Medical specialty dealing with disorders of the nervous system
POPULARITY
Categories
When we think about brain health, most of us jump straight to memory, dementia, or even Alzheimer's. But what if the real starting point is our metabolism?In this episode, I'm joined by Dr Shahrukh Mallik, Consultant Neurologist, to explore how conditions like insulin resistance, type 2 diabetes, and chronic inflammation don't just affect the body, they directly impact the brain.We dive into: ⚡ Why people with type 2 diabetes have up to a 50% higher risk of developing Alzheimer's
200,000+ leaders have become unbeatable with my elite leadership operating system, will you be the next? Join The Unbeatable Leader Challenge Today: https://www.unbeatableleader.comIn this episode of the Mark Divine Show, host Mark Divine welcomes Rafael McMaster, a visionary creative director and youth mental health advocate. McMaster discusses the shortcomings of the education system in promoting creativity and self-awareness, and shares practical tools for emotional resilience. His non-profit, Indivisible Arts, helps youth cultivate mindfulness and creativity through art. The conversation covers the importance of integrating art into education, the development of a Creative Consciousness community center, and the upcoming online platform to extend these tools nationwide. McMaster's insights emphasize the need for awareness, acceptance, and intention to foster mental well-being in young people.Key Takeaways: -Art as the Language of the Soul and a Tool for PresenceThe absence of art and creative expression in early education leads to a lack of soulful presence and self-connection later in life.-The Mental Health Crisis Among Youth and the Power of Consciousness ToolsTeaching youth to become the "aware observer" of their thoughts (mind watching) and providing them with practical tools like awareness, acceptance, intention, gratitude, compassion, forgiveness, and connection can build emotional resilience and self-regulation.-Community, Co-Creation, and the Ripple EffectBuilding a movement of conscious youth and empowering them to teach each other creates a ripple effect, spreading positive change far beyond the initial group.BUBS Naturals: I use BUBS Naturals daily for focus, recovery, and hydration—all built on a mission to honor a fallen Navy SEAL. Use code UNBEATABLE for 20% off any one time purchase or subscription at www.bubsnaturals.comGuest Links:Website: https://www.indivisiblearts.org/ & https://www.rafaelmcmaster.com/Instagram: https://www.instagram.com/mcmaster.peace/LinkedIn: https://www.linkedin.com/in/rafael-mcmaster-ba573531/YouTube: https://www.youtube.com/channel/UCVP8eNYx58zbFZuBSZj6b8wFacebook: https://www.facebook.com/rafaelmcmasterart/Mark Links: Website: https://unbeatableleader.comYouTube: https://www.youtube.com/@markdivineofficial/Instagram: https://www.instagram.com/markdivineofficialLinkedIn: https://www.linkedin.com/in/markdivine/Facebook: https://www.facebook.com/markdivineofficial/Subscribe to https://www.youtube.com/@markdivineofficial for more inspiring conversations on leadership, growth, and impact.Rate and review the show to help us reach more listeners.Share your thoughts and takeaways in the comments!Timestamps:00:00 Introduction: Defining Art and Its Importance00:41 Welcome to the Mark Divine Show01:23 Introducing Rafael McMaster: Visionary and Advocate02:21 The Power of Art in Everyday Life04:40 The Crisis in Arts Education08:16 Mental Health and Youth: A Growing Concern10:23 Teaching Consciousness and Emotional Resilience16:44 Innovative Approaches to Youth Education26:06 The Heart of Service26:29 Overcoming Homework Hurdles27:45 The Impact of Phones on Youth29:40 A Movement for Conscious Youth30:21 Tools for Overcoming Challenges31:54 The Neurology of Addiction33:56 Mental Health Epidemic43:03 Creative Consciousness Community Centers48:00 Conclusion and Call to Action#leadership #mental toughness #mindset #peakperformance #NavySEAL #executivecoaching #resilience #selfimprovement #growthmindset #unbeatablemind #highperformance #mindfulness #personaldevelopment #warriormindset #stoicleadershipSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Is it possible to maintain mental acuity well into your golden years? How do we assess ourselves (instead of waiting to see)? Dr. Dale Bredesen earned his M.D. from Duke University Medical Center & served as Chief Resident in Neurology at the University of California. He's now a Neuroscience researcher & internationally recognized expert in the mechanisms of neurodegenerative diseases. His newest book is The Ageless Brain: How to Sharpen and Protect Your Mind for a Lifetime. In this episode, we cover helpful early detection tests, the stages of decline & proven protocols for brain health. If you like this episode, you'll also like episode 285: IS HEART COHERENCE A CHAOS CURE-ALL? HEALTH, BEHAVIOR & INTUITION Guest:https://a.co/d/jawEi3J https://www.apollohealthco.com/ https://www.facebook.com/drdalebredesen/abouthttps://x.com/DrDaleBredesen https://www.instagram.com/apollohealthco/ Host: https://www.meredithforreal.com/ https://www.instagram.com/meredithforreal/ meredith@meredithforreal.comhttps://www.youtube.com/meredithforreal https://www.facebook.com/meredithforrealthecuriousintrovert Sponsors: https://www.jordanharbinger.com/starterpacks/ https://www.historicpensacola.org/about-us/ 00:00 — Why we excuse brain blips01:02 — The doctor redefining “inevitable” Alzheimer's02:15 — Early detection that starts in your kitchen03:40 — Prevention without the sales pitch05:00 — The four stages of cognitive decline07:00 — How to know if you're in stage two08:30 — The MOCA test and what scores really mean11:30 — When neurodivergence clouds self-awareness12:15 — Free tools to gauge your brain health13:00 — Alzheimer's vs. Parkinson's: the subtle difference15:00 — How toxins quietly cripple your mitochondria17:00 — Early signs of Parkinson's most people ignore18:30 — The gut-brain link you need to know20:00 — Mold, metals, and the six “bad guys”22:00 — Functional vs. conventional medicine: finding real help24:00 — Why doctors must ask “why,” not “what”26:00 — The emotional weight of pursuing vitality28:00 — True or false: the biggest Alzheimer's myths30:00 — The genetic odds—and how to beat them31:30 — Oral health and Alzheimer's connection33:00 — The seed oil and statin debate34:30 — Fighting the medical bystander effect38:00 — Ketones, cold plunges, and other brain hacks40:00 — The real deal on nootropics and psychedelics42:30 — When memory and music come back to life44:00 — Screen time, circadian rhythms, and your cognition47:00 — Sugar: the brain's ultimate saboteur49:00 — The KetoFlex 12/3 diet for brainspan52:00 — How sleep detoxes your brain55:00 — Exercise as neuroprotection57:00 — The caregiving paradJoin me and Scott Johnson for a virtual meet up! Thursday, November 6th at 6pm US Central Time.https://us02web.zoom.us/j/89420413041?pwd=n7U64pcT5kNa4bxIEgerlHvj45yblg.1#successRequest to join my private Facebook Group, MFR Curious Insiders https://www.facebook.com/share/g/1BAt3bpwJC/
Dr. Alison Christy talks with Dr. Jennifer L. McGuire about neuroimaging findings linked to ICANS, exploring whether specific imaging patterns correlate with distinct neurologic symptoms. Read the related article in Neurology®. Disclosures can be found at Neurology.org.
