Practical Neurology Podcast

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Practical Neurology Podcast episodes

September 29 Adoptive immunotherapy, updated MS criteria, and misleading meters - Editors' Highlights October 2026
A rare sight on the podcast: a paper from the cutting edge of practice, with the novel use of CAR-T cells in treating neurological diseases. Editors Phil Smith and Geraint Fuller bring a selection of papers from the October 2026 issue of the journal to discuss. Returning to the more commonplace, they present a how-to on conversations around lower back pain. There's the editors' choice for the issue: a majestic paper on suspected encephalitis, as well as non-motor symptoms in Parkinson's, a review of the 2024 McDonald criteria for MS diagnosis, and pitfalls to avoid with oxygen desaturation.
Read the issue: https://pn.bmj.com/content/26/5/413
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.
52 min
September 16Mystifying malabsorption, and brain stem syndromes - Case Reports August 2026
Diet continues to be a growing presence in the neurological diagnoses cropping up for the Case Reports team, returning again after its previous appearance with gastric sleeves.
The first case (1:25), from UCLH in London, is that of a 49-yo woman, presenting with a history of worsening intermittent headaches and blurred vision. Metabolic testing identified high values for homocysteine and methyl malonic acid. Further probing of the patient's history revealed a previous eating disorder and recent dietary restriction after a bereavement, with subsequent weight loss. She was treated with a course of vitamin supplementation for B2, B6, B9 (folate), and B12, but re-presented again with persistent symptoms.
https://pn.bmj.com/content/26/4/400

The second case (22:19) comes from Cork, Ireland. A 19-yo woman presents with gradual onset headache, vomiting and unsteadiness. Her temperature is read at 38.4 ℃, prompting consideration of brain stem infections such as Lyme disease, tuberculosis and listeria. The MRI brain scan returned some unusual findings.
https://pn.bmj.com/content/26/4/395
This episode is the last appearance on the podcast for our dear discussant Dr. Ruth Wood, who - by now an able seaman - is disembarking for new shores. The paper on aquatic neurology may be the high water mark of her years on the podcast, but each episode was a pearl in its own right. Best wishes, Ruth!

