31 e-Letters

published between 2013 and 2016

  • 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...

    Show More
  • aetiology of myoclonus
    Dr Ramesh Kumarans


    Can myoclonus involve large muscles like the trunk muscles giving out just one jerk with a duration of a fraction of a second?Would it be justified to term this phenomena as a myoclonic seizure or a complex myoclonus when there is LOC for that fraction of a second;happening while falling asleep only.Or can it be a sleep disorder,a hypnic jerk?

    Conflict of Interest:

    Show More
  • Pre-protocol experience from Belfast.
    Michael O. Kinney

    We welcome the article by Jones et al, and in particular the chance to compare the protocol used in their institution with the one we hope to implement (1).

    In Northern Ireland, we are in the process of drawing up a regional protocol for the management of status epilepticus, due to wide variation in current practice. We carried out preliminary work to see where the gaps in knowledge are, so that we can create a...

    Show More
  • Re:What is the risk of PCP in patients with neurological disease?
    Simon Cronin

    We thank Dr Lilleker for his comments. We agree that use of PCP prophylaxis must provide benefit that would outweigh any attendant risk. As suggested in our article, this risk is likely to vary depending on the dose and duration of steroid therapy, the co-administration of other biologicals and the systemic health of the patient. A patient with e.g., systemic vasculitis-associated mononeuritis multiplex who has also b...

    Show More
  • What is the risk of PCP in patients with neurological disease?
    James B Lilleker

    I thank the authors for highlighting this difficult topic with a very thought provoking article.

    In immunosuppressing a patient with neurological disease, as with anything a physician does to a patient, there are potential risks to take into account and to be weighed up against the proposed benefits. Indeed, this sort of "cost-benefit" analysis is a central tenant of decision making in much of life outside of me...

    Show More
  • Superb Book
    Roger L. Albin

    This is a superb book that deserves to be better known, at least on my side of the Atlantic. In addition to Barker's outstanding depiction of WW1 Britain, the sympathetic and revealing exploration of the physician- patient relationship is peerless. Interested readers should know that Regeneration is the first book in a trilogy, though neither is quite as good as Regeneration. The second book, The Eye in the Door, is qui...

    Show More
  • Chocolate Consumption, Nobel Prizes and -Scientific Integrity
    Bradford D. Pendley

    In a paper published last year in the New England Journal of Medicine (NEJM), Messerli noted "a surprisingly powerful correlation between chocolate intake per capita and the number of Nobel laureates in various countries," which he postulated as "most likely" related to the cognitive enhancing benefits of chocolate.1 This article in one of the premier journals in the world received extraordinary press reports around the t...

    Show More
  • Spontaneously resolving cerebellar syndrome as a sequelae of dengue viral infection
    Viroj Wiwanitkit

    Sir, the report on "spontaneously resolving cerebellar syndrome as a sequelae of dengue viral infection" is very interesting [1]. In fact, neurological complication of dengue is not common but it can be detectable [2]. The spontaneously resolving cerebellar syndrome in this report is questionable for the relationship to dengue. Based on the previous study from Thailand, the spontaneously resolving pathology of cerebellum...

    Show More
  • Neurophilia! Not.
    Rory Roopnarine

    I really enjoyed Dr. Fuller's wonderful article on a likely emerging public and professional fascination with neurology. The bad news, however, is humankind's perpetual fascination with phobias; a fascination with 'death' being but one example. I'd perhaps say that neurology has joined some rather elite company.

    I would postulate that neurophobia, rather than neurophilia, drives the impetus to produce copious ar...

    Show More
  • 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...

    Show More