Geç Yaşta Tanı Konan, Psikiyatrik Yakınmaların ve Statusun Eşlik Ettiği Sturge Weber Sendromu: Olgu Sunumu. (Turkish)

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    • Alternate Title:
      Sturge Weber Syndrome Diagnosed at Late Age, Associated with Psychiatric Complaints and Status: A Case Report. (English)
    • Abstract:
      Sturge-Weber syndrome (SWS) is a rare, sporadic neurocutaneous syndrome characterized by a usually unilateral facial port-wine stain, ipsilateral leptomeningeal angiomatosis, glaucoma, epileptic seizures that are difficult to control, and progressive cerebral dysfunction. A 41-year-old woman presented with headache, nausea, vomiting, and a speech disorder. On examination a lesion on the right side of her face consistent with hemangioma was noted, as well as a high fever, hyperglycemia, and tonsillitis. Electroencephalography revealed a paroxysmal abnormality in the right frontotemporal region, and contrast-enhanced cranial magnetic resonance imaging revealed vascularization and dural contrast enhancement in the right cerebral hemisphere. The patient was diagnosed with SWS and discharged with acetylsalicylic acid (ASA) and valproic acid therapy, but returned 2 weeks later with tonic-clonic status epilepticus. The seizures were controlled with an infusion of diazepam in the intensive care unit and the dosage of valproic acid was increased. Aripiprazole was initiated for visual and auditory hallucinations. The patient was discharged after 10 days with a normal neurological examination and follow-up has not revealed any seizure or sequel findings with the ASA and valproic acid therapy. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Sturge-Weber sendromu (SWS), yüzde porto şarabı renginde çoğunlukla tek taraflı fasiyal anjiom, aynı tarafta leptomeningeal anjiomatozis, glokom, kontrolü zor epilepsi nöbetleri ve ilerleyici serebral fonksiyon bozukluğu ile karakterize nadir görülen sporadik bir nörokutanöz sendromdur. Baş ağrısı, bulantı, kusma, konuşma bozukluğu yakınmaları ile başvuran 41 yaşında kadın hastada sağ yüz yarımında hemanjiomla uyumlu lezyon, yüksek ateş, hiperglisemi ve tonsillit saptandı. Elektroensefalografide (EEG) sağ frontotemporal bölgede paroksismal bozukluk ile uyumlu bulgular ve kontrastlı beyin manyetik rezonans görüntülemede (MRG) sağ serebral hemisferde artmış vaskülarizasyon ile dural kontrastlanma görüldü. Sturge-Weber sendromu tanısı konulan hasta asetil salisilik asit (ASA) ve valproik asit tedavisi ile taburcu edildi, ancak çıkışından iki hafta sonra status epileptikus tablosu ile getirildi. Nöbetleri yoğun bakım şartlarında diazepam infüzyonu ile kontrol altına alındı. Valproik asit dozu yükseltildi. Daha sonra ortaya çıkan görsel ve işitsel halüsinasyonlar nedeni ile aripiprazol başlandı. On gün sonra nörolojik muayenesi normal olarak taburcu edildi. Valproik asit ve ASA tedavisi ile nöbetsiz ve sekelsiz olarak takip edilmektedir. [ABSTRACT FROM AUTHOR]
    • Abstract:
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