Although anti-CD20 treatments are effective in inflammatory neurological diseases, they have some risks, especially infections. Determining the predictor factors of infection helps risk management in patients receiving anti-CD20 treatments. The effect of ocrelizumab (OCR) and rituximab (RTX) associated hypogammaglobulinemia (HGG) and lymphopenia on infection risk is controversial. The aim of this study to evaluate relationship between HGG and lymphocytopenia and infection risk and infection-related mortality in patients under RTX and OCR treatments and also compare these parameters between two agents. In our findings no relationship was found between HGG and infection risk in patients receiving OCR and RTX. In the RTX group, a significant relationship was detected between lymphocytopenia and severe infection. And, all three patients with infection-related mortality under rituximab treatment had HGG. No infection-related mortality was happened in OCR treatment. While lymphocytopenia and HGG were not detected as significant risk factors for infection, older age, female gender and > 4 EDSS score were determined as risk factors for infection in patients receiving OCR treatment. Identifying factors predicting infection risk may provide better risk management in patients receiving anti-CD20 therapy.

Aim: Lesional epilepsy accounts for a substantial proportion of epilepsy cases, with treatment outcomes varying according to lesion type. Identifying predictors of drug resistance is essential to guide management and surgical planning. This study evaluated clinical, radiological, and electroencephalographic (EEG) predictors of treatment response in adults with lesional epilepsy. Materials and Methods: Medical records of patients ≥18 years with MRI (magnetic resonance imaging)-confirmed structural lesions and ≥1 year of antiepileptic drug (AED) therapy were retrospectively reviewed. Patients with psychogenic non-epileptic seizures, acute symptomatic seizures, non-adherence, or prior epilepsy surgery were excluded. Data included demographics, seizure type, AED regimen, MRI lesion features, and interictal EEG findings. Drug resistance was defined as failure of two appropriately chosen, well-tolerated AED regimens. Results: Ninety-six patients (41 males, 45 females; mean age 42 years) were included. Encephalomalacia was the most frequent lesion (43%), followed by tumors (26%), malformations of cortical development (MCD) (8%), cystic lesions (6%), vascular malformations (6%), and mesial temporal sclerosis (5%). Drug resistance occurred in 26% of cases, with MCD showing the highest rate (62%, p = 0.026). Gender, age at onset, generalized motor seizures, EEG abnormalities, and lesion laterality were not significantly associated with drug resistance. Conclusion: MCD is strongly associated with AED resistance in adults with lesional epilepsy, while other lesion types tend to respond more favorably. Early recognition of high-risk patients may facilitate timely surgical evaluation and improve seizure control outcomes.

Minör cerrahi veya kısa süreli anestezi uygulamalarından sonra nadir de olsa perioperatif inme görülebilmektedir. İnme; bulanık görme, görme alanı bozuklukları, körlük gibi görsel sorunlara yol açabilmektedir. Bu yazıda, 3 yıl önce sedasyon ve spinal anestezi altında genital siğil koterizasyonu yapılan, perioperatif olarak posterior serebral arter infarktı ve buna bağlı olarak sağ homonim hemianopsi şeklinde ani görme alanı kaybı gelişen 30 yaşındaki erkek olgu sunulmuştur. Olgunun genital siğil koterizasyonu operasyonundan 3 gün sonra başvurduğu ilk göz hekimiyle ilgili olarak hekimin teşhis ve tedavi kaynaklı kusurunun olup olmadığı hususunda adli raporunun düzenlenmesi istenmiş olup; bu nadir olgu adli tıp açıdan tartışılmış ve rutin uygulamada görme alanı tetkikinin önemi vurgulanmıştır.