Whistleblower Michael Fitzhugh Bell is a victim of what is referred to as an Unacknowledged Special Access Program (U.S.A.P.) that he says was created by the United States government, believed to be part of the Military Black Ops portion of the shadow government. He was victimized through the illegal misuse of advanced nanotechnology, biomedical devices embedded throughout his body, using clandestine government classified technologies.Become a supporter of this podcast: https://www.spreaker.com/podcast/the-x-zone-radio-tv-show--1078348/support.Please note that all XZBN radio and/or television shows are Copyright © REL-MAR McConnell Meda Company, Niagara, Ontario, Canada – www.rel-mar.com. For more Episodes of this show and all shows produced, broadcasted and syndicated from REL-MAR McConell Media Company and The 'X' Zone Broadcast Network and the 'X' Zone TV Channell, visit www.xzbn.net. For programming, distribution, and syndication inquiries, email programming@xzbn.net.We are proud to announce the we have launched TWATNews.com, launched in August 2025.TWATNews.com is an independent online news platform dedicated to uncovering the truth about Donald Trump and his ongoing influence in politics, business, and society. Unlike mainstream outlets that often sanitize, soften, or ignore stories that challenge Trump and his allies, TWATNews digs deeper to deliver hard-hitting articles, investigative features, and sharp commentary that mainstream media won't touch.These are stories and articles that you will not read anywhere else.Our mission is simple: to expose corruption, lies, and authoritarian tendencies while giving voice to the perspectives and evidence that are often marginalized or buried by corporate-controlled media
Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Dr. Yousuf Patel presents a case of diplopia and fever to Vale and Sebastian. Yousuf Patel Dr. Yousuf Patel is currently a resident in neurology in Cape Town, South Africa. He completed his undergraduate training at Stellenbosch University. He… Read More »Episode 428: Neurology VMR – Diplopia and fever
The November 2025 Recall revisits four insightful episodes centered on muscle and neuromuscular diseases. Kicking off the episode is a two-part series on myositis, where Dr. Stacey Clardy speaks with Dr. Andrew Mammen. The episode continues with an interview featuring Dr. Eric Voorn, who discusses the effectiveness of combining personalized, home-based aerobic exercise with coaching to improve physical fitness in individuals with neuromuscular diseases. The episode wraps up with Dr. Elia Sechi discussing the critical role of interpreting lab test results, understanding assay performance, and recognizing the real-world impact of false positives in myasthenia gravis diagnostics. Podcast links: Updates on All Things Myositis – Part 1 Updates on All Things Myositis - Part 2 Efficacy of Aerobic Exercise and Coaching on Physical Fitness in Neuromuscular Disease False Positivity of Acetylcholine Receptor Autoantibodies in Clinical Practice Article links: Efficacy of Combined Aerobic Exercise and Coaching on Physical Fitness in People With Neuromuscular Diseases Risk of False Acetylcholine Receptor Autoantibody Positivity by Radioimmunoprecipitation Assay in Clinical Practice Show citations: Oorschot S, Brehm MA, van Groenestijn AC, et al. Efficacy of Combined Aerobic Exercise and Coaching on Physical Fitness in People With Neuromuscular Diseases: A Randomized Clinical Trial. Neurology. 2025;105(1):e213781. doi:10.1212/WNL.0000000000213781 Zara P, Chessa P, Deiana GA, et al. Risk of False Acetylcholine Receptor Autoantibody Positivity by Radioimmunoprecipitation Assay in Clinical Practice. Neurology. 2025;104(9):e213498. doi:10.1212/WNL.0000000000213498 Disclosures can be found at Neurology.org.
Dr. Katie Krulisky and Dr. Stefano Meletti discuss the incidence and characteristics of postictal central apnea in focal seizures. Show citation: Meletti S, Burani M, Ballerini A, et al. Persistent Postictal Central Apnea in Focal Seizures: Incidence, Features, and Imaging Findings. Neurology. 2025;105(4):e213856. doi:10.1212/WNL.0000000000213856
Un nouvel épisode du pharmascope est maintenant disponible! Dans de ce 102ème épisode, Nicolas, Sébastien et Isabelle discuteront de vitamine B12. Dans ce premier épisode d'une série de deux, on discute de manifestations cliniques, d'évaluation biochimique, d'approche diagnostique et de bénéfices (ou pas) du traitement d'un déficit en vitamine B12. Les objectifs pour cet épisode sont les suivants: Identifier les patients avec une indication de doser la vitamine B12 Discuter de la fiabilité du dosage de la vitamine B12 Discuter de l'approche diagnostique du déficit en vitamine B12 Expliquer les bénéfices d'un supplément de vitamine B12 dans le traitement et la prévention de diverses conditions Ressources pertinentes en lien avec l'épisode Boughrassa F, Framarin A. Usage judicieux de 14 analyses biomédicales: Outil pratique. Institut national d'excellence en santé et services sociaux. Avril 2014. Solomon LR. Cobalamin-responsive disorders in the ambulatory care setting: unreliability of cobalamin, methylmalonic acid, and homocysteine testing. Blood. 2005;105:978-85. Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ. 2014;349:g5226. Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368:149-60. Didangelos T et coll. Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2021;13:395. Dangour AD et coll. Effects of vitamin B-12 supplementation on neurologic and cognitive function in older people: a randomized controlled trial. Am J Clin Nutr. 2015;102:639-47. McCleery J et coll. Vitamin and mineral supplementation for preventing dementia or delaying cognitive decline in people with mild cognitive impairment. Cochrane Database Syst Rev. 2018;11:CD011905. Rutjes AW et coll. Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life. Cochrane Database Syst Rev. 2018;12:CD011906. Kwok T et coll. A randomized placebo-controlled trial of using B vitamins to prevent cognitive decline in older mild cognitive impairment patients. Clin Nutr. 2020;39:2399-2405. Kwok T et coll. A randomized placebo controlled trial of vitamin B12 supplementation to prevent cognitive decline in older diabetic people with borderline low serum vitamin B12. Clin Nutr. 2017;36:1509-1515. Van der Zwaluw NL et coll. Results of 2-year vitamin B treatment on cognitive performance: secondary data from an RCT. Neurology. 2014;83:2158-66. Almeida OP et coll. B vitamins to enhance treatment response to antidepressants in middle-aged and older adults: results from the B-VITAGE randomised, double-blind, placebo-controlled trial. Br J Psychiatry. 2014;205:450-7.
Dr. Katie Krulisky talks with Dr. Stefano Meletti about the incidence and characteristics of postictal central apnea in focal seizures. Read the related article in Neurology®. Disclosures can be found at Neurology.org.
Dr. Greg Cooper and Dr. Claudia Suemoto discuss the association between consumption of low- and no-calorie sweeteners and cognitive decline. Show citations: Gonçalves NG, Martinez-Steele E, Lotufo PA, et al. Association Between Consumption of Low- and No-Calorie Artificial Sweeteners and Cognitive Decline: An 8-Year Prospective Study. Neurology. 2025;105(7):e214023. doi:10.1212/WNL.0000000000214023
Non è solo una questione di sorriso, ma di vita. Uno studio recente pubblicato su Neurology e condotto presso l'Università della Carolina del Sud dimostra che malattie gengivali e carie aumentano il rischio di ictus e infarto. In questo mese di ottobre, mese della Prevenzione Dentale, scopriamo insieme perché prendersi cura della bocca è prendersi cura di tutto il corpo. Ospite di Obiettivo Salute il prof. Luca Levrini, Odontoiatra e Docente, l'università degli Studi dell'Insubria di Varese.
