Objectives: This study aimed to present the implementation of the computer-based Turkish National Neurology Board Examination (TNNBE) process, which was digitalized by the Turkish Board of Neurology (TBN) using an open-source learning management system to improve accessibility, and the feedback from candidates. Materials and methods: Neurology academics submitted items to the exam pool. From this pool, TBN members selected 79 multiple-choice questions (MCQs) and 10 key feature problems (KFPs), each containing two to four items (totaling 30 questions), through 20 h of online meetings and discussions to ensure content validity. Standard setting was applied using the Nedelsky (MCQ) and Angoff (KFP) methods. Instructions and a sample exam were created and sent to candidates for piloting purposes. Sixty neurologists (35 females, 25 males; mean age: 30.6±1.48 years; range, 28 to 36 years) who fulfilled the eligibility criteria participated in the exam, which was conducted in December 2023 at one venue, under supervision, with online security measures such as individual passwords for login, question shuffling, and browser lockdown. The total exam time was 130 min, divided into MCQs followed by KFPs. Each question was worth 1 point, with a maximum of 100 points obtainable. The MCQ scores were calculated automatically by the learning management system, while KFP responses were downloaded and scored by two different board members, with a final consensus mark determined through discussion among all board members. The final score was the sum of MCQ and KFP scores. Candidates’ feedback was obtained via an online survey using a 9-point scale (1=strongly disagree/very bad; 9=strongly agree/very good). Results: Seven MCQs were omitted from the exam set due to various reasons. The mean scores were 47.73±6.61 for MCQs, 16.09±3.82 for KFPs, and 63.83±8.79 overall. Thirty (50.0%) candidates scored higher than the minimum acceptable level of performance (65/100) and passed the exam. The mean score percentage for the MCQ section (68.2%) was significantly higher than for the KFP section (53.1%; p<0.001). Cronbach's alpha coefficients for the MCQ (63 items) and KFP (30 items) sections were 0.75 and 0.67, respectively. Candidates provided positive feedback (n=56), indicating that the exam venue was comfortable (X̄=6.02±2.42), the digital format was easy to use (X̄ =5.44±2.62), and the exam user interface was convenient (X̄ =5.96±2.45). The highest satisfaction was for the inclusion of clinical case questions (X̄ =6.63±2.21). Candidates also found the KFP section (X=6.59±1.80) more challenging than the MCQ section (X̄ =6.13±1.61). Conclusion: The computer-based TNNBE effectively streamlined the exam process and received positive feedback from candidates, particularly for its user interface and inclusion of KFPs. However, KFP scoring was still challenging due to the range and small differences in formulating the acceptable answers, which made it difficult to standardize scoring by machines. In addition, implementing computer-based exams, particularly in large-scale settings, require advanced technology and logistical planning, which can be costly and challenging to manage.

GİRİŞ ve AMAÇ: İskemik inme hastalarında gelişen serebral ödem mortalite ve morbiditenin en önemli nedenidir. Medikal tedaviye cevap alınamayan hastalarda dekompresif hemikraniyektomi yararlı olabilir. Bu yazıda, kliniğimizde akut iskemik inme nedeniyle dekompresif hemikraniyektomi uygulanan hastaların klinik özellikleri ve prognoz ile ilişkili faktörler değerlendirilmiştir. YÖNTEM ve GEREÇLER: Bu çalışmaya iskemik inme nedeni ile dekompresif hemikraniyektomi uygulanan 21 hasta alındı. Hastaların demografik özellikleri ile görüntüleme bulguları kaydedildi. Hastaların fonksiyonel durumu modifiye Rankin Skalası ile değerlendirildi. Hastanedeki izlem süresinde eksitus olan ve yaşayan hastaların klinik özellikleri ve görüntüleme bulguları karşılaştırıldı.BULGULAR: Çalışmaya 12’si erkek, 9’u kadın, yaş ortalaması 58.7±8.2 (46 - 78) olan 21 hasta alındı. Hastaların başvuru NIHSS skoru ortalaması 12.5±4.5 idi. İnfarkt 17 hastada orta serebral arter, 4 hastada internal karotis arter alanındaydı. Dekompresif hemikraniyektomi uygulama zamanı ortalama 2.9±2.5 gün ve hastanede ortalama kalış süresi 42.6±39.2 gün idi. Hastanedeki izlem süresinde beş (% 23.8) hasta eksitus oldu. Dekompresif hemikraniyektomi uygulanan hastalarda klinik özellikler ve görüntüleme bulguları mortalite ile ilişkili bulunmadı.TARTIŞMA ve SONUÇ: İskemik inmede dekompresif hemikraniyektomi medikal tedavi uygulanmasına rağmen kötüleşen hastalarda önemli bir tedavi seçeneğidir.

