eLetters

131 e-Letters

  • Comment on Death in pregnancy: a call for neurological action (JP Leach. Practical Neurology 2015)
    Dr. Dominic Paviour

    Dear Sirs, We welcome Dr Leach's comments and a call for action from Neurologists, regarding service provision for women of childbearing age with neurological disorders1. We would also like to highlight that quietly, a number of us are grasping the nettle. Risk is inherent in clinical practice. Managing risk effectively and pro- actively in preference to reactively minimises the likelihood of a poor outcome. This can be...

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  • Re:Comment on Death in pregnancy: a call for neurological action (JP Leach. Practical Neurology 2015)
    Dr John Paul Leach

    The outlined model of cooperative and integrative services for pregnant women with neurological conditions is warmly welcomed (and not a little envied!). While such services are provided the English centres mentioned, it is sad that such high quality provision remains patchy and incomplete. This nettle-grasping should no longer be quiet, but should be loudly heralded and made the norm. The recently updated SIGN guideline...

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  • A case of functional cognitive disorder with acute onset?
    Rachel A Cichosz

    While reading Pennington et al's (2015) article on Functional Cognitive Disorder, I was struck by the similarity between their descriptions and a patient seen in clinic (patient X), with the exception that X's symptoms appeared over the course of a few days with no identifiable precipitating event. Extensive physical tests and brain imaging investigations were carried out and no organic disease was found yet symptoms we...

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  • Re: Pennington et al. Functional cognitive disorder: what is it and what to do about it?
    Jan A Coebergh

    Pennington and colleagues review of Functional Cognitive Disorder (FCD) [1] is very welcome to guide practice in a complex condition that is presenting increasingly to general and cognitive neurology clinics. However, in our view Pennington's presumption towards specialist assessment, investigation and surveillance is unnecessary and misses an opportunity to provide patients with a prompt diagnosis, explanation and reas...

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  • Reply from Pennington et al.
    C Pennington

    We welcome debate around this emerging condition. We all recognise a situation when as clinicians we have had a strong feeling that a patient has a functional complaint from early on in the consultation. However, the differential diagnosis for Functional Cognitive Disorder is neurodegenerative dementia which itself affects behaviour and personality and could, therefore, influence many of the cues clinicians pick up on wh...

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  • OPTIC NEURITIS AND VISUAL ELECTROPHYSIOLOGY
    Fabio Bandini

    Sir, I read with much interest the review by Weerasinghe and Lueck on the diagnosis of optic neuritis. The authors provide an extensive and detailed analysis on the differential diagnoses and the management of the disease. The importance of retinal electrophysiology is also acknowledged when differentiating retinal disorders that can mimic optic neuritis. Surprisingly, however, the diagnostic role of pattern-reversal Visua...

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  • Nerve ultrasonography in practical work
    Mahamoud M Gabal

    Dear Editor,

    I read with interest this work ..indeed nerve ultrasonography has other parameters more than cross section area measurements in detection of the pathological changes and prediction of outcome of the treatment (medical or surgical}...the normal nerve as seen by high resolution ultrasonography is:

    1- oval shaped or round with high ability to change its shape in response to applied pressure easi...

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  • Clinical neurology in practice
    Abhijit Chaudhuri

    Dear Editor,

    I felt rather uncomfortable with some of the articles in the August 2006 issue of the Practical Neurology and it was not because I was reading the journal in a sultry afternoon of Indian summer.

    Andrew Chancellor was wrong in invoking a clinical diagnosis of multiple sclerosis in his fourth problem (Test Yourself, p260). The diagnosis of multiple sclerosis (MS) cannot be made without objecti...

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  • Ulnar neuropathy
    A J Larner

    Dear Editor

    I very much enjoyed Dr Stewart’s informative article on ulnar neuropathies in the August issue of the journal,1 which included images of Rodin’s The Thinker to demonstrate that elbow flexion may increase the likelihood of nerve damage.

    May I suggest the painting of Saint Bartholomew of 1661 (see fig) by Rembrandt van Rijn (1606–69) in the J Paul Getty Museum, Los Angeles, as a possible exam...

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  • Xanthopsia in the absence of absinthe
    Rhys H Thomas

    Dear Editor,

    I must thank Dr Smith for his entertaining and informative case study of van Gogh. (1) It pains me to ask for caution to be used when interpreting his findings, (particularly as I love a good pun for a title).

    Arnold and Loftus in 1991 calculated that one must drink 182 litres of absinthe to induce xanthopsia. (2,3,4) After that lethal load, one can only speculate that it may be difficult for Mr V...

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