Headache is among the most frequently encountered symptoms in clinical practice. Occipital neuralgia is characterized by sudden, sharp, electric shock-like pains in the distribution area of the occipital nerve. In this report, we present a 54-year-old female patient who developed occipital neuralgia-like symptoms shortly after the initiation of metformin treatment for type 2 diabetes mellitus. The symptoms resolved following the discontinuation of the drug. This case is discussed in light of the literature to highlight a potentially rare headache pattern triggered by metformin. This case describes an unusual form of headache possibly associated with metformin therapy. It underscores the importance of considering uncommon side effects of commonly prescribed medications, such as metformin in differential diagnoses.

In young patients presenting with acute neurological symptoms, distinguishing between psychogenic and organic causes is crucial. Patent foramen ovale (PFO) is a significant factor that can lead to cardioembolic stroke in young individuals. This case report presents a patient who was initially misdiagnosed with a psychogenic disorder but was later found to have suffered a cardioembolic stroke. A 17-year-old female presented with speech disturbances (stuttering, difficulty in articulation) and became emotional during history taking. Her past medical history revealed recurrent similar episodes. Neurological examination was normal; thus, a psychogenic etiology was suspected, and she was discharged after benzodiazepine infusion. However, she returned in the evening with right-sided numbness in her arm and leg, was again diagnosed with a psychogenic disorder, and received another benzodiazepine infusion. Later that night, she fell while attempting to use the restroom and was brought to the emergency department with speech impairment and right-sided weakness. This time, a neurological evaluation revealed left central facial paralysis, right hemiparesis, dysarthria, and cerebellar dysfunction. Brain MRI showed bilateral lacunar ischemic infarcts. A cardiology evaluation suspected PFO, which was confirmed via transesophageal echocardiography. The patient was diagnosed with acute ischemic stroke, started on fractionated heparin therapy, and underwent PFO closure five days later. Although psychogenic disorders are common in young patients, organic causes must be ruled out in cases of acute neurological deficits. PFO is a leading cause of cryptogenic strokes in young adults, often presenting with recurrent transient ischemic attacks (TIAs). Overlooking a cardioembolic etiology can lead to diagnostic and treatment delays, potentially worsening outcomes. Unexplained neurological symptoms in young patients should be thoroughly investigated before attributing them to psychogenic causes. Cardioembolic conditions such as PFO can be successfully managed with early diagnosis and appropriate intervention.

Background and Objectives: Migraine is a chronic, throbbing type of headache that affects large populations worldwide. This condition is associated with neuroinflammation. Materials and Methods: In this study, polymorphism analyses were performed by KASP PCR. Serum interleukin-6 (IL-6) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels were measured using kits based on the enzyme-linked immunosorbent assay (ELISA) principle. Results: In the APE1 Asp148Glu (rs1130409) gene polymorphism analysis, the frequency of the mutant G (Glu) allele was 93.1% and 48.0% in the control and migraine populations, respectively, while the frequency of the wild-type T (Asp) allele was 6.9% and 52.0% (p < 0.001). The frequency of the T/T (Asp/Asp) genotype was high in the migraine group (p < 0.001), while the frequency of the G/G (Glu/Glu) genotype was higher in the control group at 86.2%, compared to the migraine group (p < 0.001). The total frequency of the T/G+ G/G (Asp/Glu+Glu/Glu) composite genotype was determined to be 65.9% in the control group and 34.1% in the migraine group (p < 0.001). There was no statistical difference in allele and genotype frequency between the control and migraine groups for the XRCC1 Arg399Gln (rs25487) gene polymorphism. Serum 8-OHdG and IL-6 levels were comparable between the groups, with no statistically significant differences observed. Conclusions: Future studies with larger and more homogeneous populations are needed to further elucidate the potential interactions between inflammatory processes and DNA damage in migraine. Consideration of attack duration and environmental exposures may improve interpretation of biomarker variability. Expanding the analysis to additional DNA repair gene polymorphisms may also contribute to a better understanding of the molecular background of migraine and the evaluation of potential biomarkers.

Background: Legal capacity assessment requires multidisciplinary evaluation integrating cognitive, functional, neurological, psychiatric, and medico-legal information. Although large language models (LLMs) have shown promise in structured clinical reasoning, their role in supporting legal capacity assessment remains unclear. This study evaluated the performance of LLMs as AI-assisted decision-support tools using standardized medico-legal case vignettes, with interdisciplinary medical board (IMBD) recommendations under the Turkish Civil Code (TCC) as the expert medical reference standard; IMBD recommendations constitute an expert medical reference standard rather than final judicial determinations. Methods: We retrospectively analyzed 234 court-referred adult cases (2018–2024). Standardized, anonymized medico-legal case vignettes were independently evaluated by ChatGPT-5.2, Gemini 3 Pro, and Claude 4.5 Sonnet. Model outputs were compared with IMBD recommendations. The models were evaluated as AI-assisted decision-support tools and did not replace or influence clinical or judicial decision-making. Performance was assessed using accuracy, macro-F1, Cohen’s κ, AUC, calibration, decision-curve analysis, test–retest reliability, and human-factor outcomes; probability-based metrics were derived from secondary logistic models fitted to the categorical model outputs. Results: Article 405 was the most frequent outcome (65.8%). Dementia increased the likelihood of Article 405 recommendations (OR 6.5, 95% CI 1.2–35.2; p = 0.029), whereas higher Activities of Daily Living scores were protective (OR 0.96; p = 0.004). Gemini 3 Pro achieved the highest accuracy (86.3%), while ChatGPT-5.2 achieved the highest macro-F1 score (0.79) and AUC (0.91). Agreement with IMBD recommendations ranged from κ = 0.60 to 0.73, with high temporal stability (κ = 0.87–0.95); pairwise differences between the three models were not statistically significant after Holm correction. Performance was highest for cases in which Article 405 was recommended and for cases in which no guardianship was recommended, but remained limited for Article 408 (29.6% accuracy). The mean System Usability Scale score was 72.4, and safety flags were identified in 4 of 234 cases (1.7% of cases, corresponding to 4 of 702 individual model outputs). Conclusions: LLMs demonstrated agreement with IMBD recommendations on standardized medico-legal case vignettes, supporting further investigation of their potential role as AI-assisted decision-support tools under expert supervision. Because errors in this domain can directly affect fundamental rights, the use of AI in the legal system and in sensitive medical fields carries substantial risks and must remain strictly limited to expert-supervised decision support. Further prospective studies are needed to evaluate their safe integration into medico-legal practice.

Fahr's disease is defined as idiopathic basal ganglia calcification. Calcinosis develops in the basal ganglia and cerebral cortex due to impaired calcium and phosphorus metabolism. Calcium deposition or mineralization usually develops in vascular and perivascular areas. It results in vascular obliteration, perivascular neuronal degeneration, and gliosis in the brain. Intracranial calcifications are symmetrical and occur primarily in the basal ganglia, dentate nucleus, thalamus, and centrum semiovale. If intracranial calcifications develop due to a known cause, it is called Fahr syndrome. It is an inherited or sporadic neurological disorder and is thought to be rare. It is more common in males than females and occurs mainly in the fourth decade of life. The disease may present with clinical signs such as slurred speech, gait instability, involuntary movements, or muscle cramps. It may be accompanied by neuropsychiatric symptoms such as psychosis and personality changes. Because of the symptoms, it may be confused with other neurological diseases and misdiagnosed. This retrospective study was planned to evaluate the frequency of patients in our region and their clinical findings.