-19 vaccination. Questionnaires assessing COVID-19 vaccination-related headaches at three time points (initial visit, 3rd month follow-up, and 6th month follow-up) were developed for the study. Headache specialists/clinicians evaluated patients using these questionnaires in a prospective manner. Repeated K-means cluster analysis was performed to identify patient profiles with prolonged or worsened headaches related to COVID-19 vaccination. RESULTS Among the 174 patients included in the study, there was a female-to-male ratio of 128 (73.6%) to 46 (26.4%). The mean age of the patient group was 45.2 ± 13.3 years, and 107 patients (61.5%) had a pre-existing history of primary headaches. Through the analysis, two major clusters were identified based on headache characteristics at each visit. During the first visit (n = 174), Cluster 1 primarily comprised patients with a history of primary headaches, frontal localization of pain, throbbing pain type, more severe headaches accompanied by symptoms such as nausea, phonophobia, photophobia, and osmophobia, and worsened by physical activity. In contrast, Cluster 2 consisted of patients with longer headache durations (over one month) and a stabbing/pressing quality of pain. Patients in Cluster 1 had a higher prevalence of migraine as the pre-existing primary headache disorder compared to Cluster 2 (90.48% vs. 68.18%, respectively; p = 0.005). CONCLUSION The identification of two distinct phenotypes of prolonged or worsened headaches related to COVID-19 vaccination can provide valuable clinical insights. Having an awareness of the potential worsening of headaches following COVID-19 vaccination, particularly in patients with a primary headache disorder such as migraine, can help clinicians and headache experts anticipate and adjust their treatment strategies accordingly. This knowledge can aid in preplanning treatment modifications and optimize patient care.
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Affiliation(s)
- Arife Çimen Atalar
- Department of Neurology, Health Sciences University, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey.
| | | | - Betül Baykan
- Department of Neurology, Headache Center, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
- Department of Neurology, EMAR Medical Center, Istanbul, Turkey
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Hayrunnisa Bolay
- Medical Faculty, Department of Neurology and Algology, Gazi University, Ankara, Turkey
| | - Mustafa Ertaş
- Department of Neurology, Headache Center, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Esme Ekizoğlu
- Department of Neurology, Headache Center, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ömer Karadaş
- Department of Neurology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Burcu Polat
- School of Medicine, Department of Neurology, Istanbul Medipol University, Istanbul, Turkey
| | - Işıl Yazıcı Gençdal
- Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, University of Health Sciences, Istanbul, Turkey
| | - David Garcia Azorin
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Headache Unit, Valladolid, Spain
| | - Dimos Mitsikostas
- First Neurology Department, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Loukia Apostolakopoulou
- First Neurology Department, Medical School, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Hamit Genç
- University of Health Sciences, Van Training and Research Hospital, Van, Türkiye
| | - Pınar Yalınay Dikmen
- School of Medicine, Department of Neurology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | | | - Elif Ilgaz Aydınlar
- School of Medicine, Department of Neurology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Rabia Gökçen Gözübatık-Celik
- Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, University of Health Sciences, Istanbul, Turkey
| | - Javid Shafiyev
- Department of Neurology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Bahar Taşdelen
- Department of Biostatistics and Medical Informatic, Mersin University School of Medicine, Mersin, Turkey
| | - Aynur Özge
- Medical Faculty, Department of Neurology, Mersin University, Mersin, Türkiye
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Öztürk Durmaz E, Demircioğlu D, Yalınay Dikmen P, Alanay Y, Alanay A, Demirkesen C, Tokat F, Karaarslan E. A Review on Cutaneous and Musculoskeletal Manifestations of CLOVES Syndrome. Clin Cosmet Investig Dermatol 2022; 15:621-630. [PMID: 35444443 PMCID: PMC9013705 DOI: 10.2147/ccid.s351637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/17/2022] [Indexed: 01/19/2023]
Abstract
CLOVES syndrome is a novel sporadic mosaic segmental overgrowth syndrome, currently categorized under the canopy of PROS (PIK3CA-related overgrowth spectrum) disorders. All PROS disorders harbor heterozygous postzygotic activating somatic mutations involving the PIK3CA gene. As an upstream regulator of the PI3K/AKT/mTOR signal transduction pathway, activating mutations of PIK3CA gene commence in uncontrolled growth of cutaneous, vascular (capillaries, veins, and lymphatics), adipose, neural, and musculoskeletal tissues. The excessive growth is segmental, patchy, asymmetric, and confined to body parts affected by the mutation. The term ‘CLOVES’ is an acronym denoting congenital lipomatous overgrowth, vascular malformations, epidermal nevi and spinal (scoliosis) and/ or skeletal anomalies. The syndrome is characterized by an admixture of overgrown tissues, derived mainly from mesoderm and neuroectoderm. Among PROS disorders, CLOVES syndrome represents the extreme end of the spectrum with massive affection of almost the entire body. The syndrome might judiciously be treated with medications hampering with the PI3K/AKT/mTOR signal transduction pathway. This article aims at reviewing the cutaneous and musculoskeletal manifestations of CLOVES syndrome, as the paradigm for PROS disorders. CLOVES syndrome and other PROS disorders are still misdiagnosed, underdiagnosed, underreported, and undertreated by the dermatology community.
