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Background Epilepsy may affect cardiac function early due to seizure and pathophysiology-related autonomic changes. Strain echocardiography is a valuable method that reveals myocardial deformity with high sensitivity in these patients. This study aims to identify subclinical cardiac involvement in the epilepsy population using this method and to examine the contribution of the obtained data to cardiac risk assessment. Methods In this cross-sectional observational study, 49 epilepsy patients who underwent electroencephalography (EEG) examination, and 57 age and sex-matched healthy controls were examined. Standard transthoracic echocardiography (TTE) measurements, including tissue doppler indices, left and right ventricular global longitudinal strain (LVGLS, RVGLS), left atrial strain (LAS), and electrocardiography (ECG) parameters were compared between groups. Results Conventional systolic indices were partially preserved; however, patients with epilepsy exhibited significantly reduced LVGLS, RVGLS, and LAS values compared with controls (p < 0.05). Some diastolic functions such as isovolumetric relaxation and contraction time and medial e′ velocities were significantly affected (p < 0.05). ECG abnormalities, particularly conduction and repolarization disturbances, were more frequent in the epilepsy group. Notably, left ventricular ejection fraction (within normal range in both group) was significantly lower in epilepsy group, suggesting early systolic vulnerability. Conclusion Despite preserved some conventional echocardiographic findings, patients with epilepsy demonstrate significant subclinical myocardial deformation abnormalities detectable by strain imaging. Incorporation of speckle-tracking echocardiography into routine cardiovascular evaluation may facilitate early identification of myocardial involvement and improve cardiovascular risk stratification in this population.

Multipl skleroz (MS), inflamasyon, demiyelinizasyon ve nörodejenerasyon ile seyreden kronik otoimmün bir santral sinir sistemi hastalığıdır. Hastalık modifiye edici tedavilere rağmen bazı hastalarda yüksek hastalık aktivitesi ve progresyon devam edebilmektedir. Bu durumlarda immünsupresif tedaviler, bağışıklık aracılı patolojik süreçleri baskılayarak hastalık kontrolünde önemli bir seçenek sunar. Bu bölümde MS’nin patofizyolojisi, klinik alt tipleri ve hastalık progresyon mekanizmaları özetlenmiş; siklofosfamid, metotreksat, azatiopürin, mitoksantron ve seçici immünsupresif ajanlar başta olmak üzere immünsupresif tedavilerin etki mekanizmaları, klinik etkinlikleri ve güvenlilik profilleri güncel literatür ışığında ele alınmıştır. İmmünsupresif tedavilerin uygun hasta seçimiyle, özellikle agresif ve progresif MS formlarında anlamlı klinik fayda sağlayabileceği vurgulanmıştır.

Objective: Demyelinating optic neuritis (ON) and non-arteritic anterior ischemic optic neuropathy (NAION) represent distinct clinical entities with different pathophysiological mechanisms, yet both are believed to involve systemic inflammatory responses. This study aimed to compare systemic inflammatory indices derived from complete blood count (CBC), including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV), in patients with ON and NAION. Material and Methods: Inflammatory indices (SII, SIRI, PIV, NLR, PLR, and MLR) were calculated using CBC parameters obtained before corticosteroid treatment. A total of 18 patients with demyelinating ON and 25 with NAION were included, along with age- and sex-matched healthy control groups (16 for ON, 11 for NAION). ROC analyses were performed for SII and PIV in the NAION group to assess diagnostic performance. Results: SII (p = 0.015), PIV (p = 0.004), and SIRI (p = 0.001) were significantly elevated in the NAION group compared to controls. ROC analyses demonstrated AUC values of 70.1% for SII and 73.8% for PIV, indicating moderate diagnostic utility in distinguishing NAION. No significant differences in these indices were observed between the ON group and their respective controls. In the direct comparison between disease groups, patients with NAION exhibited higher SIRI and monocyte levels than those with ON. Conclusions: Composite inflammatory indices derived from CBC, particularly SII, SIRI, and PIV, were significantly elevated in patients with NAION. These findings support the role of systemic inflammation in NAION pathophysiology and highlight the potential diagnostic and prognostic value of these indices. Further prospective studies with larger cohorts are warranted to validate their clinical relevance.

Objective: Decreased level of serum albumin is shown to be associated with an increased risk of mortality after stroke. However, the significance of the albumin/globulin ratio (AGR) as a paraclinical marker in determination of the prognosis of stroke is unclear. In this study, we aimed to examine the potential utility of AGR in determination of the need of intensive care unit monitorization and prognosis of patients with acute stroke. Material and Methods: Sequential samples of all the patients with acute ischemic stroke (AIS) who were hospitalized between 2018 and 2022 in the mentioned centers were analyzed in this research. The data regarding the demographic features, stroke subtypes, and laboratory findings including hemogram, and biochemistry were recorded. AGR, serum osmolality, and colloid osmotic pressure (COP) were also measured. The survival curves of the patients were constructed using the Kaplan-Meier methods and log-rank tests. Estimates of survival changes were made by applying the Cox regression analysis. Results: Ultimately, the data of 328 patients were analyzed. Thirty nine (30.2%) had passed away before discharge. There were significant differences between the deceased patients and patients surviving in terms of stroke classification, serum albumin, AGR, CRP, COP, and white blood cell count (p < 0.05). Serum AGR of 94 patients who were intensive care unit patients showed a statistical difference compared to albumin (p < 0.05). The Cox’s regression analyses showed that low AGR moderately predicted the mortality of patients. Conclusion: We found that the AGR provided important data regarding the necessity of critical care monitorization and prognosis of patients with AIS. Our findings support the potential utility of AGR as a simple, and useful paralinical laboratory marker in patients with AIS.

Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited. To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG. Multicenter, retrospective, observational study. Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz Mayıs University's Faculty of Medicine were included in the study. Of the 104 patients with anti-MOG-IgG, 56.7% were women and 43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients. For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.