Podcasts about practical neurology

This episode's theme is new diseases, whether they are newly described, or old diseases back in a new form. We start off with IgG4-related disease, a chronic multisystem disorder that is still being understood. Then there is a genetics paper on repeat expansion disorders, a group of conditions often thought as disparate but with quite a few commonalities. Next along is a fascinating case following gastric sleeve bariatric surgery, highlighting the dangers of travelling for unsupervised surgeries, and raising the question, “Are you getting enough soil in your diet?” There's also a discussion of what else Hoover's sign might represent, and the evolution of immunoglobulin use. Closing the episode is a paper offering a masterclass on the assessment of best interests in  prolonged disorder of consciousness.   Read the issue: https://pn.bmj.com/content/25/3/199   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. Production and editing by Brian O'Toole. Thank you for listening. 

Two wide open cases from the latest issue of the journal. Starting with a case from Italy (1:18), of a 63-yo man having a history of behavioural and cognitive problems since retiring. His many changes included low mood, significant weight loss, and problems with sleep and temperature regulation. He had a background of type 2 diabetes. Initial treatment was on a suspicion of Alzheimer's, but there was no clinical improvement. https://pn.bmj.com/content/25/2/159  A case from the United States is next (17:36), featuring a 66-yo lady experiencing 10 days of generalised weakness, with episodes of forgetfulness and a series of falls. She had previously been treated for left-sided ophthalmic herpes zoster. Neurological examination showed mild right arm and leg weakness. https://pn.bmj.com/content/25/2/164    The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Babak Soleimani³ 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 2025 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 Research Fellow, Oxford Laboratory for Neuroimmunology and Immunopsychiatry, Nuffield Department of Medicine, University of Oxford 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. Production and editing by Brian O'Toole. Thank you for listening. 

Immune checkpoint inhibitors can significantly improve cancer survival rates. But resulting immune-related toxicities are common, requiring multidisciplinary cooperation between oncology and neurology.  This episode, PN's podcast editor Dr. Amy Ross Russell speaks with a panel of experts on the balancing act required when treating cancer patients with these new drugs. Oncologist Dr. Heather Shaw is alongside neurologists Dr. Aisling Carr and Dr. Mark Willis, and they are amongst the authors of the editors' choice paper for the latest issue of Practical Neurology. Read the paper: Neurological complications of immune checkpoint inhibitors: a practical guide  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. Production by Letícia Amorim, Brian Kennedy, Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening. 

The latest guidelines on disease-modifying treatment in multiple sclerosis (MS) from the Association of British Neurologists is discussed in this intercontinental podcast with perspectives from the UK, the USA, and Australia.   Participants: Professor Alasdair Coles is Head of Department for Clinical Neuroscience and also Co-Director of the Cambridge Centre for Myelin Repair, UK. Dr. Tamara Kaplan is Assistant Professor of Neurology at Harvard Medical School, and is also affiliated with the Brigham and Women's Hospital, Boston, USA. Professor Michael Barnett is a consultant neurologist at Royal Prince Alfred Hospital Sydney, Central Clinical School, and Director of the RPAH MS Clinic and the MS Clinical Trials Unit at the Brain and Mind Centre, University of Sydney, Australia. Read the paper (https://pn.bmj.com/content/25/1/18) which is part of the February issue of the Practical Neurology journal.   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. Production and editing by Letícia Amorim. Thank you for listening.     

It's a podcast of pairs this time, for the latest issue of the journal. There's two hosts, two halves of the brain, two sides to a clinical debate, and two themes to the episode itself. Leading off is a discussion on peripheral neurology, taking a look at the editors' choice paper on immune checkpoint inhibitors. That's followed by a paper on  secondary hypertension, and another on small fibre neuropathies. The second half covers elements of cognitive neurology, including a topic with increasing awareness - that of brain fog. There's the dramatically named STOP-BANG questionnaire, a notable appearance from a monkey, and a reflection on modern practices for cognitive assessment. Read the issue: https://pn.bmj.com/content/25/2/101 Listen to Dr. Laura McWhirter on the JNNP podcast: Brain fog demystified 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. Production by Letícia Amorim and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening. 

A puzzling pair of Case Reports from the most recent issue of the journal. First up (1:35) is a man in his mid-fifties, presenting with lumbar spine fractures, which then developed into confusion, vomiting, and abdominal pain. An x-ray showed  dilated intestinal loops and his blood sodium levels were low. https://pn.bmj.com/content/25/1/87 The second case (23:06) involves a 21-yo woman, who presented  at 18 weeks pregnant with  multiple episodes of right upper limb tonic extension, and subsequently developed new-onset refractory status epilepticus (NORSE). https://pn.bmj.com/content/25/1/56    The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Xin You Tai³ 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 2025 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. Production and editing by Letícia Amorim and Brian O'Toole. Thank you for listening. 

Intermittent painful spasms, stiffness and rigidity of the proximal and truncal muscles are only a few symptoms of the relatively uncommon Stiff-person syndrome (SPS). In this podcast, we delve into the characteristics and diagnosis of this complex autoimmune condition. PN's podcast editor Dr. Amy Ross Russell interviews Professor Saiju Jacob (University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK). The paper is the Editor's Choice paper of the February issue of Practical Neurology. The episode is released to coincide with world Encephalitis day. For more information about World encephalitis day, or encephalitis international please follow this link: https://www.encephalitis.info/world-encephalitis-day/  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. Production by Letícia Amorim and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening. 

The practice of neurology is constantly changing, and the papers in this issue exemplify that trend. On this episode, journal editors Dr. Geraint Fuller and Prof. Philip Smith discuss their highlights from the latest issue of Practical Neurology, for February 2025. They begin with the editors' choice paper on stiff person syndrome, then speak about new guidance from the ABN on disease-modifying treatments for MS. There's also life-improving interventions for posterior cortical atrophy, changing attitudes towards stroke as a career option for neurologists, and management techniques for cryptococcal meningitis - including a resourceful substitute for India ink.  Read the issue: https://pn.bmj.com/content/25/1/1  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. Production by Letícia Amorim and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening. 

Two more fascinating Case Reports from the latest issue of the journal. The first case (1:15) is of a 57-yo woman, with an intermittent posterior headache, which had an associated bilateral pressure-like sensation. Her symptoms had begun on a recent trip to Sri Lanka. https://pn.bmj.com/content/24/6/526  Following on is the second case (22:18), which features a 54-yo man experiencing deterioration in his speech and mobility. He had a background of chronic HIV infection with ongoing treatment. https://pn.bmj.com/content/24/6/507   The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Xin You Tai³ 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 June 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. Production and editing by Letícia Amorim and Brian O'Toole. Thank you for listening. 

It's the Christmas Special for 2024! Joining Amy in the studio is Dr. Steven Lewis. Steven is the current secretary general of the World Federation of Neurology, and is based in the United States, where he works as a general neurologist. Their conversation builds on a recent article by Dr. Bas Bloem, "Islands and bridges in healthcare: the importance of general neurology”. Listen in for insights on the differences in training and practice in the US and UK, the value of developing a network as a neurologist, and the enduring need for general neurology's broad diagnostic approach. Related links: "Welcome to the mainland: general neurology's role in rescue from the islands of subspecialisation", the editorial by Dr. Steven Lewis "In defence of general neurology", an editorial by Dr. Neil Anderson 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. Production and editing by Letícia Amorim, Amy Ross Russell, and Brian O'Toole. Thank you for listening. 

The often challenging diagnosis of neuromuscular junction (NMJ) disorders can be explained by suspicious red flags for the key differential diagnoses (mimics) and atypical presentations (chameleons).  In the latest Editor's Choice paper podcast, PN's podcast editor Dr. Amy Ross Russell interviews Dr Stephen Reddel and Dr Shadi El-Wahsh, both from the Concord Hospital, New South Wales, Australia, and the authors of Neuromuscular junction disorders: mimics and chameleons. 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. Production and editing by Letícia Amorim, Amy Ross Russell, and Brian O'Toole. Thank you for listening. 

Neuromuscular junction disorders can present in a variety of challenging ways, with the potential to mislead neurologists. Journal editors Prof. Philip Smith and Dr. Geraint Fuller begin with this subject as they talk through the latest issue Practical Neurology, for December 2024. The conversation moves to neck flexion and brain zaps, reflects on the undiminished importance of "general" neurology, and also touches on maternal epilepsy risks, frailty's impact on stroke patients, timely recognition of glaucoma, and sustainable practices for green physicians. To finish, there's the now-traditional recital of eponymous syndromes. Read the issue: https://pn.bmj.com/content/24/6  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. Production by Letícia Amorim and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening. 

