Objectives: Although compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the nerves are reduced in sciatic nerve injury due to intramuscular injection (SNIII), they may still be higher than the reference values if there is a mild axonal degeneration. In this case, comparing the outcomes of nerve conduction studies of intact and affected lower extremities becomes important. We aimed to determine the role of this comparison in the diagnosis of SNIII. Methods: Patients with SNIII were included. Reference values for lower extremity nerve conduction studies were obtained from healthy participants. Peroneal, posterior tibial, superficial peroneal, and sural nerve conduction studies were performed in both lower extremities. In the first analysis, the CMAP or SNAP amplitude of the nerve was considered abnormal if it was less than the reference value. In the second analysis, the CMAP or SNAP amplitude of the nerve was considered abnormal if it was less than the reference value or <50% of the CMAP or SNAP amplitude obtained from the intact limb nerve. Results: Thirty patients and 31 controls were included in the study. Compared with those found in the first analysis, the number of posterior tibial nerve CMAPs with reduced amplitudes, and the sural and superficial peroneal nerve SNAPs with reduced amplitudes were higher in the second analysis (P = 0.008, P < 0.001, and P = 0.031; respectively). Conclusion: This study showed that nerve conduction studies should be performed in both the intact and affected extremities in SNIII.

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Motor unit number estimation (MUNE) methods have been found to be better suited than any other electrophysiological test to study the degree and time course of lower motor unit loss. However, MUNE methods have not yet been implemented in clinics and research. This may be because an ideal method has not been developed yet. This review aims to give an overview of the strengths and limitations of the existing MUNE methods, why a new method was necessary and how the novel MScanFit MUNE can overcome some of the limitations that the other methods had. In the end, the existing literature MScanFit applied has been summarised.

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Objectives: The objectives of this study were to compare the results of pharmacologic management options and vestibular rehabilitation (VR) programs in the context of dizziness, balance problems, and headache in patients with vestibular migraine. Materials and Methods: Sixty patients with migraine with vestibular symptoms were evaluated in three groups in the neurology, physical medicine, and rehabilitation and otorhinolaryngology clinics of a medical school hospital. The groups were defined as routine pharmacologic therapy (PT), VR, or both. Patients were evaluated with static posturography, the Dizziness Handicap Inventory (DHI), and the Activities-Specific Balance Confidence (ABC) Scale as primary outcome measures and symptom frequency and severity (headaches and vertigo attacks) as secondary outcome measures. In-group and between-group comparisons were made using relevant statistical methods. Results: DHI scores were significantly reduced (P < 0.001) in all treatment groups. ABC scores increased significantly (P < 0.001) in patients taking PT and those on VR + PT. Posturographic examinations revealed that sway velocity values recorded on foam with eyes closed, which targets vestibular assessment, were significantly reduced (P < 0.001) in groups taking VR either alone or with PT. VR benefited patients with migraine in terms of headaches, vertigo attack frequency, intensity, and duration. Conclusion: Patients with predominant vestibular disorders can benefit from VR alone, and patients with combined symptoms (headache and vertigo) can benefit from pharmacologic and rehabilitation therapies.

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Objective: Motor imagery (MI) is the mental representation of a movement without any body movement, and it has been recently used as a therapeutic intervention in rehabilitation. The Movement Imagery Questionnaire-3 (MIQ-3) is the most recent, modified version of the MIQ-revised, second edition, which is commonly used to measure the imagery ability of patients with movement dysfunction. The purpose of the study was to translate the MIQ-3 into Turkish and evaluate its test and retest reliability and validity for the Turkish-speaking population. Methods: Among 185 healthy participants, 181 completed the procedures. The questionnaire was applied to 86 participants with 1-week interval to evaluate internal consistency and test–retest reliability. The construct validity of the MIQ-3 was tested by confirmatory factor analysis (CFA). Results: The internal consistency of the Turkish MIQ-3 was satisfactory (Cronbach's alpha was 0.87 for test and 0.86 for retest reliability). The internal consistency of subscales for test–retest reliability (internal visual items, external visual items, and kinesthetic items) was 0.73–0.68, 0.74–0.72, and 0.79–0.73, respectively. Test–retest reliabilities of each item ranged from 0.84 to 0.95. In terms of criterion validity, there was an excellent correlation between subscales and total scale correlations, which ranged from 0.50 to 0.90 (P < 0.001). The validity of the MIQ-3 was examined with CFA, and the results supported a three-factor model of movement imagery ability. Conclusion: The Turkish MIQ-3 has an excellent reliability and good-to-excellent validity in evaluating MI ability.