What if one side of your body suddenly stopped moving — and your doctor said, “It's a migraine”?Hemiplegic migraines are rare, disorienting, and often confused with strokes. They challenge everything you think you know about how your brain, body, and energy connect.In this episode of Migraine Heroes Podcast, hosted by Diane Ducarme, we explore the science and the story behind this rare form of migraine — one that blurs the line between neurology and mystery. Together, we look at how the body can temporarily lose its flow, and how to gently help it find its rhythm again.In this episode, you'll learn:
In this episode, we are joined by Dr. Pradyumna J. Oak. Dr. Oak is a Senior Neurologist and Director of Neurology at Nanavati Super Speciality Hospital, Mumbai. His extensive experience in stroke management and neurocritical care makes him a perfect expert to speak on brain stroke. Vikas & Dr. Oak discussed causes, diagnosis, risk factors, important tests, and primary and secondary prevention.Here are some key takeaways: Blockages in blood vessels supplying blood to the brain may lead to a brain stroke. It is different from a heart attack or cardiac arrest.Diabetes, hypertension, Obesity, smoking, and use of tobacco are the major risk factors that contribute to a brain stroke.Statins may help stabilize the plaque and reduce LDL cholesterol levels.Brain stroke can happen due to occlusion (blockage) in arteries or hemorrhage(rupture) of blood vessels. A person experiencing a Transient Ischemic Attack might have difficulty speaking. Unfortunately, in the symptoms of a brain stroke, there is no pain. Running and other endurance activities may help condition your heart and even keep your baseline heart rate in check.A well planned workout program is helpful in mitigation of similar issues including a condition such as brain stroke.About Vikas Singh:Vikas Singh, an MBA from Chicago Booth, worked at Goldman Sachs, Morgan Stanley, APGlobale, and Reliance before coming up with the idea of democratizing fitness knowledge and helping beginners get on a fitness journey. Vikas is an avid long-distance runner, building fitpage to help people learn, train, and move better.For more information on Vikas, or to leave any feedback and requests, you can reach out to him via the channels below:Instagram: @vikas_singhhLinkedIn: Vikas SinghTwitter: @vikashsingh101Subscribe To Our Newsletter For Weekly Nuggets of Knowledge!
A Joyful Opportunity On a certain level, we human beings are quite an accomplished species. And this is because there is a key part to our consciousness that is always trying to improve, always trying to make things better. We call this our striving mind and without it, we'd still be living up in trees, let alone in caves. But like every other part of our awareness this can be a real double-edged sword, causing us every bit as much suffering as it does happiness. But when it comes to striving, it so happens that we have another part of our awareness that is on a completely different wavelength and we're going to examine this unique level of awareness in our episode today. The Transformative Value of Making Effort To begin, I once read of a conversation between Ted Turner and Captain Jacques Cousteau. They were traveling together on the Calypso, and everywhere they went, they saw the same thing — garbage and pollution everywhere, forests stripped bare, and the ocean losing its color along with its sea life. Turner turned to Cousteau and said, "Captain, I'm getting discouraged." And Cousteau, as I remember it, responded with something like: "Don't do that. Even if we knew without a doubt that we were going to fail, and that our efforts would be to no avail, we would still carry on — and we would do it with joy in our hearts, grateful for the blessing of having been given the gift of serving the highest good." I have no idea how long ago I read that or where, but as you can tell, I placed it on a high shelf in my mind's personal hall of fame. The simple truth of that idea has never left me, because it brings up the essence of what is known in Universal Wisdom as selfless service — the act of doing something purely for the sake of serving the higher good. And that kind of action can be transformative on many levels. When we serve something larger than ourselves, the very act of making our best effort — regardless of whether or not it will succeed — becomes the place where meaning and grace merge. There's a particular kind of beauty in that moment when a person realizes that the offering of trying itself is sacred. What Cousteau offered Turner, and what is being offered to us still, is not merely an argument for optimism but a reminder of the sacredness and purity of serving the highest. Even when the world may seem irredeemably broken, the act of caring — of showing up, of doing one's part with the highest intention, even with love, if possible — has the power to change the very fabric of our own being. It can turn despair into service, and on some deep level, the river of service eventually flows into the river of joy. The Meaning of Effort This kind of effort is very different from the frantic strivings of self-serving ambition. It's more like a deliberate and wholehearted engagement with life itself. Although we live in a culture that tends to measure worth by results: grades, profits, likes, followers, medals and the like, there is a deeper truth beneath those surface metrics. On a neurological level, the right kind of effort can lead to a profound biochemical affirmation of purpose. Every time we take action toward something meaningful, the brain's reward system releases small waves of dopamine, which noticeably increases when we are engaged in an activity for the higher good. This is what neuroscientists call the reward prediction system. It's the brain's way of saying: keep going — this really matters. The Inner Alchemy The transformative value of effort lies in this invisible alchemy: we are changed not by the reward, but by the rhythm of trying. Each time we resist the pull of doubt, resignation, or failure, we strengthen the neural pathways that connect intention to perseverance. It is the inner moral equivalent of muscle growth. Within the framework of neuroplasticity, the fibers of attention, will, and patience are slowly woven together through repetition and sincere effort. The ancients knew this long before neuroscience gave it language. The Bhagavad Gita reminds us, "You have the right to your actions, but not to the fruits of your actions." Krishna's counsel to Arjuna was not a cold command of detachment—it was a revelation of liberation: that freedom is born when effort itself becomes an offering, a form of devotion. When we engage fully, without clinging to the outcome, we step into a sacred rhythm of creation. In that rhythm, the mind begins to quiet, the heart steadies, and the soul recognizes itself in the very act of striving with surrendered effort. The Sacred Practice of Trying Sometimes we come to believe that trying and failing is our lot in life—that, like Sisyphus, we are doomed to endless futility. Yet the capacity to keep trying, especially when the outcome is uncertain, is one of the most noble signs of an awakened life. The Stoics taught that to love the effort itself—even when the result remains unseen—is to live in harmony with the deeper order of things. To persist with grace is not naïve optimism; it is a conscious alignment with what is true and life-giving. When we learn to love our higher efforts, our joy is no longer hostage to the world's approval. Instead, we begin to feel a quiet, inner strength in the act of being faithful to our own higher purpose. The Neuroscience of Purpose Modern neuroscience offers an intriguing mirror to these timeless truths. Studies from Stanford, Harvard, and the Max Planck Institute reveal that when people engage in purposeful effort—especially acts rooted in compassion, creativity, or mastery—the brain's prefrontal cortex begins to synchronize with deeper limbic structures such as the amygdala and hippocampus. This state of alignment produces what researchers call harmonic resonance—a condition in which emotion and reason cease to be adversaries and become partners in coherence. This, at its essence, is what the NeuroHarmonic Method is all about: aligning the hemispheres, unifying the self, and transforming the inner world into a harmmonic field of peace. The effect is truly transformative on every level of life. A Story of Renewal Over the past several years, I've been a consultant to a halfway house for men in recovery from substance abuse and alcoholism and have been privileged to witness this profound change with many of them. The recovery process can often feel exhausting because so often, it involves the process of beginning again—to stand once more at the foot of the mountain after another slipup or setback. But once the neurology is in place, beginning again stops feeling like failure. It becomes an empowering expression of perseverance, expressing the resilience of inner faith in motion. With that change, each new beginning continues to rewire the brain and the days become less defined by the past and more attuned to the present. In short, the brain learns hope by practicing it. The NeuroHarmonic View