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, […]
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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 […]
Parkinsons disease: managment includes more than just treating the motor symptoms
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 […]
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 […]