Vertigo explained, including a way to easily remember the causes of Vertigo, as well as the different symptoms associated and the HINTS exam. Also covers vertigo pathophysiology, as well as the different treatment options for vertigo.Consider subscribing on YouTube (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Patreon: https://www.patreon.com/rhesusmedicineBuy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineTimestamps:0:00 What is Vertigo? 1:11 Benign Paroxysmal Positional Vertigo2:52 Vestibular Migraine3:52 Meniere's Disease5:15 Persistent Postural Perceptual Dizziness6:59 Vestibular Neuritis8:17 Posterior Circulation Stroke9:24 HINTS Examination Central vs Peripheral VertigoReferences:Kaylie D, M - MSD Manual Pro (2022) - “Dizziness and Vertigo”. Available at https://www.msdmanuals.com/professional/ear-nose-and-throat-disorders/approach-to-the-patient-with-ear-problems/dizziness-and-vertigoHamiter, M - MSD Manual Pro (2023) - “ Benign Paroxysmal Positional Vertigo”. Available at https://www.msdmanuals.com/professional/ear-nose-and-throat-disorders/inner-ear-disorders/benign-paroxysmal-positional-vertigoLilien, V - The British Medical Journal (2019) - “Vestibular migraine”. Available at https://www.bmj.com/content/366/bmj.l4213.fullMeniere's UK - “Migraine Associated Vertigo”. Available at https://www.menieres.org.uk/information-and-support/symptoms-and-conditions/migraine-associated-vertigoHohnen, H - Geeky Medics (2020) - “The Head Impulse, Nystagmus, Test of Skew (HINTS) Examination”. Available at https://geekymedics.com/the-head-impulse-nystagmus-test-of-skew-hints-examination/Practical Neurology (2016) - “Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness”. Available at https://pn.bmj.com/content/18/1/5Clinical Knowledge Summaries (2023) - “Ménière's disease”. Available at https://cks.nice.org.uk/topics/menieres-disease/Clinical Knowledge Summaries (2023) - “Vestibular neuronitis”. Available at https://cks.nice.org.uk/topics/vestibular-neuronitis/Please remember this podcast and all content from Rhesus Medicine is meant for educational purposes only and should not be used as a guide to diagnose or to treat. Please consult a healthcare professional for medical advice. 

The immune system is a recurring feature in the cases discussed in this edition of the Case Reports podcast. The first paper details the cases of two young women, sisters, presenting with overlapping conditions but resulting in tragically different outcomes (1:16). Both were in their twenties, had given birth recently, and developed limb weakness along with several other neurological symptoms. https://pn.bmj.com/content/24/5/422 Our second case is a 72-yo woman with a range of symptoms including diplopia, ptosis, myalgia, and worsening shortness of breath (21:27). She had had surgical resection of a malignant melanoma, and was receiving immunotherapy treatment. Her presentation resembled myasthenia gravis, but initial treatment did not yield a response. https://pn.bmj.com/content/24/5/428  The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Xin You Tai³ 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 June 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. This episode was produced and edited by Brian O'Toole. Thank you for listening. 

"Could this presenting syndrome be caused by a neurotoxin?" Oftentimes neurologists will pass over toxins when diagnosing. Yet disease caused by neurotoxins is widespread, with many having quite typical syndromes.  In the studio to discuss this is the first author of the October 2024 Editors' Choice paper, Dr. Frederick Vonberg¹. He draws attention to some hobbies and occupations to watch out for, the global prevalence of lead poisoning, presentations of botulism, and the origin of the infamous Mad Hatter syndrome.  Read the paper: Neurotoxicology: a clinical systems-based review 1. National Hospital for Neurology and Neurosurgery, Queen Square, London, UK Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest episodes. 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. This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Letícia Amorim, Brian O'Toole, and Amy Ross Russell. Editing by Brian O'Toole.

The surgical sieve and Occam's razor may sound like familiar diagnostic metaphors, but what about Crabtree's bludgeon? These are just a few of the tools touched on by journal editors editors Prof. Philip Smith and Dr. Geraint Fuller, as they discuss the October 2024 issue of Practical Neurology. They cover recent publications on oligoclonal bands, neurotoxicology, methotrexate, carotid artery disease, epilepsy surgery, and how unsolved cases remain part of the "art of neurology". To finish, there is a conversation on the topic of neurology podcasts themselves.  Read the issue: https://pn.bmj.com/content/24/5   Further reading: The BMJ - What Three Wise Men have to say about diagnosis JNNP - Neurotoxicology: what the neurologist needs to know   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. Production by Letícia Amorim and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening. 

This month's cases both feature sudden onset neurological syndromes. The first case (1:23) is that of a 26-yo Brazilian man who awoke from sleep with weakness in all four limbs. The signs suggest a possibility of Guillain-Barré syndrome or polio. A normal cranial nerve examination follows, with no unusual findings - https://pn.bmj.com/content/24/4/342  A 69-yo woman is the subject of the second case (14:33), after she presents with sudden onset unsteadiness and slurred speech when getting out of bed. A stroke was initially examined for by CT head scan, proving unremarkable, but a subsequent MRI scan showed an intense midbrain lesion. The patient subsequently improved, but then returned three months later with occurrences of the same symptoms multiple times throughout the day - https://pn.bmj.com/content/24/4/310 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 August 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.  Listen to the JNNP podcast, "Nutritional peripheral neuropathies, with Dr. Alexander Rossor" on Apple (https://apple.co/3WjTmrM), Spotify (https://spoti.fi/4bKOhNA), Web (https://bit.ly/4cYhx4m). 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. This episode was produced and edited by Brian O'Toole. Thank you for listening. 

Genetic testing is a useful tool for any practising neurologist, but they must know how to interpret the results. This Editors' Choice podcast features two experts on the subject, Prof. Mary Reilly¹ and Dr. Christopher Record¹. They're in the studio to talk through their paper, covering the technology of genome sequencing itself, testing strategies, clinical use cases, and the constant changes in this developing field. Read the paper: Lessons and pitfalls of whole genome sequencing 1. Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest episodes. 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. This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Letícia Amorim, Brian O'Toole, and Amy Ross Russell. Editing by Brian O'Toole.

Journal editors Prof. Philip Smith and Dr. Geraint Fuller discuss the August 2024 issue of Practical Neurology, with room for mystery, history and practical advice. In particular, they cover topics like whole genome sequencing, foot surgery for Charcot-Marie-Tooth disease, safe prescribing in steroids, and fertility treatment for the epileptic. There are also good reasons for dusting off the old optokinetic nystagmus drum, and a touching story of neuro palliative care. Read the Highlights - https://pn.bmj.com/content/24/4/261 - and the full issue - https://pn.bmj.com/content/24/4. 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.

Two highly unusual cases in this edition of Case Reports. The first case describes a 64-yo woman presenting to the emergency department with a five day history of bizarre behaviours (1:45). A BBC radio show prompts her, out of character, to reflect aloud about her childhood, and she experiences recurrent periods of unresponsiveness followed by intense agitation. She was kept in hospital for scans and discharged after two weeks, but returned soon after with a similar presentation - (link) A lifetime bodybuilder is the patient in the second case (21:12), with a practice of anabolic steroid injection over several decades. He presents with a three year history of unsteadiness when walking and tingling in his feet, as well as reduced dexterity. His symptoms are found to be brought on by a toxicity from an unexpected source - (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 June 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.  Listen to the JNNP podcast, "Nutritional peripheral neuropathies, with Dr. Alexander Rossor" on Apple (https://apple.co/3WjTmrM), Spotify (https://spoti.fi/4bKOhNA), Web (https://bit.ly/4cYhx4m). 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. This episode was produced and edited by Brian O'Toole. Thank you for listening. 

Neurodegenerative disease is the subject of this month's Editors' Choice podcast, with Dr. Patrick Cullinane¹ and Dr. Zane Jaunmuktane.¹ They join the podcast for an overview of brain examination, explaining the process of protein misfolding, the spread of pathology through the brain, and what new discoveries can tell us about old diseases. Read the paper: Pathology of neurodegenerative disease for the general neurologist 1. Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, UK Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest episodes. 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. This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Letícia Amorim, Brian O'Toole, and Amy Ross Russell. Editing by Brian O'Toole. Special thanks to The Podcast Studios Dublin for their assistance with the recording of this episode, and thank you for listening.

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.

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. 

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.

