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    Alien hand syndrome [Yabanci el sendromu]
    (2006) Şahin S.; Tan D.; Karşidag S.
    Alien hand syndrome (AHS) refers to the occurrence of apparently purposeful movements in the hand which are independent of volitional control. Two subtypes of AHS have been proposed: 'anterior-motor' subtype with grasp reflex and impulsive manipulation of tools by the dominant hand and 'posterior-sensorial' subtype with hemispheric neglection. Here in a case of Corticobasal Ganglionic degeneration (CBGD), we report, anteriortype AHS with symptoms of impulsive grasping and apraxia in his left hand. Cranial magnetic resonance imaging (MRI) showed diffuse atrophy of cortex and periventricular millimetric ischemic-gliotic lesions. Single - photon emission computed tomography (SPECT) analysis labelled with 99m technetium hexamethylpropyleneamineoxime (Tc-99m-HMPAO) demonstrated hypoperfusion in the left frontal lobe and the temporo-parietal areas dominantly in the left hemisphere. In this article, we aim to review the literature about AHS based on our case's findings.
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    Delirium-associated disulfiram and ethanol interactions
    (Physicians Postgraduate Press Inc., 2005) Mirsal H.; Yalug I.; Tan D.; Stern T.A.; Kalyoncu A.; Pektas O.; Erdogan G.; Beyazyürek M.
    Background: Disulfiram, an agent used for the treatment of alcohol dependence, can exacerbate psychiatric syndromes (including psychosis, catatonia, delirium, depression, and mania) after extended use. However, delirium has yet to be reported following the short-term use of disulfiram in the setting of alcohol use. Objectives: We report a case with a neuropsychiatric presentation and discuss the prevention and the progression of delirium associated with an interaction of disulfiram and ethanol. Case Report: We report the case of a 51-year-old woman who developed disorganized speech, diminished communication, a decrease in appetite, and thoughts of suicide 10 days after she began taking disulfiram (250 mg/day), to which she added 1 glass of alcoholic beverage for 2 days. Delirium developed in association with an interaction between disulfiram and alcohol. The patient met DSM-IV criteria for major depressive disorder, alcohol dependence, and delirium. Discussion: Neuropsychiatric manifestations may develop in association with co-administration of disulfiram and alcohol; timely recognition and treatment are recommended. © Copyright 2005 Physicians Postgraduate Press, Inc.
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    Near-fatal skin-picking due to obsessive compulsive disorder responding to combined fluoxetine and cognitive-behavioral therapy: A case report
    (2004) Şahin E.; Kalyoncu O.A.; Pektaş Ö.; Tan D.; Mirsal H.; Beyazyürek M.
    Pathological skin-picking has been reported to be associated with major psychiatric disorders. The most common comorbid psychiatric diseases found in patients with skin-picking were major depression and anxiety disorders (especially obsessive-compulsive disorder). Skin-picking may also lead to medical complications. We describe a 40-yeor-old, married woman with compulsive skin-picking who developed the dangerously self-destructive habit of squeezing or digging debris out of skin tissue and picking at acne and scabs on her forehead, cheeks and chin. The patient was successfully treated with a combination of fluoxetine and cognitive-behavioral psychotherapy.
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    Olanzapine augmentation in elderly patients with treatment-resistant major depression: An open trial [Tedaviye dirençli majör depresyonu olan yaşli hastalarda olanzapin ekleme tedavisi: Bir açik çalişma]
    (2003) Mirsal H.; Kalyoncu A.; Pektaş Ö.; Tan D.; Beyazyürek M.
    Objective: Multiple therapeutic approaches are available for the treatment of patients who are not responding to standard antidepressant medications. One of them is drug augmentation. The effectiveness of olanzapine augmentation treatment for refractory or treatment-resistant major depression in patients over 60 years of age was studied. Methods: An 6-week open label study was conducted in 23 patients with recurrent major depression without psychotic features. The refractory or treatment-resistant depression was defined retrospectively by history of failure to respond to antidepressants at an acceptable therapeutic doses and duration and, patients were required to score >20 on the 17-item Hamilton Depression Rating Scale (HDRS). Subjects were assigned to two phases of treatment; optimization with antidepressant monotherapy at two weeks, and then augmentation with olanzapine (10mg/day). Results: The study subjects were 15 female patients (65.2%), 8 male patients (34.8%). The mean age of the study group was 65.5 years (SD=5.6). The mean HDRS score before and after optimization was 25.6 (SD=3.1) and 25.2 (SD=5.6), respectively. The mean HDRS score at the end of one week of olanzapine augmentation treatment was 15.8 (SD=1.9), at the end of 4 weeks 12.6 (SD=2.1) and at the end of 6 weeks 11.3 (SD=2.7). The differences between the means were statistically significant (p<0.001). HDRS scores for 65.2% of patients (n=15) at the end of 6 weeks of olanzapine augmentation treatment decreased more than 50%. Conclusions: Olanzapine plus standart antidepressant treatment demonstrated superior efficacy for treating refractory or treatment-resistant depression in over 60 age patients.