Practical Neurology Podcast

Valproate restriction, sexual dysfunction, and neuropathology - Editors’ Highlights June 2024

Journal editors Prof. Philip Smith and Dr. Geraint Fuller discuss the June 2024 issue of Practical Neurology, covering some of the interesting articles published this month. A number of difficult challenges and tradeoffs are featured, relating to recent men-only guidance for sodium valproate use, folic acid dosing for women with epilepsy, post-mortem brain donation, and sexual dysfunction caused by neurological medication. There is also some insight into the treatment of hepatic encephalopathy and congenital myasthenia.
Read the issue: https://pn.bmj.com/content/24/3
Further reading:
Cancer Risk in Children of Mothers With Epilepsy and High-Dose Folic Acid Use During Pregnancy. Vegrim HM, Dreier JW, Alvestad S, et al. JAMA Neurol. 2022;79(11):1130–1138.
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Ptosis with paroxysmal cough, and ”just another kinase” - Case Reports

The first of this episode's two case reports features a 62-yo man, referred from ophthalmology with a drooping eyelid, chronic coughing, and excess sweating in the face provoked by eating (1:21). An MR scan finds abnormal deposits in his brain - (link)
The second report describes two patients (17:05), firstly a 70-yo man presenting with abnormal facial movements and weight loss, and secondly a 90-yo woman with abnormal movements of her right arm and leg. Routine blood tests at presentation for both patients were normal at presentation - (link)The case reports discussion is hosted by Prof. Martin Turner (1), who is joined by Dr. Ruth Wood (2) and Dr. Xin You Tai (3) for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the April 2024 issue of the journal.(1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital.(2) Neurology Registrar, University Hospitals Sussex.(3) Clinical Academic Fellow, Nuffield Department of Clinical Neurosciences, Oxford University, and Neurology Specialty registrar, Oxford University Hospital. Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening. 

A new guideline for spontaneous intracranial hypotension

The first multidisciplinary consensus guideline for the diagnosis and treatment of spontaneous intracranial hypotension (SIH) has recently been published by the UK SIH Specialist Interest Group. Group members Prof. Manjit Matharu (1), Dr. Indran Davagnanam (2), and Mr. Parag Sayal (3) join Dr. Amy Ross Russell to explain their recommendations. They discuss the impact this condition has on patients, the possible presentations, and approaches for diagnosis and treatment.
 
Read the article: Spontaneous intracranial hypotension
 
(1) Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK(2) Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK(3) Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UKPlease subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

An underappreciated vitamin, eponymous syndromes, and drop attacks - Editors’ Highlights April 2024

Journal editors Prof. Philip Smith and Dr. Geraint Fuller discuss the April 2024 issue of Practical Neurology, covering some of the interesting articles published this month. Topics include inconsistencies observed in functional gait, the consequences of restrictive diets with reduced riboflavin, and a guideline to managing patients with spontaneous intracranial hypotension. In syndromic sightings there's a scattering of Ehlers-Danlos, Strachan and Alzheimer's to name but a few. Plus, some correspondence shedding light on the meaning behind an oversized comb - or was it an extreme brush?
Read the issue: https://pn.bmj.com/content/24/2
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Tonic-clonic seizures, and persistent abdominal pain - Case Reports

The first case for this issue's discussion is one of a young man with a history of involuntary jerks and photosensitivity (1:20). Several more seizures followed his initial presentation with a general tonic-clonic seizure. A number of examinations were done including an MR scan and EEG - (link)
Case two involves a 69-yo woman who developed non-convulsive status epilepticus, having been examined as a gastroenterology inpatient for abdominal pain (22:20). A positive PCR for Whipple’s disease in stools and saliva, but negative in the CSF, prompted further testing - (link)
The case reports discussion is hosted by Prof. Martin Turner (1), who is joined by Dr. Ruth Wood (2) and Dr. Xin You Tai (3) for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the February 2024 issue of the journal.
Further reading:
Panegyres PK. Diagnosis and management of Whipple’s disease of the brain. Practical Neurology 2008;8:311-317.
 
Association of British Neurologists. Rare Diseases Ascertainment and Recruitment (RaDAR).
 