Host: Mary Katherine Cheeley, PharmD, BCPS, CLS, FNLA Guest: Ahmed Zayed Obeidat, MD, PhD Guest: Lauren Beranek, BS Polypharmacy is defined as the regular use of five or more prescribed medications, and due to their disease course, related symptoms, and side effects, patients with multiple sclerosis are at an increased risk of polypharmacy. So to hear insights on ways to identify, manage, and prevent polypharmacy, Dr. Mary Catherine Cheeley is joined by Dr. Ahmed Obeidat, Associate Professor of Neurology, and Lauren Beranek, MD candidate at the Medical College of Wisconsin. Find a full article on their findings published in Practical Neurology.

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. 

Host: Michael Greenberg, MD Guest: Chris Bundy, MD, MPH, FASAM Along with the general population, physicians are vulnerable to substance use disorder (SUD) with rates as high as 10 to 14 percent. And with demanding careers, stress and burnout can often exacerbate SUD. Tune into part one of this discussion with Dr. Michael Greenberg as he takes a deep dive into the prevalence of SUD and use characteristics among physicians with Dr. Chris Bundy, Executive Medical Director of the Washington Physicians Health Program and Clinical Assistant Professor of Psychiatry at the University of Washington School of Medicine. Read the original publication, titled "The Whole Physician: Physicians with Substance Use Disorder: Help is Available," which was published on Practical Neurology in November 2023.

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, 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: Automated Interpretation of Clinical Electroencephalograms Using Artificial Intelligence Electroencephalographic (EEG) features of encephalopathy in the setting of Covid-19: A case series 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.

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.

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 via all podcast platforms, including Apple Podcasts and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). 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. 

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 The PN Editors' Choice podcast is hosted by Dr. Amy Ross Russell, and produced and edited by Brian O'Toole. Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

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 via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the December 2023 issue of the journal - https://pn.bmj.com/content/23/6/461  Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053).  The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Prof. Martin Turner (1) hosts Dr. Ruth Wood (2) and Dr. Xin You Tai (3), as they puzzle through two Case Reports from the latest issue of the Practical Neurology journal. The first case (1:11) is one of a 27-yo man, whose initial presentation suggests a form of multiple sclerosis, but turns out to be something more rare - (https://pn.bmj.com/content/23/5/414). The second case (19:16) is that of a 59-yo woman, with a two month history of progressive confusion and gait difficulty against a background of schizophrenia - (https://pn.bmj.com/content/23/5/453).  Additional reading: Practical approach to the diagnosis of adult-onset leukodystrophies: an updated guide in the genomic era -  https://jnnp.bmj.com/content/90/5/543 (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 via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). 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. 

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Tirisham Gyang, MD Guest: Gopika Govindan Kutty, MD In past studies, it was seen that multiple sclerosis was more prevalent in White individuals from Northern European ancestry. However, more recent data is showing that MS can happen in anyone and everyone, and there may be slight clinical variations in the disease when we look at different demographic populations. So how can we better serve minority communities? To dive in further, Dr. Charles Turck is joined by Dr. Tirisham Gyang, Clinical Assistant Professor of Neurology at the Ohio State University School of Medicine, and Dr. Gopika Kutty, Neurologist at the University of Pittsburgh Medical Center. Read their publication, titled “Disparities in Multiple Sclerosis: Incorporating Equity into Clinical Care and Research,” which was published on Practical Neurology in July 2023.

Dr. Amy Ross Russell (1) is joined by Dr. Desmond Kidd (2) to discuss the paper “Neurological involvement by Behçet's syndrome: clinical features, diagnosis, treatment and outcome”. Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/23/5/386) and the October print issue of the journal. The paper is also discussed by the Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://pnbmj.podbean.com/e/editors-highlights-of-the-october-2023-issue/ (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) Behçet's Syndrome Centre of Excellence, The Royal London Hospital, London, UK (https://www.behcets.nhs.uk) Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the October 2023 issue of the journal (https://pn.bmj.com/content/23/5/365). Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053).  The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

In the third episode of this new series of the Practical Neurology podcast, Prof. Martin Turner (1) hosts Dr. Ruth Wood (2) and Dr. Xin You Tai (3) in a discussion of two Case Reports from the latest issue of the Practical Neurology journal. The first case (0:36) is one of a 78-yo man with variable slurring speech and swallowing difficulties - "Bilateral hypertrophic olivary degeneration in symptomatic palatal tremor" (https://pn.bmj.com/content/23/4/346). The second case (19:21) is a first-person report from the "Me and My Neurological Illness" section, with a 56-yo man living with Parkinson's getting into difficulty while swimming in open water - "Near-drowning in Parkinson's disease: common or uncommon?" (https://pn.bmj.com/content/23/4/354).  (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 via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). 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. 

Dr. Amy Ross Russell (1) is joined by the authors of the paper “First-line immunosuppression in neuromuscular diseases”, Dr Michael Foster, Prof Michael Lunn, Dr Aisling Carr (2). Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/23/4/327) and the August print issue of the journal. The paper is also discussed by the Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://pnbmj.podbean.com/e/editors-highlights-of-the-august-2023-issue/ (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, London, UK Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the August 2023 issue of the journal (https://pn.bmj.com/content/23/4/269). Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053).  The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

In the second episode of this new series of the Practical Neurology podcast, Prof. Martin Turner (1) hosts Dr. Ruth Wood (2) and Dr. Xin You Tai (3) as they delve into two Case Reports from the latest issue of the Practical Neurology journal. First up this month (0:42) is a young man, presumed suffering from a drug overdose, with symptoms of transient global amnesia. This case is determined to be an example of "Cerebellar Hippocampal and Basal Nuclei Transient Edema with Restricted diffusion (CHANTER) Syndrome" (https://pn.bmj.com/content/early/2023/04/17/pn-2023-003724). Next (13:07) is a young woman with urinary retention and leg paraesthesia over multiple days. Investigations showed this to be "Conus medullaris syndrome as a presenting feature of MOG-associated disease" (https://pn.bmj.com/content/early/2023/01/13/pn-2022-003560). (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 via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053).    The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Dr. Amy Ross Russell (1) is joined by the authors of "Multiple system atrophy", a review recently published in Practical Neurology. The guests, Dr. Yee Yen Goh (2), and Dr. Viorica Chelban (2), detail the effects of this condition, describe its detection, and provide information on the support that patients can receive.  Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/23/3/208) and the June print issue of the journal. The paper is also discussed by the Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://pnbmj.podbean.com/e/editors-highlights-of-the-june-2023-issue/  (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) UCL Queen Square Institute of Neurology, London, UK Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the June 2023 issue of the journal (https://pn.bmj.com/content/23/3). Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053).  The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the June 2023 issue of the journal (https://pn.bmj.com/content/23/3/189). Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