From the NeuroHarmonic perspective, the right kind of effort is the music of transformation. The circuitry of the self begins to shift from fragmentation to harmony. The fear of failure grows more quiet and the higher mind, which delights in growth, begins to lead. The surrendered act of trying becomes a note in the great symphony of becoming—proof that the universe responds not to perfection, but to sincerity. The Gift of Serving the Highest The words attributed to Cousteau remind us that joy can coexist with uncertainty. We don't serve because we know we will succeed or because we anticipate the rewards of success. This is larger than just the striving mind. We act because we feel called to serve. To act on behalf of life, love, and truth—even in a broken world—is to affirm the sacred pulse of existence itself. The paradox is that in surrendering, we become most effective. Our energy stops fragmenting into worry and begins to flow as calm, clear intention. In this way, the wave finds peace by realizing it belongs to the ocean. And in that recognition, effort transforms into offering, and service becomes joy. Closing Reflection So, when you feel weary of trying—when the world's noise or your own doubts pull you toward hopelessness or despair—remember this: according to the universal wisdom of human growth, effort is never wasted. Every time you offer your best, no matter how small the act, something deep within you expands and grows. The act of trying is itself a prayer. It aligns you with the rhythm of creation, the current of compassion, and the unseen architecture of renewal. To make effort in this way—with joy in your heart—is to live as if the Divine were watching from within, and not only watching, but smiling. Because in the end, the one who makes effort in this surrendered way has already succeeded in the only way that truly matters. The NeuroHarmonic Perspective On the deepest level, neuroscience reveals that the process of making meaningful effort activates the same neural pathways associated with pleasure and purpose. The act of trying itself sends a signal to the brain that life still holds meaning. It's as though the brain whispers, "You are alive, and your choices matter." When we understand this, even small acts—cleaning a space, comforting a friend, or returning to a state of inner balance regardless of externals, become deep neurological affirmations. Each one reinforces a living pattern that says, "I am engaged with life. I am participating in something greater than guilt, doubt, or fear." The Higher Labor of Liberation This is why the great spiritual masters of every age have emphasized right action over right results. The Gita, the Tao, the Sermon on the Mount—each reveals the same paradox: that higher labor leads to liberation, and serenity is born through sincere effort. When we act with a purity of intent untethered from personal gain, something profound occurs within us. The brain begins to synchronize effort with meaning, generating a sense of coherence that modern psychologists now recognize as essential to well-being. It's not merely what we do, but the state of consciousness in which we do it that determines the depth of our fulfillment. The Gentle Nature of True Perseverance Now, when discouragement arises—as it inevitably will—it is not a failure of strength, but a momentary forgetting of this higher truth. And here's the wonder if it all: the human nervous system is built for adaptation. It can absolutely remember to walk on the high road again. That's why true perseverance can be so remarkably gentle, rather than forceful. It listens inwardly. It knows when to rest, when to breathe, and when to begin again. And in that transformation, we witness the remarkable miracle as the brain literally rewires itself for resilience, encoding the pattern of true inner evolution. And perhaps this is the quiet secret behind every genuine awakening: the recognition that persistence, when joined with grace, is not about merely enduring — it is transforming. The Company of Saints and Scientists To make effort without attachment in this way is to walk in the company of saints and scientists alike for both seek truth beyond outcome. Both are fueled by creativity as well as devotion. When a musician practices scales, a gardener tends the soil, or a recovering soul makes it through another day sober — each is performing an act of faith disguised as making effort. And the joy lies not only in successful resolution but more importantly, in active participation. In the willingness to be part of the unfolding harmony of life. The Neurology of Wholehearted Effort As a kind of neural validation, imaging studies reveal that in moments of wholehearted effort, there is increased connectivity between the anterior cingulate cortex—the region responsible for emotional regulation—and the insula, which monitors bodily awareness. This means that surrendered effort literally harmonizes thought and feeling, creating what might be called a neurological symphony. In these states, time itself seems to soften. Effort and ease merge. The boundary between the doer and the doing begins to dissolve, and we experience what mystics have long described as unity: the seamless flow in which action, awareness, and presence become one. Neuroplasticity in Motion In essence, this is neuroplasticity in action. Each new beginning sends a small electrical signal through the prefrontal cortex, quietly strengthening the pathways of intuitive understanding. Even in moments of weakness, the brain begins remembering strength. Even when a certain part of the ordinary mind generates doubts, the neurons keep learning hope. That's how transformation really happens through faithful and surrendered repetition of meaningful effort. The Quiet Joy of Service And over time, we begin to understand that serving the highest does not require heroism. More often, it reveals itself in small, unseen acts of kindness, in quiet endurance, or in the patient willingness to keep learning. In those humble moments, the joy Cousteau spoke of—the joy of service—rises like a tide. It is the joy of knowing that life itself is the master artist, and we can be the masterpiece. For when we stop trying to control the painting and instead give ourselves wholly to each stroke, the brush moves through us with grace. Effort becomes art, and service becomes beauty in motion. Love in Motion So if you'd like, consider this larger understanding — drawn from Universal Wisdom and now validated by modern brain science: real service is higher love in motion. Every breath that reaches for harmony, every attempt to mend what is broken, every act that restores humanity, is all part of a greater intelligence continuously unfolding through us. When we make our efforts with conscious awareness, we become conduits for grace. And even if the outer world never notices, the inner universe expands just the same — because nothing is ever lost wherever love is expressed through our thoughts, our words, and our deeds. Closing Well, this has been a lot to digest, so let's end the episode here. As always, keep your eyes, your mind, and your heart open — and let's get together in the next one.
Kendra Pauley, FNP-C, a nurse practitioner with Riverside Neurology Specialists, joins us to discuss strokes - signs and symptoms, risk factors, and how Riverside's neurologists can help.
Defy Dementia – The podcast for anyone with a brain, by Baycrest
Everything is connected. Like the connection between oral hygiene and brain health. In this episode of Defy Dementia™, we'll join Dr. James Noble, Professor of Neurology and author of Navigating Life with Dementia, as he discusses how poor oral health and inflammation could increase dementia risk, and just how important oral care is for brain health. We'll also follow 65-year-old Ben Schaub, a journalist specializing in science and technology – and a Defy Dementia producer – as he shares how he keeps his brain healthy by taking care of his oral health. Tune in at defydementia.org, or anywhere you get your podcasts. Key Messages: Gum infections are common, especially in older adults. Maintaining healthy teeth and gums benefits your overall health and may reduce your dementia risk. Key Actions: Brush and floss daily.If available, visit your dental professional for regular cleaning and check-ups or if you are experiencing issues with your teeth or gums. About our guests: Ben Schaub is an award-winning science journalist and Defy DementiaTM's writer and chase producer. Ben researched episodes of CBC's The Nature of Things and produced interviews and documentaries for Discovery Channel Canada's Daily Planet. Dr. James Noble is a Professor of Neurology in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Irving Medical Center. He was the first to discover an association between the periodontal pathogen Porphyromonas gingivitis and impaired memory, and leads a project exploring the relationship of oral health conditions and cognitive trajectories. He is also the author of Navigating Life with Dementia.
Dr. Greg Cooper talks with Dr. Claudia Suemoto about the association between consumption of low- and no-calorie sweeteners and cognitive decline. Read the related article in Neurology®. Disclosures can be found at Neurology.org.
