The term itself is scary enough-“traumatic brain injury” (TBI). What exactly does it mean? Well, it is possibly the commonest cause of death and disability worldwide. It refers to neurological symptoms that occur as a consequence of sudden trauma to the brain. It is most commonly due to a direct blow to the head, but […]
Month: June 2014
Seizures and malignant MCS strokes: A real problem!
The risk of seizures after structural brain lesions, such as strokes, would be expected to be high, although this has not been studied in detail. Clearly, such issues would have great bearing on patient management. In this issue of JNNP, the risk of seizures in patients post malignant MCA territory strokes that underwent decompressive hemicraniectomy […]
Surgery in Normal Pressure Hydrocephalus: Dont wait to shunt!
Normal pressure hydrocephalus (NPH), a misnomer as the intracranial pressure is increased, may be a debilitating disorder presenting with cognitive decline, gait abnormalities and urinary incontinence. Surgery may arrest and reverse the neurological deficits. The consequences of postponing shunting surgery remain unknown, although the eager neurologist may be reassured by the neurosurgeons that there may […]
Dystrophin levels in Beckers MD: A cliff effect?
Becker muscular dystrophy (BMD) is an inherited muscle disorder caused by deficiency of dystrophin. The relationship between disease severity and dystrophin levels needs further assessment. In this issue of JNNP, a Dutch group reported an association between dystrophin level s and disease severity in BD. Specifically, dystrophin levels were not a major determinant of disease […]
Navigating the sea of rare disease: a roadmap for leukodystrophies
Many of you will have seen the movie, Lorenzo’s Oil, with Nick Nolte and Susan Sarandon. It tells of the moving story of a young boy with a serious neurological illness. Despite the considerable difficulties with both diagnosing and treating him, his parents, Augusta and Michael Odone, remain resolute in trying to help their son, […]
Treatment of dystonic tremor: Time to get educated.
Dystonic tremor, such as writer’s cramp, may be a debilitating condition often missed by non-neurology physicians, and even neurologists. Importantly, dystonic tremors may be misdiagnosed leading to unnecessary investigations and delay in effective therapies. In this issue of JNNP, Langs group from Toronto write a superb review on this subject. The review focuses on therapies […]
Separating the treatable from the untreatable: a neurologist’s dilemma
My last blog (27th May) was all doom and gloom about having to break bad news to patients. It is not always thus in Neurology. Sometimes the converse happens and you are able to give a patient some unexpectedly good news. I saw a patient recently who had significant muscle weakness and wasting and who […]
Reduction in blood pressure: Does the J curve still talk??
A ‘J-curve’ association between blood pressure (BP) and stroke has been previously reported, whereby highest and the lowest BPs were associated with increased risks of recurrent stroke among patients with recent ischaemic stroke. Clearly, such a finding has management implications. In an upcoming issue of JNNP, the PROGRESS Collaborative Group dismiss this myth. Namely, large reductions […]
Ultrasound of therapeutic utility in essential tremor?
Essential tremor (ET) may be a debilitating neurological condition, interfering with activities of daily living. Therapy for ET may be ineffective and remains relatively limited. In an upcoming issue of JNNP (online first) an innovative methods for treating ET was reported, namely magnetic resonance-guided focused ultrasound (MRgFUS). This “surgical technique” aims to induce lesion in […]