1,110 results match your criteria Practical Neurology [Journal]


by Edward Docx.

Authors:
Gavin Langlands

Pract Neurol 2019 Apr 17. Epub 2019 Apr 17.

National Creutzfeldt-Jakob Disease Research and Surveillance Unit, University of Edinburgh, Edinburgh, UK

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2018-002032
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http://dx.doi.org/10.1136/practneurol-2018-002032DOI Listing
April 2019
1 Read

Brody disease: when myotonia is not myotonia.

Pract Neurol 2019 Apr 17. Epub 2019 Apr 17.

Neurology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.

A 56-year-old man presented with painless impairment of muscle relaxation on vigorous contraction (eg, eyelid closure, hand grip, running). There were no episodes of paralysis, symptom progression, weakness or extramuscular symptoms. Five of his fifteen siblings had similar complaints. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2019-002224
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http://dx.doi.org/10.1136/practneurol-2019-002224DOI Listing
April 2019
1 Read

Difficult case: rituximab in anti-SRP antibody myositis in pregnancy.

Pract Neurol 2019 Apr 12. Epub 2019 Apr 12.

Imperial College Healthcare NHS Trust, London, UK

A 30-year-old nulliparous woman presented at 15-week gestation with severe skeletal and respiratory muscle weakness, having been diagnosed with anti-signal recognition particle antibody myositis 3 years before. Remission had previously been induced with rituximab (after failure of standard therapies). She had continued oral prednisolone and rituximab every 6 months but had stopped this when planning pregnancy. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002168DOI Listing
April 2019
1 Read

Book Club review: (by Helen Keller).

Pract Neurol 2019 Apr 11. Epub 2019 Apr 11.

Neurology, University Hospital of Wales, Cardiff, UK

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http://dx.doi.org/10.1136/practneurol-2019-002212DOI Listing

Multiple system atrophy mimicked by multi-organ pathology.

Pract Neurol 2019 Apr 11. Epub 2019 Apr 11.

Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK

Both multiple system atrophy and Parkinson's disease may present with parkinsonism and autonomic dysfunction. We describe a patient who initially met the diagnostic criteria for multiple system atrophy and had atypical features for Parkinson's disease including blackouts and pyramidal signs. Ultimately, he was found to have three separate diagnoses rather than a single unifying one. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2019-002233
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http://dx.doi.org/10.1136/practneurol-2019-002233DOI Listing
April 2019
2 Reads

Proximal muscle weakness.

Pract Neurol 2019 Apr 4. Epub 2019 Apr 4.

Department of Neurology, Harvard Medical School, Brigham Women's Hospital, Boston, Massachusetts, USA.

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2019-002204
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http://dx.doi.org/10.1136/practneurol-2019-002204DOI Listing
April 2019
2 Reads

Spinal vascular disease: a neglected cause of myelopathy.

Authors:
Robin S Howard

Pract Neurol 2019 Apr 4. Epub 2019 Apr 4.

Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK

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http://dx.doi.org/10.1136/practneurol-2019-002194DOI Listing

Genetic chameleons: remember the relapsing disorders.

Pract Neurol 2019 Apr 4. Epub 2019 Apr 4.

Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

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http://dx.doi.org/10.1136/practneurol-2018-002181DOI Listing
April 2019
1 Read

Noticing in Neurology.

Authors:
A J Lees

Pract Neurol 2019 Apr 4. Epub 2019 Apr 4.

Reta Lila Weston Institute of Neurological Studies, University College London, London WC1H 9JR, UK

The three cardinal qualities necessary for the ideal neurologist are observation, the ability to reason backwards inferentially and specialist knowledge. Modern medical technology has greatly increased the ability to diagnose and treat disease but it has also encouraged a benign variant of abulia, which is killing off the art and science of clinical reasoning. Intent gazing at the unfamiliar with old eyes or a long look at the familiar with new eyes offers the neurologist an opportunity to discover hitherto unnoticed diagnostic signs far beyond the resolution of the brain scanner and even the light microscope. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002176DOI Listing

Vogt-Koyanagi-Harada syndrome: what neurologists need to know.