In part one of this two-part series, Dr. Kaitlyn Palmer discusses two new MRI biomarkers to increase diagnostic specificity for multiple sclerosis. Show reference: Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria. Montalban, Xavier, et al. The Lancet Neurology, Volume 24, Issue 10, 850 - 865
In this episode, we review the high-yield topic of Complex Partial Seizure from the Neurology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic of Cervical Spine Injury from the Neurology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic of Epidural Hematoma from the Neurology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
Dr. Katie Krulisky and Dr. Rosemary Dray-Spira discuss the trends in prenatal exposure to antiseizure medications over the past decade. Show reference: https://www.neurology.org/doi/10.1212/WNL.0000000000213933 Citation: Pouneh S, Jérôme D, Sara M, et al. Trends in Prenatal Exposure to Antiseizure Medications Over the Past Decade: A Nationwide Study. Neurology. 2025;105(4): e213933.
Dr. Katie Krulisky talks with Dr. Rosemary Dray-Spira about trends in prenatal exposure to antiseizure medications over the past decade, according to medication safety profiles. Read the related article in Neurology®. Read the related North American Antiepileptic Drug Pregnancy Registry. Read the related Continuum article. Disclosures can be found at Neurology.org.
In this episode, we review the high-yield topic of Friedrich Ataxia from the Neurology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
Dr. Greg Cooper and Dr. Jonathan Graff-Redford discuss the key takeaways from the recent Alzheimer's Association International Conference (AAIC).
In this second part of a two-part series, Brain & Life co-host Dr. Katy Peters sits down with author and journalist Tom Zeller Jr. to delve into his personal journey with cluster headaches. They explore treatment options and the cultural stigma surrounding cluster headaches. Dr. Peters is then joined by Dr. Stephanie Nahas, professor of neurology at Thomas Jefferson University and Program Director for the Headache Medicine Fellowship at the Jefferson Headache Center of Thomas Jefferson University. Dr. Nahas the importance of advocacy and community support when it comes to cluster headaches. Additional Resources Tom Zeller Jr. Clusterbusters - The Cluster Headache Advocacy Group Finding Relief for Cluster Headaches Headache on the Hill: Advocating for Migraine Patients Nationwide Other Brain & Life Podcast Episodes on These Topics Broadcast Journalist Deborah Roberts on Living with Migraine Mulling over Migraines with Photographer Bill Wadman Apps and Self-Advocacy with Roon's Dr. Rohan Ramakrishna We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? · Record a voicemail at 612-928-6206 · Email us at BLpodcast@brainandlife.org Social Media: Guests: Tom Zeller Jr. @tomzellerjr; Dr. Stephanie Nahas @stephanienahasgeiger Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD
On October 23, 2025 we met with Dr. Peter Crino about how mutations occurring during cell division in the developing cerebral cortex can lead to localized developmental malformations of cortical structure and neurological disorders including focal epilepsy.Guest:Peter Crino, Richard and Kathryn Taylor Professor, Chair, Department of Neurology, University of Maryland School of Medicine.Participating:Jenny Hsieh, Department of Neuroscience, Developmental and Regenerative Biology, UT San Antonio.Host:Charles Wilson, Department of Neuroscience, Developmental and Regenerative Biology, UT San Antonio.
In this episode, we review the high-yield topic of Trigeminal Neuralgia from the Neurology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, I'm joined by Dr. Burhan Chaudhry, MS neurologist and clinical lead at Bristol Myers Squibb, to discuss CAR-T cell therapy which is an innovative treatment currently enrolling in clinical trials for multiple sclerosis (MS). We dive into how CAR-T cell therapy targets B cells within the central nervous system, offering hope for both relapsing and progressive MS. Dr. Chaudhry explains what sets CAR-T apart from traditional disease modifying therapies, how to get involved in MS clinical trials, and what participants can expect throughout the process. Whether you're newly diagnosed or living with MS for years, join us for empowering strategies, expert advice, and the latest updates on breakthroughs in MS treatment! Bio on Burhan Chaudry: Dr. Burhan Chaudhry is a MS neurologist and clinical lead at Bristol Myers Squibb. His sister was diagnosed with MS when he was in medical school. This inspired him to pursue Neurology. A few years after Burhan was diagnosed with MS as well. After becoming a MS neurologist, Burhan has treated MS patients both in the US and internationally. He is currently clinical lead for a global clinical trial evaluating a novel cell therapy across the MS spectrum. Resources mentioned in this episode: Website to view CAR-T info: https://www.cartautoimmune.com/ ECTRIMS 2025 Results/Report: https://distribute.congrex.com/from.storage?image=rqetJOF1YXChDh_STAPoNpjPhysyG76sohBKnHJhR-TsF3Mvxzx13zdmic5t9umH0 Additional Resources: https://www.doctorgretchenhawley.com/insider Reach out to Me: hello@doctorgretchenhawley.com Website: www.MSingLink.com Social: ★ Facebook: https://www.facebook.com/groups/mswellness ★ Instagram: https://www.instagram.com/doctor.gretchen ★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1 → Game Changers Course: https://www.doctorgretchenhawley.com/GameChangersCourse → Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram → The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink
Dr. Margarita Fedorova discusses whether living near a golf course impacts the risk of Parkinson disease. Show reference: Krzyzanowski B, Mullan AF, Dorsey ER, et al. Proximity to Golf Courses and Risk of Parkinson Disease. JAMA Netw Open. 2025;8(5):e259198. doi:10.1001/jamanetworkopen.2025.9198
Eberechi Nwogu-Onyemkpa is an assistant professor in the Division of Palliative Medicine at Washington University in St. Louis. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E. Nwogu-Onyemkpa and Others. Involving Palliative Care to Improve Outcomes in Sickle Cell Disease. N Engl J Med 2025;393:1553-1556. E. Costa and Others. Thirty Years of Hydroxyurea for Sickle Cell Anemia — Scientific Progress, Global Health Gaps. N Engl J Med 2025;393:1556-1559.
