There are literally hundreds of different causes for peripheral neuropathy. While in most cases a decent history and a few blood tests can provide a potential cause, which often turns out be metabolic in nature (e.g diabetes, impaired glucose tolerance), in some patients a diagnosis proves elusive despite extensive investigations. This is a major problem […]
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Betaferon still works: A new ray of hope for the injectables?
Over the last 5 years, the therapy for RRMS has radically changed. Oral therapies have come to the fore, leaving the injectables a “not so flavor of the month”. In this months issue of JNNP the BENEFITS study group reports on utility of betaferon in CIS. The time to second relapse was significantly longer when […]
New frontiers in epilepsy surgery
Epilepsy remains one of the most common and disabling neurological conditions. Even though there has been some progress in educating the public about epilepsy, patients with this condition suffer significantly, not just from seizures, but also from the social and psychological consequences of an illness that continues to remain a stigma in many parts of […]
Expanding the antibody spectrum of limbic encephalitis!
Limbic encephalitis (LE) mat have an underlying autoimmune etiologiy. over the last decade numerous antibodies have emerged as potenital causative agents, and the antibodies have been directed against external epitopes of specific receptors. In an upcoming issue of JNNP, Onugoren and colleagues reaffirm the association between GABAB and AMPR receptor antibodies and LE. Importantly neoplastic […]
Cholinesterase inhibitors in Parkinsons disease?
Cholinesterase inhibitors (ChIs) improve cholinergic transmission and thereby may lead to improved cognitive function in PD, although the risk of side-effects such as falls may be potentially increased. In an upcoming issue of JNNP (On line first) Pagano and colleagues conducted a meta-analysis to further assess these issues. The results show a clear improvement of […]
IVIg versus methylprednisone in CIDP: The treatment dilemmas!
The long-term treatment of CIDP is a vexing one often mired in lack of data from randomized controlled trials. The ICE study suggested that a maintenance IVIg dose of 1g/kg every 3 weeks is associated with good therapeutic outcome. Subsequent studies have suggested that steroids may lead to remission in a greater proportion of patients, […]
Tinnitus: don’t just “live with it”, let’s do something about it
Of the many conditions in medicine that are thrown into the ‘too hard basket’, tinnitus, that perception that there is constant noise in your ear even when there is no clear source, would have to be one of the most prevalent. I see a lot of GP referral letters that provide an electronically generated list […]
Neurological disorders: bad to the bone.
It can be tempting to think of the brain, nervous system and the practice of neurology in general as existing in their own discrete compartment, separate from the rest of the body and from other facets of medicine. After all, there is a blood-brain barrier and a blood-nerve barrier and I can’t think of any […]
NMO versus MS: The debate of discriminators continues!
Differentiating NMO from MS may be a difficult task. Yet the distinction is crucial as treatment and prognosis vary. In an upcoming issue of JNNP (On line first) an elegant review discusses potential clinical, CSF and radiological discriminators between NMO, NMO spectrum disorder and MS. Read more at: J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2014-308984 Multiple sclerosis […]
Attention junior doctors: assessing delirium in hospital, it’s time to pay attention.
If you take a wander through your local hospital emergency department, you will generally not find any similarity to what you see on TV. It will not look like an episode of ‘ER’, with ambulances pulling up at breakneck speed and doctors yelling instructions in an attempt to save a life. Generally, the atmosphere is […]