In this new series of the Practical Neurology podcast, Professor Martin Turner (1) invites Dr Ruth Wood (2) and Dr Xin You Tai (3) to discuss the nitty-gritty details of two Case Reports from the latest issue of the Practical Neurology journal. This month, they start by commenting on a case of a woman in her 70s with renal failure who developed confusion and seizures after receiving aciclovir, and was subsequently diagnosed with aciclovir-induced neurotoxicity (Aciclovir-induced neurotoxicity - https://pn.bmj.com/content/23/2/157). They also talk (starting at 23:05) about an unusual case of an acute posterior spinal artery syndrome in a man in his 60s with vascular risk factors (Posterior spinal artery infarct - https://pn.bmj.com/content/23/2/160). (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 via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Dr. Amy Ross Russell(1) is joined by a selection of the authors of "Toxic neuropathies; a practical approach", a review recently published in Practical Neurology. The guests, Dr. Duncan Smyth(2), Dr. Aisling Carr(3) and Prof. Michael Lunn(3), explain the background to these conditions and describe approaches to treatment and care of toxic neuropathy patients. Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/23/2/120) and the April print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-of-the-april-2023-issue?in=bmjpodcasts/sets/pn-podcast (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) Dept. of Neurology, Wellington Hospital, Wellington, NZ (3) MRC Centre for Neuromuscular Diseases, National Hospital for Neurology, University College London Hospitals, UK Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the April 2023 issue of the journal (https://pn.bmj.com/content/23/2/103). Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Dr. Amy Ross Russell(1) discusses a recently published review by Dr. Christopher Carswell(2) on the historical context of normal pressure hydrocephalus, the challenges faced when dealing with patients, and the current state of clinical evidence for diagnosis and treatment. Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/23/1/15) and the February print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-of-the-february-2023-issue?in=bmjpodcasts/sets/pn-podcast (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) Imperial College Healthcare NHS Trust, London, UK Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the February 2023 issue of the journal (https://pn.bmj.com/content/23/1/1). Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Dr. Amy Ross Russell(1) discusses a recently published review by Dr. Jeremy Rees(2) and Dr. Michael Kosmin(3) on the subject of radiation therapy on the brain, the history and motivation of its use, and its benefits and limitations. Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/22/6/450) and the December print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-of-the-december-2022-issue?in=bmjpodcasts/sets/pn-podcast (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) Neurology, National Hospital for Neurology and Neurosurgery, London, UK (3) Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the December 2022 issue of the journal (https://pn.bmj.com/content/22/6/445). Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Dr. Amy Ross Russell(1), interviews Dr. Jon Walters(2) about his recent review of approaches to weakness in the Intensive Care Unit (ICU). Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/22/5/358) and the June print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-of-the-october-2022-issue?in=bmjpodcasts/sets/pn-podcast (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) Consultant Neurologist, Morriston Hospital, Swansea, UK Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the October 2022 issue of the journal. Read the highlights: https://pn.bmj.com/content/22/5/341. Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Dr. Amy Ross Russell(1), interviews Dr. Stephen Kirker(2) about his recent paper detailing the use of appropriate orthoses for patients with weakness or abnormal posture of their lower leg, and they discuss the sorts of problems that can be helped in neurological practice and the range of devices commonly used. Read the latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/22/4/311) and the August print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-of-the-august-2022-issue (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) Rehab Medicine Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The Practical Neurology podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Neste segundo episódio da PEBMED em parceria com a Pfizer, Marcelo Gobbo e Viviane Carvalho abordam um pouco mais sobre a investigação da doença rara PAF, Polineuropatia Amiloidótica Familiar, para diagnóstico precoce e diferenciais. Referências bibliográficas: 1- Luiz F. Pinto, et al. The most common amyloidosis are both treatable; accurate diagnosis is paramount. Practical Neurology, July, 2021. 2- Salvi F, et al. Genotypic and phenotypic correlation in an Italian population of hereditary amyloidosis TTR-related (HA-TTR): clinical and neurophysiological aids to diagnosis and some reflections on misdiagnosis. Amyloid. 2012;19 Suppl 1:58-60. 3-Sopacua M, Hoeijmakers JGJ, Merkies ISJ, Lauria G, Waxman SG, Faber CG. Small-fiber neuropathy: Expanding the clinical pain universe. J Peripher Nerv Syst. 2019 Mar;24(1):19-33. doi: 10.1111/jns.12298. Epub 2019 Jan 8. PMID: 30569495. 4- Sekijima, Y. Transthyretin (ATTR) amyloidosis: clinical spectrum, molecular pathogenesis and disease-modifying treatments. J Neurol Neurosurg Psychiatry. 2015;86(9):1036-43. 5- Ando Y, et al. Guideline of transthyretin-related hereditary amyloidosis for clinicians. Orphanet J Rare Dis. 2013; 8(1):31. 6- Adams D, et al. First European consensus for diagnosis, management, and treatment of transthyretin familial amyloid polyneuropathy. Curr Opin Neurol. 2016;29(suppl. 1):S14-26. 7-Du K, Xu K, Cheng S, Lv H, Zhang W, Wang Z, Yuan Y, Meng L. Nerve Ultrasound Comparison Between Transthyretin Familial Amyloid Polyneuropathy and Chronic Inflammatory Demyelinating Polyneuropathy. Front Neurol. 2021 Feb 26;12:632096. doi: 10.3389/fneur.2021.632096. PMID: 33716932; PMCID: PMC7953716. 8- Ministério da Saúde (Brasil). Comissão Nacional de Incorporação de Tecnologias no SUS (CONITEC). Relatório de recomendação: Tafamidis meglumina no tratamento da polineuropatia amiloidótica familiar relacionada à proteína transtirretina. Brasília: Ministério da Saúde; 2018. 43 p 9-Conceição I, et al. “Redflag” symptom clusters in transthyretin familial amyloid polyneuropathy. J Peripher Nerv Syst. 2016;21:5–9.

Neste episódio especial da PEBMED em parceria com a Pfizer, Marcelo Gobbo, médico de comunidade e família e editor médico do Portal recebe a neurologista Viviane Carvalho para falar sobre PAF, a Polineuropatia Amiloidótica Familiar, uma condição rara que pode ter sua trajetória modificada quando identificada precocemente e adequadamente tratada. Referências Bibliográficas: 1- Picken MM. The Pathology of Amyloidosis in Classification: A Review. Acta Haematol. 2020;143(4):322-334. doi: 10.1159/000506696. Epub 2020 May 11. PMID: 32392555. 2- Adams D, Koike H, Slama M, Coelho T. Hereditary transthyretin amyloidosis: a model of medical progress for a fatal disease. Nat Rev Neurol. 2019 Jul;15(7):387-404. doi: 10.1038/s41582-019-0210-4. Epub 2019 Jun 17. PMID: 31209302. 3- Guevara C, Barrientos N, Flores A, Idiáquez J. Polineuropatia amiloidótica familiar tipo I. Rev Méd Chile. 2003;131:1179-82. 4- Centenário do nascimento de Corino de Andrade. Sinapse, publicação da Sociedade Portuguesa de Neurologia, Suplemento 1, Volume 6, Nº1, Maio de 2006. 5- Andrade, C. A peculiar form of peripheral neuropathy; familiar atypical generalized amyloidosis with special involvement of the peripheral nerves. Brain. 1952 Sep;75(3):408-27. doi: 10.1093/brain/75.3.408. PMID: 12978172.) 6- Saporta, M. A. C., C Zaros, M W Cruz, C André, M Misrahi, et al. "Penetrance estimation of TTR familial amyloid polyneuropathy (type I) in Brazilian families." European journal of neurology 16.3 (2009): 337-341. 7- Vieira M, Saraiva MJ. Transthyretin: a multifaceted protein. Biomol Concepts. 2014 Mar;5(1):45-54. doi: 10.1515/bmc-2013-0038. PMID: 25372741. 8- Galant NJ, Westermark P, Higaki JN, Chakrabartty Al. Transthyretin amyloidosis: an under-recognized neuropathy and cardiomyopathy. Clin Sci. 2017 ;131(5):395-409 9-Simões M. V., Fernandes F, Marcondes-Braga F, Scheinberg P, Correia E, et al. Posicionamento sobre Diagnóstico e Tratamento da Amiloidose Cardíaca (2021). Arquivos Brasileiros de Cardiologia, 117, 561-598. 10- Bonaiti B, Olson M, Hellman U, Surh O, Bonaiti-Pellie C, et al. TTR familial amyloid polyneuropathy: does a mitochondrial polymorphism entirely explain the parent-of-origin difference in penetrance? Eur J Hum Genet. 2010;18(8):948- 52 11- Ando Y, Coelho T, Berk J, Cruz M, Ericzon B-G, et al. Guideline of transthyretin- related hereditary amyloidosis for clinicians. Orphanet J Rare Dis. 2013;8:31 12- Salvi F, Pastorelli F, Plasmati R, Bartolomei I, Dall'Osso D, et al. Genotypic and phenotypic correlation in an Italian population of hereditary amyloidosis TTR-related (HA-TTR): clinical and neurophysiological aids to diagnosis and some reflections on misdiagnosis. Amyloid. 2012;19 Suppl 1:58-60. 13-Gertz MA, Benson M, Dyck PJ, Grogan M, et al. Diagnosis, Prognosis, and Therapy of Transthyretin Amyloidosis. J Am Coll Cardiol. 2015 Dec 1;66(21):2451-2466. doi: 10.1016/j.jacc.2015.09.075. PMID: 26610878 14- Luiz F. Pinto, MD; and Marcus V. Pinto, MD, MS. The most common amyloidosis are both treatable; accurate diagnosis is paramount. Practical Neurology, July, 2021.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the August 2022 issue of the journal. Read more on the PN website: https://pn.bmj.com/content/22/4/261 The full issue here: https://pn.bmj.com/content/22/4 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

In today's episode, we will be talking with Dr David Geary. How do you know when you should be in the sympathetics or the parasympathetics? What if you find a potential subluxation in both areas? Today, we are going to be talking about how to think about neurology and how to determine which system to be in. We will also be talking a little bit about how the scope works and what we should infer from that. --- Support this podcast: https://anchor.fm/david-fowler/support