Limb-girdle muscular dystrophies (LGMDs) encompass a group of genetically heterogeneous skeletal muscle disorders. There has been an explosion of newly identified LGMD subtypes in the past decade, and results from preclinical studies and early-stage clinical trials of genetic therapies are promising for future disease-specific treatments. In this episode, Gordon Smith, MD, FAAN, speaks with Teerin Liewluck, MD, FAAN, FANA, author of the article “Limb-Girdle Muscular Dystrophies” in the Continuum® October 2025 Muscle and Neuromuscular Junction Disorders issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Liewluck is a professor of neurology at the Division of Neuromuscular Medicine and Muscle Pathology Laboratory at Mayo Clinic College of Medicine in Rochester, Minnesota. Additional Resources Read the article: Limb-Girdle Muscular Dystrophies Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Guest: @TLiewluck Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Smith: This is Dr Gordon Smith with Continuum Audio. Today I'm interviewing Dr Teerin Liewluck, a good friend of mine at the Mayo Clinic, about his article on the limb girdle muscular dystrophies. This article appears in the October 2025 Continuum issue on muscle and neuromuscular junction disorders, a topic that is near and dear to my heart. Teerin, welcome to the podcast, and maybe you can introduce yourself to our listeners. Dr Liewluck: Thank you very much, Gordon, and I want to say hi to all the Continuum fans. So, I'm Dr Teerin Liewluck, I'm the professor of neurology at Mayo Clinic in Rochester, Minnesota. So, my practice focus on all aspects of muscle diseases, both acquired and genetic myopathies. Glad to be here. Dr Smith: I just had the great pleasure of seeing you at a seminar in Houston where you talked about this topic. And so, I'm really primed for this conversation, which I'm very excited about. I find this topic a little hard, and I'm hoping I can learn more from you. And I wonder if, as we get started, recognizing many of our listeners are not in practices focused purely on muscle disease, maybe you can provide some context about why this is important for folks doing general neurology or even general neuromuscular medicine? Why do they need to know about this? Dr Liewluck: Yes, certainly. So, I would say limb girdle muscular dystrophy probably the most complex category of subgroup of muscle diseases because, by itself, it includes thirty-four different subtypes, and the number's still expanding. So, each subtype is very rare. But if you group together, it really have significant number of patients, and these patients present with proximal weakness, very high CK, and these are common patients that can show up in the neurology clinic. So, I think it's very important even for general neurologists to pick up what subtle clues that may lead to the diagnosis because if we are able to provide correct diagnosis for the patients, that's very important for patient management. Dr Smith: So, I wonder if maybe we can talk a little bit about the phenotype, Terran. I mean, your article does a great job of going over the great diversity. And you know, I think many of us here, you know, limb girdle muscular dystrophy and we think of limb girdle weakness, but the phenotypic spectrum is bananas, right? Rhabdomyolysis, limb girdle distal myopathy. I mean, when should our listeners suspect LGMD? Dr Liewluck: Yes, I think by the definition to all the LGMD patients will have limb girdle of proximal weakness and very high CK. So, these are common phenotypes among thirty-four different subtypes. But if it did take into details, they have some subtle differences. In the article, what I try to simplify all these different subtypes that we can categorize at least half of them into three main group that each group the underlying defect sharing among those subtypes and also translate into similar muscles and extra muscular manifestations. You will learn that some of the limb girdle muscular dystrophy may present with rhabdomyolysis. And we typically think of this as metabolic myopathies. But if you have a rhabdomyolysis patient, the CK remain elevated even after the acute episode, that's the key that we need to think this could be LGMD. That's for an example. Dr Smith: So, I wonder if maybe we can start there. I was going to go in a different direction, but this is a good transition. It's easy to see the opportunity to get confused between LGMD or, in that case, a metabolic myopathy or other acquired myopathies. And I think particularly adult neurologists are more accustomed to seeing acquired muscle disease. Are there particular clues that, or pearls that adult neurologists seeing patients with muscle disease can use to recognize when they should be thinking about LGMD given the diverse phenotype? Dr Liewluck: Yes. What I always tell the patient is that there are more than a hundred different types of muscle diseases, but we can easily divide into groups: acquired and genetic or hereditary. So, the acquired disease is when you encounter the patients who present with acute or subacute cause of the weakness, relatively rapidly progressive. But on the opposite, if you encounter the patient who present with a much more slowly progressive cause of weakness over several months or years, you may need to think about genetic disease of the muscle with also including limb-girdle muscular dystrophy. The detailed exam to be able to distinguish between each type of muscular dystrophy. For example, if proximal weakness, certainly limb girdle muscular dystrophy. If a patient has facial weakness, scapular winking, so you would think about facial scapular hematoma dystrophy. So, the slowly progressive cause of weakness, proximal pattern of weakness, CK elevation, should be the point when you think about LGMD. Dr Smith: So, I have a question about diagnostic evaluation. I had a meeting with one of my colleagues, Qihua Fan, who's a great peripheral nerve expert, who also does neuromuscular pathology. And we were talking about how the pathology field has changed so much over the last ten years, and we're doing obviously fewer muscle biopsies. Our way of diagnosing them has changed a lot with the evolution of genetic testing. What's your diagnostic approach? Do you go right to genetic testing? Do you do targeted testing based on phenotype? What words of wisdom do you have there? Dr Liewluck: Yes, so, I mean, being a muscle pathologist myself, it is fair to say that the utility of muscle biopsies when you encounter a patient with suspects that limb girdle muscular dystrophy have reduced over the year. For example, we used to have like fifteen, seventeen hundred muscle biopsies a year; now we do only thirteen hundred biopsies a year. Yes, as you pointed out, the first step in my practice if I suspect LGMD is to go with genetic testing. And I would prefer the last gene panel that not only include the LGMD, but also include all other genetic muscle disease as well as the conjunctive myopic syndrome, because the phenotype can be somehow difficult to distinguish in certain patients. Dr Smith: So, do you ever get a muscle biopsy, Teerin? I mean you obviously do; only thirteen hundred. Holy cow, that's a lot. So, let me reframe my question. When do you get a muscle biopsy in these patients? Dr Liewluck: Muscle biopsy still is present in LGMD patients, it's just we don't use it at the first-tier diagnostic test anymore. So, we typically do it in selected cases after the genetic testing in those that came back inconclusive. As you know, you may run into the variant of unknown significance. You may use the muscle biopsy to see, is there any histopathology or abnormal protein Western blot that may further support the heterogenicity of the VUS. So, we still do it, but it typically comes after genetic testing and only in the selected cases that have inconclusive results or negative genetic testing. Dr Smith: I'd like to ask a question regarding serologic testing for autoantibodies. I refer to a really great case in your article. There are several of them, but this is a patient, a FKRP patient, who was originally thought to have dermatomyositis based on a low-titer ME2 antibody. You guys figured out the correct diagnosis. We send a lot of antibody panels out. Wonder if you have any wisdom, pearls, pitfalls, for how to interpret antibody tests in patients with chronic myopathies? We send a lot of them. And that's the sort of population where we need to be thinking about limb-girdle muscular dystrophies. It's a great case for those, which I hope is everyone who read your article in detail. What do you have to say about that? Dr Liewluck: Yes, so myositis antibodies, we already revolutionized a few of muscle diseases. I recall when I finished my fellowship thirteen years ago, so we don't really have much muscle myositis antibodies to check. But now the panel is expanded. But again, the antibodies alone cannot lead to diagnosis. You need to go back to your clinical. You need to make sure the clinical antibodies findings are matched. For example, if the key that- if the myocytes specific antibodies present only at the low positive title, it's more often to be false positive. So, you need to look carefully back in the patient, the group of phenotypes, and when in doubt we need to do muscle biopsies. Now on the opposite end, the other