Practical Neurology Podcast

The first multidisciplinary consensus guideline for the diagnosis and treatment of spontaneous intracranial hypotension (SIH) has recently been published by the UK SIH Specialist Interest Group. Group members Prof. Manjit Matharu (1), Dr. Indran Davagnanam (2), and Mr. Parag Sayal (3) join Dr. Amy Ross-Russell to explain their recommendations. They discuss the impact this condition has on patients, the possible presentations, and approaches for diagnosis and treatment.   Read the article: Spontaneous intracranial hypotension   (1) Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK (2) Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK (3) Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK

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.

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. 

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

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 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. 

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

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

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 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.

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 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.

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.

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.