Dr. Amy Ross Russell(1), interviews Assoc. Prof. Todd Hardy(2) and Dr. James Triplett(3), about their recent paper detailing the clinical approach to diagnosis and management of Posterior Reversible Encephalopathy Syndrome (PRES). Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/22/3/183) and the June print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr. Phil Smith and Dr. Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-of-the-june-2022-issue?in=bmjpodcasts/sets/pn-podcast (1) Neurology, University Hospital Southampton NHS Foundation Trust, UK (2) Staff Specialist Neurologist at Concord Hospital, Clinical Associate Professor in Medicine at the University of Sydney, Australia (3) Staff Specialist Neurologist and Neurophysiologist, Concord Hospital, Sydney, Australia Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the June 2022 issue of the journal. Read more on the PN website: https://pn.bmj.com/content/22/3/175 The full issue here: https://pn.bmj.com/content/22/3 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Dr Amy Ross Russell, Neurology, University Hospital Southampton NHS Foundation Trust, interviews Dr William Diprose, Dept. of Neurology, Auckland City Hospital and Dept. of Medicine, Faculty of Medicine and Health Science, University of Auckland, New Zealand; Dr Anthony Jordan, Dept. of Clinical Immunology and Allergy, Auckland City Hospital, NZ; and Dr Neil Anderson, Dept. of Neurology, Auckland City Hospital, NZ about their recent paper reviewing the neurological features of specific autoinflammatory syndromes. Read this latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/22/2/145) and the April print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr Phil Smith and Dr Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/pn-april-2022-highlights?in=bmjpodcasts/sets/pn-podcast Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the April 2022 issue of the journal. Read more on the PN website: https://pn.bmj.com/content/22/2/93 The full issue here: https://pn.bmj.com/content/22/2 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Dr Amy Ross Russell, Neurology, University Hospital Southampton NHS Foundation Trust, interviews Dr Sophie Binks and Professor Sarosh Irani, from the Oxford Autoimmune Neurology Group, about their recent paper about a practical approach to diagnosis and management of paraneoplastic neurological syndromes. Read the latest Editor's Choice paper on the Practical Neurology website (https://pn.bmj.com/content/22/1/19) and the February print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr Phil Smith and Dr Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-of-the-february-2022-issue?in=bmjpodcasts/sets/pn-podcast Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the February 2022 issue of the journal. Read more on the PN website: https://pn.bmj.com/content/22/1/1 The full issue here: https://pn.bmj.com/content/22/1 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Dr Amy Ross Russell, Neurology, University Hospital Southampton NHS Foundation Trust, interviews Dr Fahmida Chowdhury and Dr Matthew Walker, both from the National Hospital for Neurology and Neurosurgery, London, about their recent paper, summarising the current literature on localisation in focal epilepsies using illustrative cases and discussing possible pitfalls in localisation. Read the paper on the Practical Neurology website (https://pn.bmj.com/content/21/6/481) and the December print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr Phil Smith and Dr Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-december-2021-issue?in=bmjpodcasts/sets/pn-podcast Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the October issue of the journal. Read more on the PN website: https://pn.bmj.com/content/21/6/463. The full issue here: https://pn.bmj.com/content/21/6 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Autoimmune encephalitis comprises a group of disorders in which the host immune system targets self-antigens expressed in the central nervous system (CNS). Some of the best-characterised diseases are associated with autoantibodies that target neuroglial antigens. These autoantibodies are considered pathogenic because they are directed against the extracellular—and hence in vivo exposed—domains of their target antigens. Associate Editor of Practical Neurology, Dr Tom Hughes, Department of Neurology, Cardiff, interviews Prof Sarosh R Irani, Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, Oxford University, about his recent paper, in which he summarised the well-known autoantibody-mediated encephalitis syndromes with neuronal cell-surface antigens and focus on practical aspects of their diagnosis and treatment, offer their clinical experiences of managing such cases and highlight more basic neuroimmunological advances that will inform their future diagnosis and treatments. Read the paper on the Practical Neurology website (https://pn.bmj.com/content/21/5/412) and the October print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr Phil Smith and Dr Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-of-the-october-2021-issue?in=bmjpodcasts/sets/pn-podcast Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the October issue of the journal. Read more on the PN website: https://pn.bmj.com/content/21/5/373 The full issue here: https://pn.bmj.com/content/21/5 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

As the number of people with dementia worldwide approaches 50 million, the need for early and accurate diagnosis is more urgent than ever. However, the biggest challenge is often suspecting dementia in the first place and deciding why this is not ‘just' Alzheimer's disease. Associate Editor of Practical Neurology, Dr Tom Hughes, Department of Neurology, Cardiff, interviews Dr Jeremy Johnson and Dr Jason Warren, both from the Dementia Research Centre, UCL Queen Square Institute of Neurology, London, about their recent paper, in which they outline a practical, symptom-led, bedside approach to suspecting dementia and its likely diagnosis, inspired by clinical experience and based on recognition of characteristic syndromic patterns. You can read the paper on the Practical Neurology website (https://pn.bmj.com/content/21/4/300) and the August print issue of the journal. The paper is also discussed by Practical Neurology editors, Dr Phil Smith and Dr Geraint Fuller, in their latest podcast: https://soundcloud.com/bmjpodcasts/editors-highlights-of-the-august-2021-issue?in=bmjpodcasts/sets/pn-podcast Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the Practical Neurology Podcast iTunes page (https://podcasts.apple.com/gb/podcast/pn-podcast/id942932053). Thank you for listening.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the August issue of the journal. Read more on the PN website: https://pn.bmj.com/content/21/4/273 The full issue here: https://pn.bmj.com/content/21/4 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify.

In medieval Strasbourg, during a period of unimaginable suffering and poverty, a mania took hold. Infected people were gripped by the compulsion to dance in the streets until they dropped senseless from exhaustion - or died. When the strange illness began to spread, the city took a series of steps to help the afflicted, culminating in a thirty-mile trek to seek the intervention of an obscure saint who may or may not have been angry at the city's sinful lifestyle. On this episode, we look at the time period leading up to the dancing plague, possible causes, how it spread, what the cure looked like (it came with a free pair of red shoes!) and what made this event so much worse than similar ones across the late Middle Ages. Sources for this episode include: “The Dancing Mania: The Strange, True Story of an Extraordinary Illness”, J. Waller, 2009 “The Black Death and the Dancing Mania”, J F K Hecker, (Babington translation), 1856 “The Differential Diagnosis of Chorea”, E J Wild et al, published in ‘Practical Neurology', 2007 “The Dancing Plague of the Middle Ages”, M. Petcova, published in ‘Medium', 2020 “Dancing Plagues and Mass Hysteria”, J Waller, published in ‘The Psychologist' (British Psychological Society), 2009

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the June issue of the journal. Read more on the PN website: https://pn.bmj.com/content/21/3/183 The full issue here: https://pn.bmj.com/content/21/3 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the April issue of the journal. Read more on the PN website: https://pn.bmj.com/content/21/2/91 The full issue here: https://pn.bmj.com/content/21/2 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify.

