Dystonia and the inspired sensory tricks

Sensory tricks, also called geste antagoniste, is a typical feature of primary and secondary dystonias.  The sensory tricks may take many forms and if not recognized, may lead to misdiagnosis and mislabeling as “psychogenic”.  Importantly, the sensory tricks are associated with neurophysiological changes, including normalization of TMS parameters such as intracortical facilitation as well as […]

Read More…

Glutamate and memory: A novel paradigm in MS

Glutamate is a major excitatory  neurotransmitter in the human brain vital for multiple functions, including memory and cognition.  Importantly, excessive glutamate activity may be harmful to the CNS, leading to neurodegeneration.  In this issue of JNNP, Muhlert and colleagues report a link between glutamate levels and memory, a unique link in MS.  Given that forgetfulness […]

Read More…

Genetic mutations: Predisposing but not causative?

Hereditary IBM is an autosomal recessive myopathy characterized by distal muscle weakness, and the absence of the classical IBM phenotype.  mutations in the UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase (GNE) gene has been linked with development of this myopathy.  However, there has been a paucity of genotype-phenotype correlation studies, critical for understanding disease mechanisms.   In this issue […]

Read More…

Thunderclap headache and subarachnoid haemorrhage: yes, it’s as bad as it sounds.

Aside from publishing ground-breaking insights into the mechanisms of neurological disease, JNNP also publishes many manuscripts that focus on common hard-to-manage clinical problems, things that neurologists come across on a daily basis. In this issue of JNNP, there is a very interesting paper from Bakker and colleagues http://jnnp.bmj.com/content/85/8/885.abstract that concerns one of the most feared […]

Read More…

MS and Pregnancy: Control the disease before conception for good outcomes?

Pregnancy has been traditionally associated with lower frequency of relapses and more quiescent MS disease activity.  Consequently, cessation of medications is encouraged, and is necessary for some of the newer oral therapies.  In this issue of JNNP the Italisn MS group publish an important and elegant paper documenting that the control of disease post-partum is […]

Read More…

CIDP: Diversity in therapy?

CIDP is an autoimmune disorder of the peripheral nerves.  As its name implies, the disorder is chronic and long-term treatment (therapeutic dependance) may be frequently observed.  The factors predicting such treatment dependence need to be elucidated in order to achieve a more appropriate patient management.  In this issue of the journal, Rabin and colleagues identify […]

Read More…

Pregnancy and MS. The need to commence treatment post-partum?

While pregnancy is associated with a reduced risk of relapses, caution is required in the post-partum period.  In this issue of JNNP, Portaccio and colleagues elegantly demonstrate an increased risk of relapse in the post-partum period.   Greater disease activity before and during pregnancy were reported as predictors of an increased chance of a relapse […]

Read More…