Further reading:
Whippits, nitrous oxide and the dangers of legal highs
Beriberi following sleeve gastrectomy
Functional vitamin B12 deficiency
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 August 2026 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) Clinical Lecturer in Neurology at the Institute of Cognitive Neuroscience, University College London, and an Honorary Neurology SpR at the National Hospital for Neurology and Neurosurgery.
(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 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.
Production and editing by Brian O'Toole. Thank you for listening.
46 min
August 26Mapping the blindspot: papilloedema for neurologists
Space, the final frontier. A new domain for the podcast opens, as we learn how astronauts are preparing for Mars transit by lying in bed. But first - the ophthalmology department refers a patient with a swollen optic disc. When is it papilloedema, and when is it not? And what does that have to do with Martian vistas?
In this editors' choice podcast, PN podcast editor Dr. Amy Ross Russell interviews Prof. Susan Mollan¹ ², last author of the paper, "How to diagnose papilloedema", published in the August 2026 edition of the journal.
From crashing visual loss to pulsatile tinnitus, they discuss the signs in a patient history which can build a picture of their condition. There's a practical walkthrough of the key elements of the eye exam, as well as discussion of the modern tools that are available to assist. Sometimes backup is needed, and Prof. Mollan explains when it's the right time to call the ophthalmologists back, and how to buy yourself extra time on a late Friday shift.
Links:
Fundoscopy: to dilate or not to dilate?
Dr. Andrew Lee Explains Spaceflight-Associated Neuro-Ocular Syndrome in New Whiteboard Video
1. Ophthalmology Department, Queen’s University, Kingston, Ontario, Canada
2. Metabolic and Systems Science, University of Birmingham College of Medical and Dental Sciences, Birmingham, England, 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 Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.
52 min
July 25 Papilloedema, Parkinson's follow-up, and subhairline EEG - Editors' Highlights August 2026
The latest highlights from the journal will deliver confidence when managing complex everyday presentations. In this podcast for the August 2026 issue of Practical Neurology, co-editors Phil Smith and Geraint Fuller present the key highlights from a cracking 100-page edition spanning the full spectrum of neurological care.
They examine how to accurately diagnose papilloedema and distinguish swollen optic discs from pseudo-swelling or other mimics. Next, they discuss a comprehensive guide to the Parkinson's disease follow-up consultation, focusing on non-motor symptoms, lifestyle advice, and long-term management. The editors also explore a structured approach to assessing neurogenic bladder, bowel, and sexual dysfunction, before covering the key clinical clues and investigations for evaluating pulsatile tinnitus. They also review the intricate link between chronic kidney disease and cognitive impairment, and finish with a critical look at the practical uses and limitations of subhairline EEG monitoring in neurocritical care.
Read the issue: https://pn.bmj.com/content/26/4
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.
Production and editing by Brian O'Toole, Nick Currey and Letícia Amorim. Thank you for listening.
47 min
July 06 Refractory epilepsy surgery, and the paradox of autoimmune encephalitis - live from the ABN Meeting 2026
In this special episode coming live from the Association of British Neurologists (ABN) annual meeting in Birmingham, Practical Neurology co-editors Phil Smith and Geraint Fuller join hosts Ruth Wood and Babak Soleimani to discuss the perennial clinical and educational value of case reports in which, in a rare event, the patients are actually referred to directly by their first names.
The team discusses two compelling, patient-centered narratives.
They look at a complex case of refractory focal epilepsy from 2024 where the patient actively partnered in the high-stakes decision to balance seizure freedom against a predicted post-surgical motor deficit.
A review of a poignant "Me and My Neurological Illness" piece written in 2016 by a prominent epileptologist is a reflection on his subtle subacute presentation of autoimmune encephalitis, how a doctor's baseline cognitive reserve can mask complex focal seizures, and the unique clinical and personal challenges faced when dealing with medical colleagues who lack diagnostic insight into their own condition.
Archive papers discussed in this episode:
Case Report 1: Complicated epilepsy surgery: importance of balancing benefit and deficit.
https://pn.bmj.com/content/24/5/393

Case Report 2: Me and my neurological illness. Autoimmune limbic encephalitis due to VGKC-Ab. Thanks for the memory. Leo Robin (Title of song, 1937).
https://pn.bmj.com/content/16/2/162

Read the full papers on Practical Neurology.

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.
Production and editing by Brian O'Toole, Letícia Amorim and Pritesh Kapadia. Thank you for listening.
31 min
June 11 Not all insomnia is insomnia: a guide to sleep neurology
What's the real difference between a night owl and a morning lark?
The Editors' Choice paper for the June 2026 issue of Practical Neurology is a review of all the ways sleep intersects with neurological practice. Last author Prof. Guy Leschziner¹ joins PN podcast editor Dr. Amy Ross Russell to the wide variety of sleep-related disorders: insomnia, hypersomnolence, and sleep-related movement disorders. Each category contains pitfalls to be avoided when treating, like overlooking critical signs or reaching for drugs too eagerly. You'll also learn about "sleep reactivity", teenage sleep patterns in the animal kingdom, and diagnostic insight that can be gained from partners.
Sleep neurology: pearls and pitfalls
1. Sleep Disorders Centre, Guy's and St Thomas’ Hospitals NHS Trust, London, England, 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 Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.
55 min
May 28 Drug-induced seizures, limb-shaking, and holistic myasthenia treatment - Editors' Highlights June 2026
The latest highlights from the journal are set to give confidence when trying something new. In this podcast for the June 2026 issue of Practical Neurology, co-editors Phil Smith and Geraint Fuller bring a distillation of the wisdom found in the journal's pages. They explain the crucial role of a Zeitgeber for healthy sleep cycles, question the involvement of drugs like SSRIs in seizures, and share a transatlantic follow-up to the ABN myasthenia gravis guidelines which provides an approach to optimising over all patient well-being. There's also a guide to recent treatment of Parkinson's using foslevodopa-foscarbidopa infusion, also known as Produodopa. Then the editors explore the structure of the retina while touching on optic neuritis, and finish with limb-shaking transient ischaemic attacks, an early warning signal for stroke. Listen to the very end for some editorial insight into practical uses for the podcast itself!
Read the issue: https://pn.bmj.com/content/26/3/205