If your loved one is living with Alzheimer’s Disease, there may be days where you just feel helpless. It might seem like no treatment is working, that your loved one’s struggles with communication and mood swings are only progressing, with no end in sight. Alzheimer’s can be a devastating disease – but there are ways to possibly help patients meet those milestones – to encourage communication, peace of mind, and even joy in patients and their loved ones. One way is through music. Believe it or not, the effect of music on Alzheimer’s patients has been studied carefully for decades and has been found to be one of the most effective ways to help patients with communication, mood, and memory. While music is no cure from Alzheimer’s, it is a medicine-free treatment that can make an enormous difference for both patients and their caregivers. For patients with Alzheimer’s, peace can be hard to come by. Alzheimer’s is a progressive neurological disorder that impacts language, memory, thinking, movement, problem solving, and personality. That’s a long list – so you can only imagine how difficult it is for patients to lose control of their basic abilities until they cannot perform daily tasks anymore. The disease is as frustrating as it is debilitating, as heartbreaking as it is exhausting, and patients will often face severe confusion, anxiety, and even depression. People with Alzheimer’s have an increasingly difficult time communicating. Language gets lost as confusion and memory problems get more severe – and eventually, your loved one could lose their ability to speak at all. Without being able to communicate, it can be impossible to understand how your loved one is feeling, what she needs, and what she wants. That can make the act of caregiving, or even of spending time with your loved one, particularly challenging. It can be devastating for you and your loved one when your loved one can’t communicate what they need – and you just want to make sure you are taking good care of them, that they are comfortable and content. While music cannot help a person speak in full sentences again or fully recover their communication – it has been proven to help a person express herself – among a myriad of other positive things. For a person with Alzheimer’s, this is a really big deal, and can mean the difference between discontent and frustration and peace and joy. Today, we’ll dive into how music helps patients with Alzheimer’s – and what you can do to use music to help your loved one. From the research that proves just how effective this form of therapy is, to how and when to use it, we’ll cover all you need to know about music and Alzheimer’s disease in today’s episode of All Home Care Matters. Jeff Anderson, MD, PHD, and associate professor of radiology at University of Utah Health, was a contributing author of a study on how music can help patients with dementia and Alzheimer’s. “People with dementia are confronted by a world that is unfamiliar to them, which causes disorientation and anxiety,” he told reporters following the study, “we believe music will tap into the salience network of the brain that is still relatively functioning.” Sure enough, that’s exactly what the study found. Patients underwent MRI brain scans as they listened to both music and silence. The music chosen was specific to that patient’s life – a list of songs that caregivers and loved ones believed would be especially meaningful to them. Through the brain scans, researchers found that when music was playing, the brain seemed to be awakened. According to Science Daily, the results of the study found that, “by listening to the soundtrack, the visual network, the salience network, the executive network, and the cerebellar and corticocerebellar network pairs all showed significantly higher functional connectivity.” In short, the brain imaging showed that listening to meaningful music can activate the brain – perhaps making symptoms more manageable and improving the quality of a patient’s life. This study only researched 17 patients – but it is one of dozens that has tackled the subject matter – and found overwhelmingly positive results. A similar study at The University of California at Davis found that music lessens the aggressive behaviors of Alzheimer’s patients and decreases the amount of medication needed. This study followed 4,107 patients in 265 nursing homes across California. It found that “the use of antipsychotic drugs declined by 13% and anti-anxiety medications declined by 17% each quarter for residents with dementia using the music program. The odds of depressive symptoms decreased 16% per quarter and the odds of reported pain decreased 17% per quarter. In addition, the number of days on medications declined by 30% and aggressive behaviors reduced by 20%.” So, why does music work so well for dementia and Alzheimer’s patients? Well, for one thing, our musical memory is stronger than the part of our brain that stores names, faces, and words. Ever listened to a song you hadn’t heard since high school and been surprised when you remembered every lyric? The same is true for dementia and Alzheimer’s patients. In some cases, patients with dementia have been able to complete full songs on the piano, even when they struggle to communicate anything else. That’s because music – along with the muscle memory that makes it so hard to forget how to ride a bike or throw a ball – is known as Procedural Memory. Explicit Memory is what stores other information – like faces, names, events, and reasoning. So, when a dementia patient forgets aspects of their Explicit Memory, their Procedural Memory often remains unaffected. Research has found that for some patients – particularly those with musical backgrounds themselves – have a preserved response to music, even after their dementia is in its advanced stages. According to Practical Neurology, “familiar tunes and lyrics can be recognized across all stages of Alzheimer’s Disease. Due to bonds formed early in life between highly familiar tunes and lyrics, the ability to recognize such information is very functional in individuals with Alzheimer’s Disease.” Now, this doesn’t mean that a person with Alzheimer’s will be belting out every lyric of an old favorite song – but it does mean that the song may illicit a reaction – like a smile, a laugh, or even dancing – from a patient. In some cases, a patient will sing along to the lyrics – even in the late-stages of Alzheimer’s.  Music helps people with Alzheimer’s recall memories and emotions – especially in the earlier stages of the disease. This is because in addition to music being stored in a different section of our memory, music also evokes emotion. According to neurologist Oliver Sacks, “music evokes emotion, and emotion can bring with it memory…it brings back the feeling of life when nothing else can.” In addition, music aptitude and appreciation are abilities that last in Alzheimer’s patients even after many other abilities have deteriorated. That means that a person can be reached through music even after other means of communication are lacking. So, music is sort of a window to the soul in this way – a way to connect on a personal level with a loved one, when other methods have not succeeded. Emotional connectivity is especially meaningful in the later stages of Alzheimer’s, after a person has lost the ability to engage physically and emotionally with a loved one. When a patient listens to music, they might dance – which can lead to touching, hugging, or even just a level of togetherness they have not felt in some time. Socialization, especially meaningful socialization in the form of human contact, can help a person have an increased quality of life – and make them feel at peace and contented. This also helps with communication. Music is a way for a person to communicate without needing to speak. They can indicate how they feel by reacting to a song. When they come to life through music, it’s because they feel connected in communication in a way they simply aren’t without the use of music. It’s not just listening to music. Many folks with Alzheimer’s or dementia take music or singing lessons or engage in interactive music therapy. Singing and playing an instrument exercises the brain in an engaging and fun way for patients. The more a brain is exercised, the stronger and healthier it will be. Music also works wonders for stress and anxiety – both prevalent in Alzheimer’s patients. Music engages the parts of the brain involved in cognition, emotion, socialization, and even motor functioning. Music decreases stress and anxiety in people across all walks of life, and Alzheimer’s patients are no different. The calming and familiar sound of music can help a person feel safe and secure, nostalgic and even joyful. This is so important for Alzheimer’s patients because so much of the world feels unfamiliar to them as they lose their memory and grip on reality. Music can keep them grounded, help them to feel at home, even in the late stages of the disease. It’s not surprising, then, that music can help a great deal with changes in mood and agitation. Mood swings are ever common in Alzheimer’s patients, and they can be especially difficult to know how to solve. It’s heartbreaking and frustrating when our loved one lashes out, suffers a meltdown, or becomes paranoid – and most people will try anything to keep these mood swings at bay. Mood swings occur, in part, because patients do not have a grip on their surroundings, and become panicked, confused, and disoriented. They are exacerbated when people react in harsh, angry, or frustrated manners, and can usually be calmed when people react in a soothing, understanding tone. By playing meaningful, thoughtfully chosen music for a patient, their grip on reality becomes that much clearer, their stress that much more decreased, and their mood swings less frequent. When a person feels safe, calmed, and soothed, they are less likely to act out – because their mood is increased, their sense of security is increased, and their quality of life is improved.  It’s not just the patients who benefit from music. Music can help caregivers, too. Playing music helps a caregiver to connect with his or her patient in a more meaningful way. Songs that illicit memory will help a caregiver to learn more about their patient. Songs that make a patient dance give the caregiver an opportunity to connect with a patient through touch and laughter. Additionally, just like music decreases the stress and anxiety of patients, it does the same for the caregiver. Caregivers deal with enormous amounts of stress and anxiety, which can lead to depression or even poor physical health. Music creates a sense of calm and escape for the caregiver – so they can feel relaxed and at peace while they’re helping their loved one. In this way, music is a form of self-care – which is enormously beneficial for caregivers. How do you implement music into your loved one’s life? Unfortunately, it’s not quite as simple as blasting whatever you want when your loved one is around. Songs need to be carefully selected to fit your loved one’s personality – and the wrong music could make them feel more stressed or anxious. So, when choosing a playlist for your loved one, think about their preferences. What song did your parent used to play again and again? What music might evoke memories for them – from happier, more peaceful times? If you aren’t sure, talk to other friends and family who might have an idea – and you can even look through your parents’ own music collection to see what they like to listen to. You can choose music that aligns to the time of day and the mood of the situation. Soothing music is great for meals and baths, upbeat music is wonderful when you want your loved one to feel happy and uplifted. Avoid playing other sounds when music is playing. Overstimulation can lead to headaches, stress, and confusion. So when it’s music time, make sure the TV is turned off, windows and doors are shut, and other distractions are out of the way. Don’t overdo the volume, but make sure it’s loud enough for your loved one to hear. Mayo Clinic suggests playing music that won’t be interrupted with commercials. Commercials can interrupt the mood and cause confusion and disorientation. In addition, look for songs that encourage movement. If a song has a beat to clap to or even dance with, that’s fantastic. You can even start dancing first, to encourage your loved one to follow. In addition to dancing, feel free to sing along to the music. Your loved one just might sing along with you – which can help stimulate memories and strengthen the brain. If your loved one is reacting negatively to a song, change it. Remember – music is meant to have a positive, calming effect – so you want to make sure it’s doing just that. Otherwise, mood swings and agitated moods, headaches and exhaustion, might be to come. On the contrary, if your loved one reacts happily and positively to a certain song – play it often! Never be afraid to repeat the same song again and again, as long as your loved one seems to be benefitting from it. In addition to playing your own music for your loved one, consider music therapy or even instrument or singing lessons (depending on the severity of your loved one’s disease). A music therapist is trained to help their patients strengthen emotion, cognitive abilities, thoughts, and memories. They will use music to enrich and stimulate, to help with focus and stability. Music therapists will also have plans in place for the different stages of Alzheimer’s – and know what methods will be the most beneficial for each stage. Music lessons and singing lessons can be hugely beneficial, too. Playing an instrument stimulates the brain enormously – and at the same time, lessons can provide social engagement for patients, which can help increase a patient’s quality of life. Playing an instrument engages motor skills, listening, visual characteristics, and attention. The brain has to communicate with the hands while they play an instrument, while also being stimulated by the music itself. It’s an incredibly beneficial cognitive experience.   There are plenty of music lessons designed for people with memory problems, including Alzheimer’s. Check out your local listings to see if there are Alzheimer’s music or singing classes in your loved one’s area. Music is not a guaranteed treatment for people with Alzheimer’s. Some respond to it more than others, and unfortunately, there’s no way to know how it will affect your loved one until you give it a try. Time and again, though, research has shown positive reactions to music, and it’s one treatment plan that is well worth the effort. Other creative activities, such as art, can also help Alzheimer’s patients with their stimulation and quality of life. Creativity is a meaningful way to engage with parts of the brain that benefit from stimulation – so the more you can help your loved one engage with, the better. Many people choose to enroll their loved ones in music and art therapy, or else they implement both practices themselves at home. While music is not a guaranteed solution, it can work wonders on patients with Alzheimer’s – and their caregivers. The more you can do to increase quality of life and reduce stress, the better. Music can help people with Alzheimer’s find meaning, security, and a great sense of peace. We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them. Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please join us next time as we talk about Tips for Family Caregiver’s.   Sources: https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/music-and-alzheimers/faq-20058173   https://www.alz.org/help-support/caregiving/daily-care/art-music   https://www.caringseniorservice.com/blog/music-awakens-those-with-alzheimers   https://alzres.biomedcentral.com/articles/10.1186/s13195-019-0523-y   https://www.arborcompany.com/blog/study-music-therapy-benefits-alzheimers-patients   https://www.frontiersin.org/articles/10.3389/fnins.2019.00132/full   https://practicalneurology.com/articles/2017-june/music-and-dementia-an-overview   https://health.ucdavis.edu/health-news/newsroom/music--memory-reduces-dementia-medications-and-aggressive-behavior/2020/08   https://www.elmcroft.com/blog/2018/june/benefits-of-music-for-dementia-patients/   https://www.verywellhealth.com/using-music-in-alzheimers-disease-97624   https://stagemusiccenter.com/music-school-blog-winchester-ma/2019/8/18/music-and-alzheimers   https://www.fivestarseniorliving.com/blog-post/music-is-powerful-therapy-for-adults-with-alzheimers-disease   https://www.alzheimers.net/why-music-boosts-brain-activity-in-dementia-patients   https://cloudcovermusic.com/music-psychology/dementia-alzheimers/   https://cloudcovermusic.com/music-psychology/medical-benefits/   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369551/   https://arborsatmilford.com/announcement/music-memory-the-benefits-of-music-therapy-for-alzheimers-patients/   https://www.alzheimers.net/2013-06-04-music-therapy-for-dementia   https://musicandmemory.org/    