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Objective: Pain, a nonmotor symptom in Parkinson's disease (PD), affects approximately 40%–85% of patients and adversely affects their daily activities. Therefore, our aim was to establish the validity and reliability of the Turkish version of King's PD Pain Scale (KPDPS) and to make it available for Turkish patients with PD patients. Methods: The first phase of the study involved the translation and adaptation of the KPDPS to Turkish. For the language validity of the scale, a translation back-translation method was applied, and expert's opinion was considered for content validity. In the second stage, the developed Turkish scale was administered to 152 patients with PD. In the study, test-retest was performed in 50 patients for 1 week. Results: The internal consistency value was found as 0.856 in the KPDPS. When the test-retest was performed, the internal consistency value of the scale showed excellent reliability. The test-retest-Cronbach's alpha value for the whole scale was 0.827. According to the data analysis results, it showed that 14 items on the scale were sufficient for the evaluation of pain in patients with PD. Conclusion: The results from this study show that KPDPS items have adequate internal consistency and test-retest reliability. The Turkish KPDPS can be used as a reliable and valid instrument for assessing the pain symptoms common to patients with PD.

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Background and Purpose: We aimed to assess whether severe leukoaraiosis (LA) is associated with outcomes and symptomatic intracerebral hemorrhages (sICH) in patients who were treated with recombinant tissue-plasminogen activator (rt-PA) for acute stroke. Methods: We analyzed the data of anterior circulation stroke patients who were treated with rt-PA at our stroke center during 2009–2016. LA was scored according to the van Swieten scale (VSS) on computed tomography (CT) and dichotomized into groups as absent or moderate versus severe LA. We used the safe implementation of thrombolysis in stroke definition for sICH and the modified Rankin Scale (mRS) scores at 3 months after rt-PA were recorded. Results: Of 302 patients, 47 (15.6%) showed severe LA (VSS >4) on CT. The overall sICH rate was 3.6%. Moreover, sICH was significantly more frequent in patients with severe LA (n = 5 of 47; 10.6%) than in patients with absent/moderate LA (n = 6 of 255; 2.4%; P = 0.017). In addition, patients with severe LA had higher baseline glucose level (P = 0.006) and systolic blood pressure (P = 0.005) compared to patients with absent/moderate LA. Patients with severe LA were more likely to have a poor outcome (mRS: 3–6) compared to those without severe LA (P = 0.009). Conclusion: The presence of severe LA on CT increases the risk of sICH and poor outcome in patients treated with rt-PA for acute stroke.

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Introduction: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. The role of oxidative stress has gained importance in the pathogenesis of free radicals in cells such as protein, lipid, and nucleic acids by showing myelin loss and axonal degeneration. In this study, serum total oxidant level total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and paraoxonase (PON) in patients with relapsing-remitting-MS (RRMS) were examined. The hypothesis was that antioxidants might indicate the attack phase or the progression phase. Methods: Twenty-four patients with RRMS known to have undergone new attacks and 24 healthy controls whose demographic data were appropriate were included. PON and TAS/TOS measurements were performed once in the healthy group and twice in the serum samples of patients during relapse and remission periods. The Number Cruncher Statistical System 2007 and Power Analysis and Sample Size 2008 Statistical Software (Utah, USA) program was used for statistical analysis. Results: TAS, TOS, and PON levels were similar in the patient and control groups during the attack. In remission, only a positive, statistically significant relationship between the duration of the disease and TAS measurements was noted (r = 0.435; P = 0.034). No significant relationship was found between sociodemographic characteristics, illness duration, laboratory/imaging findings, and antioxidant parameters in blood. Conclusion: In this study, TOS, TAS, OSI, and PON serum levels had no role in determining attack and remission periods in RRMS. There were only significant differences between disease duration and TAS results during the remission period. Following TAS results may help in monitoring progression in patients with early MS.