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Affiliation(s)
- Emel Öztürk Durmaz
- Department of Dermatology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Deniz Demircioğlu
- Department of Dermatology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Pınar Yalınay Dikmen
- Department of Neurology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Yasemin Alanay
- Department of Pediatrics, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Ahmet Alanay
- Department of Orthopedics, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Cüyan Demirkesen
- Department of Pathology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Fatma Tokat
- Department of Pathology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
| | - Ercan Karaarslan
- Department of Radiology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey
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Ekizoglu E, Gezegen H, Yalınay Dikmen P, Orhan EK, Ertaş M, Baykan B. The characteristics of COVID-19 vaccine-related headache: Clues gathered from the healthcare personnel in the pandemic. Cephalalgia 2021; 42:366-375. [PMID: 34510919 PMCID: PMC8988457 DOI: 10.1177/03331024211042390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction Headache is a frequent adverse event after viral vaccines. We aimed to investigate the frequency and clinical associations of COVID-19 vaccine-related headache. Methods The characteristics, associations of this headache, main comorbidities, headache history following the influenza vaccine and during COVID-19 were investigated using a web-based questionnaire. Results A total of 1819 healthcare personnel (mean age: 44.4 ± 13.4 years, 1222 females), vaccinated with inactivated virus, contributed to the survey; 209 (11.4%) had been infected with COVID-19. A total of 556 participants (30.6%) reported headache with significant female dominance (36.1% vs. 19.3%), 1.8 ± 3.5 (median: 1; IQR: 0–2) days following vaccination. One hundred and forty-four participants (25.9%) experienced headache lasting ≥3 days. Headache was mostly bilateral without accompanying phenomena, less severe, and shorter than COVID-19-related headache. The presence of primary headaches and migraine were significantly associated with COVID-19 vaccine-related headache (ORs = 2.16 [95% CI 1.74–2.68] and 1.65 [1.24–2.19], respectively). Headache during COVID-19 or following influenza vaccine also showed significant association with headache following COVID-19 vaccine (OR = 4.3 [95% CI 1.82–10.2] and OR = 4.84 [95% CI 2.84–8.23], respectively). Only thyroid diseases showed a significant association (OR = 1.54 [95% CI 1.15–2.08]) with vaccine-related headache among the common comorbidities. Conclusion Headache is observed in 30.6% of the healthcare workers following COVID-19 vaccine and mostly experienced by females with pre-existing primary headaches, thyroid disorders, headache during COVID-19, or headache related to the influenza vaccine.