group of the antibody is the one for necrotizing autoimmune myopathy; or, the other name, immune-mediated necrotizing myopathy. This is the new group that we have learned only just recently that some patients may present as a typical presentation. I mean, when even thinking about the whole testing autoimmune myopathy, we think about those that present with some acute rapidly progressive weakness, maybe has history of sudden exposures. But we have some patients that present with very slowly progressive weakness like muscular dystrophies. So now in my practice, if I encounter a patient I suspect LGMD, in addition to doing genetic testing for LGMD, I also test for necrotizing doing with myopathy antibodies at the same time. And we typically get antibody back within what, a week or two, but projected testing would take a few months. Dr Smith: Yeah. And I guess maybe you could talk a little bit about pitfalls and interpretation of genetic tests, right? I think you have another case in your article, and I've certainly seen this, where a patient is misdiagnosed as having a genetic myopathy, LGMD, based on, let's say, just a misinterpretation of the genetic testing, right? So, I think we need to think of it on both sides. And I like the fact that the clinical aspects of diagnosis really are first and foremost most important. But maybe you can talk about wisdom in terms of interpretation of the genetic panel? Dr Liewluck:Yes. So genetic testing, I think, is a complex issue, particularly for interpretation. And if you're not familiar with this, it's probably best to have your colleagues in genetics that help looking at this together. So, I think the common scenario we encounter is that in those dystrophies that are autosomal recessive, so we expect that the patient needs to have two abnormal copies of the genes to cause the disease. And if patients have only one abnormal copy, they are just a carrier. And commonly we see patients refer to us as much as dystrophy is by having only one abnormal copy. If they are a carrier, they should not have the weakness from that gene abnormality. So, this would be the principle that we really need to adhere. And if you run into those cases, then maybe you need to broaden your differential diagnosis. Dr Smith: I want to go back to the clinical phenomenology, and I've got a admission to make to you, Teerin. And I find it really hard to keep track of these disorders at, you know, thirty-four and climbing a lot of overlap, and it's hard to remember them. And I'm glad that I'm now going to have a Continuum article I can go to and look at the really great tables to sort things out. I'm curious whether you have all these top of mind? Do you have to look at the table too? And how should people who are seeing these patients organize their thoughts about it? I mean, is it important that you memorize all thirty-four plus disorders? How can you group them? What's your overall approach to that? Dr Liewluck: I need to admit that I've not memorize all twenty-four different subtypes, but I think what I triy to do even in my real-life practice is group it all together if you can. For example, I think that the biggest group of these LGMD is what we call alpha-dystroglycanopathies. So, this include already ten different subtypes of recessive LGMD. So alpha-dystroglycan is the core of the dystrophin-associated glycoprotein complex. And it's heavy glycosylated protein. So, the effect in ten different genes can affect the glycosylation or the process of adding sugar chain to this alpha-dystroglycan. And they have similar features in terms of the phenotype. They present with proximal weakness, calf pseudohypertrophy, very high CK, some may have recurrent rhabdomyolysis, and cardiac and rhythmic involvement are very common. This is one major group. Now the second group is the limb-girdle muscular dystrophy due to defective membrane repair, which includes two subtypes is the different and on dopamine five. The common feature in this group is that the weakness can be asymmetric and despite proximal weakness, they can have calf atrophy. On muscle biopsy sometimes you can see a myeloid on the muscle tissues. And the third group is the sarcoglycanopathy, which includes four different subtypes, and the presentation can look like we share. For the rest, sometimes go back to the table. Dr Smith: Thank you for that. And it prompts another question that I always wonder about. Do you have any theories about why such variability in the muscle groups that are involved? I mean, you just brought up dystroglycanopathy, for instance, as something that can cause a very distal predominant myopathy; others do not. Do we at this point now have an understanding given the better genetics that we have on this and work going on in therapeutic development, which I want to get to in a minute, that provides any insight why certain muscle groups are more affected? Dr Liewluck: Very good question, Gordon. And I would say the first question that led me interested in muscle disease---and this happened probably back in 2000 when I just finished medical school---is why, why, why? Why does muscle disease tend to affect proximal muscles? I thought by now, twenty-five years later, we'd have the answer. I don't. I think this, you don't know clearly why muscle diseases, some affect proximal, some affect distal. But the hypothesis is, and probably my personal hypothesis is, that maybe certain proteins may express more in certain muscles and that may affect different phenotypes. But, I mean, dysferlin has very good examples that can confuse us because some patients present with distal weakness, some patients present with proximal weakness, that's by the same gene defect. And in this patient, when we look at the MRI in detail, actually the patterns of fatty replacements in muscle are the same. Even patient who present clinically as a proximal or distal weakness, the imaging studies show the same finding. Bottom line, we don't know. Dr Smith: Yeah, who knew it could be so complex? Teerin, you brought up a really great point that I wanted to ask about, which is muscle MRI scan, right? We're now seeing studies that are doing very broad MR imaging. Do you use some muscle MRI very frequently in your clinical evaluation of these patients? And if so, how? Dr Liewluck: Maybe I don't use it as much as I could, but the most common scenario I use in this setting is when I have the genetic testing come back with the VUS. So, we look at each VUS, each gene in detail. And if anything is suspicious, what I do typically go back to the literature to see if that gene defect in particular has any common pattern of muscle involvement on the MRI. And if there is, I use MRI as one of the two to try to see if I can escalate the pathogenicity of that VUS. Dr Smith: And a VUS is a “Variant of Unknown Significance,” for our listeners. I'm proud that I remember that as a geneticist. These are exciting times in neurology in general, but particularly in an inherited muscle disease. And we're seeing a lot of therapeutic development, a lot going on in Duchenne now. What's the latest in terms of disease-modifying therapeutics and gene therapies in LGMD? Dr Liewluck: Yes. So, there are several precritical and early-phase critical trials for gene therapy for the common lymphoma of muscular dystrophies. For example, the sarcoglycanopathies, and they also have some biochemical therapy that arepossible for the LGMD to FKRP. But there are many things that I expect probably will come into the picture broader or later phase of critical tryouts, and hopefully we have something to offer for the patients similar to patients with Duchenne muscular dystrophy. Dr Smith: What haven't we talked about, I mean, holy cow? There's so much in your article. What's one thing we haven't talked about that our listeners need to hear? Dr Liewluck: Good questions. So, I think we covered all, but often we get patients with proximal weakness and high CK, and they all got labeled as having limb-girdlemuscular dystrophy. What I want to stress is that proximal weakness and high CK is a common feature for muscle diseases, so they need to think broad, need to think about all possibilities. Particularly don't want to miss something treatable. Chronic, slowly progressive cause, as I mentioned earlier, we think more about muscle dystrophy, but at the cranial range, we know that rare patients with necrotic autonomyopathy and present with limb good of weakness at a slowly progressive cost. So, make sure you think about these two when suspecting that LGMD patient diabetic testing has come back inconclusive. Dr Smith: Well, that's very helpful. And fortunately, there's several other articles in this issue of Continuum that help people think through this issue more broadly. Teerin, you certainly don't disappoint. I enjoyed listening to you about a month ago, and I enjoyed reading your article a great deal and enjoy talking to you even more. Thank you very much. Dr Liewluck: Thank you very much, Gordon. Dr Smith: Again, today I've been interviewing Dr Teerin Liewluck about his article on limb-girdle muscular dystrophy, which appears in the October 2025 Continuum issue on muscle and neuromuscular junction disorders. Please be sure to check out Continuum Audio episodes for this and other issues. And thanks to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.