Dr Tom Hughes, Department of Neurology, Cardiff, interviews Dr Luis Idrovo, Department of Neurology, Leeds, about one of the most prevalent, disabling and undertreated conditions in neurological clinical practice: headaches. They discuss the administration of peripheral nerve blocks to treat various headache disorders both in the acute and outpatient setting. Please read the related paper, which is the Editor's Choice of the February 2021 issue of the journal: https://pn.bmj.com/content/21/1/30 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify.

In the return of the Practical Neurology Podcast, Dr Tom Hughes interviews Dr Saúl Reyes, Consultant Neurologist at the Blizard Institute, and The London School of Medicine and Dentistry, Queen Mary University of London, UK. They discuss the important issues regarding what vaccinations people with MS should have, and when they should have them in relation to their immunosuppressant drugs. Read the accompanying paper on the Practical Neurology's November issue and online at http://dx.doi.org/10.1136/practneurol-2020-002527 Please subscribe via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify.

In this special episode recorded live at Wild West Vet 2019, host Beckie Mossor, RVT, sits down with Rebecca Windsor, DVM, DACVIM (Neurology), to discuss practical approaches to neurological cases. Dr. Windsor reviews the unique aspects of handling geriatric patients, including treatment trials and managing expectations. She also explains why a visit to the neurologist means so much more than just advanced diagnostics. Finally, Dr. Windsor shares her tips on how to handle one of the biggest challenges facing veterinary medicine: neurologic examination of the domestic cat.Contact us:Podcast@briefmedia.comWhere to find us:Cliniciansbrief.com/podcastsFacebook.com/clinciansbriefTwitter: @cliniciansbriefInstagram: @clinicians.briefThe Team:Beckie Mossor, RVT - HostAlexis Ussery - Producer & Digital Content CoordinatorRandall Stupka - Podcast Production & Sound EditingMichelle Munkres - Senior Director of Content

Essential tremor is the most common form of tremor in humans. In this podcast, Dr Tom Hughes, Practical Neurology Associate Editor, interviews Dr Elan D Louis, Yale Neurology, Division of Movement Disorders, New Haven, CT, who’s the author of a recent paper called, ‘Essential tremor: a nuanced approach to the clinical features’. They discuss this condition, not always easy to diagnose, and the distinction between essential tremor and Parkinson’s disease as well as dystonia. Read the paper on the Practical Neurology website: https://pn.bmj.com/content/19/5/389.

‘Query encephalitis’ is a common neurological consultation in hospitalised patients. Identifying the syndrome is only part of the puzzle. Although historically encephalitis has been almost synonymous with infection, we increasingly recognise parainfectious or postinfectious as well as other immune-mediated causes. Encephalitis must also be distinguished from other causes of encephalopathy, including systemic infection, metabolic derangements, toxins, inherited metabolic disorders, hypoxia, trauma and vasculopathies. The paper discussed in this podcast reviews the most important differential diagnoses (mimics) of patients presenting with an encephalitic syndrome and highlight some unusual presentations (chameleons) of infectious encephalitis. Listen to the conversation of Dr Tom Hughes, Practical Neurology Associate Editor, with Dr Nicholas Davies (Department of Neurology, Chelsea and Westminster Hospital, London, UK) and read the paper on the Practical Neurology website: http://dx.doi.org/10.1136/practneurol-2018-002114.

What do adult neurologists need to know ahead of the likely licensing of Epidiolex for epilepsy in the UK in 2019? It is quite possible that cannabidiol, currently licensed in the USA for treating rare genetic epilepsies, may open the door for the widespread legalisation of recreational cannabis. Dr Rhys Thomas (Neurologist at the Institute of Neuroscience, Newcastle University, UK) tells fellow Practical Neurology Associate Editor Dr Tom Hughes why the arguments about who may benefit from cannabis-derived medicines have to be separate from the discussion about the legalisation of recreational cannabis. They also discuss the distinction between cannabidiol oils and the cannabidiol rigorously tested in clinical trials. Read the review on the Practical Neurology website - https://pn.bmj.com/content/early/2018/10/18/practneurol-2018-002058 - and on the journal's December 2018 issue.

In collaboration with many different specialists, professions and patient representatives, Mollan et al (2018) have developed the first ever guidelines for the investigation and management of idiopathic intracranial hypertension (IIH). Senior author, Dr Alexandra Sinclair (University of Birmingham) discusses these with the JNNP podcast editor, Elizabeth Highton. Read the full guidelines here: https://jnnp.bmj.com/content/89/10/1088 Access the Practical Neurology infographic summary here: https://pn.bmj.com/content/early/2018/08/28/practneurol-2018-002009

Valproate is now contraindicated in pregnancy and women of child-bearing potential. The new stipulations from the Coordination Group for Mutual Recognition and Decentralised Procedures-Human (CMDh), a regulatory body representing European Union member states, about the use of valproate in women of child-bearing potential states that “Valproate should never be started unless alternative treatments are not suitable”. However, people taking this drug used to treat epilepsy should not stop valproate use abruptly, without consulting their doctor. The new regulations are discussed in this podcast by Professor Sanjay Sisodiya (UCL Institute of Neurology, London), who’s the author of a Practical Neurology editorial on this subject (http://pn.bmj.com/content/early/2018/04/19/practneurol-2018-001955). Other related articles in the Practical Neurology website: ►http://pn.bmj.com/content/early/2018/04/19/practneurol-2018-001932 ► http://pn.bmj.com/content/early/2018/04/19/practneurol-2018-001931

Professor Michael Hanna, Senior Consultant Neurologist at Queen Square, UCL, London, discusses the developments in genetics in neuromuscular diseases with Eric Hoffman, Gordon Holmes lecturer at the ABN meeting 2017, in Liverpool. Professor Eric Hoffman (Binghampton University, USA) describes in this conversation his extensive work on the rare condition of Duchenne’s muscular dystrophy. This is the last of a series of podcasts recorded at the 2017 ABN meeting, held in May, in Liverpool, UK. More on this subject on the Practical Neurology website: http://pn.bmj.com/, where you can find these particular articles as well: "Muscle disease" - http://pn.bmj.com/content/9/1/54; "Muscle diseases: mimics and chameleons" - http://pn.bmj.com/content/14/5/288.