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Affiliation(s)
- Esme Ekizoglu
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
| | - Haşim Gezegen
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
| | - Pınar Yalınay Dikmen
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, Department of Neurology, Istanbul, Turkey
| | - Elif Kocasoy Orhan
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
| | - Mustafa Ertaş
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
| | - Betül Baykan
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
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Acar E, Aydınlar EI, Dikmen PY, Golabi P, Bolsoy S. Cerebral Venous Thrombosis and Delayed Awakening in a Young Adult with COVID-19: A Case Report. Neurology 2021. [DOI: 10.17925/usn.2021.17.1.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Yalınay Dikmen P. Diagnosis and Treatment in Vestibular Migraine. tnd 2020. [DOI: 10.4274/tnd.2020.38665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Yalınay Dikmen P, Onur Aysevener E, Kosak S, Ilgaz Aydınlar E, Sağduyu Kocaman A. Relationship between MIDAS, depression, anxiety and alexithymia in migraine patients. Acta Neurol Belg 2020; 120:837-844. [PMID: 29147944 DOI: 10.1007/s13760-017-0856-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/28/2017] [Indexed: 01/03/2023]
Abstract
The co-existence of psychiatric comorbidities with migraine is well known; however, the relationship between alexithymia and migraine has not been persuasively shown yet. The aim of the study was to assess the relationships between migraine-related disability, depression, anxiety and alexithymia. One hundred and forty-five migraine patients (33.18 ± 8.6; 111 females, 34 males), and 50 control subjects (29.06 ± 7.6; 34 females, 16 males) were prospectively enrolled for the study. The participants completed a demographic data form and Migraine Disability Assessment Scale, Beck Depression Inventory, Beck Anxiety Inventory and Toronto Alexithymia Score-20 (TAS-20). All migraine patients were more depressive (p = 0.01) and anxious (p = 0.001) than the healthy subjects. TAS-20 scores of the migraine sufferers and the control group did not indicate alexithymia. The migraine-related disability of all migraine patients was severe (27.84 ± 29.22). Depression and anxiety scores in the migraine patients were highly correlated with each other and TAS-20 (r = 0.485, p = 0.001) and all its subscales in turn: difficulty in identifying (r = 0.435, p < 0.001) and describing feelings (r = 0.451, p = 0.001) and externally oriented thinking (r = 0.302, p = 0.001). Moreover, logistic regression analysis revealed that depression and anxiety predicted alexithymia. Our findings showed a complex relationship between migraine, depression, anxiety and alexithymia. On the other hand, alexithymia apparently was not directly connected to migraine, but its presence could be predicted in migraine patients because of co-morbid depression and anxiety.
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Affiliation(s)
- Pınar Yalınay Dikmen
- Neurology Department, School of Medicine, Acıbadem University, Ic Erenkoy Mah. Kerem Aydınlar Kampusu. Kayısdag Cad., 34752, Atasehir/Istanbul, Turkey.
| | - Elif Onur Aysevener
- Faculty of Medicine, Psychiatry Department, Dokuz Eylul University, Kultur Mah. Cumhuriyet Blv. No: 144, 35220, Konak/Izmır, Turkey
| | - Seda Kosak
- Neurology Department, School of Medicine, Acıbadem University, Ic Erenkoy Mah. Kerem Aydınlar Kampusu. Kayısdag Cad., 34752, Atasehir/Istanbul, Turkey
| | - Elif Ilgaz Aydınlar
- Neurology Department, School of Medicine, Acıbadem University, Ic Erenkoy Mah. Kerem Aydınlar Kampusu. Kayısdag Cad., 34752, Atasehir/Istanbul, Turkey
| | - Ayşe Sağduyu Kocaman
- Neurology Department, School of Medicine, Acıbadem University, Ic Erenkoy Mah. Kerem Aydınlar Kampusu. Kayısdag Cad., 34752, Atasehir/Istanbul, Turkey
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Özdilek A, Yalınay Dikmen P, Acar E, Ayanoğlu Aksoy E, Korkut N. Determination of Anxiety, Health Anxiety and Somatosensory Amplification Levels in Individuals with Benign Paroxysmal Positional Vertigo. J Int Adv Otol 2020; 15:436-441. [PMID: 31347508 DOI: 10.5152/iao.2019.6874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Psychiatric comorbidities may intensify peripheral vertigo and increase the number of repositioning maneuvers required. This study was designed to examine the relationship between benign paroxysmal positional vertigo (BPPV) and anxiety and assess its association with somatic amplification and health anxiety. MATERIALS AND METHODS Sixty patients with BPPV (43 women, 17 men; age range: 24-81 years, mean age 40.4±13.3), and 60 healthy participants (29 women, 31 men; age range: 18-71, mean age 38.2±11.43) were prospectively enrolled. The participants completed the Beck Anxiety Inventory (BAI), Short Health Anxiety Inventory (SHAI), and Somatosensory Amplification Scale (SSAS) questionnaires. RESULTS The BAI scores of the patients with BPPV were higher than those of the control group participants and were as follows: (16.4 vs. 12.7; p=0.01). The SHAI (p=0.44) and SSAS (p=0.60) scores were not significantly different between the two groups. The BAI scores were positively correlated with the SHAI (rho: 0.273, p=0.035) and SSAS (rho: 0.357, p=0.005) scores. Neither the number of BPPV attacks nor the number of Epley maneuvers required showed any correlation with the BAI [(rho: 0.208, p=0.11); (rho: -0.007, p=0.96)], SHAI [(rho: 0.068, p=0.06); (rho: 0.021, p=0.87)], and SSAS [(rho: -0.081, p=0.53); (rho: -0.012, p=0.92)] scores. CONCLUSION Our findings indicate that patients with BPPV had higher anxiety scores than healthy participants. Although our findings indicated normal health anxiety and somatic amplification levels in patients with BPPV, regular evaluation of psychological status would be a good strategy to prevent chronic dizziness.