Have you ever felt like the room is spinning, even though you're perfectly still? That sudden, surreal dizziness can be more than unsettling—it might be a sign your migraines are doing more than causing pain.And get grounded in the truth behind dizzy migraines.For many migraine warriors, dizziness isn't just a side symptom—it's a life-disrupting force. In this episode of Migraine Heroes Podcast, hosted by Diane Ducarme, we untangle why migraines can throw off your balance, confuse your diagnosis, and make you feel like you're losing control—both physically and emotionally.In this episode you'll learn to:
In this episode, we review the high-yield topic of Parenchymal Hemorrhage from the Neurology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In the second episode of this two-part series, Dr. Justin Abbatemarco and Dr. Jennifer E. Fugate discuss patient outcomes and how to manage these individuals both in the hospital and outside the hospital. Show reference: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00232-7/abstract
Although it may seem like science is completely separate from faith, they both play a very important role in our understanding. They are not opposed and can exist together as both strive to find the truth. It's just a matter of looking at the topic from different angles, according to our guest today, Dr. Gary Simonds, a retired neurosurgeon who's treated tens of thousands of patients. Today he talks about burnout in the healthcare system, especially during and after Covid. He stresses the importance of keeping a positive attitude and focusing on resilience. Dr. Simonds suggests practicing gratitude and asks us to think of 3 things we are grateful for throughout the day. He explains how our brains actually have a different chemical reaction when looking for the positive. He suggests considering uplifting material or realizing something as simple as a smile. Sometimes we need to force ourselves to look for the positive. As a neurosurgeon, doctors typically look for the worst-case scenario, so they can plan in advance if something goes wrong. He talks about consciously directing thoughts toward possibilities and solutions. Dr. Simonds, as an expert neurosurgeon, also discusses how to deliver difficult news, while managing expectations. He's had to do it so many times, with many patients and families. He explains how it's all about trust -- a delicate walk between honesty and compassion with empathy. An expert on burnout and trauma, Dr. Simonds is the Founding Chief of Neurosurgery at the Carilion Clinic, Virginia Tech Carilion School of Medicine (retired) and the author of three non-fiction books. “Death's Pale Flag” is his first novel and his latest book. This is Part 1 of the interview. Info: GaryRSimonds.com.
Dr. Greg Cooper talks with Dr. Jonathan Graff-Redford about key takeaways from the recent Alzheimer's Association International Conference (AAIC). Disclosures can be found at Neurology.org.
In this episode, we review the high-yield topic of Essential Tremor from the Neurology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In the first episode of this two-part series, Dr. Justin Abbatemarco and Dr. Jennifer E. Fugate discuss posterior reversible encephalopathy syndrome (PRES), highlighting both typical and atypical MRI findings. Show reference: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00232-7/abstract
Here we review ashwagandha a nutritional supplement that has plausible mechanisms for slowing ALS, promising pre-clinical evidence, and a reasonable safety profile. There is one person with ALS who experienced a reversal of symptoms on a cocktail of treatments that included ashwagandha. Cases like this are difficult to interpret as there can be multiple explanations for a person experiencing an ALS reversal. We have not found any other cases suggesting improvement on this product. We hope to see the data from the completed phase 2 trial soon.
Dr. Gregg Day and Drs. Laura Baker and Melissa Yu discuss interventions that enhance or safeguard cognitive function in older adults at risk of cognitive decline and dementia. Show reference: https://jamanetwork.com/journals/jama/article-abstract/2837046
In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Doug Kirsch, Medical Director of Atrium Health Sleep Medicine and Clinical Professor in the Department of Neurology at Wake Forest School of Medicine, and Dr. Fariha Abbasi-Feinberg, president-elect of the AASM and private practice physician with Millennium Physician Group in Fort Myers, Florida, to introduce PLATO—a groundbreaking longitudinal assessment tool for obstructive sleep apnea. The Epworth Sleepiness Scale has been a cornerstone of sleep medicine practice for decades, yet clinicians universally acknowledge its limitations in capturing the full patient experience. Similarly, PAP adherence—while important and part of Medicare's MIPS program—tells only part of the story about treatment success. During his AASM presidency, Dr. Kirsch recognized the need for a more comprehensive metric and convened an expert advisory panel to develop a better solution. The conversation traces PLATO's development journey, which Dr. Rosen described as "Doug's baby with a prolonged gestation." Starting with 44 potential questions and utilizing the ICON methodology, the panel carefully refined the tool to capture domains beyond simple sleepiness—including quality of life, functional impairment, and symptom burden that the Epworth overlooks. Dr. Kirsch and Dr. Abbasi-Feinberg explain the validation process, how the tool discriminates between OSA severity levels, and why certain seemingly similar questions about sleepiness were all retained. The episode addresses practical implementation questions: How is PLATO scored? Why do the first two sections use 5-point scales while the final section uses 10 points? Is it free to use, and how does one access it? Will it integrate into electronic health record systems like Epic? Most importantly, how should clinicians use this tool—will it replace the Epworth for Medicare requirements, or does it serve a different purpose? The discussion also explores how PLATO relates to the recent AHRQ report on OSA treatment outcomes and why the tool focuses on patient-reported symptoms rather than solely cardiovascular endpoints. Dr. Kirsch shares his vision for PLATO's future, including hopes for foundation grants to further study the tool and demonstrate that treating OSA and its associated sleepiness meaningfully improves patient outcomes. Whether you're frustrated with current assessment limitations, interested in value-based care metrics, or seeking better ways to document treatment efficacy beyond adherence data, this episode provides essential insights into a tool that may reshape how we measure success in sleep medicine. Join us for this important discussion about moving beyond PAP adherence and Epworth scores to truly capture what matters to our patients.
Dr. Gregg Day talks with Drs. Laura Baker and Melissa Yu about the impact of lifestyle interventions on cognitive function in older adults. Read the related article in JAMA. Disclosures can be found at Neurology.org.
In the second part of this two-part series, Casey Kozak concludes the discussion about the TOAST criteria for classifying acute ischemic stroke.
In the first part of this two-part series, Casey Kozak discusses the TOAST criteria for classifying acute ischemic stroke. In this episode, she covers large artery atherosclerosis and small vessel disease.
Many people will be familiar with Parkinson's disease: the progressive brain disorder that causes symptoms including tremors and slower movement, leading on to serious cognitive problems. You might not know that it's the fastest-growing neurological condition in the world. Today it affects around 11.8 million people and that's forecast to double by 2030. Dr Sonia Gandhi is one of the scientists working to change that trend. As Professor of Neurology at University College London and Assistant Research Director at the Francis Crick Institute, her work involves using stem cells to build models of the human brain, helping to drive the development of drugs and other therapies for Parkinson's patients.Talking to Professor Jim Al-Khalili, Sonia explains why this destructive condition is on the rise - and the promising routes they're studying to find new ways to tackle it.Presented by Jim Al-Khalili Produced by Lucy Taylor for BBC StudiosFor details of organisations that offer advice and support to anyone affected by Parkinson's Disease, please go online to bbc.co.uk/actionline.
In the final episode of this five-part series, Dr. Paul Crane concludes the measles series by discussing testing and prevention.
Neurology professor Daniel Weissman on brain farts, Bernie Miklasz on football, and Middle East peace!- h2 full 2060 Mon, 13 Oct 2025 20:59:37 +0000 5Xv2Aq9Ax5PZqvi9mfFO8bTlPKpW6I2q comedy,religion & spirituality,society & culture,news,government The Dave Glover Show comedy,religion & spirituality,society & culture,news,government Neurology professor Daniel Weissman on brain farts, Bernie Miklasz on football, and Middle East peace!- h2 The Dave Glover Show has been driving St. Louis home for over 20 years. Unafraid to discuss virtually any topic, you'll hear Dave and crew's unique perspective on current events, news and politics, and anything and everything in between. © 2025 Audacy, Inc. Comedy Religion & Spirituality Society & Culture News Government False
Dr. Justin Abbatemarco talks with Dr. Jennifer E. Fugate about posterior reversible encephalopathy syndrome (PRES), focusing on its clinical presentation, diagnosis, imaging techniques, and management strategies. Read the related article in The Lancet Neurology. Disclosures can be found at Neurology.org.