Professor Andrew Schwartz (University of Pittsburgh, USA) discusses the latest progress toward high-performance neural prosthetics with Practical Neurology's editor Geraint Fuller. The subject was highlighted at the ABN annual meeting 2017, held in May, in Liverpool, UK. For more content on this topic please visit http://pn.bmj.com/.

Practical Neurology Editor Geraint Fuller is joined by Jon Stone to discuss two of his recent Practical Neurology papers on the subject of functional disorders. Dr Jon Stone is a Consultant Neurologist and Honorary Senior Lecturer in Neurology. The discussed papers: Functional neurological disorders: the neurological assessment as treatment - http://pn.bmj.com/content/16/1/7.full Explaining functional disorders in the neurology clinic: a photo story - http://pn.bmj.com/content/16/1/56.full http://www.neurosymptoms.org/

Welcome to another Practical Neurology book club podcast with PN editor Phil Smith. This time the club and discussed Oliver Sack’s ‘The man who mistook his wife for a hat’, and were honoured to be joined via Skype by Dr Sacks himself. Listen to hear his thoughts on understanding patients, how writing has influenced his clinical approach, and changes in neurology in the past few decades.

1) Aspirin and intracerebral hemorrhage: Where are we now and 2) Topic of the month: Autoimmune and paraneoplastic encephalitis. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Andy Southerland interviews Dr. Reza Behrouz about his paper on where we are regarding aspirin use in relation to intracerebral hemorrhage. Dr. Adam Numis is reading our e-Pearl of the week about POLG mutations in neurologic disease. In the next part of the podcast Dr. Stacy Clardy interviews Dr. Josep Dalmau about some of his recent discoveries regarding pathogenic mechanism in autoimmune encephalitis, as well as current challenges facing autoimmune neurology. The participants had nothing to disclose except Drs. Southerland, Behrouz, Numis and Dalmau.Dr. Southerland serves as Podcast Deputy Editor for Neurology®; serves as Clinical Research Advisor for Totier Technologies, Inc.Dr. Behrouz serves as a Contributing Editor to Practical Neurology and as an Associate Editor for BioMed Central Neurology; and has participated in medico-legal cases.Dr. Numis serves on the editorial team for the Neurology® Resident and Fellow Section. Dr. Dalmau serves as an editorial board member of Neurology® and UptoDate; serves as Editor-in-Chief of Neurology® Neuroimmunology and Neuroimflammation; is a consultant for Advance Medical; receives royalties for the following patents: Patent Ma2 autoantibody test, Patent NMDAR autoantibody test, patent application for the use of GABA(B) receptor, DPPX and IgLON5 autoantibody tests; received license fee payments for DPPX and IgLON5 autoantibody tests from Euroimmun; receives research support from Euroimmun, ISCIII, and the NIH.

Martin Samuels, professor of Neurology, Harvard Medical School, tells Huw Morris, professor of Clinical Neuroscience at the National Hospital for Neurology and Neurosurgery how neurologists make decisions, and the value of making mistakes.Professor Samuels gave the 20th Gordon Holmes lecture, supported by Practical Neurology, at the 2014 ABN Annual Meeting, where this podcast was recorded.

When searching for clues to reach a diagnosis, neurologists often empathise with the detective who is trying to solve a case, write Peter Kempster and Andrew Lees in JNNP sister journal Practical Neurology bit.ly/1dqReQq. In this podcast, journal editor Phil Smith and Andrew Lees, director of the Queen Square Brain Bank in London, discuss how neurologists draw upon detective skills. They also talk about neurologists who have turned these skills to crime fiction writing, and the use of narrative in clinical case histories. The expert witnesses called upon are: - Oliver Sacks, best selling author and professor of neurology at NYU School of Medicine - Peter Gautier Smith, now retired from consulting at Queen Square and author of 31 detective novels - Chris Goetz, who worked at Rush University Medical Centre with Harold Klawans, crime fiction writer and authority on Parkinson’s disease Listen to the full interviews here: Andrew Lees bit.ly/1cPaoxM Peter Gautier-Smith bit.ly/1d5HhKj Harold Klawans bit.ly/19cXR Oliver Sacks bit.ly/1hBsbgz

When searching for clues to reach a diagnosis, neurologists often empathise with the detective who is trying to solve a case, write Peter Kempster and Andrew Lees in BMJ sister journal Practical Neurology bit.ly/1dqReQq. In this podcast, journal editor Phil Smith and Andrew Lees, director of the Queen Square Brain Bank in London, discuss how neurologists draw upon detective skills. They also talk about neurologists who have turned these skills to crime fiction writing, and the use of narrative in clinical case histories. The expert witnesses called upon are: - Oliver Sacks, best selling author and professor of neurology at NYU School of Medicine - Peter Gautier Smith, now retired from consulting at Queen Square and author of 31 detective novels - Chris Goetz, who worked at Rush University Medical Centre with Harold Klawans, crime fiction writer and authority on Parkinson's disease Listen to the full interviews here: Andrew Lees bit.ly/1cPaoxM Peter Gautier-Smith bit.ly/1d5HhKj Harold Klawans bit.ly/19cXR Oliver Sacks bit.ly/1hBsbgz

Peter Gautier-Smith, now retired from neurological consulting at Queen Square, and crime fiction writer, describes how he made the leap from clinician to novelist.This interview is part of a Practical Neurology package on neurology and detective writing. For more information, and the other interviews in the set, see bit.ly/19YiaEM

Listen to Chris Goetz, director of the Parkinson's Disease and Movement Disorders Program at Rush University Medical Center, Chicago, talk about the parallel careers of neurologist and crime fiction writer of his friend and colleague Harold Klawans.This interview is part of a Practical Neurology package on neurology and detective writing. For more information, and the other interviews in the set, see bit.ly/19YiaEM

Listen to Andrew Lees, director of the Reta Lila Weston Institute for Neurological Studies at UCL and director of the Queen Square Brain Bank for Neurological Disorders, discuss his article on the intersection between neurology and crime writing.This interview is part of a Practical Neurology package on neurology and detective writing. For more information, and the other interviews in the set, see bit.ly/19YiaEM

Listen to Oliver Sacks, professor of neurology and NYU School of Medicine, discuss the role of narrative in neurology, and the parallels between the skills of detectives and clinicians in the specialty.This interview is part of a Practical Neurology package on neurology and detective writing. For more information, and the other interviews in the set, see bit.ly/19YiaEM.

When searching for clues to reach a diagnosis, neurologists often empathise with the detective who is trying to solve a case, write Peter Kempster and Andrew Lees in Practical Neurology bit.ly/1dqReQq.In this podcast Andrew Lees, director of the Queen Square Brain Bank, discusses with PN editor Phil Smith how neurologists draw upon detective skills (and how this is changing as the specialty changes), those who have turned these skills to crime fiction writing, and the use of narrative in clinical case histories.The expert witnesses called upon are Oliver Sacks, best selling author and professor of neurology at NYU School of Medicine, Peter Gautier Smith, now retired from consulting at Queen Square and who wrote 31 detective novels, and Chris Goetz, who worked at Rush University Medical Centre with Harold Klawans, crime fiction writer and authority on Parkinson’s disease.Listen to the full interviews here:Andrew Lees bit.ly/1cPaoxMPeter Gautier-Smith bit.ly/1d5HhKjHarold Klawans bit.ly/19cXRGCOliver Sacks bit.ly/1hBsbgz

Andrew Chancellor, consultant neurologist in Tauranga, New Zealand, gives the background to his reported case of honey neurotoxicity in the June issue of Practical Neurology.Read Dr Chancellor's report here http://bit.ly/15EnIam