Practical Neurology Podcast

• 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 Neu...

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 e...

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  mul...

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 E...

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-...

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...

It’s the Christmas Special for 2024! Joining Amy in the studio is Dr. Steven Lewis. Current secretary general of the World Federation of Neurology, Steven 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 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 jun...

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 of 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 e...

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

Ou...

"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 pois...

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 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 cas...

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...

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 pap...

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 to...

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...

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 ...

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...

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 woma...