{"id":10579,"date":"2021-06-11T19:58:30","date_gmt":"2021-06-11T16:58:30","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=10579"},"modified":"2021-06-11T19:58:33","modified_gmt":"2021-06-11T16:58:33","slug":"migren","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/migren\/","title":{"rendered":"Migren"},"content":{"rendered":"\n
\"\"
(Ba\u015fa\u011fr\u0131s\u0131 \u00e7eken ofis personeli. G\u00f6rsel Kayna\u011f\u0131: Prostock-studio\/<\/a>Shutterstock<\/a>)<\/figcaption><\/figure>\n\n\n\n

Genetik alan\u0131nda yap\u0131lan ara\u015ft\u0131rmalar artt\u0131k\u00e7a ba\u015f a\u011fr\u0131s\u0131n\u0131n genlerle olan ili\u015fkisi daha iyi anla\u015f\u0131lm\u0131\u015ft\u0131r. D\u00fcnyadaki yeti\u015fkinlerin neredeyse yar\u0131s\u0131 aktif ba\u015f a\u011fr\u0131s\u0131ndan yak\u0131nmaktad\u0131r. Ba\u015f a\u011fr\u0131s\u0131 primer ve sekonder olarak ikiye ayr\u0131l\u0131r. Primer ba\u015f a\u011fr\u0131s\u0131n\u0131n alt\u0131nda yatan ba\u015fka bir sebep yoktur. Sekonder ba\u015f a\u011fr\u0131s\u0131 ise n\u00f6rolojik ya da sistemik bir hastal\u0131ktan dolay\u0131 a\u00e7\u0131\u011fa \u00e7\u0131kar. Bu yaz\u0131da migrenin genlerle ili\u015fkisi i\u015flenmi\u015ftir.<\/p>\n\n\n\n

Migren<\/p>\n\n\n\n

Toplum bazl\u0131 aile \u00e7al\u0131\u015fmalar\u0131, aileden aktar\u0131lan genler ile migren riskinin artt\u0131\u011f\u0131n\u0131 g\u00f6stermi\u015ftir. Migren hem genetik hem de \u00e7evresel fakt\u00f6rlerden etkilendi\u011fi i\u00e7in \u00e7ok fakt\u00f6rl\u00fc bir bozukluktur. Ancak geneti\u011fin etkisi bask\u0131nd\u0131r. Migren genlerinin aktar\u0131lma olas\u0131l\u0131\u011f\u0131 %40-50\u2019dir.<\/p>\n\n\n\n

Auras\u0131z ve aural\u0131 migrenin farkl\u0131 hastal\u0131klar oldu\u011fu ileri s\u00fcr\u00fclm\u00fc\u015ft\u00fcr. Bu auran\u0131n \u00fc\u00e7 tipi vard\u0131r: G\u00f6rsel, i\u015fitsel aura ve dil auras\u0131. Migren ba\u015flamadan \u00f6nce bu \u00fc\u00e7 duyuda da ge\u00e7ici bozukluklar meydana gelebilir. En yayg\u0131n\u0131 g\u00f6rsel aurad\u0131r ve migreni olan bireylerin %99\u2019unda g\u00f6r\u00fcl\u00fcr.<\/p>\n\n\n\n

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(Migren aura \u00f6rne\u011fi. G\u00f6rsel Kayna\u011f\u0131: Marti Bug Catcher\/<\/a>Shutterstock<\/a>, ID: 1245008320<\/a>)<\/figcaption><\/figure>\n\n\n\n

Ailesel Hemiplejik Migren (FHM)<\/strong><\/p>\n\n\n\n

Ailesel Hemiplejik (Fel\u00e7li) Migren (FHM) nadir g\u00f6r\u00fclen \u015fiddetli ve aural\u0131 bir migrendir. Aura s\u0131ras\u0131nda Hemiparezi<\/em> (v\u00fccudun bir yar\u0131s\u0131nda zay\u0131fl\u0131k) ile karakterizedir. Hemiparezi<\/em> birka\u00e7 dakika, bazen g\u00fcnler s\u00fcrebilir. Ba\u015fta s\u0131kl\u0131kla Epilepsi<\/em> ile kar\u0131\u015ft\u0131r\u0131l\u0131r. FHM ataklar\u0131n\u0131 hafif kafa travmalar\u0131 tetikleyebilir. Hemiparezi<\/em> d\u0131\u015f\u0131nda hastalar\u0131n %20\u2019sinde Serebellar Ataksi, Epilepsi<\/em>, zeka gerili\u011fi, beyin \u00f6demi ve \u00f6l\u00fcmc\u00fcl koma g\u00f6r\u00fclebilir.<\/p>\n\n\n\n

