Categories
Neurochecklists updates

20 recently updated practical neurology checklists

Neurochecklists is a comprehensive and practical neurology database

Handy and fully referenced, it is in a constant state of review and renewal

Below are just 21 of our recently updated neurology checklists

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Cervical artery dissection: clinical features 

Epilepsy: blood and CSF features 

Huntington’s disease: clinical features 

Leber hereditary optic neuropathy: management 

Parkinson’s disease tremor

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Behcet’s disease: clinical features

MND C9orf72 variant

Thrombectomy 

Neuropathy: toxic and drug-induced 

Narcolepsy: clinical features

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Epicrania fugax

West Nile virus: clinical features 

Thrombolysis: complications 

Migraine: CGRP monoclonal antibodies

Lambert Eaton myasthenic syndrome: clinical features

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Alzheimer’s disease

Pes cavus

Immune checkpoint inhibitor toxicity: management

Adrenoleukodystrophy: phenotypes

Myotonic dystrophy type 2: management

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Categories
Multiple sclerosis Sleep disorders

What are the sleep-related disorders of multiple sclerosis?

Sleep-related disorders and their relationship with MRI findings in multiple sclerosis.

Foschi M, Rizzo G, Liguori R, et al.

Sleep Med 2019; 56:90-97.

Abstract

Background:

Sleep-related disorders have been reported to have a higher prevalence in multiple sclerosis (MS) than in the general population. They are often undervalued for the presence of more severe physical problems and the occurrence at night, without a direct observation in common clinical practice, but if not recognized and treated they can negatively affect the quality of life causing daytime drowsiness and worsening fatigue. Sleep related disorders most commonly reported in MS are as follows: insomnia, sleep-related breathing disorders (SRBD), restless legs syndrome (RLS) and periodic limb movement disorders (PLMD). Secondary narcolepsy, REM sleep behavior disorder (RBD) and propriospinal myoclonus have been also described in some case reports or series.

Methods:

The purpose of this review is to correlate the more common sleep disturbances in MS patients to the involvement of specific brain regions, analyzing their relationship with MRI findings.

Results:

While insomnia is usually secondary to other disabling symptoms such as nocturia or pain, SRBD, RLS, narcolepsy, RBD and propriospinal myoclonus in MS patients can be the consequence of an injury of specific central nervous system (CNS) areas. Lesions in the pontine tegmentum and the dorsal medulla have been associated with SRBD, spinal cord lesions or atrophy with RLS, bilateral lesions in the lateral hypothalamus with narcolepsy-like symptoms, lesions in the dorsal pontine tegmentum with RBD and intramedullary demyelinating plaques in spinal cord with propriospinal myoclonus.

Conclusions:

MS specialists and general neurologists should be aware of these comorbidities since neuroimaging, which is routinely performed in MS, could provide helpful clinical indications on patients with secondary sleep-related disorders and to categorize symptomatic patients who need to underdo more in-depth sleep studies.

This paper is cited in the neurochecklist:

Multiple sclerosis (MS): unusual presentations

Abstract link

In the middle of the night, sleepless. glasseyes view on Flickr. https://www.flickr.com/photos/axelhartmann/16892508838

 

Categories
Sleep disorders

Is narcolepsy associated with heightened creative thinking?

Increased creative thinking in narcolepsy

Lacaux C, Izabelle C, Santantonio G, et al.

Brain 2019; 142:1988-1999.

Abstract

Background:

Some studies suggest a link between creativity and rapid eye movement sleep. Narcolepsy is characterized by falling asleep directly into rapid eye movement sleep, states of dissociated wakefulness and rapid eye movement sleep (cataplexy, hypnagogic hallucinations, sleep paralysis, rapid eye movement sleep behaviour disorder and lucid dreaming) and a high dream recall frequency. Lucid dreaming (the awareness of dreaming while dreaming) has been correlated with creativity. Given their life-long privileged access to rapid eye movement sleep and dreams, we hypothesized that subjects with narcolepsy may have developed high creative abilities.

Methods:

To test this assumption, 185 subjects with narcolepsy and 126 healthy controls were evaluated for their level of creativity with two questionnaires, the Test of Creative Profile and the Creativity Achievement Questionnaire. Creativity was also objectively tested in 30 controls and 30 subjects with narcolepsy using the Evaluation of Potential Creativity test battery, which measures divergent and convergent modes of creative thinking in the graphic and verbal domains, using concrete and abstract problems.

Results:

Subjects with narcolepsy obtained higher scores than controls on the Test of Creative Profile (mean ± standard deviation: 58.9 ± 9.6 versus 55.1 ± 10, P = 0.001), in the three creative profiles (Innovative, Imaginative and Researcher) and on the Creative Achievement Questionnaire (10.4 ± 25.7 versus 6.4 ± 7.6, P = 0.047). They also performed better than controls on the objective test of creative performance (4.3 ± 1.5 versus 3.7 ± 1.4; P = 0.009). Most symptoms of narcolepsy (including sleepiness, hypnagogic hallucinations, sleep paralysis, lucid dreaming, and rapid eye movement sleep behaviour disorder, but not cataplexy) were associated with higher scores on the Test of Creative Profile.

Conclusion:

These results highlight a higher creative potential in subjects with narcolepsy and further support a role of rapid eye movement sleep in creativity.

This paper is cited in the neurochecklist:

Narcolepsy: clinical features

Abstract link

CreativeTools.se. Creative Tools on Flickr. https://www.flickr.com/photos/creative_tools/5930069142
Categories
Neurochecklists updates

30 recently revised and updated practical neurology checklists

Neurochecklists is proud of being comprehensive and practical.

But more than that, we take pride in keeping each checklist updated.