Pract Neurol 2019 Mar 19. Epub 2019 Mar 19.

Neurology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia

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http://dx.doi.org/10.1136/practneurol-2018-002165DOI Listing

Vogt-Koyanagi-Harada disease.

Pract Neurol 2019 Mar 19. Epub 2019 Mar 19.

Birmingham Neuro-Ophthalmology Unit, Ophthalmology Department, University Hospitals Birmingham NHS Trust, Birmingham, UK.

Vogt-Koyanagi-Harada disease is a rare, multisystem, autoimmune disorder with numerous clinical manifestations, mediated through a T-helper 1 response against melanocytes in the eye, inner ear, central nervous system, hair and skin. We describe a 20-year-old British-Honduran man with recent worsening headache and photophobia, vomiting and visual blurring. On examination, his pupils reacted sluggishly and visual acuities were bilaterally reduced. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002152DOI Listing
March 2019
3 Reads

Dissociative (non-epileptic) seizures: tackling common challenges after the diagnosis.

Authors:
Markus Reuber

Pract Neurol 2019 Mar 16. Epub 2019 Mar 16.

Royal Hallamshire Hospital, Academic Neurology Unit, University of Sheffield, Sheffield, UK

Dissociative (non-epileptic) seizures are one of the three major causes of transient loss of consciousness. As such, their treatment cannot be left to superspecialised experts. In this article I draw on personal experience to suggest ways to tackle some challenges that commonly arise after diagnosing dissociative seizures, focusing on three issues: "I want to know what is wrong with me," "I hear what you are saying but it doesn't apply to me" and "What if I have a seizure?" The suggestions detail both actions and words that may help at a crucial point in the patient's journey. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002177DOI Listing

Infectious encephalitis: mimics and chameleons.

Pract Neurol 2019 Mar 16. Epub 2019 Mar 16.

Department of Neurology, Chelsea and Westminster Hospital, London, UK

'Query encephalitis' is a common neurological consultation in hospitalised patients. Identifying the syndrome is only part of the puzzle. Although historically encephalitis has been almost synonymous with infection, we increasingly recognise parainfectious or postinfectious as well as other immune-mediated causes. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002114DOI Listing

Tip of the iceberg in idiopathic intracranial hypertension.

Pract Neurol 2019 04;19(2):178-179

Metabolic Neurology, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK

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http://dx.doi.org/10.1136/practneurol-2019-002198DOI Listing
April 2019
2 Reads

Indication to use a non-pencil-point lumbar puncture needle.

Pract Neurol 2019 04;19(2):176-177

Neuro-Ophthalmology Clinic, St Vincent's Public Hospital, Melbourne, Victoria, Australia.

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http://dx.doi.org/10.1136/practneurol-2018-002103DOI Listing
April 2019
1 Read

Seeing again: treatment of functional visual loss.

Pract Neurol 2019 Apr;19(2):168-172

Centre for Clinical Brain Sciences, University of Edinburgh, Western General Hospital, Edinburgh, UK

There is very little published literature on treatment strategies for functional visual loss. We present two people with long duration of functional visual loss who achieved complete recovery with a novel combination of therapeutic approaches. These included: (1) the clinician being transparent regarding positive signs such as optokinetic nystagmus, in order to persuade family members of the diagnosis, (2) regularly positively acknowledging everyday events that indicated visual ability, (3) using occipital transcranial magnetic stimulation to induce phosphenes as an artificial temporary visual experience and (4) using hypnotherapy to promote visual recovery. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2018-002092
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http://dx.doi.org/10.1136/practneurol-2018-002092DOI Listing
April 2019
3 Reads

The Waiting Room: neurological observations made outside the movement disorder specialist's consulting office.

Pract Neurol 2019 Mar 14. Epub 2019 Mar 14.

Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands

The neurological examination should always begin before the patient enters the doctor's office. Movement disorders in particular lend themselves to a spot diagnosis. In today's busy buzzing world, it seems wasteful not to make use of the various diagnostic clues that can be picked up readily while the patient is still in the waiting room. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002110DOI Listing
March 2019
8 Reads

Management of a wake-up stroke.

Pract Neurol 2019 Mar 14. Epub 2019 Mar 14.

Department of Neurology, St. George's University Hospitals NHS Foundation Trust, London, UK.

Current national guidelines advocate intravenous thrombolysis to treat patients with acute ischaemic stroke presenting within 4.5 hours from symptom onset, and thrombectomy for patients with anterior circulation ischaemic stroke from large vessel occlusion presenting within 6 hours from onset. However, a substantial group of patients presents with acute ischaemic stroke beyond these time windows or has an unknown time of onset. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002179DOI Listing
March 2019
4 Reads

My year off: Rediscovering life after a stroke.

Pract Neurol 2019 Mar 5. Epub 2019 Mar 5.

Department of Neurology, University Hospital of Wales, Cardiff, UK.

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http://dx.doi.org/10.1136/practneurol-2018-002190DOI Listing
March 2019
1 Read

Hemifacial angioedema following alteplase for acute stroke.

Pract Neurol 2019 Mar 5. Epub 2019 Mar 5.

Division of Pulmonary, Critical Care and Sleep Medicine, Bridgeport Hospital, Yale-New Haven Health System, Bridgeport, Connecticut, USA.

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http://dx.doi.org/10.1136/practneurol-2018-002112DOI Listing
March 2019
2 Reads

Autoantibody testing in idiopathic inflammatory myopathies.

Pract Neurol 2019 Mar 2. Epub 2019 Mar 2.

Department of Neurology, Center for Neuroscience Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.

The diagnosis and classification of idiopathic inflammatory myopathies are based mainly on clinical and histological features. The discovery of myositis-specific and myositis-associated antibodies has simplified the (sub)classification of inflammatory myopathies. Patients suspected of having an idiopathic inflammatory myopathy should undergo routine antibody testing to gain more insight into distinct phenotypes, comorbidities, treatment response and prognosis. Read More

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http://dx.doi.org/10.1136/practneurol-2017-001742DOI Listing
March 2019
1 Read

Atrial fibrillation and stroke: a practical guide.

Pract Neurol 2019 Mar 2. Epub 2019 Mar 2.

Stroke Research Centre, University College London Queen Square Institute of Neurology, London, UK

Neurologists and stroke physicians will be familiar with atrial fibrillation as a major cause of ischaemic stroke, and the role of anticoagulation in preventing cardioembolic stroke. However, making decisions about anticoagulation for individual patients remains a difficult area of clinical practice, balancing the serious risk of ischaemic stroke against that of major bleeding, particularly intracranial haemorrhage. Atrial fibrillation management requires interdisciplinary collaboration with colleagues in cardiology and haematology. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002089DOI Listing
March 2019
8 Reads

Relapsing necrotising encephalomyelopathy due to mutation.

Pract Neurol 2019 Feb 22. Epub 2019 Feb 22.

Neurology, Flinders Medical Centre, Adelaide, South Australia, Australia.

A young woman with a history of previously undiagnosed episodic neurological deterioration since early childhood associated with viral illnesses developed fulminant encephalitis. Standard investigations gave no diagnosis. Next-generation sequencing identified a heterozygous mutation c. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002063DOI Listing
February 2019
1 Read

Explaining dissociative seizures: a neuropsychological perspective.

Pract Neurol 2019 Feb 12. Epub 2019 Feb 12.

Department of Neurology, University Hospital of Wales, Cardiff, UK.

Dissociative seizures are common in routine neurological practice and cause considerable morbidity. However, explaining such episodes to patients is rarely straightforward. Taking a neuropsychological perspective, we present a strategy for communicating this diagnosis to both patients and families. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002100DOI Listing
February 2019
2 Reads

Obstetric anaesthesia: what a neurologist needs to know.