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Background: Facioscapulohumeral muscular dystrophy (FSHD) occurs as a consequence of genetic deletion of D4Z4 repeats on chromosome 4q35. Onset of FSHD is earlier in males, suggesting that testosterone may trigger the disease. In accordance, the rapid progression of disease in women after menopause suggests a protective role for estrogen and progesterone. No studies have examined levels of all these hormones in relation with the severity of FSHD. Aims: To evaluate the possible correlation between the severity of FSHD with sex hormones, age, and genetic deletion on chromosome 4q35. Subjects and Methods: D4Z4 repeat units were investigated in 33 patients (19 males/14 females) with FSHD. In the blood samples, luteinizing hormone, follicle-stimulating hormone, free estriol, estradiol, free testosterone and total testosterone, progesterone, 17-OH progesterone, prolactin, albumin, and fibrinogen were measured. The severity of FSHD was identified using a Clinical Severity Score (CSS) scaling system. Spearman's correlation and regression analyses were performed as statistical analyses. Results: Age (P = 0.001, r = 0.541) and total testosterone (P = 0.045, r = 0.351) were positively correlated, and the progesterone/total testosterone (P = 0.025, r = −0.390) and estradiol/total testosterone ratios (P = 0.025, r = −0.389) were negatively correlated with the severity of FSHD. Conclusions: Our results indicate that age, total testosterone, ratios of estradiol and progesterone to total testosterone, but not deletion on chromosome 4q35, have a significant relation with the severity of FSHD. Given that both estrogen and testosterone treatment are considered in therapy, our results suggest that estrogen and progesterone but not testosterone are likely to be more effective on the severity of FSHD.

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A temporal overlap between vestibular symptoms, such as vertigo and head movement intolerance, and migraine symptoms, such as headache, photophobia, and phonophobia, is a requisite diagnostic criterion for the diagnosis of vestibular migraine (VM). Diagnostic criteria for VM have been proposed by an International Vestibular Research Group (the Bárány Society) and a headache research group (International Headache Society); however, in practice, it is still acceptable to divide patients suspected of VM into “definite VM” and “probable VM” groups. Here, a neuro-otologist and a headache specialist consider VM from their own points of view using four real cases, two from a dizzy clinic and two from a headache clinic, with expert opinions and arguments according to the current literature. The management is summarized on the basis of mechanism and comorbidity and the importance of prophylactic medication.

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Pembrolizumab is an immune checkpoint inhibitor. Most cases of myasthenia gravis (MG) reported with the use of immune checkpoint inhibitors have been in melanomas, and small and non-small cell lung carcinoma, but there are no reported cases in thymic epithelial carcinoma. A 57-year-old male with thymic carcinoma presented with symptoms of diplopia, drooping eyelids, and difficulty in talking and swallowing after a second dose of pembrolizumab. Contrast-enhanced brain magnetic resonance imaging, laboratory tests, and electroneuromyography were normal. Single-fiber electromyography showed increased jitter (six muscle fibers were collected, range of jitter 29–140 μs, mean 75 μs; normal <35 μs) in bilateral orbicularis oculi muscles supporting MG. Serum screening showed no any positivity for acetylcholine receptor and muscle-specific tyrosine kinase autoantibodies. The patient died of bulbar dysfunction related to aspiration pneumonia despite receiving intravenous immunoglobulin and methylprednisolone therapy. Physicians should be alert to possible exacerbations of autoimmune diseases and associated risks, especially during treatment with checkpoint inhibitors in thymic malignancy.

