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 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-2022-issue?in=bmjpodcasts/sets/pn-podcast

(1) Neurology, University Hospital Southampton NHS Foundation Trust, UK
(2) Consultant Neurologist, Morriston Hospital, Swansea, UK

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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.

Weakness in the ICU

The Practical Neurology Podcast is the essential guide for the everyday life of all neurologists. 

The crucial point of Practical Neurology is that it is practical in the sense of being 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 journal for jobbing neurologists who plough through the tension headaches and funny turns week in and week out.

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Medicine

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Health & Fitness

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.

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

The first multidisciplinary consensus guideline for the diagnosis and treatment of spontaneous intracranial hypotension (SIH) has recently been published by the UK SIH Specialist Interest Group. Group members Prof. Manjit Matharu (1), Dr. Indran Davagnanam (2), and Mr. Parag Sayal (3) join Dr. Amy Ross-Russell to explain their recommendations. They discuss the impact this condition has on patients, the possible presentations, and approaches for diagnosis and treatment.
 
Read the article: Spontaneous intracranial hypotension
 



(1) Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK(2) Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK(3) Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UKPlease subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
The PN podcast is produced by Letícia Amorim and edited by Brian O'Toole. Thank you for listening.

A new guideline for spontaneous intracranial hypotension

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.

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

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.

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

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.

Weakness in the ICU

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