Pract Neurol 2019 Feb 12. Epub 2019 Feb 12.

Department of Neurology, Brigham and Women's Hospital, Roslindale, MA 02115, USA

Neurologists are often consulted to see women postpartum who are having difficulties involving the lower extremities; weakness, numbness and pain. Many of these women have received labour analgesia. Often, there is limited understanding by the neurologist of how these procedures are performed, why a neuraxial technique is chosen and their potential complications. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002081DOI Listing
February 2019

Multiple cerebral infarcts: a rare complication of neurosarcoidosis.

Pract Neurol 2019 Jan 30. Epub 2019 Jan 30.

Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

A 52-year-old man experienced a relapse of neurosarcoidosis, characterised by obstructive hydrocephalus and multiple posterior circulation infarcts. He was taking methotrexate, but his prednisolone was being weaned because of adverse effects. Stroke is rare in neurosarcoidosis and typically relates to granulomatous inflammation with a predilection for the perforator arteries. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002133DOI Listing
January 2019
2 Reads

Dystonic crises in dopa-responsive dystonia induced by energy drinks.

Pract Neurol 2019 Jan 30. Epub 2019 Jan 30.

Alfred Hospital, Melbourne, Victoria, Australia.

We present an interesting case of recurrent dystonic crises in dopa-responsive dystonia (DRD) likely induced by excessive consumption of aspartame-containing products, in particular sugar-free energy drinks. This has a strong practical value as acute presentations to the emergency department can be avoided in these susceptible individuals. Usual medical and dietary advice in the treatment of DRD would include the avoidance of high-dose phenylalanine-containing products, and to this we would advocate the avoidance of high-dose aspartame-containing products. Read More

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http://dx.doi.org/10.1136/practneurol-2018-001900DOI Listing
January 2019
3 Reads

Investigating adults with early-onset epilepsy and intellectual or physical disability.

Pract Neurol 2019 Apr 24;19(2):115-130. Epub 2019 Jan 24.

Metabolic Disease (Adult Inherited), Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK.

This article focuses on investigating adults with early-onset epilepsy and intellectual or physical disability within adult neurology services. We aim to guide general neurologists in the diagnostic reassessment of people with epilepsy and complex neurological problems of unknown cause. Following an overview, we address imaging, electroencephalography, genetic studies and metabolic testing, and give examples where diagnosis directly influences treatment. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2018-001965
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http://dx.doi.org/10.1136/practneurol-2018-001965DOI Listing
April 2019
13 Reads

ABN News Feb 2019.

Pract Neurol 2019 02;19(1):86

Department of Neurology, University Hospitals Trust, Birmingham, UK.

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http://dx.doi.org/10.1136/practneurol-2018-002173DOI Listing
February 2019
1 Read

UK consensus on pregnancy in multiple sclerosis: 'Association of British Neurologists' guidelines.

Pract Neurol 2019 Apr 5;19(2):106-114. Epub 2019 Jan 5.

Department of Neurology, King's College Hospital NHS Foundation Trust, London, UK.

Multiple sclerosis (MS) is more common in women than men and is most commonly diagnosed in early adulthood; thus, many patients will not have completed their families at the time of diagnosis. There is increasing awareness of the importance of early treatment in preventing long-term disability in MS. Delaying treatment until women with MS have completed their families can lead to the development of irreversible disability in at least some cases. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002060DOI Listing
April 2019
2 Reads

Capecitabine leukoencephalopathy.

Pract Neurol 2019 Jan 5. Epub 2019 Jan 5.

Department of Neurology, Sheffield Teaching Hospital NHS Trust, Royal Hallamshire Hospital, Sheffield, UK.

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http://dx.doi.org/10.1136/practneurol-2018-002121DOI Listing
January 2019
2 Reads

Diagnosis of amyloid neuropathy.

Pract Neurol 2018 Dec 30. Epub 2018 Dec 30.