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.
44 min
May 13 Perplexing keladophilia and post-surgical symptoms - Case Reports April 2026
It's the return of Merlin. Not the birdsong identification app this time, but the Rolls-Royce Merlin - engine of the historic Supermarine Spitfire warplane. The Case Reports trio are faced with another set of patient puzzles to work through in this latest episode.
In the first case (1:25), a 68-yo man, retired from farming, presents with a 6-year history of behavioural changes. Most notably, he had developed a sense of great pleasure in listening to engine sounds, like those of the historic aircraft flying over his house. He had become increasingly emotionally detached and ritualistic, and gained a sweet tooth. MR scans of the brain revealed an uncommon syndrome.
https://pn.bmj.com/content/26/2/169
The second case (21:15) relates to a 47-yo woman who developed abnormal movements in all of her limbs. She had undergone a complex cardiac surgery 12 years before, and another prolonged cardiac surgery within recent weeks. The case discusses the longterm follow-up of her treatment for these involuntary movements.
https://pn.bmj.com/content/26/2/157

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 April 2026 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) Clinical Lecturer in Neurology at the Institute of Cognitive Neuroscience, University College London, and an Honorary Neurology SpR at the National Hospital for Neurology and Neurosurgery.
(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://bit.ly/4aXF46i). We'd love to hear your feedback on social media - @PracticalNeurol.
Production and editing by Brian O'Toole. Thank you for listening.
38 min
April 22 Radiologically isolated syndrome: managing the preclinical phase of MS
What should a neurologist do when a routine MRI for migraine reveals incidental white matter lesions that look remarkably like Multiple Sclerosis (MS), despite the patient having no neurological symptoms?
The Editors' Choice paper for the April 2026 issue of Practical Neurology is a practical guide to the clinical diagnosis and management of radiologically isolated syndrome (RIS). Author Dr. Audrey Reynolds¹ joins PN podcast editor Dr. Amy Ross Russell to discuss her work on how updated diagnostic criteria and advanced imaging markers now enable a more proactive, biological approach to the disease.
Their discussion highlights the importance of risk stratification - using tools like CSF analysis and spinal imaging - to identify those most likely to benefit from early intervention with disease-modifying therapies. They also examine the delicate balance between preventing future disability and avoiding misdiagnosis in this rapidly evolving area of neurology.

Read the paper: Radiologically isolated syndrome: a practical guide.

(1) St Vincent’s University Hospital, Dublin; University College Dublin, Ireland

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 Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.
31 min
March 27Bone health in Neurology: managing the fracture risk
In this Practical Neurology bonus international podcast linked to the February issue, host Alasdair Coles (Cambridge, UK) is joined by movement disorder specialist Dr. Ashley Paul (Johns Hopkins, US) and epilepsy expert Dr. Lata Vadlamudi (Brisbane, Australia) to discuss the integration of bone health into neurology clinics.
They discuss the identification of osteoporosis in patients on steroids or anti-seizure medications and evaluate the use of FRAX assessment tools for neurological populations. They also address the implementation of screening protocols and checklists to prevent fragility fractures.
Read the related paper: Osteoporosis and fracture risk: a practical guide for neurologists
Participants:
Professor Alasdair Coles is Head of Department for Clinical Neuroscience and also Co-Director of the Cambridge Centre for Myelin Repair, UK.
Associate Professor Lata Vadlamudi, Senior Staff Specialist in Neurology at the Royal Brisbane and Women's Hospital, Australia.
Dr. Ashley Paul, Assistant Professor of Neurology in the Division of Movement Disorders at Johns Hopkins University, USA.
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.
33 min

About Practical Neurology Podcast

From the publisher's feed

The Practical Neurology Podcast is the essential guide for the everyday life of all neurologists. Just like our journal Practical Neurology, this podcast is useful for everyone who sees neurological patients and who wants to keep up-to-date and safe in managing them. In other words, this is a podcast for jobbing neurologists who plough through the tension headaches and funny turns week in and week out.