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Affiliation(s)
- Alper Özdilek
- Clinic of Ear Nose and Throat, Maslak Acibadem Hospital, İstanbul, Turkey
| | - Pınar Yalınay Dikmen
- Department of Neurology, Acibadem Mehmet Ali Aydinlar University School of Medicine, İstanbul, Turkey
| | - Erkan Acar
- Department of Neurology, Acibadem Mehmet Ali Aydinlar University School of Medicine, İstanbul, Turkey
| | - Elif Ayanoğlu Aksoy
- Department of Ear Nose and Throat, Acibadem Mehmet Ali Aydinlar University School of Medicine, İstanbul, Turkey
| | - Nazım Korkut
- Clinic of Ear Nose and Throat, Maslak Acibadem Hospital, İstanbul, Turkey
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Yalınay Dikmen P, Ozden VE, Dikmen G, Aydınlar EI, Tozun IR. Intraoperative neuromonitoring of anterior root muscle response during hip surgery under spinal anesthesia. J Clin Monit Comput 2018; 33:695-702. [PMID: 30415323 DOI: 10.1007/s10877-018-0212-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 10/10/2018] [Indexed: 11/25/2022]
Abstract
The aim of this study was to evaluate the anterior root muscle (ARM) response monitorability during total hip arthroplasty (THA) under spinal anesthesia. A total of 20 adults (64.6 ± 13.87 years old) were monitored using ARM response and free-run electromyography during THA. To elicit the ARM response from muscles, percutaneous stimulation of the lumbosacral roots was performed by self-adhesive electrodes placed over the skin of the projection of the first and third lumbar interspinous space (anode) and over the abdominal skin of the umbilicus (cathode). Latency and amplitude values of the ARM response were recorded from both sides (non-operated and operated) and from five muscles as follows: rectus femoris (RF), vastus lateralis (VL), biceps femoris long-head (BF), Tibialis Anterior (TA) and gastrocnemius. The most recorded ARM response in a muscle was the TA (n = 38); the least recorded AMR response in a muscle was the BF (n = 33). The mean stimulus intensities for the non-operated and the operated sides were 462.5 ± 112.8 V and 520.0 ± 172.3 V (p = 0.834), respectively. The mean latencies and amplitude values of the ARM response from muscles were as follows: 8.8 ± 1.4 ms; 98.8 ± 114.5 µV for RF; 9.8 ± 2.1 ms; 119.1 ± 122.23 µV for VL; 9.5 ± 1.6 ms; 39.6 ± 30.3 µV for BF; 15.1 ± 1.9 ms; 146.6 ± 150.9 µV for TA; 15.6 ± 2.4 ms; 81.0 ± 99.9 µV for Gastrocnemius. The present study demonstrates that the ARM response could easily and safely be obtained during THA under spinal anesthesia. This non-invasive technique may have a potential to detect early neurological deficit in patients who need complex hip surgery under spinal anesthesia.
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Affiliation(s)
- Pınar Yalınay Dikmen
- Neurology Department, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Ic Erenkoy Mah. Kerem Aydınlar Kampusu, Kayısdag Cad., Atasehir, 34752, Istanbul, Turkey.
- Department of Neurology, Maslak Acıbadem Hospital, Büyükdere Caddesi. No: 40, 34390, Istanbul, Turkey.