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Aims and Objectives: The aim of this study was to investigate the difference between sensory brain responses of nonpainful tactile stimuli applied to the fingers of the right-hand dominant individuals between the hemispheres. Materials and Methods: Nineteen healthy volunteers (9 women, mean age ± standard deviation: 23.00 ± 2.24 years) participated in the study. Electroencephalogram (EEG) recordings were taken from 40 channels polysomnography system. A uniform nonpainful stimulus was applied to two fingers (index and middle fingers) of the right and left hand with a pneumatic stimulator unit. Results: Non-rapid eye movement sleep (NREM) whole night sleep-related potentials were evaluated. When the stimulus was applied to the right hand, central and parietal regions of the P50 response component appeared significantly earlier in the left hemisphere. When the left-hand stimulus was applied, the P50 and N100 response components appeared significantly early in central, parietal, and temporal regions in the left hemisphere. Hence, amplitudes of the right-hand response components (P50 and N100) were found to be greater in the central, parietal, and temporal regions in the left hemisphere. When the stimulus is applied to the left hand, the amplitude of the P50 component was greater in the central and temporal regions in the left hemisphere. Conclusion: P50 and N100 are components related to sensory processing. The difference in latency and amplitude observed in these components between hemispheres indicates the presence of lateralization in sensory processing during sleep.

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Background: People are divided into different chronotypes in relation to their circadian rhythm features. The Morningness–Eveningness Questionnaire (MEQ), developed by Horne and Östberg, was the first and is the most used questionnaire for determining the chronotype of people. The reliability and validity of MEQ were tested in this study due to some deficiencies and inconsistencies in previous reliability and validity studies for the Turkish versions of MEQ and deficiencies regarding the validity and reliability of other versions of MEQ. Subjects and Methods: MEQ was translated into Turkish based on the opinions of five academics who were experts in their respective fields and the suitability and content validity of the questionnaire were ensured. The Turkish MEQ was administered to 419 undergraduate students aged 18–34 years. Robust minimum rank factor analysis (MRFA) was used to reveal the construct validity of the questionnaire. Results: As a result of the analyses, the questionnaire was examined in three factors. None of the items were excluded from the study and all items were collected under three factors. The explained total variance value was 42.7%, and the factors explained 64% of common (shared) variance in MRFA. According to the reliability analysis, Cronbach's alpha value for the MEQ Turkish version was satisfactory for the overall questionnaire (0.765). Conclusions: The MEQ version developed in this study is more valid and reliable compared with other versions. However, these results support that a more detailed instrument for morningness and eveningness can be developed.

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Aim: Reported results of botulinum toxin (BoNT) injections vary widely in different studies and in different neurological disorders. The aim of this study was to investigate the efficacy and safety of BoNT injections for each neurological disorder and to report our experience in this area since 1994. Materials and Methods: All patients who were injected with BoNT since 1994 were included in this retrospective study. Age, gender, etiology, specific diagnosis, time from first symptom to first injection, type of BoNT (onabotulinum toxin-abobotulinum toxin), doses, treatment response, and complications were extracted from patient files. Etiologies were classified into five main groups: hyperkinetic movement disorders, focal spasticity, painful conditions, sialorrhea, and hyperhidrosis. Positive treatment response was defined as any objective clinical improvement determined by the attending physician and declared by the patient. Results: We determined that 1792 patients were considered for BoNT injections. Among them, 341 were not found to be suitable for injections or did not accept to have the procedure done. In total, 1451 different patients were included in the study. The most common indications for BoNT injection were hyperkinetic movement disorders (72.3%) and focal spasticity (15.2%). Other disorders included painful conditions, hyperhidrosis, and sialorrhea. In 74.3% of the patients, the only injected toxin was onabotulinum toxin, whereas 10.2% of the patients were injected only with abobotulinum toxin. In 14.7% of the patients, the injection type was changed from one to the other, due to ineffectiveness or unavailability. Response rates were 95.4% for focal spasticity, 92.6% for hyperkinetic movement disorders, 81.1% for painful conditions, 66.7% for hyperhidrosis, and 63.1% for sialorrhea. Severe complications were seen in 0.6% of the patients. Conclusion: BoNT injections seem to be effective in all of the neurological disorders which we investigated. Except for mild cosmetic complications, BoNT is generally safe in experienced hands.

