Evaluation of video head impulse test during vertiginous attack in vestibular migraine.

Objective: The aim of this study is to evaluate vestibular functions with video head impulse test (VHIT) and to understand the value of VHIT in differential diagnosis in patients with vestibular migraine (VM) during dizziness attack. Materials and methods: Two groups were enrolled in this study. The first consisted of 84 vestibular migraine patients, and second group of 74 healthy subjects. VHIT was applied to patients with VM during vertigo attack and the results were compared with the VHIT values applied to subjects in the control group. Results: The mean vestibulo-ocular reflex (VOR) in all semicircular canals in the VM group was lower than healthy individuals, but the results were not statistically significant. Refixation saccades were found in 52.3% of VM patients and in 10.2% of healthy individuals. Conclusions: When patients with VM were evaluated with VHIT during vertiginous attack, VOR gain values were not different from healthy individuals, but the number of catch-up saccades were higher in VM patients, which indicates peripheral vestibular involvement. For differential diagnosis in patients with VM, vestibular tests should be performed during the vertigo attack. When evaluating VHIT results, the presence of refixation saccades should also be evaluated.

Management of Pregnancy-and Lactation-Related Osteoporosis: Case Series.

AIM: To share the experience regarding management and follow-up of patients with Pregnancy- and lactation-related osteoporosis (PLRO) who were effectively treated. MATERIAL AND METHODS: This case series presented 10 patients diagnosed with PLRO and treated from January 2010 to December 2019. Visual analog scale and laboratory findings were evaluated. Spinal and extremity magnetic resonance imaging was obtained for patients with spinal and extremity pains. Dual energy X-ray absorptiometry was used for the measurement of bone mineral density. Values assessed on dual energy X-ray absorptiometry were L1?L4 T score, L2?L4 T score, and femoral neck T score. RESULTS: In the first-month follow-ups, all patients had meaningful pain relief and symptom resolution. The mean duration of pain control during the treatment period was 2.4 months. Two patients who continued breast-feeding were also the patients whose pain control was achieved at the latest. One patient required vertebroplasty. CONCLUSION: Patients with PLRO should be promptly treated and followed up. Discontinuation of breast-feeding will provide rapid advantage and should be the first step of the management. Early diagnosis and treatment of calcium and vitamin D with conservative procedures with spinal braces are very important for the treatment of PLRO patients. Additionally, bisphosphonates or teriparatide can improve the bone mineral density in patients with PLRO.

Frequency of left atrial dilatation in ischemic stroke.

OBJECTIVE: The study aimed to evaluate the frequency of left atrial dilatation in cases of first-ever acute ischemic stroke with or without atrial fibrillation in a cohort of patients hospitalized for ischemic stroke. METHODS: Files of 120 patients admitted to our hospital with the diagnosis of acute ischemic stroke were investigated. All patients had at least one brain imaging. Etiology of stroke was categorized according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Transthoracic and/or transoesophageal echocardiography was used to measure left atrium size. Optimal cut-off value of left atrial diameter was determined as 4 cm. SPSS 11.5 was used for statistical analyses. RESULTS: In 40% of the patients, left atrial dilatation was detected. Nineteen patients with left atrial dilatation had atrial fibrillation, which was statistically significant (p<0.05). Ninety-four (30.8%) patients with no atrial fibrillation had left atrial dilatation. In the TOAST classification trial, as a statistically significant finding, left atrial dilatation was detected 68.9% of the patients with cardioembolic infarcts. The most frequently encountered risk factor in patients was hypertension. CONCLUSION: Left atrial dilatation is an important marker for cerebrovascular diseases, and if accompanied by atrial fibrillation becomes even more significant.