| | - V Emre Ozden
- Orthopedic and Traumatology Department, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Ic Erenkoy Mah. Kerem Aydınlar Kampusu. Kayısdag Cad. Atasehir, 34752, Istanbul, Turkey
| | - Goksel Dikmen
- Orthopedic and Traumatology Department, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Ic Erenkoy Mah. Kerem Aydınlar Kampusu. Kayısdag Cad. Atasehir, 34752, Istanbul, Turkey
| | - Elif Ilgaz Aydınlar
- Neurology Department, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Ic Erenkoy Mah. Kerem Aydınlar Kampusu, Kayısdag Cad., Atasehir, 34752, Istanbul, Turkey
| | - I Remzi Tozun
- Orthopedic and Traumatology Department, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Ic Erenkoy Mah. Kerem Aydınlar Kampusu. Kayısdag Cad. Atasehir, 34752, Istanbul, Turkey
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Abstract
OBJECTIVES The aim of this study was to evaluate the pain level of each muscle during an EMG study and also search for any association between the pain levels and gender. METHODS Two hundred and twenty-seven subjects (166 females and 111 males) participated in the present study. Numeric analogue scale (NAS) was obtained from the patients after needle EMG for each muscle. RESULTS In total, 1242 muscles were examined. The highest pain levels among examined muscles were found on Abductor Pollicis Brevis (APB) (5.8 ± 2.6), First Dorsal Interosseous (4.2 ± 2.6) and Vastus Lateralis (4.0 ± 2.6). NAS levels of the female patients (4.3 ± 2.7) were apparently higher than those of the male patients (2.8 ± 2.3) (p<0.01). CONCLUSION First Dorsal Interosseous muscle was found less painful than APB muscle for the patients. Our study displayed greater pain sensitivity among females compared with males during the needle EMG; however, the pain levels of examined muscles were not higher than moderate for both genders.
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Affiliation(s)
- Pınar Yalınay Dikmen
- Department of Neurology, Acıbadem University School of Medicine, İstanbul, Turkey.
| | - Elif Ilgaz Aydınlar
- Department of Neurology, Acıbadem University School of Medicine, İstanbul, Turkey
| | - Geysu Karlıkaya
- Department of Neurology, Acıbadem University School of Medicine, İstanbul, Turkey
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Yalınay Dikmen P. The Acute Treatment of Migraine Attack in Adults and American Headache Society Evidence Assessment of Migraine Pharmacotherapies. tnd 2016. [DOI: 10.4274/tnd.93753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Ilgaz Aydınlar E, Yalınay Dikmen P, Sılav G, Berkman MZ, Elmacı İ, Özgen S. İntraoperatif Nöromonitörleme ile Spinal Tümör Cerrahisinde Yeni Defisit Gelişiminin Önlenmesi. tnd 2014. [DOI: 10.4274/tnd.93798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Eraslan D, Yalınay Dikmen P, Ilgaz Aydınlar E, Incesu C. The relation of sexual function to migraine-related disability, depression and anxiety in patients with migraine. J Headache Pain 2014; 15:32. [PMID: 24884652 PMCID: PMC4046390 DOI: 10.1186/1129-2377-15-32] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/14/2014] [Indexed: 11/18/2022] Open
Abstract
Background Depression and anxiety are two phenomena that affect quality of life as well as sexual function. Depression and anxiety levels are reported to be high in migraine sufferers. We aimed to understand whether sexual function in women with migraine was associated to migraine-related disability and frequency of migraine attacks, and whether this relationship was modulated by depressive and anxiety symptoms. Methods As migraine is more commonly seen in females, a total of 50 women with migraine were included. The diagnosis of migraine with or without aura was confirmed by two specialists in Neurology, according to the second edition of International Headache Society (IHS) International Classification of Headache Disorders (ICHD-II) in 2004. Migraine disability assessment scale score, female sexual function index scores, Beck depression inventory score and Beck anxiety inventory scores. Results Mean MIDAS score was 19.3 ± 12.8, and mean number of migraine attacks per month were 4.3 ± 2.7. Mean Female Sexual Function Index score was 20.9 ± 5.9 and 90% of patients had sexual dysfunction. Sexual dysfunction was not related to MIDAS score or frequency and severity of attacks. No relationship between sexual function and anxiety was found, whereas severity of depressive symptoms was closely related to sexual function. Depressive symptoms affected all dimensions of sexual function, except for pain. Conclusion Sexual dysfunction seemed to be very common in our patients with migraine, while not related to migraine related disability, frequency of attacks and migraine severity or anxiety. The most important factor that predicted sexual function was depression, which was also independent of disease severity and migraine related disability. While future larger scale studies are needed to clarify the exact relationship, depressive and sexual problems should be properly addressed in all patients with migraine, regardless of disease severity or disability.
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Affiliation(s)
| | - Pınar Yalınay Dikmen
- Department of Neurology, Acıbadem University School of Medicine, Acıbadem Maslak Hospital, Büyükdere Caddesi, No:40, Maslak/Sarıyer, 34457 Istanbul, Turkey.
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