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Objectives: The introduction of deep-brain stimulation (DBS) was a milestone in the treatment of movement disorders, intractable epilepsy, and severe psychiatric disorders. We aimed to identify risk factors for hardware infection in patients with these conditions who underwent DBS at our center over a 4-year period. Materials and Methods: Bilateral DBS was performed in seventy patients by the Department of Neurosurgery at the Mersin University School of Medicine between April 2016 and January 2020. The surgical indication was Parkinson's disease in 48 patients, dystonia in 11 patients (10 primary generalized and 1 secondary), and tremor in 11 patients (10 essential tremor and 1 other). Results: Infection was detected in eight patients (11.4%). There were no hardware complications other than infection or postoperative intracerebral hematomas. The entire device was explanted in four (50%) patients with infection; device explantation occurred at 3, 13, 19, and 42 months after surgery. The other 4 (50%) patients who developed infection were successfully treated with antibiotics without complication. A patient with primary dystonia who underwent bilateral globus pallidus interna DBS sustained a severe acute subdural hematoma due to trauma 45 days after electrode implantation but prior to stimulation. We elected not to explant the device after hematoma evacuation; delayed stimulation programming was successful. Conclusion: DBS surgeries are susceptible to complications related to the anatomic target, hardware, and the procedure itself. Infection is the most common complication; however, there is no established protocol for its treatment. Antibiotics and partial removal of the device may be a rational approach.

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Objectives: Among different theories about pathogenesis of obstructive sleep apnea syndrome (OSAS), dysfunction of upper airway muscles still awaits to be delineated. The aim of this study is to examine differences in motor unit potential (MUP) parameters of upper airway muscles between OSAS patients and healthy controls. Methods: Ten male patients diagnosed as OSAS by whole-night polysomnography were analyzed for MUP parameters of genioglossus (GG) muscle, palatoglossus muscle (PG), palatopharyngeus muscle, and uvular (U) muscle. Eight healthy volunteer men matched by age were enrolled as a control group. Results: In PG muscle parameters, the mean MUP area was significantly smaller (P = 0.040) in OSAS patients than those in controls. On the other hand, U muscle parameters showed a significantly larger mean MUP area (P = 0.022) in OUAS patients compared to those in the control group. In OSAS patients, the percentages of polyphasic MUPs of GG and PG muscles were significantly high (P < 0.001 and P = 0.05, respectively). Body mass index was positively correlated with number of phases of GG muscle (r_s = 0.63, P < 0.05) and duration of U muscle (r_s = 0.71, P < 0.05) in OSAS patients. Other MUP parameters of palatal muscles were similar between the two groups. Conclusion: Our results showed that, although mild in severity, structural neurogenic and myogenic changes characterized as mild and nonuniform MUP changes may co-exist in OSAS patients. These changes in palatal muscles may be attributed to compensatory adaptation of muscle fibers to other precipitating factors in OSAS.

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Objective: Human SH-SY5Y cell line has been frequently used for in vitro experiments in neuroscience-related research. To reflect a better neuronal characteristic the cell line needs to a differentiation. To compare the results obtained from in vitro models, the similarity of the phenotype and characteristic of the cells has great importance. However, many studies have been performed using the different medium ingredients which affect the differentiation progress of the cells. Therefore, we aimed to compare generally used differentiation mediums, contain only retinoic acid (RA) and supplemented with different ingredients, in the aspect of neuron-like phenotype characteristics and stability. Materials and Methods: The effects of medium ingredients on differentiation levels were evaluated using morphological changing, neurite length, and immunofluorescence detection of neuronal markers such as NFH, β-III Tubulin, and microtubule-associated protein 2 (MAP2). The stability of differentiated cells was followed microscopically at the 7^th, 10^th, and 14^th days by morphological changings and neurite length using Neuron J software. Results: The results revealed that the cells pretreated with RA for 5-day treatment and followed by 5-day treatment with the mix medium and brain-derived neurotrophic factor (BDNF), provided significantly higher neurite length than the other groups (P < 0.001). In this group, the expressions of β-tubulin III, MAP2, and NF-H were also significantly higher than the control group (P < 0.05, P < 0.001, and P < 0.05, respectively) and differentiated cells were stable until the 7^th day. Conclusion: The results demonstrated that enriched mediums are necessary for a better differentiation of SH-SY5Y cells. We recommend 10-day treatment period and using of RA, BDNF, dc-AMP, KCI together in SH-SY5Y cell differentiation.

