Parkinson’s disease is a slowly progressive neurodegenerative disorder of the exptrapyramidal system. Clinically, PD is regraded as a predominantly motor disorder, and the current therapies are aimed at managing this aspect of PD. However, the PD population is elderly and so often, a holistic approach, some may call it a “geriatric approach”, is not heeded […]
Month: May 2014
Breaking bad (news): doctors and the conversations they don’t want to have.
I am writing this midway through a Tuesday, meaning that I am about 30% through my working week. How is it going, you ask? Well, it’s all relative isn’t yet? In the last 24 hours, I have had to break some really terrible news to two young patients, both in their mid 30’s, one of […]
Radiation induced myopathy: Beware of it?
Radiation induced tissue damage is an important but under recognized issue in neurology. Radiation therapy usually induces central nervous system pathology manifesting as “tumor” like lesions. Less recognized are disorders of the peripheral nervous system, which radiation therapy could also injure. In an upcoming issue of JNNP, Ghosh and Milone report an incidence […]
Alemtuzumab: The new effective and safe frontier in active RRMS?
Alemtuzumab is a recently licensed monoclonal antibody directed against the CD52 antigen on lymphocytes. The efficacy of alemtuzumab has been established in phase II and III studies for RRMS, with spectacular reduction in relapse rates, although the disability reduction was better in the Phase II studies, where a reversal of disability was noted. Clearly, alemutuzumab […]
Neuroimaging in dementias: An important diagnostic aid!
Althgally the diagnosis of dementias remains clinically based, neuroimaging techniques have been increasingly utilised as diagnostic aids. While “older” or more conventional techniques have been implmenented to exclude “mimc” disorders, newer techniques have been implemented to identify patters of atrophy or metabolic abnormalites that could aid in the type of dementia. In this issue of […]
Managing epilepsy: a challenge for the neurologist
Managing epilepsy is hard work. The detailed history of events, trying to work out if each seizure is the same type of event or if there are many different semiologies… not easy, not easy at all. Then there is the issue of anticonvulsants and monitoring not only their effectiveness, but also their potential adverse effects. […]
Single nerve conduction study in GBS: is it sufficient?
The diagnosis of GBS is a clinically based. Nerve conduction studies are utilized to confirm the type of GBS, i.e. demyelinating versus axonal. Serial nerve conduction studies have been proposed as a means of confirming whether an”apparently” axonal form of GBS represent distal demyelination. Such confirmation has prognostic implications for the patients. In addition, previous […]
Alcohol and seziures: A bad mix!!
Alcohol fulled violence and head trauma has potentially devastating medical & social impacts. The development of new-onset seizures post head trauma is well recognized, although it has been poorly researched. In the June issue of JNNP, a Finnish group tackle this vexing issue. In a large database study, the authors report on the risk factors […]
Intracerebral haemmorhage (ICH): Grave prognosis indeed
Strokes are invariably a clinical biomarker of “unwellness” of the central nervous system leading potentially life long disability and shorter survivial. While there is good prognostic data peratining to ischeamic strokes, that of ICH remains unknown. As a neurology trainee it was implied, largely from consensus, that ICH strokes exhibit a better prognosis. In this […]
Autologous haematopoietic stem cell transplantation in CIDP: Taking a hammer to the walnut?
Chronic inflammatory demyelinating neuropathy (CIDP) remains a difficult disorder to treat, particularly when patients fail to respond to one of the first line therapies. In addition, complications relating steroid and impressive treatments remain high and disability for this disorder is invariably a difficult management problem. In the June issue of JNNP, the utility of […]