(1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital.(2) Neurology Registrar, University Hospitals Sussex.(3) Clinical Academic Fellow, Nuffield Department of Clinical Neurosciences, Oxford University, and Neurology Specialty registrar, Oxford University Hospital. Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening. 

Making the most of electroencephalography, with Dr. Nick Kane

Neurophysiologists may "lock ourselves away in rooms looking at screens with wiggly lines on", but what are the applications in a clinical context for electroencephalography (EEG)?
In this deep-dive episode, podcast editor Dr. Amy Ross Russell is joined by Dr. Nick Kane (1), an author of the Editors' Choice for the Feb 2024 issue, "Electroencephalography in encephalopathy and encephalitis". They discuss the strategy of serial EEGs in epilepsy diagnosis, neuroinflammation in both autoimmune and COVID19 cases, prognostication for coma patients, and how automated AI systems may be integrated into ICU monitoring. 
Further reading:
Tveit J, Aurlien H, Plis S, et al. Automated Interpretation of Clinical Electroencephalograms Using Artificial Intelligence. JAMA Neurol. 2023;80(8):805–812.
L.J.W. Canham et al. Electroencephalographic (EEG) features of encephalopathy in the setting of Covid-19: a case series. Clin Neurophysiol Pract (2020)
 
(1) Grey Walter Dept of Clinical Neurophysiology, North Bristol NHS Trust, Westbury on Trym, UK
 
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Gait analysis, CBT, and neurology book clubs - Editors’ Highlights February 2024

Journal editors Prof. Philip Smith and Dr. Geraint Fuller discuss the February 2024 issue of Practical Neurology, covering some of the interesting articles published this month. The papers discussed touch on the use of electroencephalography (EEG) for encephalopathies, neurologists' role in the integration of cognitive behavioural therapy (CBT) in treatment, key signs to look for in walking patients, and how rising temperatures due to climate change may affect our brains. The final topic of conversation is book clubs, including a cunning tip for boosting your attendance figures.
Read the issue: https://pn.bmj.com/content/24/1
Further listening: Climate change and the brain, with Prof. Sanjay Sisodiya
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Periocular pain, and sciatic nerve thickening - Case Reports

In the first case this episode, a 69-yo woman has developed severe pain around her right eye with blurring to the vision on that side (1:08), which prompts use of a "rediscovered" treatment technique by the ophthalmology department - (https://pn.bmj.com/content/23/6/527).
The second case (15:23) is that of a 45-yo man with progressive pain in his lower limbs, hyperaesthesia and then weakness, who was initially diagnosed with meralgia paraesthetica by tele-medicine examination - (https://pn.bmj.com/content/23/6/516).
The case reports discussion is hosted by Prof. Martin Turner (1), who is joined by Dr. Ruth Wood (2) and Dr. Xin You Tai (3), for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the December 2023 issue of the journal.
(1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital.(2) Neurology Registrar, University Hospitals Sussex.(3) Clinical Academic Fellow, Nuffield Department of Clinical Neurosciences, Oxford University, and Neurology Specialty registrar, Oxford University Hospital. Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening. 

Artificial intelligence for neurologists, with Prof. James Teo

With artificial intelligence (AI) being declared the solution to many of the challenges faced in our personal and professional lives, Prof. James Teo (1) joins the podcast to set us straight on where AI tools fit into neurological practice. This discussion follows the publication of the December 2023 Editors' Choice paper, "Artificial intelligence (AI) for neurologists: do digital neurones dream of electric sheep?" (https://pn.bmj.com/content/23/6/476)
(1) Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
The PN Editors' Choice podcast is hosted by Dr. Amy Ross Russell, and produced and edited by Brian O'Toole. Thank you for listening.

Climate change and the brain, with Prof. Sanjay Sisodiya

In this extra episode of the PN podcast, recorded to coincide with the COP28 summit, podcast editor Dr. Amy Ross-Russell (1) speaks to Prof. Sanjay Sisodiya (2) about his paper, "The hot brain: Practical climate change advice for neurologists". They discuss the role that neurologists have to play in treating and guiding patients as they find themselves exposed to shifts in their habitual climate.
Read the paper: https://pn.bmj.com/content/early/2023/11/10/pn-2023-003777 (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK(2) Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole.
Thank you for listening.