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Practical Neurology

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https://www.readbyqxmd.com/read/29123022/the-shaking-woman-or-a-history-of-my-nerves-by-siri-hustvedt
#1
Fiona Moreton, Tim Wilkinson
No abstract text is available yet for this article.
November 9, 2017: Practical Neurology
https://www.readbyqxmd.com/read/29097555/lupus-myelopathy
#2
Dominika D Raciborska, Alastair John Noyce, Dev Pyne, Benjamin P Turner
Although neurological manifestations of systemic lupus erythematosus (SLE) are well recognised, myelopathy complicating SLE is rare. A 35-year-old woman presented with non-specific symptoms and a respiratory tract infection but had serological evidence of SLE. She subsequently deteriorated rapidly, developing a catastrophic spinal cord syndrome. Her initial MRI was normal; but after 1 month, her encephalopathy having progressed, repeat imaging showed characteristic myelitic changes. She responded only slowly to a combination of cyclophosphamide and corticosteroids...
November 2, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28972036/sudep-the-aftermath-supporting-the-bereaved
#3
Lina Nashef, John Paul Leach
Sudden unexpected death in epilepsy is a recurring calamity, yet there is little evidence to guide standards of care for supporting the bereaved. Grief in bereavement includes loss, feelings of guilt, anger and blame. There is also the shock and trauma of the sudden event. How can this be alleviated? This paper focuses on guiding the physician to support the bereaved, while recognising the limited evidence and the varying circumstances that may not always facilitate this. We propose a pathway of care and mode of communication with the deceased's family, with whom contact is currently limited...
September 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28972035/practice-under-pressure-what-neurology-can-learn-from-anaesthesia
#4
REVIEW
Mark Stacey
Performing a stressful task under pressure is challenging. Strategies to optimise our training must focus on learning a skill correctly, and then practising that skill sufficiently to avoid compromising that performance in the cauldron of the clinical environment. This article discusses ways of doing things better, based on practical strategies employed in anaesthesia, but developed primarily in elite sport and the military. It involves taking a skill, practising it until it becomes a habit and over time making it part of normal behaviour...
September 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28972034/neurologist-under-pressure-what-neurology-can-learn-from-anaesthesia
#5
EDITORIAL
David Joseph Nicholl
No abstract text is available yet for this article.
September 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28972033/multifocal-necrotising-leucoencephalopathy-following-salmonella-infection-in-an-immunocompetent-patient
#6
Michael A O'Gara, Sonali Dharia, David Hilton, Nicholas J Gutowski
Multifocal necrotising leucoencephalopathy is a rare disorder affecting the central nervous system. It is characterised pathologically by microscopic areas of necrosis with pontine predilection but also involvement of extrapontine regions, including the cerebellum, medulla and cerebral hemispheres. It usually occurs on the background of immunosuppression. Here we describe an immunocompetent patient with a recent history of Salmonella infection who presented with subacute neurological deterioration. At postmortem, she had evidence of multifocal necrotising leucoencephalopathy...
September 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28972032/diverse-phenotype-of-hypokalaemic-periodic-paralysis-within-a-family
#7
Albi Jose Chalissery, Tudor Munteanu, Yvonne Langan, Francesca Brett, Janice Redmond
Hypokalaemic periodic paralysis typically presents with intermittent mild-to-moderate weakness lasting hours to days. We report a case with an uncommon phenotype of late-onset myopathy without episodic paralytic attacks. Initial work-up including muscle biopsy was inconclusive. A subsequent review of the right deltoid biopsy, long exercise testing and repeated family history was helpful, followed by appropriate genetic testing. We identified a heterozygous pathogenic mutation in calcium ion channel (CACNA1S:c...
September 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28972031/gordon-holmes-syndrome-finally-genotype-meets-phenotype
#8
Shahid Mehmood, Nigel Hoggard, Marios Hadjivassiliou
We describe a patient with Gordon Holmes syndrome presenting with a combination of hypogonadotropic hypogonadism, ataxia and progressive cognitive decline, with distinct MRI brain findings. Recent genetic advances allowed the identification of the genetic defects responsible for this rather unusual combination of endocrine and neurological involvement.
September 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28947637/vitamin-d-supplementation
#9
EDITORIAL
Ruth Dobson, Hannah R Cock, Peter Brex, Gavin Giovannoni
Vitamin D testing and supplementation is of great interest to neurologists and their patients. Recommended nutritional intakes of vitamin D in the UK remain focused on bone health, despite increasing evidence for a role outside this area. Here we discuss how neurologists might approach vitamin D testing and supplementation, focusing on two conditions associated with vitamin D deficiency that have an increased risk of downstream complications resulting from these: multiple sclerosis and epilepsy. We set out a rationale for testing serum 25-hydroxyvitamin D concentrations and discuss our personal practice in terms of supplementation, with evidence where available...
September 25, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28918396/trochlear-nerve-palsy
#10
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
#11
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
#12
Rose Bosnell, Katharine Harding
No abstract text is available yet for this article.
August 26, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28844040/rhino-orbito-cerebral-mucormycosis-recovery-against-the-odds
#13
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/29142055/abn-new-for-december
#14
Joanne Lawrence, David Joseph Nicholl
No abstract text is available yet for this article.
December 2017: Practical Neurology
https://www.readbyqxmd.com/read/29097554/restless-legs-syndrome-clinical-features-diagnosis-and-a-practical-approach-to-management
#15
REVIEW
Subhashie Wijemanne, William Ondo
Restless legs syndrome (RLS) is a chronic neurological disorder that interferes with rest and sleep. It has a wide spectrum of symptom severity, and treatment is started when symptoms become bothersome. Dopamine agonists and calcium channel apha-2-delta antagonists (gabapentin, gabapentin enacarbil and pregabalin) are first-line treatments; calcium channel alpha-2-deltas are preferred over dopamine agonists because they give less augmentation, a condition with symptom onset earlier in the day and intensification of RLS symptoms...
December 2017: Practical Neurology
https://www.readbyqxmd.com/read/28844041/how-to-use-pen-and-paper-tasks-to-aid-tremor-diagnosis-in-the-clinic
#16
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...
December 2017: Practical Neurology
https://www.readbyqxmd.com/read/28928153/abn-news
#17
Joanne Lawrence, David Joseph Nicholl
No abstract text is available yet for this article.
October 2017: Practical Neurology
https://www.readbyqxmd.com/read/28928152/highlights-of-the-issue
#18
Geraint N Fuller, Phil E M Smith
No abstract text is available yet for this article.
October 2017: Practical Neurology
https://www.readbyqxmd.com/read/28823991/focal-precentral-gyrus-involvement-in-osmotic-demyelination
#19
EDITORIAL
Martin R Turner, John Jacob, Lucy Matthews, Fintan Sheerin
No abstract text is available yet for this article.
October 2017: Practical Neurology
https://www.readbyqxmd.com/read/28778933/muscle-hypertrophy-and-pseudohypertrophy
#20
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...
October 2017: Practical Neurology
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