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Context: This was an investigation of inflammation markers on the prediction and prognosis of patients with sleep apnea. Aims: Clinical detection of inflammatory markers is useful to assess systemic inflammation in patients with obstructive sleep apnea syndrome (OSAS). The aim of the study was to evaluate whether the lymphocyte-to-C-reactive protein (CRP) ratio (LCR) was a predictive marker in diagnosing and determining the severity of OSAS. Settings and Design: This was a retrospective clinical study. Subjects and Methods: One hundred and forty-one patients who had undergone polysomnography were included in the study. The sex, age, Apnea–Hypopnea Index (AHI), body mass index, and complete blood count parameters of the patients were recorded. AHI scores were used to classify the severity of OSAS. Statistical Analysis Used: Differences among the groups for each parameter were analyzed using Student's t-test and one-way analysis of variance with Tukey correction for normally distributed parameters and the Mann–Whitney U test and Kruskal–Wallis test for nonnormally distributed parameters. The correlation between LCR, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, CRP, and AHI scores was assessed using Pearson's correlation coefficient. Results: First, the patients were divided into four groups according to their AHI results, as control group, mild, moderate, and severe OSAS groups. The median LCR levels were 2.57 (1.59, 3.51) in the control group, 1.28 (0.74, 3.27) in Group 2, 1.63 (0.86, 2.6) in Group 3, and 1.05 (0.62, 2.31) in Group 4. In the comparison of all patients with OSAS and the control group, the median LCR level was 1.27 (0.7, 2.74) in patients with OSAS and 2.57 (1.59, 3.51) in the control group (P = 0.002). Conclusions: This study demonstrated that LCR is an important marker for systemic inflammation in patients with OSAS. LCR may be a new predictive marker in the diagnosis and prognosis of patients with OSAS.

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Objectives: In this study, we aimed to compare the neutrophil/lymphocyte ratio (NLR) levels of migraine patients with and without gliotic lesions on brain magnetic resonance imaging (MRI). Materials and Methods: The records of the patients who were followed up in the neurology outpatient clinic of Ufuk University, Faculty of Medicine, between 2016 and 2019 with the diagnosis of migraine between the ages of 18 and 50 were reviewed retrospectively. Eighty-six patients without systemic, neurological, and infectious diseases between 18 and 50 years of age were included in the study. Patients were divided into two groups: Group 1 – subclinical ischemic/gliotic lesions on MRI and Group 2 – normal MRI. Subparameters and calculated NLRs in whole blood results were compared between the two groups. Results: When the two groups were compared in terms of leukocyte and neutrophil counts, a statistically significant difference was found. The leukocyte and neutrophil counts of the patients in Group 1 were significantly higher than those of Group 2 (P = 0.038/P = 0.004). NLR was higher in patients with gliotic lesions on MRI than in patients with normal MRI and was statistically significant (P = 0.016). Conclusion: This study aimed to evaluate the relationship between NLR and white matter lesions in patients with migraine. We have conducted this study to see if we can confirm this with a parameter in migraine patients with white matter lesions. Despite the small number of patients, leukocyte count, neutrophil count, and NLR were significantly higher in migraine patients with white matter lesions which support our hypothesis.

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Objective: This study aimed to evaluate primary headache disorders and other causative comorbidities (e.g., epilepsy, atopic disorders, recurrent abdominal pain, motion sickness, and headache) in children with tic disorders (TDs) and their mothers. Materials and Methods: In a multi-center, cross-sectional, familial association study using case–control design, youth (between 7 and 17 years) with TDs (TD, as per Diagnostic and Statistical Manual of Mental Disorders-5 criteria) and age- and sex-matched healthy controls and their mothers were evaluated in the aspect of functional syndromes spectrum including migraine, epilepsy, atopic disorders, motion sickness, and recurrent abdominal pain. Results: Seventy-nine youth with TD and 101 controls were included. Causative comorbidities, other than epilepsy and motion sickness were more common in children with TD with an odds ratio (OR) of 2.1 (atopy) and 3.9 (food allergy). Specifically, recurrent abdominal pain and migraine were found in 36.7% and 31.7% of children (vs. 18.8% and 16.8% of controls, ORs 2.5 and 2.3, respectively). Mothers of youth with TDs also have higher rates of atopy, drug allergy and allergic dermatitis (ORs; 3.8, 3.2 and 2.1; respectively). Conclusion: Results of recent studies suggest a possible link between atopic disorders, migraine, recurrent abdominal pain and TDs. Our results contribute to those studies and suggest that this relationship may extend to the mothers of children as well.