To do this, we keep a keen eye on all relevant developments in the literature.

And below are just a few of the checklists that we have recently revised.

They all reflect findings from the latest neurology publications.

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Anti Ma2 syndrome

Cerebral aneurysms rupture risk factors

Cerebral vein thrombosis

CGRP monoclonal antibodies

CJD

Dural AV fistula management

Giant cell arteritis treatment

Gluten sensitivity neurology

IIH clinical features

King-Denborough syndrome

Levetiracetam

Migraine acute treatment

MND c9orf72

Multiple sclerosis clinical features

Narcolepsy

Normal pressure hydrocephalus

Ocular myasthenia gravis

Oculopharyngeal muscular dystrophy

Ocrelizumab

Parkinson’s disease risk factors

Post stroke recrudescence

PSP variants

Psychogenic seizures

Rapid onset dystonia-parkinsonism

Retinal migraine

Seizure manifestations

Stiff person syndrome

Subacute combined degeneration

Suprascapular neuropathy

Thrombolysis

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Categories
General

What are the 10 most eminently curable neurological disorders?

Neurologists are often at the receiving end of the jokes of other medical specialists. They facetiously remark that neurologists know a lot, but do very little to cure their patients. Admittedly we do our fair share of dispensing weak platitudes, and we do break bad news with embarrassing regularity. There is no doubt that, for many diseases, all we have in stock are symptomatic or palliative. This is sadly the case with many familiar disorders such as Alzheimer’s disease (AD), Huntington’s disease, Charcot Marie Tooth disease (CMT), Freidreich’s ataxia (FA), essential tremor (ET), and myotonic dystrophy.

Three treatment capsules close-up. Marco Verch Professional Photographer and Speaker on Flickr. https://www.flickr.com/photos/30478819@N08/46513130444/in/photostream/

It is even true that at the extreme end of neurological practice, there are conditions that literally turn a deaf ear to all our entreaties, brush off everything we hurl at them, taunt us with reckless abandon, and run relentlessly mortal courses. Such is the dismal state of affairs with diseases such as rabies encephalitis, Creutzfeldt Jakob disease (CJD), and motor neurone disease (MND).

 

Hypodermic needle-IMG7418. Steven Depolo on Flickr. https://www.flickr.com/photos/stevendepolo/3020361085

But neurologists don’t just tap their patients knees, and then raise their hands up in despair. We do more than just lend our patients a listening ear, or a leaning shoulder to cry on. We do have at our disposal a vast armamentarium that can control many neurological diseases, even if we need to use these chronically. Such is the state of play with diseases such as migraine, epilepsy, multiple sclerosis (MS), narcolepsy, myasthenia gravis (MG), restless legs syndrome (RLS)Wilson’s disease, and Parkinson’s disease (PD).

Mapping the brain. NIH History Office on Flickr. https://www.flickr.com/photos/historyatnih/14359347545

But beyond just treatment, what patients really want is total cure. And neurologists can lay claim to this as well. Some diseases of the nervous system  can indeed be permanently remedied, their victims requiring no long-term medications to maintain the cure. To prove this, here are our 10 most eminently curable neurological disorders, linked to their treatment checklists.

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Bacterial meningitis

Viral encephalitis

Autoimmune encephalitis

Wernicke’s encephalopathy

Ischaemic stroke

Idiopathic intracranial hypertension (IIH)

Cervical compressive myelopathy

Guillain Barre syndrome (GBS)

Meningioma

Normal pressure hydrocephalus (NPH)

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It is important to note that curable neurological disorders are also potentially serious, and do carry the risk for serious complications, and even death, if not treated early and adequately. You may check out our previous blog posts to see the dark side of these disorders:

on ‘Have we missed anyone out? Please drop us a hint!

By JustfixingawrongnumberOwn work, CC0, Link
Categories
General

The 19 most unusual symptoms in neurology

The brain, the principal playground of neurologists, is a complex organ. The more we learn about it, the more we have to unlearn our old certainties. The more we study it, the less it seems to reveal of itself. The brain is fascinating enough when it is functioning normally; it is however most intriguing when it becomes dysfunctional.

Child brain. Isaac Mao on Flikr. https://www.flickr.com/photos/isaacmao/544928/

Some symptoms arising from the brain are straightforward, for example hemiplegia, or one-sided weakness, which often develops following stroke. Some other symptoms however defy simple explanations. In this blog post, we look at the most unusual symptoms in neurology. We will however focus only on symptoms that may be produced by diverse diseases, and will exclude equally striking symptoms such as cataplexy, seen almost only in narcolepsy, and megaphagia, seen mainly in Kleine-Levin syndrome). Here then are our 19 most unusual symptoms in neurology.

 

24K jumping brain. Emilio Garcia on Flikr. https://www.flickr.com/photos/lapolab/10692043855

 

Alien limb syndrome

Apraxia

Confabulation

Deja vu

Fugue

Normal brain. NIH Image Gallery on Flikr. https://www.flickr.com/photos/nihgov/26680098405

Gaze palsy

Hyperkplexia

Mirror movements

Mirror writing

Neglect

A twisted family tradition. Elisabeth Feldman on Flikr. https://www.flickr.com/photos/hurleygurley/4338767

Pathological crying

Pathological hiccups

Pathological laughter

Pathological sneezing

Pathological yawning

Brain cell(s). Jean-Etienne Minh-Duy Poirrier on Flikr. https://www.flickr.com/photos/jepoirrier/

Phantom limb

REM sleep behaviour disorder

Self-mutilation

Sleep violence

 

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And explore more neurology on Neurochecklists

 

Brains. Neil Conway on Flikr. https://www.flickr.com/photos/neilconway/3792906411