eLetters

121 e-Letters

  • Leprosy
    Colin L. Crawford

    Dear Editor,

    Richard Hughes does not include leprosy in his list of peripheral nerve disorders.(1) While it is true that new cases of leprosy are declining rapidly , as a result of effective anti-bacterial therapy, there are still frequent numbers with residual disabilities in endemic countries.

    In neurological text books, a mononeuropathy or multiple mononeuropathy is regarded as the sole neurolog...

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  • Clinical signs and symptoms emphasized.
    Ivy A.E. Ekem

    Dear Editor,

    I wish to commend the authors for their paper on functional vitamin B12 deficiency.

    It is important that despite the array of investigative tools that may be available at the disposal of clinicians, clinical signs and symptoms are given their due emphasis particularly in Vitamin B12 deficiency. The authors report a case where the serum cobalamin was normal in the face of anaemia and neurol...

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  • Neurologic complications of celiac disease
    Chiara Briani

    Dear Editor,

    We read with great interest the review by Grossman on neurologic complications of celiac disease in a recent issue of Pract Neurol.(1)

    Using an evidence-based approach, the author has carefully and critically analyzed articles published in the last decade on the most common neurologic manifestations associated with celiac disease, namely ataxia, epilepsy, and peripheral neur...

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  • "Functional" Vitamin B12 Deficiency
    Lawrence R. Solomon

    Dear Editor,

    I read with interest the important case report of Turner and Talbot describing clinical subacute combined degeneration in a patient with “functional” vitamin B12 deficiency (defined by elevated levels of the B12 -dependent metabolites, methylmalonic acid and homocysteine, despite normal serum B12 values).1 It is important to note that although their patient did not improve with hydroxycobalamin the...

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  • "Ice-on-eyes" test
    Andrew J Larner

    Dear Editor

    Further to previous articles on the "ice-on-eyes" test or ice-pack test in myasthenia gravis,1,2 a prior report pooling six studies adjudged to have sufficient clinical and experimental detail (n = 76 patients with myasthenia gravis, n = 77 non-myasthenic patients with ptosis), rather than just the two studies alluded to by Reddy & Backhouse,1 gave a test sensitivity of 89% and specificity of 100%....

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  • Letter from Rome: Celiac disease and brain
    Ludovico Abenavoli

    Dear Editor

    The history of celiac disease (CD) is very long. The cultivation of grains, developed in the Neolithic period after the last ice age, particularly in the “Fertile Crescent” of the Near East including the Tigris, the Euphrates and the Upper Nile. With the development of cooking, agriculture came into its own and wheat became a main support of the vast growth in population in successive millennia. Thus ar...

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  • The superspecialization of neurology
    Nitin K Sethi

    Dear Editor,

    I read with keen interest Dr. Davenport’s editorial” why can’t I make a neurological diagnoses anymore?” 1. I am currently in my second year of fellowship training in clinical neurophysiology in the USA and even though I am heading down the path of superspecialization or rather subspecialization in neurology, as Dr. Davenport points out, I could not agree more with his comments.

    Here in the U...

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  • recurrent meningitis, right to left shunts, and blood cultures
    oscar,m jolobe

    Dear Editor

    For the sake of completeness, mention must also be made of the role of right to left shunts, exemplified by pulmonary arteriovenous malformations attributable to hereditary haemorrhagic telangiectasia(1)(2), and also exemplified by patent dusctus arteriosus with shunt reversal(3), in the aetiopathogenesis of recurrent bacterial meningitis, both meningococcal(1), and pneumococcal(3), as well as cerebral...

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  • Career driven and clinically relevant research
    Andre J des Etages

    Dear Editor,

    This article highlights an important aspect of scientific training not only to neurologists, but to all clinicians. Advances in neuroimaging,genetic analysis and molecular biology constantly advance our understanding of disease and challenge our approach to treating patients. This demands that even clinically oriented neurologists and neurosurgeons have not only a basic understanding of the process o...

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  • much still needs to be done to make tests of cognitive function fit for purpose
    oscar,m jolobe

    Dear Editor,

    Given the crucial importance of evaluation of cognitive function for purposes such as assessment of capacity to make a will(1), the broadspectrum strategy employed by the Addenbrooke's Cognitive Examination(ACE)(2) will help overcome limitations of the Minimental State Examination(MMSE) exemplified by the acknowledgement that "someone who scores 27/30 may lack capacity because of impaired judgment and...

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