The diagnosis of amyotrophic lateral sclerosis (ALS) is one of exclusion, relying on the identification of upper and lower motor neuron features. Far too often ALS patients are midiagnosed with radiculoapthy potenitally resulting in unncessary surgery. While this was seen as a inconvnience, in the June issue of JNNP Pinot and colleagues report on a […]
Month: May 2014
Natiluzimab therapy: Safe after all?
The efficacy of natiluzimab therapy was established in clinical trials. It soon, emerged, however that this “life changing” medication was potentially associated with a devastating infectious disorder of the brain, progressive multifocal leucoencephalopathy (PML). This side-effect resulted in withdrawal of the medication from clinical use for a period of time. Since re-introduction rigorous screening and […]
Perivascular hyperintensities and cognitive impairment: No link
The detection of T2 hyperintensities within the CNS, often termed small vessel disease, has been linked to development of cognitive impairment and is though to be driven by vascular risk factors such as hypertension. MRI-visible perivascular spaces (PVS), see fig below, appear to be reliable MRI bio-markers of small vessel disease and have been associated […]
Deep brain stimulation: an effective treatment for essential tremor.
An accurate diagnosis in Neurology, possibly more than any other specialty in Medicine, relies on astute observation. I tell students that a good many diagnoses are made before you even lay a hand on a patient. Neurologists are also an unusual group of people. Around 15 years ago when I was a wannabe neurologist, I […]
Neurofilament proteins: Biomakers for ALS!
Neurofilament proteins, involved in the axonal transport processes, are biomarkers of axonal loss and are elevated in biological tissues, such as plasma and CSF. In ALS, NF levels may be significantly elevated, especially in the CSF. In the March issue of JNNP, Puentes and colleagues report on the utility of NF as a biomarker of […]
To MOTYB or not to MOTYB?
Assessment of delirium in the elderly is paramount for appropriate & effective management of in-patients. A bed-side test that quickly and reliably ascertains delirium is important, especially in a busy hospital environment. Once diagnosed, appropriate investigations could be instigated and management implemented. In an upcoming issue of JNNP, O’Regan and colleagues establish a potential diagnostic […]