Introduction: The psychosocial effect of the pandemic on people with a disease such as multiple sclerosis (MS) that can cause disability and which medications that affect the immune system are used in treatment should be evaluated by physicians. We aimed to determine the psychosocial effects of the pandemic on MS patients and to evaluate the working and treatment continuation status, compliance with pandemic rules, and their perceptions regarding coronavirus disease 2019 (COVID-19).Methods: This study was designed as a cross-sectional and descriptive survey study. A total of 315 MS patients' demographic data, comorbidities, and degrees of disability, Beck Depression Inventory (BDI), Coronavirus Anxiety Scale (CAS), and compliance scores with pandemic restrictions were evaluated.Results: In the first period of the pandemic, approximately one-third of the patients were found to have major depression, and approximately 10% to have COVID anxiety. Both COVID anxiety and BDI scores were significantly higher in patients with symptoms suggestive of an attack during the pandemic process (p:0.0001 and p:0.002). CAS was higher in those who had a COVID-19 contact (p:0.045). BDI scores were significantly higher (respectively p:0.034, p:0.006, p:0.0001) in married/ cohabiting patients, in patients who went on unpaid leave or lost their job, and in patients who described worsening of their previous MS -related complaints.Conclusion: Although the pandemic negatively affects the psychosocial status of MS patients, this effect can be reduced by identifying the groups that may be affected via telemedicine and taking necessary interventions.

Amaç: Nörolojik acillerin başında gelen, önemli bir mortalite ve morbidite nedeni olan iskemik inmeden korunmada altta yatan vasküler risk faktörlerinin ve etiyolojik inme tipinin belirlenmesi önem taşımaktadır. Bu çalışmada aterosklerozun erken bulgusu olan karotis intima-media kalınlık artışının iskemik inmeli hastalarda vasküler risk faktörleri ile korelasyonu ve inme tipi ile ilişkisini araştırmak amaçlanmıştır. Gereç ve Yöntem: Çalışmaya iskemik inme nedenli takip edilmiş 40-90 yaş arası hastalar dahil edilmiş olup veriler hasta dosyalarından taranarak retrospektif olarak değerlendirilmiştir. Bulgular: Çalışmaya 161 kadın, 112 erkek olmak üzere toplam 273 iskemik inmeli hasta dahil edildi. Karotis intima-media kalınlık artışının vasküler risk faktörleri ile korelasyonuna bakıldığında diyabet varlığı ile anlamlı ilişki saptanırken diğer risk faktörleri ile istatistiksel olarak anlamlı bir ilişki saptanmadı (p:0,03). İnme tipleri ile ilişkisi değerlendirildiğinde büyük arter aterosklerozuna bağlı inmelerde karotis intima-media kalınlık artışının anlamlı olarak daha fazla olduğu gösterildi. Sonuç: Bu çalışmada karotis intima-media kalınlığının vasküler risk faktörleri ile birlikte değerlendirilmesinin inme etiyolojisini aydınlatmada ve dolayısıyla inmeden korunmada önemli katkısı olabileceği vurgulanmaktadır.

Background/Objectives: Autoimmune encephalitis (AIE) comprises a heterogeneous group of inflammatory central nervous system (CNS) disorders characterized by variable clinical presentations and antibody profiles. This study aimed to identify poor prognostic factors in AIE by retrospectively evaluating patients diagnosed based on clinical, radiological, and serological findings. Methods: Forty-four patients diagnosed with AIE between 2014 and 2024 were included. Demographic, clinical, radiological, and serological data were collected retrospectively. Patients were grouped based on antibody localization (intracellular, surface, and seronegative) and classified by treatment response. Poor prognosis was defined as a lack of objective clinical improvement to treatment or death. Results: The mean age was 57.8 ± 13.6 years, with a female-to-male ratio of approximately 1:1. Limbic encephalitis (LE) was the most common clinical presentation (43.2%). Malignancy was detected in 33.3% of patients, most frequently in those with SOX1 (83.3%), anti-Hu (60.0%), and anti-Yo (50.0%) antibodies. Anti-SOX1 positivity was significantly associated with both malignancy (OR = 27.5, p = 0.007) and mortality (OR = 13.2, p = 0.009), while anti-LGI1 positivity correlated with the absence of malignancy (p = 0.036). Patients with LE showed significantly better treatment responses (OR = 14.0, p = 0.019). Mortality was 20.1% overall and highest among anti-SOX1-positive patients (66.7%). The presence of multiple antibodies was associated with higher mortality and poorer prognosis, although not statistically significantly. Conclusions: Anti-SOX1 positivity is a key indicator of poor prognosis in AIE and is strongly associated with both malignancy and mortality. In contrast, LE presentation was linked to a better treatment response. Antibody profile, clinical features, and malignancy screening are critical for risk stratification and guiding management in AIE.