MRC Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Institute of Neurology, London, UK

Systemic amyloidosis can be hereditary or acquired. The autosomal dominant hereditary transthyretin amyloidosis and the acquired light-chain amyloidosis, the result of a plasma cell dyscrasia, are multisystem disorders with cardiovascular, autonomic and peripheral nerve involvement. There are numerous investigational modalities available to diagnose systemic amyloidosis and to assess the extent of organ involvement, but it is frequently misdiagnosed due to its heterogeneous clinical presentations and misleading investigation findings. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2018-002098
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http://dx.doi.org/10.1136/practneurol-2018-002098DOI Listing
December 2018
17 Reads

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease: practical considerations.

Pract Neurol 2018 Dec 8. Epub 2018 Dec 8.

Department of Clinical Neurology, John Radcliffe University Hospital, Oxford, UK

The field of central nervous system (CNS) inflammatory diseases has recently broadened to include a new condition associated with pathogenic serum antibodies against myelin oligodendrocyte glycoprotein (MOG). This is distinct from multiple sclerosis (MS) and aquaporin-4 (AQP4) antibody neuromyelitis optica spectrum disorders (NMOSD). MOG antibody-associated disease phenotypes are varied and range from classical neuromyelitis optica to acute demyelinating encephalomyelitis and cortical encephalitis. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2017-001787
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http://dx.doi.org/10.1136/practneurol-2017-001787DOI Listing
December 2018
20 Reads

Diabetic amyotrophy: a painful radiculoplexus neuropathy.

Pract Neurol 2019 Apr 8;19(2):164-167. Epub 2018 Dec 8.

Department of Neurology, Royal Gwent Hospital, Newport, UK.

Diabetic lumbosacral radiculoplexus neuropathy is a monophasic syndrome of diffuse pain and weakness that typically affects the lower limbs asymmetrically and is often associated with significant weight loss. Recovery can be prolonged and unpredictable. It is a clinical diagnosis and investigations are performed mainly to exclude other causes. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002105DOI Listing
April 2019
3 Reads

Intracranial dural arteriovenous fistula mistaken as cervical transverse myelitis.

Pract Neurol 2018 Dec 5. Epub 2018 Dec 5.

Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK

We describe a man with an intracranial dural arteriovenous fistula that presented as a subacute longitudinally extensive cervical myelopathy. The uncommon location of the fistula and the absence of specific radiological signs resulted in initial misdiagnosis as longitudinally extensive transverse myelitis. Neurologists should have a high index of suspicion for dural arteriovenous fistula in older men, especially those with subacute or chronic symptoms, acellular cerebrospinal fluid and, particularly, if there is neurological deterioration soon after corticosteroid treatment. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002091DOI Listing
December 2018
3 Reads

Rituximab in neurological disease: principles, evidence and practice.

Pract Neurol 2019 Feb 29;19(1):5-20. Epub 2018 Nov 29.

Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK

Rituximab is a widely used B-cell-depleting monoclonal antibody. It is unlicensed for use in neurological disorders and there are no treatment guidelines. However, as a rapidly acting, targeted therapy with growing evidence of efficacy and tolerability in several neuroinflammatory disorders, it is an attractive alternative to conventional immunomodulatory medications. Read More

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http://dx.doi.org/10.1136/practneurol-2018-001899DOI Listing
February 2019
17 Reads

A pain to the patient and to the doctor.

Pract Neurol 2019 02 21;19(1):75-76. Epub 2018 Nov 21.

Department of Neurology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

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http://dx.doi.org/10.1136/practneurol-2018-002072DOI Listing
February 2019
1 Read

Taking the 'Disease' out of 'Parkinson's': has the disease had its day?

Authors:
Paul F Worth

Pract Neurol 2019 02 21;19(1):2-4. Epub 2018 Nov 21.

Addenbrooke's Hospital, Cambridge CB2 0QQ, UK

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http://dx.doi.org/10.1136/practneurol-2018-002066DOI Listing
February 2019
1 Read

A treatable hypertrophic neuropathy.

Pract Neurol 2019 02 17;19(1):80-82. Epub 2018 Nov 17.

Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA

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http://dx.doi.org/10.1136/practneurol-2018-002083DOI Listing
February 2019
1 Read

Malingering and factitious disorder.

Pract Neurol 2019 Apr 13;19(2):96-105. Epub 2018 Nov 13.

Nuffield Orthopaedic Hospital, Oxford Centre for Enablement, Oxford, UK.

Although exaggeration or amplification of symptoms is common in all illness, deliberate deception is rare. In settings associated with litigation/disability evaluation, the rate of malingering may be as high as 30%, but its frequency in clinical practice is not known. We describe the main characteristics of deliberate deception (factitious disorders and malingering) and ways that neurologists might detect symptom exaggeration. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2018-001950
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http://dx.doi.org/10.1136/practneurol-2018-001950DOI Listing
April 2019
29 Reads

Interpreting CT perfusion in stroke.

Pract Neurol 2019 Apr 13;19(2):136-142. Epub 2018 Nov 13.

Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

CT perfusion images can be rapidly obtained on all modern CT scanners and easily incorporated into an acute stroke imaging protocol. Here we discuss the technique of CT perfusion imaging, how to interpret the data and how it can contribute to the diagnosis of acute stroke and selection of patients for treatment. Many patients with acute stroke are excluded from reperfusion therapy if the onset time is not known or if they present outside of traditional treatment time windows. Read More

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http://dx.doi.org/10.1136/practneurol-2018-001917DOI Listing
April 2019
3 Reads

Clinicopathological case: rapid cognitive decline and myoclonus associated with fever, arthropathy and scleritis.

Pract Neurol 2019 Apr 13;19(2):147-155. Epub 2018 Nov 13.

Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.

A 65-year-old man presented with transient neurological symptoms, followed by rapid cognitive decline, myoclonus and fevers. He had evidence of scleritis and an arthropathy. This paper reports the clinicopathological conference discussed at the Association of British Neurologists Annual Meeting 2017. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002013DOI Listing
April 2019
14 Reads

Cataplexy.

Authors:
Paul Reading

Pract Neurol 2019 Feb 24;19(1):21-27. Epub 2018 Oct 24.

Department of Neurology, The James Cook University Hospital, Middlesbrough TS4 3BW, UK

Remarkably and almost invariably, the clinical phenomenon of cataplexy results from the loss of around 40 000 hypocretin-containing neurones in the lateral hypothalamus in the context of narcolepsy type 1. Cataplexy reflects the dysregulation of rapid-eye-movement (REM) sleep, such that REM-sleep atonia intrudes inappropriately into wakefulness as brief episodes of either focal or total paralysis of voluntary muscle. The semiology of cataplexy differs between adults and children. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002001DOI Listing
February 2019
2 Reads

Cannabis and epilepsy.

Pract Neurol 2018 Dec 18;18(6):465-471. Epub 2018 Oct 18.

School of Medicine, Discipline of Physiology, University of Dublin Trinity College, Dublin, Ireland.

Click here to listen to the Podcast The one-third of people who do not gain seizure control through current treatment options need a revolution in epilepsy therapeutics. The general population appears to be showing a fundamental and rapid shift in its opinion regarding cannabis and cannabis-related drugs. It is quite possible that cannabidiol, licensed in the USA for treating rare genetic epilepsies, may open the door for the widespread legalisation of recreational cannabis. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2018-002058
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http://dx.doi.org/10.1136/practneurol-2018-002058DOI Listing
December 2018
7 Reads

Cardiac cephalalgia: severe, non-exertional headache presenting as unstable angina.

Pract Neurol 2019 Apr 18;19(2):173-175. Epub 2018 Oct 18.

Department of Neurology, Gloucestershire Royal Hospital, Gloucester, UK.

