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Practical Neurology

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https://www.readbyqxmd.com/read/28918396/trochlear-nerve-palsy
#1
EDITORIAL
Tarig Mohammed Abkur
No abstract text is available yet for this article.
September 16, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28847916/neurological-letter-from-calcutta
#2
Tapas Kumar Banerjee
No abstract text is available yet for this article.
August 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28844042/mentored-by-a-madman
#3
Rose Bosnell, Katharine Harding
No abstract text is available yet for this article.
August 26, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28844041/how-to-use-pen-and-paper-tasks-to-aid-tremor-diagnosis-in-the-clinic
#4
EDITORIAL
Jane Alty, Jeremy Cosgrove, Deborah Thorpe, Peter Kempster
When a patient presents with tremor, it can be useful to perform a few simple pen and paper tests. In this article, we explain how to maximise the value of handwriting and of drawing Archimedes spirals and straight lines as clinical assessments. These tasks take a matter of seconds to complete but provide a wealth of information that supplements the standard physical examination. They aid the diagnosis of a tremor disorder and can contribute to its longitudinal monitoring. Watching the patient's upper limb while they write and draw may reveal abnormalities such as bradykinesia, dystonic posturing and distractibility...
August 26, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28844040/rhino-orbito-cerebral-mucormycosis-recovery-against-the-odds
#5
Saman Zafar, Aparna Prabhu
A 22-year-old woman presented with diabetic ketoacidosis, acute right eye blindness and complete ophthalmoplegia. Despite early suspicion and treatment for rhino-orbito-cerebral mucormycosis, her extensive spread of infection led to right internal carotid artery occlusion and cavernous sinus thrombosis, right-sided cerebral watershed infarctions and large abscesses in her right cerebellum, temporal lobe and pons. She underwent surgical removal of her right eye, paranasal sinuses, maxilla and palate, suboccipital craniectomy and shunting for hydrocephalus...
August 26, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28823991/focal-precentral-gyrus-involvement-in-osmotic-demyelination
#6
EDITORIAL
Martin R Turner, John Jacob, Lucy Matthews, Fintan Sheerin
No abstract text is available yet for this article.
August 19, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28819047/unusual-case-of-bilateral-hand-weakness
#7
Sayan Datta, Jeremy Cosgrove, Taimour Alam, Helen L Ford
A 35-year-old man presented with myalgia and bilateral hand weakness, 3 days after the onset of lethargy, fevers and rigours. The hand weakness caused functional impairment including difficulty pressing keys on his mobile phone. On examination, there was mild bilateral hand weakness with normal reflexes. His serum creatine kinase was mildly raised at 503 U/L (24-195), viral PCR throat swab was negative and electromyogram showed subtle myopathic changes in the distal forearm muscles. Nerve conduction studies found no evidence of neuropathy...
August 17, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28819046/tuberculous-tales-an-east-london-experience
#8
REVIEW
Apeksha M Shah, Dominika Raciborska, Matthew Stevens, Sharmilee Gnanapavan, Veronica L C White, Benjamin Turner
Tuberculous meningitis presents a diagnostic and therapeutic challenge, and considering its long history and increasing global incidence, the evidence base for its treatment is relatively scanty. Many UK neurologists will have little first-hand experience of this deadly condition, and if faced with a patient with possible tuberculous meningitis will find decision making less than straightforward. In parts of East London (UK) the rates of tuberculosis and tuberculous meningitis are among the highest in Western Europe, and so the neurologists and respiratory physicians at the Royal London Hospital have encountered many such patients over the years...
August 17, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28819045/fundus-fluorescein-angiography-in-susac-s-syndrome
#9
EDITORIAL
Gavin L Reynolds, Kevin Talbot, Srilakshmi M Sharma
No abstract text is available yet for this article.
August 17, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28778933/muscle-hypertrophy-and-pseudohypertrophy
#10
REVIEW
Jon Walters
The physical examination always begins with a thorough inspection and patients with potential neuromuscular weakness are no exception. One question neurologists routinely address during this early part of the assessment is whether or not there is muscle enlargement. This finding may reflect true muscle hypertrophy-myofibres enlarged from repetitive activity, for example, in myotonia congenita or neuromyotonia-or muscles enlarged by the infiltration of fat or other tissue termed pseudohypertrophy or false enlargement...
