Researcher:
Vanlı-Yavuz, Ebru Nur

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Doctor

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Ebru Nur

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Vanlı-Yavuz

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Vanlı-Yavuz, Ebru Nur

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2015 - 202030

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Now showing 1 - 10 of 30
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    Comparison of the effect of transcranial direct current stimulation between focal and generalized epilepsy syndromes
    (Wiley-Blackwell, 2015) Tekturk, P.; Erdogan, E. Tuna; Kurt, A.; Kocagoncu, E.; Aksu, S.; Kucuk, Z.; Yapici, Z.; Baykan, B.; Karamursel, S.; Vanlı-Yavuz, Ebru Nur; Doctor; School of Medicine; 251177
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    Reflex epileptic features in patients with focal epilepsy of unknown cause
    (Elsevier, 2020) Atalar, Arife Çimen; Yılmaz, Ebru; Bebek, Nerses; Baykan, Betül; Vanlı-Yavuz, Ebru Nur; Doctor; School of Medicine; Koç University Hospital; 251177
    Objectives: There is a gap of knowledge regarding reflex seizures in patients with focal epilepsy of unknown cause (FEUC). We aimed to evaluate the prevalence, demographic and clinical characteristics of reflex seizures in patients with FEUC to provide an insight to the underlying ictogenic mechanisms and to draw attention to this important but under-investigated topic. Patients and Methods: After carefully questioning for reflex triggers, 186 patients diagnosed according to ILAE criteria and followed-up for a minimum of 5 years were included. The demographic and clinical properties as well as electrophysiological and neuroimaging data of these patients were reevaluated and compared to the patients without reflex seizures. Results: The reflex seizure rate was 6.5 % in patients with FEUC. Patients with reflex features had lower monotherapy rates (p = 0.005) and higher major depression rates (p = 0.001) than patients without reflex features. The distribution of the patients according to their reflex triggers were as follows: hot-water induced (n = 3, 25 %), photosensitive (n = 2, 16.7 %), eating- induced (n = 2, 16.7 %), musicogenic (n = 2, 16.7 %), startle induced (n = 2, 16.7 %) and both musicogenic and startle type (n = 1, 8.3 %) respectively. The drug resistance rate of patients with reflex seizures was 25 % (n = 3). One patient with drug resistant reflex seizures showed benefit from epilepsy surgery and became seizure-free during last 3 years of follow-up. Conclusion: A careful and thoroughly history taking specifically questioning and focusing on seizure inducing factors in patients with FEUC is needed to confirm the presence of reflex seizures in patients with FEUC, who had higher rates of polytherapy and major depression. Elaborative evaluation of reflex features in FEUC might contribute to effective seizure control, ensure new therapeutic approaches, enlighten the obscurity and the resulting anxiety of having a diagnosis of FEUC in epilepsy patients.
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    Peripheral blood expression levels of inflammasome complex components in two different focal epilepsy syndromes
    (Elsevier, 2020) Ulusoy, Canan; Şanlı, Elif; Timirci-Kahraman, Özlem; Yiımaz, Vuslat; Bebek, Nerses; Küçükali, Cem İsmail; Baykan, Betül; Tüzün, Erdem; Vanlı-Yavuz, Ebru Nur; Doctor; School of Medicine; 251177
    Background: Although the role of inflammation in epilepsy pathogenesis has been extensively investigated, the inflammasome complex, a key component of neuroinflammation, has been understudied in epilepsy patients. Methods: To better understand the involvement of this system in epilepsy, levels of inflammasome complex components (NLRP1, NLRP3, CASP1, ASC), end-products of inflammasome complex activity [IL-1 beta, IL-18, nitric oxide synthase (NOS) isoforms] and other inflammatory factors (NF kappa B, IL-6, TNF-alpha) were measured in peripheral blood of patients with focal epilepsy of unknown cause (FEoUC) (n = 47), mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) (n = 35) and healthy controls using real time qPCR and/or ELISA. Results: Inflammasome complex associated factors were either downregulated or unchanged in epilepsy patients. Likewise, flow cytometry studies failed to show an increase in ratios of NLRP3-expressing CD3+ and CD14+ peripheral blood mononuclear cells (PBMC) in epileptic patients. Anti-neuronal antibody positive epilepsy patients showed increased NLRP1 and neuronal NOS mRNA expression levels, whereas patients under poly-therapy showed reduced serum inflammasome levels. FEoUC patients demonstrated increased PBMC NF kappa B mRNA expression levels and serum IL-1 beta and IL-6 levels. Both MTLE-HS and FEoUC patients displayed higher ratios of NF.B-expressing CD14+ PBMC than healthy controls. Conclusions: Although previous clinical studies have implicated increased inflammasome complex expression levels in epilepsy, our results indicate suppressed inflammasome complex activity in the peripheral blood of focal epilepsy patients. Alternatively, the IL-6-NF kappa B signaling pathway, appears to be activated in focal epilepsy, suggesting that factors of this pathway might be targeted for future theranostic applications.