FHM \u00fc\u00e7 farkl\u0131 gen sonucu a\u00e7\u0131\u011fa \u00e7\u0131kabilir. Bunlar FHM1 CACNA1A, FHM2 ATP1A2 <\/em>ve FHM3 SCNA1<\/em>\u2019dir.<\/p>\n\n\n\n

Kromozom 19p13<\/em>\u2019te bulunan CACNA1A<\/em> geni FHM i\u00e7in belirlenen ilk gendir. FHM1<\/em> geni por olu\u015fturan P\/Q tipi Cav2.1<\/em> voltaj kap\u0131l\u0131 n\u00f6ronal kalsiyum kanal\u0131n\u0131n Alpha 1A<\/em> alt birimini kodlar. Bu kanal\u0131n as\u0131l g\u00f6revi periferal n\u00f6romusk\u00fcler kav\u015faklardaki ve beyincik, beyin sap\u0131 ve serebral kortekste bulunan merkezi sinapslardaki n\u00f6rotransmiter sal\u0131n\u0131m\u0131n\u0131 mod\u00fcle etmektir. CACNA1A<\/em> geni mutasyonlar\u0131 sonucu Serebellar Ataksi, Tip 2 Episodik Ataksi, Progresif Ataksi, Tip 6 Spinoserebellar Ataksi <\/em>ve Epilepsi<\/em> g\u00f6r\u00fclebilir.<\/p>\n\n\n\n

ATP1A2<\/em> geni 1q23<\/em> kromozomunda bulunur. Na+\/K+ ATPaz pompas\u0131n\u0131n Alpha 2<\/em> alt birimini kodlar. Bu alt birim Na+, K+ ve ATP\u2019ye ba\u011flan\u0131r. Ayn\u0131 zamanda ATP hidrolizinden faydalanarak sodyumu h\u00fccre d\u0131\u015f\u0131na ve potasyumu h\u00fccre i\u00e7ine al\u0131r. Sodyumun d\u0131\u015fa pompalanmas\u0131 glutamat ve kalsiyum transportu i\u00e7in \u00f6nemlidir. ATP1A2 proteini en \u00e7ok yeni do\u011fanlar\u0131n n\u00f6ronlar\u0131nda ve eri\u015fkinlerin glia h\u00fccrelerinde sentezlenir. Eri\u015fkinlerde bu spesifik ATPaz\u2019\u0131n g\u00f6revlerinden biri glia sinaptik bo\u015flu\u011fundan potasyum ve glutamat\u0131n h\u00fccre i\u00e7ine al\u0131n\u0131m\u0131n\u0131 mod\u00fcle etmesidir. ATP1A2<\/em> genindeki mutasyon Serebellar Ataksi, \u00c7ocukluk \u00c7a\u011f\u0131 Alternan Hemipleji ve \u0130yi Huylu Fokal \u0130nfantil Konv\u00fclsiyonlar\u0131<\/em>\u2019na neden olabilir.<\/p>\n\n\n\n

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(Migren ve k\u00fcme ba\u015f a\u011fr\u0131lar\u0131n\u0131 tedavi etmek i\u00e7in kullan\u0131lan Sumatriptan. <\/em>G\u00f6rsel Kayna\u011f\u0131: Sonis Photography\/<\/a>Shutterstock<\/a>, ID: 1831964161)<\/figcaption><\/figure>\n\n\n\n

Kromozom 2q24<\/em>\u2019te bulunan SCNA1<\/em> geni n\u00f6ronal voltaj kap\u0131l\u0131 sodyum kanallar\u0131n\u0131n (Nav1.1<\/em>) Alpha 1<\/em> alt birimini kodlar. Nav1.1 <\/em>kanallar\u0131 aksiyon potansiyelinin olu\u015fumu ve da\u011f\u0131t\u0131m\u0131nda \u00f6nemli rol oynar. SCNA1<\/em> geninde meydana gelen 100\u2019den fazla mutasyonda \u00c7ocukluk \u00c7a\u011f\u0131 Epilepsisi<\/em> ve ate\u015fli n\u00f6betler g\u00f6r\u00fcl\u00fcr. Ancak bu semptomlar\u0131 g\u00f6steren hastalarda migren olmaz. SCNA1 <\/em>geni FHM\u2019yle nadiren ili\u015fkilidir.<\/p>\n\n\n\n

