eLetters

99 e-Letters

  • Are the new ABN guidlines for MS of any use in clinical practice?
    Julian N Furby

    As a jobbing MS neurologist in Southampton I am really not sure how these guidelines are going to assist in my clinical practice.

    Perhaps first and foremost, if I was to follow these guidelines I would find myself frequently in breach of NHS commissioning criteria with perhaps severe implications for both myself and my hospital trust given the cost of these therapies. As such I feel the authors should have give...

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  • Re:Letter to Practical Neurology: comment on MG: ABN's management guidelines (Sussman et al. Practical Neurology 2015 )
    Dr. Jon Sussman

    I am grateful to Drs Wong and Plant for their invaluable comments, based on their enormous experience of patients presenting with suspected ocular myasthenia. The Guidelines are intended to offer non-specialists an approach to management that will work, safely, in the majority of patients. Within them, we stressed repeatedly the need to seek specialist opinion when in any doubt, and their letter emphasises the benefit of...

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  • Letter to Practical Neurology: comment on MG: ABN's management guidelines (Sussman et al. Practical Neurology 2015 )
    Sui Hsien Wong

    Dear Sirs, Myasthenia gravis: Association of British Neurologists' management guidelines We read with interest the ABN's management guidelines on Myasthenia Gravis[1] and commend the authors for putting toget her guidelines for this condition where the evidence base is limited. The comments here reflect our experience of managing a large number of patients with ocular myasthenia gravis (OMG). Moor fields Eye Hospital is th...

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  • A need to increase understanding of brain injury in professionals carrying out DoLS assessments
    Alexandra F Richards

    I read the article "Brain Injury and deprivation of liberty on neurosciences wards" with interest - it is well-timed and provides a helpful introduction to the the recent changes to deprivation of liberty safeguarding criteria. Working in a residential neurorehabilitation centre I am very familiar with the DoLS process as the majority of our client group are admitted under this safeguard. As mentioned in the article, the...

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  • Undiagnosing neurological disease
    Nitin K. Sethi

    With great interest I read Coebergh et al. piece on how to undiagnose neurological disease. 1 My experience as a neurologist with subspecialty training in epilepsy has taught me that diagnostic labels such as seizure disorder or epilepsy once attached are very hard to purge either from the patient's medical records or his memory. I frequently encounter patients carrying a diagnostic label of epilepsy in whom continuous vi...

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  • Re:The article by Zanette et al (2014;14:351-353). T
    Stefano Tamburin MD

    We thank Dr. Davenport for his interest in our case report [1] and the opportunity to better explain our clinical reasoning. In his e-letter Dr. Davenport argues that there is a discrepancy between the distribution of the pain, which appeared more suggestive of L2 and perhaps a contribution of L1 and L3, and the involvement of L4 root as documented by clinical neurophysiology and neuroimaging. The patient was asked to d...

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  • The article by Zanette et al (2014;14:351-353). T
    Richard J Davenport DM FRCP Edin

    I thoroughly enjoyed the article by Zanette et al (2014;14:351-353). The authors are to be congratulated for their skilful history taking skills, specifically the key observation that the pain coincided with menses, suggesting the diagnosis, and thus confirming that a neurology opinion, far from being "the last resort", should have been the "first resort". I am troubled by the distribution of the pain however; the autho...

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  • CSF Evaluation
    Barbara A. Busall

    Is there any reason you can think of when the CSF protein and the CSF glucose should be evaluated from different tubes of CSF and not the same tube?

    Conflict of Interest:

    None declared

  • How I start a new patient consultation-view from across the pond
    Nitin K. Sethi

    I read with interest Allen et al. approach to starting a new patient consultation1. Apart from a few minor differences the basic methodology employed by all four physicians is essentially the same. Across the pond, I start a new patient consultation in much the same way. I walk into the reception area, call out the patient's name and upon acknowledgement ("right here" or "yes" is the usual response, rarely "yo" and I hav...

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  • HIV testing in a patient presenting with cognitive impairment-to test or not to test
    Nitin K. Sethi

    I read with interest the debate between Nightingale el al. and Schott about whether we should routinely test for HIV in patients presenting with cognitive impairment 1,2 . I assume that while the authors have taken rather polarized views to state their point, the correct answer lies somewhere in between. Testing for HIV shall not be the foremost in my mind in a 75-year-old male presenting with slowly progressive cognitive...

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