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    Investigation of generalized EEG paroxysms accompanying focal epilepsies
    (Sage Publications Inc, 2019) Atalar, Arife Çimen; Yılmaz, Ebru; Bebek, Nerses; Baykan, Betül; Vanlı-Yavuz, Ebru Nur; Doctor; School of Medicine; Koç University Hospital; 251177
    Interictal focal EEG features were frequently observed in generalized, epilepsies, but there is limited information about interictal, epileptiform/nonepileptiform generalized paroxysms in focal epilepsies. We aimed to report the frequency and associated factors of generalized EEG discharges in focal epilepsy with unknown cause (FEUC) and mesial, temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). A total of 200 patients (FEUC in 90 patients; MTLE-HS in 110 patients) were included. Generalized epileptiform (spike/sharp waves simultaneously in all regions) and nonspecific generalized discharges (paroxysmal slow waves) were investigated. All clinical and laboratory findings of 2 groups were compared with each other and with remaining control group, without generalized paroxysms, statistically. Generalized EEG features were present in 22 (11%; 4 males) patients; 9 in the FEUC group (10%; 2) and 13 in the MTLE-HS group (11.8%). Female gender (P < .021), febrile seizure (P < .034), precipitant factors (P < .025), and parental consanguinity (P < .033) were significantly higher in the group with generalized EEG findings. Monotherapy rates were lower in the MTLE-HS group (P < .05). The relationship of generalized EEG features with female gender and parental consanguinity may point out to a genetic property among focal epilepsies, while the relationship with febrile seizures and precipitant factors may be a clue about mechanisms with more extensive involvement of the neuronal networks.
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    Stroke
    (Academic Press Inc Elsevier Science, 2017) N/A; N/A; Çakmak, Özgür Öztop; Vanlı-Yavuz, Ebru Nur; Özdemir, Yasemin Gürsoy; Faculty Member; Doctor; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; School of Medicine; School of Medicine; N/A; Koç University Hospital; N/A; 299358; 251177; 170592
    Stroke is a devastating neurological disease with a few therapeutic approaches. Despite the acute and prophylactic treatment options, novel effective treatments are required. The main limitation for effective treatment strategies to be developed is the presence of the blood–brain barrier. Targeted nanoparticulate treatment options may help to overcome this issue. This chapter deals with novel studies performed for targeted drug delivery technologies for stroke.
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    Follow-up of patients with epilepsy harboring antiglycine receptor antibodies
    (Elsevier, 2019) Ekizoğlu, Esme; Baykan, Betül; Sezgin, Mine; Erdağ, Ece; Gündoğdu-Ünverengil, Gökçen; Tektürk, Pınar; Yılmaz, Ebru; Bebek, Nerses; Tüzün, Erdem; Vanlı-Yavuz, Ebru Nur; Doctor; School of Medicine; 251177
    Objective: The long-term follow-up of patients with epilepsy harboring autoantibodies against the glycine receptor (also glycine receptor antibodies or GlyR-Ab) is not well-known. Our aim was to investigate the 5-year prognosis and treatment response of patients with epilepsy who were seropositive for GlyR-Ab. Methods: Clinical features; electroencephalogram (EEG), neuroradiological, and neuropathological findings; and treatment responses of patients with epilepsy with GlyR-Ab seropositivity were investigated. Results: Thirteen (5.46%) of 238 patients with epilepsy were GlyR-Ab positive: focal epilepsy of unknown cause (FEoUC) was diagnosed in four (7.27%) out of 55 patients, mesial temporal lobe epilepsy with hippocampal sderosis (MTLE-HS) in five (4.5%) out of 111 patients, epileptic encephalopathy (EE) in two (4%) out of 50 patients, and status epilepticus (SE) in two (9.09%) out of 22 patients. None of the patients developed any other neurological symptoms or cancer during the 5-year follow-up. Seven of them had seizures that were resistant to antiepileptic drug (AED). Immunotherapy was used in two patients (with FEoUC and EE) improving seizure control. Three patients with MTLE-HS benefited from epilepsy surgery, and another patient with EE showed spontaneous remission. Conclusion: Glycine receptor antibodies are detected in a wide spectrum of epileptic disorders with undear pathogenic significance. Two GlyR-Ab seroposilive patients with AED-resistant epilepsy treated with intravenous immunoglobulin (Mg) showed dear benefit from immunotherapy. Future studies will be valuable in determining the role of screening patients with drug-resistant epilepsy for GlyR-Ab in order to identify patients who may benefit or respond to immunotherapy.
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    Investigation of the video-EEG findings and clinical data in patients diagnosed with epilepsy and psychosis