Sporadik Hemiplejik Migren (SHM)<\/strong><\/p>\n\n\n\n

Sporadik Hemiplejik Migren (SHM) \u00e7evresel fakt\u00f6rler ya da ya\u015fl\u0131l\u0131k sonucu a\u00e7\u0131\u011fa \u00e7\u0131kar. Nispeten s\u0131k g\u00f6r\u00fcl\u00fcr ve SHM\u2019nin mutasyona sebep oldu\u011fu durumlarda o ki\u015fiye \u201c\u0130lk FHM Hastas\u0131\u201d denebilir. Bu genler de FHM\u2019de oldu\u011fu gibi nesilden nesle aktar\u0131labilir. Buna ra\u011fmen FHM ve SHM aras\u0131ndaki genetik ili\u015fki tam olarak anla\u015f\u0131lmam\u0131\u015ft\u0131r.<\/p>\n\n\n\n

CSD of Leao<\/strong><\/p>\n\n\n\n

Migrenin as\u0131l sebebi Leao Kortikal Yay\u0131lan Depresyon\u2019dur (CSD of Leao). Deney hayvanlar\u0131nda CSD beyin korteksi boyunca yava\u015f\u00e7a yay\u0131lan (2-5 mm\/dk) n\u00f6ronal ve glial depolarizasyon dalgas\u0131d\u0131r ve b\u00fcy\u00fck bir iyon ak\u0131\u015f\u0131 olur. Ancak bu dalgadan sonra uzun s\u00fcreli bir inhibisyon olur. Elektrofizyolojik de\u011fi\u015fimler serebral kan ak\u0131\u015f\u0131n\u0131n art\u0131p azalmas\u0131yla ilgilidir. CSD g\u00fc\u00e7l\u00fc uyaranlara kar\u015f\u0131 bir savunma mekanizmas\u0131d\u0131r. Beyin dokusu, kortikal travma, serebral iskemi ve y\u00fcksek konsantrasyonda potasyumun ya da glutamat gibi n\u00f6roeksitat\u00f6r amino asitlerin kortekste artmas\u0131 sonucu tetiklenebilir.<\/p>\n\n\n\n

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(Parasetamol tabletleriyle migren. G\u00f6rsel Kayna\u011f\u0131: MinskDesign\/<\/a>Shutterstock<\/a>, ID: 1561126448)<\/figcaption><\/figure>\n\n\n\n

Bilgi Kaynak\u00e7as\u0131<\/p>\n\n\n\n

  1. Cutrer, F. Michael, and Karina Huerter. “Migraine aura.” The neurologist 13.3 (2007): 118-125.<\/li>
  2. Healthline. Suzanne Falck M.D., FACP. \u201cEverything You Should Know About Hemiparesis<\/a>\u201d 05.06.2017, 13.05.2021.<\/li>
  3. Van Den Maagdenberg, Arn MJM, et al. “Genetics of headaches.” Handbook of clinical neurology. Vol. 97. Elsevier, 2010. 85-97.<\/li>
  4. Green, Mark W. “Secondary headaches.” CONTINUUM: Lifelong Learning in Neurology 18.4 (2012): 783-795.<\/li>
  5. Melek, \u0130smet M., Esra Okuyucu, and Ta\u015fk\u0131n Duman. “K\u00fcme ba\u015f a\u011fr\u0131s\u0131.” T\u00fcrkiye Aile Hekimli\u011fi Dergisi 10.3 (2006): 117-122.<\/li>
  6. Robbins, Matthew S., and Richard B. Lipton. “The epidemiology of primary headache disorders.” Seminars in neurology. Vol. 30. No. 02. \u00a9 Thieme Medical Publishers, 2010.<\/li><\/ol>\n\n\n\n

    G\u00f6rsel Kaynak\u00e7as\u0131<\/p>\n\n\n\n

    1. Prostock-studio\/Shutterstock<\/a><\/li>
    2. Marti Bug Catcher\/Shutterstock<\/a>, ID: 1245008320<\/li>
    3. Sonis Photography\/Shutterstock<\/a>, ID: 1831964161<\/li>
    4. MinskDesign\/Shutterstock<\/a>, ID: 1561126448<\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

      Genetik alan\u0131nda yap\u0131lan ara\u015ft\u0131rmalar artt\u0131k\u00e7a ba\u015f a\u011fr\u0131s\u0131n\u0131n genlerle olan ili\u015fkisi daha iyi anla\u015f\u0131lm\u0131\u015ft\u0131r. D\u00fcnyadaki yeti\u015fkinlerin neredeyse yar\u0131s\u0131 aktif ba\u015f a\u011fr\u0131s\u0131ndan<\/p>\n","protected":false},"author":267,"featured_media":10581,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1,25],"tags":[2094,2093,73,894,149,115,810,86,2092,2095],"acf":[],"views":597,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/10579"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/267"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=10579"}],"version-history":[{"count":1,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/10579\/revisions"}],"predecessor-version":[{"id":10585,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/10579\/revisions\/10585"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/10581"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=10579"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=10579"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=10579"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}