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Practical Neurology

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https://www.readbyqxmd.com/read/28196841/the-10-p-m-question
#1
Katharine Harding, Clinton Mitchell
No abstract text is available yet for this article.
February 14, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28196840/the-northern-territory-australia
#2
EDITORIAL
Prashanth Ramachandran
No abstract text is available yet for this article.
February 14, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28188210/management-of-oral-secretions-in-neurological-disease
#3
REVIEW
Alexander J McGeachan, Christopher J Mcdermott
Sialorrhoea is a common and problematic symptom that arises from a range of neurological conditions associated with bulbar or facial muscle dysfunction. Drooling can significantly affect quality of life due to both physical complications such as oral chapping, and psychological complications such as embarrassment and social isolation. Thicker, tenacious oral and pharyngeal secretions may result from the drying management approach to sialorrhoea. The management of sialorrhoea in neurological diseases depends on the underlying pathology and severity of symptoms...
February 10, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28183984/abdominal-pseudocyst-a-rare-complication-of-ventriculoperitoneal-shunting
#4
Rameesha Anwar, Ahmed-Ramadan Sadek, Girish Vajramani
Abdominal cerebrospinal fluid (CSF) pseudocyst is a rare complication of ventriculoperitoneal shunting. It is well known in children but uncommon in adults. We present a 30-year-old woman with abdominal distension, vomiting and confusion caused by her developing an abdominal CSF pseudocyst, 13 years after her last shunt revision. Adult neurologists need to be aware of this late complication.
February 9, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28159879/symptomatic-intracranial-hypertension-during-recovery-from-the-syndrome-of-headache-with-neurologic-deficits-and-cerebrospinal-fluid-lymphocytosis-handl
#5
Eoin Mulroy, Joel Yap, Helen Danesh-Meyer, Neil Anderson
The syndrome of headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HANDL) is rare; it comprises migrainous headaches (generally in headache-naïve people), fluctuating neurological symptoms and cerebrospinal fluid (CSF) lymphocytosis. The syndrome generally runs a benign, self-limiting course over weeks. A small proportion of patients develop intracranial hypertension as a consequence of the illness. Recurrence of headaches or development of visual symptoms following apparent recovery from HANDL should prompt urgent re-evaluation for elevated intracranial pressure...
February 3, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28153849/corticosteroid-responsive-focal-granulomatous-herpes-simplex-type-1-encephalitis-in-adults
#6
Aravinthan Varatharaj, James Ar Nicoll, Emanuela Pelosi, Ashwin A Pinto
We describe corticosteroid-responsive focal granulomatous encephalitis as a manifestation of herpes simplex virus (HSV) type 1 disease in the brain: something easily missed and easily treated. Two adult cases presented with cognitive symptoms progressing over weeks, despite aciclovir treatment. Brain imaging showed temporal lobe abnormalities, with gadolinium enhancement but no abnormal diffusion restriction. HSV-1 PCR analysis was negative in cerebrospinal fluid (CSF) but positive in brain biopsies, which showed vasocentric granulomatous inflammation...
February 2, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28153848/cjd-mimics-and-chameleons
#7
REVIEW
Simon Mead, Peter Rudge
Rapidly progressive dementia mimicking Creutzfeldt-Jakob disease (CJD) is a relatively rare presentation but a rewarding one to become familiar with, as the potential diagnoses range from the universally fatal to the completely reversible. Patients require urgent decisions about assessment and investigation and have quickly evolving needs for treatments and support, through symptom management and end-of-life care in most cases. We have based this pragmatic review on the experiences of a specialist prion referral centre in the UK, which, unsurprisingly, is strongly biased towards seeing patients with CJD...
February 2, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28131990/bell-s-that-did-not-ring-true
#8
Gemma Maxwell, Paul Reading
No abstract text is available yet for this article.
January 28, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28119379/neurological-consults-on-the-renal-unit
#9
REVIEW
Dearbhla M Kelly, Michael R Clarkson, Simon Cronin
Neurological symptoms commonly occur in chronic kidney disease and may result from its treatments and complications. Impaired renal function also influences treatments for other neurological conditions, requiring various cautions, dose adjustments and timing considerations, particularly in the context of renal replacement therapy. In this review, we present six illustrative clinical vignettes to highlight these challenges.
January 24, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28119378/guanidinoacetate-methyltransferase-gamt-deficiency-a-rare-but-treatable-epilepsy
#10
William M Stern, Joel S Winston, Elaine Murphy, J Helen Cross, Josemir W Sander
Epilepsy commonly presents in childhood as part of a syndrome, and some such children may reach adult services without an underlying syndromic diagnosis. For adult neurologists taking over their care, it is often unclear how hard to search for an underlying diagnosis. The diagnostic yield may be small and such a diagnosis may not change management. Young adults with learning difficulties are also challenging to investigate, as they may not tolerate standard epilepsy tests.We present such a case in which simple tests identified a unifying diagnosis...