    (Lippincott Williams & Wilkins, 2018) Mehdikhanova, Lala; Çıkrıkçılı, Uğur; Kulaksızoğlu, Işın Baral; Bebek, Nerses; Gürses, Candan; Gökyiğit, Ayşen; Baykan, Betül; Vanlı-Yavuz, Ebru Nur; Doctor; School of Medicine; 251177
    Background: Studies on electrophysiological characteristics of patients with epilepsy and concomitant psychosis are limited. We aimed to investigate the clinical and video-electroencephalography (EEG) findings of patients with epilepsy-related psychosis (EP). Materials and Methods: Fifteen patients diagnosed with EP, assessed at the video-EEG monitoring unit and were under follow-up at both epilepsy and psychiatry clinics, were included. A total of 67 nonpsychotic epilepsy patients, investigated at the video-EEG monitoring unit were randomly selected as the control group and compared statistically with the EP group. Results: In medical history, patients with EP had experienced significantly higher level of status epilepticus (P=0.002) and perinatal cerebral injury (P=0.04), whereas drug-resistant epilepsy was detected at a lower level (P=0.015). With respect to seizure onset zone, the EP group had significantly more seizures of unknown foci, whereas the control group had mostly temporal lobe origin (P=0.0004). EEG findings showed that slow background activity was significantly common among patients with EP (P=0.009). Although only 5 of 15 patients with EP had been operated, 43 of 67 patients had undergone epilepsy surgery (P=0.04) in the control group. However, there was no significant difference between the 2 groups with respect to postoperative seizure control as per Engel classification. Conclusions: Although our sample size could be considered small, slowed EEG background activity, and the marked frequency of initial precipitant factors such as status epilepticus, perinatal cerebral injury, and detected neuronal autoantibodies suggested that EP is associated with more extensive involvement. EP is not a contraindication for epilepsy surgery, when appropriately investigated preoperatively.
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    Neuronal auto- antibodies in mesial temporal lobe epilepsy with hippocampal sclerosis: epiphenomenon or marker for an autoimmune subtype?
    (Wiley, 2016) Tuzun, E.; Ekizoglu, E.; Erdag, E.; Baysal-Kirac, L.; Ulusoy, C.; Peach, S.; Gundogdu, G.; Sencer, S.; Sencer, A.; Kucukali, C., I; Bebek, N.; Gurses, C.; Gokyigit, A.; Vincent, A.; Baykan, B.; Vanlı-Yavuz, Ebru Nur; Doctor; School of Medicine; 251177
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    Long-term follow-up of a large cohort with focal epilepsy of unknown cause: deciphering their clinical and prognostic characteristics
    (Springer Heidelberg, 2020) Atalar, Arife Çimen; Yılmaz, Ebru; Bebek, Nerses; Baykan, Betül; Vanlı-Yavuz, Ebru Nur; Doctor; School of Medicine; Koç University Hospital; 251177
    Background and Purpose: Focal epilepsy of unknown cause (FEUC) is an under-investigated topic despite its remarkable frequency. We aimed to report the long-term follow-up findings along with the drug-response, 5 year remission rates and diagnostic changes to give an insight about the heterogeneous characteristics of FEUC. Methods: Demographic, clinical, neurophysiological and imaging data of 196 patients diagnosed as FEUC according to ILAE criteria, with a minimum 5-year follow-up were evaluated in a tertiary epilepsy center. The drug resistance, 5 years of remission and relapse rates were investigated and the subgroups were compared statistically. Results: The rate of drug resistance was 21.8% and status epilepticus (p < 0.001), abnormal neurological examination (p = 0.020), seizure onset before 10 years (p = 0.004) and a high initial seizure frequency (p = 0.006) were significant predictors of drug resistance. The rates of terminal 5-year remission, 5-year remission ever and relapse were 39.9%, 44.26% and 24.04%, respectively. There were 13 patients (6.6%) with a changed final diagnosis. Drug resistance (p = 0.004), pathological EEG (p = 0.034) and status epilepticus (p = 0.021) were negative variables for achieving remission. The lobar localization of seizures was not a predictor of remission or relapse. Onset after 10 years of age had a higher probability of achieving a 5-year remission according to Kaplan-Meier curves (p < 0.001). Conclusions: Focal epilepsy of unknown cause has a benign electroclinical subgroup with favorable long-term course, lower drug resistance and higher 5 years of terminal remission and remission ever rates, when appropriately treated. Our findings might be valuable in terms of counseling and management of patients with FEUC at the first referral to epilepsy clinics.
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    The predictors of drug-resistance in patients with mri-negative focal epilepsies of unknown cause
    (Wiley, 2018) Atalar, Arife Çimen; Bebek, Nerses; Baykan, Betül; Vanlı-Yavuz, Ebru Nur; Doctor; School of Medicine; Koç University Hospital; 251177
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