August 4, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28778932/recovery-from-blindness-following-accidental-quinine-overdose
#11
EDITORIAL
Hildegard Nikki Hall, Andrew J Tatham
No abstract text is available yet for this article.
August 4, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28778931/hypothyroid-ataxia-complicating-monoclonal-antibody-therapy
#12
Abdul Badran, Carla Moran, Alasdair J Coles
We present a case of cerebellar dysfunction due to severe hypothyroidism induced by pembrolizumab, a member of the 'immune checkpoint inhibitor' class of cancer immunotherapies. Thyroxine replacement completely resolved his symptoms and signs. We also discuss the neurological immune-related complications of checkpoint inhibitors.
August 4, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28778930/useless-hand-of-oppenheim-how-to-understand-it
#13
EDITORIAL
Louise Wiblin, Joe Guadagno
Hermann Oppenheim described the 'Useless Hand' in 1911 as a classical but uncommon presentation of multiple sclerosis, in which a hand loses useful function due to proprioceptive loss, with relatively preserved motor function. Light touch perception may be subjectively altered or can be relatively intact. The lesion is (usually) a demyelinating plaque in the posterior columns of the cervical spinal cord. Depending on its location, it may affect one limb, or if more central, may produce a bilateral (if asymmetrical) picture...
August 4, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28778929/a-portrait-of-the-brain-by-adam-zeman
#14
Ania Crawshaw, Katharine Harding
No abstract text is available yet for this article.
August 4, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28778928/tracheostomy-and-salivary-gland-radiotherapy-for-severe-sialorrhoea-in-motor-neurone-disease
#15
Adrian J Wills, Juliet Colt, Roger Selby
The management of excessive secretions in patients with motor neurone disease can be challenging. In this paper, we highlight the main issues from the perspectives of a patient, specialist nurse and neurologist and the importance of a multidisciplinary approach.
August 4, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28754695/eastern-equine-encephalitis
#16
Daniel Berlin, Ahmed I Gilani, Amrit K Grewal, Mary Fowkes
We describe a patient who died from a fulminant presentation of encephalitis. After an exhaustive search, we found no treatable cause. Postmortem PCR analysis of brain tissue led to a diagnosis of eastern equine encephalitis. We have identified several clinical pearls that may assist others in making the diagnosis earlier in the disease course.
July 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28743792/treatment-of-the-unknown-patient-insights-from-acute-stroke
#17
EDITORIAL
Simon M Bell, Dilraj Sokhi, Tom Hughes, Marc S Randall
When an unidentified patient who cannot communicate presents with symptoms and signs suggesting an acute stroke, the decision to thrombolyse is a particular challenge. In a time-pressured environment, clinicians need clear thought processes for diagnosis and treatment. Ethical considerations, diagnosis, identity and previous history, contraindications, time of symptom onset (EDICT) can help decision-making in this situation.
July 25, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28743791/imaging-in-acute-ischaemic-stroke-pearls-and-pitfalls
#18
REVIEW
James Caldwell, Manraj K S Heran, Ben McGuinness, P Alan Barber
Prompt and accurate diagnosis is the foundation of acute ischaemic stroke care. Multiple positive endovascular thrombectomy trials in ischaemic stroke patients with large vessel occlusions have further emphasised this but also added complexity to treatment decisions. CT angiography is now routine for patients who present with an acute stroke syndrome around the world. Members of the neurology and stroke teams (rather than radiologists) are often the first doctors to lay eyes on the CT images and are best equipped to integrate the clinical picture with the imaging findings...
July 25, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28743790/the-right-way-or-the-best-way-to-do-the-ankle-jerk
#19
Chris Allen
No abstract text is available yet for this article.
July 25, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28717053/pure-autonomic-failure
#20
REVIEW
Thomas P Brown
Pure autonomic failure is a degenerative disorder of the peripheral autonomic nervous system. Patients experience symptomatic hypotension that requires them to sit, squat or lie down to prevent syncope. It is associated with characteristic histopathological findings, resulting in neuronal cytoplasmic inclusions in the peripheral autonomic nerves. These lesions are responsible for defects in the synthesis and release of norepinephrine from sympathetic nerve terminals, resulting in significant hypotension. Patients with autonomic failure also have exaggerated blood pressure responses to common stimuli such as food or fluid intake, heat, exercise and medications...
July 17, 2017: Practical Neurology
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