Organic solvents that are widely used in industrial production and abused amongst teenagers for recreational purposes may cause some neurological abnormalities including polyneuropathy. Poorly ventilated working environments and working without protective garments are the most common reasons of intoxication. N-hexane toxicity often causes sensorimotor mixed type demyelinating neuropathy, but axonal degeneration is not rare. We report five cases that had mainly axonal motor polyneuropathy due to n-hexane containing glue usage, with clinical and electrophysiological data. Clinical and electrophysiological examinations revealed predominantly motor findings. One patient had delayed P100 potential, two had abnormal conduction in fasciculus gracilis. “Coasting” phenomenon was observed in one patient. Neuropathy due to toxic agents is an important public health problem. Working place conditions must be strictly controlled if toxic materials are present. Patients who had electromyography compatible with polyneuropathy should be questioned for toxic exposure. Asymptomatic workers should also be examined. Patients should be followed for the possibility of “coasting” effect.

Parkinson’s disease (PD) is the second most common degenerative disease which may cause blood pressure abnormalities due to autonomic dysfunction. Early morning rise of blood pressure which is called morning surge is found to be related with some cardiovascular diseases when it is exaggerated. We wanted to search the relation of Morning blood pressure surge (MBPS) and inflammation in PD. Method: Ambulatory blood pressure monitoring for 24 hours, fibrinogen to albumin ratio, hs-CRP are used in this retrospective study. Fifty idiopathic PD patients and 50 age and sex matched control cases were included. MBPS, it has been defined as the difference between morning BP (measured 2 hours after awakening) and the lowest night-time BP. Body mass index (BMI) is used as an independent variable. Results: Median value of MBPS for PD group (21,63) was significantly different from the control group values (18,63) (p

Background: Nerve conduction studies (NCS) are an important tool for the diagnosis of neuromuscular diseases. In NCS, factors such as temperature, age, sex, body metrics, and recording technique can affect the values. There are currently no universal normative data. The standardization of NCS is essential for the reliable and consistent identification of pathologic conditions for each laboratory.Aim: We wanted to obtain normal values of our electrophysiology laboratory for the Turkish population.Materials and Methods: The volunteer group consisted of 120 people aged 15–74 years. They were distributed into 12 subgroups according to their age. Each subgroup included five male and five female subjects. Age, sex, weight, height, profession, body mass index, and hand preferences were recorded. Median and ulnar NCS were performed by two experienced clinical neurophysiologists. The skin temperature was corrected to 35.5°C, which was the highest measured value.Results: Age 50 years was used for the cutoff point for nerve conduction velocities (NCVs) because there was no significant difference within the groups aged ≥50 years and <50 years. However, the NCVs of groups aged 50 years were significantly different. NCVs and action potential amplitudes were higher in females than males in both age groups. Women had higher NCV values and action potential amplitudes of motor and sensory fibers.Conclusion: Age, temperature, and sex are important factors that affect NCS. We believe this study will provide normal values for future studies, especially in the Turkish population.

Background and Objectives: Essential tremor (ET) is a common neurological disorder, typically presenting as bilateral, rhythmic, and symmetric kinetic or postural tremors. In contrast, Parkinson’s disease (PD) is a progressive neurodegenerative disorder, characterized by resting tremor, rigidity, bradykinesia, and postural instability. Although both disorders involve tremor, ET and PD differ in clinical presentation and pathophysiology: ET generally involves action tremor and has a strong familial component, while PD more commonly presents with resting tremor and a weaker family history. A subset of ET patients may develop Parkinsonian features over time, although the relationship between ET and subsequent PD remains unclear. Genetic studies have identified only a few pathogenic variants in ET, suggesting it develops as a result of multifactorial genetic and environmental influences rather than simple Mendelian inheritance. ET is also recognized as a risk factor for developing PD, although the underlying mechanisms remain poorly understood. This study aimed to clarify potential genetic overlaps and distinctions in patients diagnosed with both ET and PD. Materials and Methods: We retrospectively analyzed 40 patients with a family history of ET or PD who were initially diagnosed with ET and later developed PD. Genetic screening and clinical assessments were conducted to investigate associated variants and clinical features. Results: Among these 40 patients, 17 different mutations were detected in 16 individuals. Three pathogenic or likely pathogenic variants were identified. The clinical characteristics and treatment responses of these patients were reviewed in relation to their genetic findings. Notably, none of the identified variants had previously been reported in association with PD following ET. Conclusions: A comprehensive clinical and genetic evaluation of ET patients who develop PD may offer insights into the underlying pathophysiology and inform future therapeutic strategies. Our findings support the need for further studies to explore the genetic landscape of patients with overlapping ET and PD features.