eLetters

29 e-Letters

published between 2012 and 2015

  • The use of stimulation single fibre EMG in investigation of congenital myasthenia
    Matthew C Pitt

    We enjoyed the review by our colleagues Finlayson et al 1 from the United Kingdom, Congenital Myasthenic service, covering all aspects of the congenital myasthenic syndromes. We would, however, suggest that the section on neurophysiology could have been expanded and elaborated more. To state that the neurophysiological findings in congenital myasthenic syndromes are similar to those in autoimmune myasthenia gravis is corr...

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  • Functional symptoms in neurology-making the right diagnosis
    Nitin K. Sethi

    The borderland between functional diseases and neurological diseases gets blurred especially when the patient presents with a myriad of symptoms which do not localize to any one level of the neural axis.1 If in addition the neurological examination is normal (especially the lack of 'hard' neurological signs such as upgoing plantars, cranial nerve signs, definite asymmetry of the deep tendon reflexes, cerebellar signs and...

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  • Shying away from making a clinical diagnosis
    Nitin K. Sethi

    Turner and Talbot rightly emphasize that in spite of advances in EMG techniques and emergence of novel neuroimaging and CSF biomarkers the diagnosis of motor neuron disease (MND) still remains a clinical one.1 Find upper motor neuron (UMN) and lower motor neuron (LMN) signs in the same limb and MND should be high up in the differential I recall was taught to me in medical school. EMG was to be used in atypical cases wher...

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  • Help!-I have a bad case of neurophilia
    Nitin K. Sethi

    Neurophilia can be loosely defined as the love of or fascination for neurology. Now you may think this is a new recently described exotic neurological syndrome but dwell into the ancient eastern Hindu and Buddhist philosophies and you shall quickly realize that the disorder is as ancient as these civilizations themselves 1. The workings of the brain and of the mind fascinated these first neurophilia inflicted philosopher...

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  • Familial Neurophilia - Is neurophilia hereditary?
    Sui H. Wong

    I enjoyed Fuller's description of 'neurophilia' - we can finally label this condition afflicting neurologists, and recognise that is widespread within medicine and the general population.(1) Neurophilia is probably infectious (i.e. environmental); my personal experience and informal discussions with neurology colleagues revealed that many chose neurology as a career following positive experiences during their Senior Ho...

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  • SUDEP-useful information or TMI?
    Nitin K. Sethi

    I read with interest the article by Dr. Leach. As things stand at present, it is not mandatory for physicians in the United States to discuss about SUDEP with patients or their caregivers. In fact this was not included in the recently released American Academy of Neurology (AAN) performance measures for epilepsy 1. Advice about safe recreation and driving though is included as one of the 8 performance measures. So is...

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  • Ambiguity in EEG lies in the eyes of the beholder
    Nitin K. Sethi

    The term generalized in EEG is certainly ambiguous and can be a cause of confusion, especially to a reader who is not formally trained in neurophysiology. As a neurology resident in training, the importance of personally reviewing the patient's CT or MRI scan was impressed upon me time and time again. Do not just take the radiologist's report at face value, look at the pictures yourself since you after seeing the patient...

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  • We all need someone to lean on
    Nitin K. Sethi

    Dear Editor,

    Dr. Fuller makes a strong case for coaching in neurology(1). Formal coaching in neurology usually occurs during residency and fellowship training. In the United States we have the 360 degree evaluation. The resident physician in training is evaluated and coached by everyone he comes in contact with namely the staff attending, nursing staff, other residents, patient and even the medical student. There...

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  • Amantadine for Tardive dyskinesia: active in patients with overactive NMDA receptors
    Salvador Vale

    In the Saifee TA et al article (1) regarding the treatment of "Tardive movment disorders" (TD), the authors recommend the use of amantadine as second or third line among other possible drugs ("each with fairly limited evidence for effectiveness" in author?s words).

    In 1971, the late Dr. Espejel and I informed for the first time the benefits of amantadine in drug-induced dyskinesias (2); consequently, I have f...

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