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Objectives: Distal electrical stimulation of an upper extremity mixed nerve can generate a reflex response from the trapezius muscle. This reflex response may have a central neural pathway and can be affected by postural changes. Materials and Methods: In this study, long latency reflexes (LLRs) from both distal and trapezius muscle were evaluated in patients with Parkinson's disease (PD) with and without postural dysfunction and in patients with cerebellar ataxias. Thirty-three patients with PD, 10 patients with degenerative cerebellar ataxia and 22 healthy volunteers were included in the study. LLRs were recorded from ipsilateral thenar and trapezius muscles. Latencies and amplitudes of LLRs obtained from thenar (thenar LLR) and trapezius (trapezius LLR) muscles were analyzed. Results: In patients with PD, thenar LLRs showed significant shortening in the onset latencies and significant increase in the amplitudes in comparison with healthy controls. Trapezius LLRs did not show any significant difference in latencies or amplitudes; however, these responses showed a significant absence in one or two components in patients with Parkinson's disease with postural dysfunction. Additionally, this reflex was not recorded in patients with cerebellar ataxia. Conclusion: Trapezius LLRs can give some information regarding the physiology of neural circuits responsible for postural arrangement. Cerebellar connections may have a major role in the generation of trapezius LLRs.

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Objective: The aim is to evaluate the vestibular system using the video head impulse test (vHIT) and vestibular evoked myogenic potentials (VEMP) in patients with multiple sclerosis (MS) without central vestibular involvement in magnetic resonance imaging (MRI), and to determine whether there was subclinical vestibular system impairment. Materials and Methods: The study comprised 27 patients with MS and 26 healthy participants. The participants had no lesions in the central vestibular system in an MRI taken in the past 3 months. Detailed neuro-otologic and neuro-ophthalmologic examinations were performed on all participants. Then, the Dizziness Handicap Inventory (DHI) was completed for subjective vestibular system evaluation. In addition, vHIT and cervical VEMP (cVEMP) were performed for objective vestibular system evaluation. The results were analyzed statistically. Results: The mean age of the patients in the MS group was 39.3 ± 11.4 years and 42.7 ± 9.7 years in the control group. The median DHI score was 4 (range, 0–8) in the MS group and 2 (range, 0–6) in the control group. There were no statistically significant differences between the DHI score averages of the groups. The mean vestibulo ocular reflex (VOR) gain in vHIT was 0.76 ± 0.21 in the MS group and 0.99 ± 0.13 in the control group. VOR gain was statistically significantly lower in patients with MS. The VOR gain cut-off level was considered as 0.8. Gain level was below the cut-off level in 53.7% of patients with MS. There was no cVEMP response in 31.5% of patients with MS. In addition, patients with MS had prolonged P1 and N1 latencies and decreased P1-N1 peak-to-peak amplitudes. Conclusion: We found subclinical involvement in electrophysiologic tests (vHIT and cVEMP) in patients with MS without MRI lesions and without subjective vestibular system symptoms. We believe that vHIT and cVEMP can be used for subclinical evaluation in patients with MS without central vestibular system involvement in MRI.

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2019-novel Coronavirus disease (COVID-19) is a global health problem that affected >2.000.000 people in the world. Although the main component of the disease is pulmonary disturbances, recent reports suggested neurological manifestations. Neurological complications have been rarely reported with other Coronavirus associated diseases. In this short review, we would like to draw attention to COVID-19-related neurological symptoms. Heath-care providers should be aware that COVID-19 can associate neurological manifestations.

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