Cardiac cephalalgia is a migraine-like headache that occurs during episodes of myocardial ischaemia. Clinical characteristics of the headache vary widely but are often severe in intensity, worsen with reduced myocardial perfusion and resolve with reperfusion. It can present along with typical symptoms of angina pectoris, although not always. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2018-002045
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http://dx.doi.org/10.1136/practneurol-2018-002045DOI Listing
April 2019
9 Reads

Long QT syndrome masquerading as epilepsy.

Pract Neurol 2019 Feb 15;19(1):56-61. Epub 2018 Oct 15.

Department of Neurology, Frimley Health NHS Foundation Trust, Frimley, UK.

The diagnosis of epilepsy is incorrect in up to 20% of cases so should be revisited if attacks are not responding to treatment. We present a case of long QT syndrome that remained undiagnosed in the epilepsy clinic for 15 years until a near-fatal arrhythmia revealed the diagnosis and allowed effective treatment of her attacks. We hope this near miss raises awareness of long QT syndrome as a potentially fatal, rare but treatable condition that neurologists must consider in people with a label of refractory epilepsy. Read More

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http://dx.doi.org/10.1136/practneurol-2018-001959DOI Listing
February 2019
2 Reads

Disseminated cerebral hydatid disease (multiple intracranial echinococcosis).

Pract Neurol 2019 Apr 10;19(2):156-163. Epub 2018 Oct 10.

Imaging Department, University College Hospital, London, UK.

Intracranial echinococcosis is relatively uncommon and usually occurs in the context of echinococcal lesions elsewhere in the body, mostly liver and lung. Multiple intracranial lesions can result from rupture of an initial single intracranial cyst (in cystic echinococcosis) or from dissemination of systemic disease of the lung, liver or heart (cystic and alveolar echinococcosis). The two main subtypes, cystic and alveolar echinococcosis, present differently and have distinct imaging features in the brain. Read More

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http://dx.doi.org/10.1136/practneurol-2018-001954DOI Listing
April 2019
4 Reads

How to do it: investigate exertional rhabdomyolysis (or not).

Pract Neurol 2019 Feb 10;19(1):43-48. Epub 2018 Oct 10.

Division of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK.

Rhabdomyolysis is the combination of symptoms (myalgia, weakness and muscle swelling) and a substantial rise in serum creatine kinase (CK) >50 000 IU/L; there are many causes, but here we specifically address exertional rhabdomyolysis. The consequences of this condition can be severe, including acute kidney injury and requirement for higher level care with organ support. Most patients have 'physiological' exertional rhabdomyolysis with no underlying disease; they do not need investigation and should be advised to return to normal activities in a graded fashion. Read More

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http://dx.doi.org/10.1136/practneurol-2018-002008DOI Listing
February 2019
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Anti-NMDAR encephalitis complicating pregnancy.

Pract Neurol 2019 Apr 10;19(2):131-135. Epub 2018 Oct 10.

Department of Neurology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis was first reported in 2005 in four patients with ovarian teratomas; there have been many further cases reported since the antigen for the NMDAR antibody was confirmed in 2007. Patients characteristically have a well-defined set of features, characterised by psychiatric disturbance, seizures and cognitive disturbance, followed by movement disorders, disorders of consciousness and dysautonomia. To date, 14 cases of NMDAR encephalitis have been described in the context of pregnancy. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2018-002042
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http://dx.doi.org/10.1136/practneurol-2018-002042DOI Listing
April 2019
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Lyme disease: diagnosis and management.

Pract Neurol 2018 Dec 3;18(6):455-464. Epub 2018 Oct 3.

Neurology Department, Wessex Neurosciences Centre, Southampton General Hospital, Tremona Road, Southampton, UK.

Lyme disease (borreliosis) is a tick-borne bacterial infection caused by the spirochaete , transmitted by hard-backed ticks. Actual numbers of cases are increasing and it appears that the distribution across the UK is widening; however, it occurs most frequently in area of woodland, with temperate climate. It typically presents in mid to late summer. Read More

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http://pn.bmj.com/lookup/doi/10.1136/practneurol-2018-001998
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http://dx.doi.org/10.1136/practneurol-2018-001998DOI Listing
December 2018
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