January 24, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28119377/a-50-year-old-with-rapid-neuropsychiatric-deterioration-and-choreiform-movements
#11
Graham Andrew Mackay, Stewart Campbell, Ravi Jampana, Jonathan Cavanagh
No abstract text is available yet for this article.
January 24, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28119376/pyramidal-weakness
#12
Charles Mark Wiles
No abstract text is available yet for this article.
January 24, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28073921/parascapular-muscle-atrophy-as-a-delayed-effect-of-radiation-treatment
#13
EDITORIAL
Shivam Om Mittal, Bashar Katirji
No abstract text is available yet for this article.
January 10, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28073920/sweet-food-preference-in-amyotrophic-lateral-sclerosis
#14
EDITORIAL
Martin R Turner, Kevin Talbot
No abstract text is available yet for this article.
January 10, 2017: Practical Neurology
https://www.readbyqxmd.com/read/27974376/navigating-the-island-of-reil-how-to-understand-the-insular-cortex
#15
EDITORIAL
Ray Wynford-Thomas, Rob Powell
Insular-onset seizures are rare and easily misdiagnosed. In this article, we aim to highlight the often distinctive semiology of seizures involving the insula with reference to three cases. We suggest three points to aid the recognition of seizures involving the insula: (1) Seizures originating in the insula frequently present with a sensation of laryngeal constriction, dyspnoea or unpleasant somatosensory symptoms; (2) Seizures involving the anterior insula may have a silent onset, but tend to propagate rapidly to motor areas causing motor or hypermotor symptoms; (3) Seizures involving the posterior insula cause somatosensory symptoms, which are normally contralateral to the seizure onset...
December 14, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27941127/leprosy-in-a-patient-infected-with-hiv
#16
Clare M Galtrey, Hamid Modarres, Zane Jaunmuktane, Sebastian Brandner, Alexander M Rossor, Diana Nj Lockwood, Mary M Reilly, Hadi Manji, Fred Schon
A 60-year-old Nigerian man, who had lived in Europe for 30 years but had returned home frequently, presented with right frontalis muscle weakness and right ulnar nerve palsy, without skin lesions. Neurophysiology showed a generalised neuropathy with demyelinating features. Blood tests were positive for HIV, with a normal CD4 count. There was nerve thickening both clinically and on MRI. Nerve biopsy showed chronic endoneuritis and perineuritis (indicating leprosy) without visible mycobacteria. His neuropathy continued to deteriorate (lepra reaction) before starting treatment with WHO multidrug therapy, highly active antiretroviral therapy and corticosteroids...
December 9, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27927777/internuclear-ophthalmoplegia
#17
Jonathan D Virgo, Gordon T Plant
A brainstem lesion of any type that involves the medial longitudinal fasciculus (MLF) can cause internuclear ophthalmoplegia (INO). This primarily affects conjugate horizontal gaze and classically manifests as impaired adduction ipsilateral to the lesion and abduction nystagmus contralateral to the lesion. Here, we describe the anatomy of the MLF and review the clinical features of INO. We also describe conjugate horizontal gaze palsy and some of the 'INO-plus' syndromes.
December 7, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27927776/clinicopathological-case-progressive-cognitive-decline-with-gait-disturbance-in-a-steel-worker
#18
Fiona C Moreton, Robert Brenner, Jayam Lazarus, Richard Davenport
A 57-year-old male steel plant worker presented with fatigue and altered liver function tests. Over the next two years, he developed cognitive decline, parkinsonism and seizures. This paper reports the clinicopathological conference at the 37th Edinburgh Advanced Neurology Course 2015 and outlines what we can learn from this case.
December 7, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27927775/memantine-induced-chorea-and-dystonia
#19
Letizia Goncalves Borges, Borna Bonakdarpour
Memantine is an uncompetitive N-methyl-d-aspartate receptor antagonist and probably also has an indirect dopaminergic action at high concentrations. We describe a person with Alzheimer's disease who developed chorea and dystonia after inadvertently doubling of her daily dose by taking extended-release (XR) memantine twice daily, rather than once daily (planned dose memantine XR, 21 mg once daily), after the drug was switched from immediate release (IR, 10 mg twice daily). Memantine is rarely associated with movement disorders, but this case emphasises the need for awareness of potential problems when switching from memantine IR to XR...
December 7, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27903764/epilepsy-and-music-practical-notes
#20
REVIEW
M Maguire
Music processing occurs via a complex network of activity far beyond the auditory cortices. This network may become sensitised to music or may be recruited as part of a temporal lobe seizure, manifesting as either musicogenic epilepsy or ictal musical phenomena. The idea that sound waves may directly affect brain waves has led researchers to explore music as therapy for epilepsy. There is limited and low quality evidence of an antiepileptic effect with the Mozart Sonata K.448. We do not have a pathophysiological explanation for the apparent dichotomous effect of music on seizures...
November 30, 2016: Practical Neurology
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