Amantadine was incorrectly listed as an N-metyhl-d-aspartate (NMDA) receptor agonist twice in the text. Once in the abstract and once in the second paragraph of the discussion. The authors confirm it is an NMDA antagonist.
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]]>Spontaneous intracranial hypotension, although first described in the 1930s, has become much more widely recognised because of its MRI findings, and its well-characterised clinical syndrome is now familiar to all neurologists. Many patients recover well when the condition is recognised and treated with an epidural blood patch. However, many do not. Manjit Matharu and colleagues have developed the first multi-disciplinary consensus that outlines the condition’s clinical features, diagnosis, management and likely causes—notably a dural tear and CSF venous fistulas—and use their experience of this condition...]]>
His MR scan of brain suggested autoimmune encephalitis
Calcified cerebral emboli are...]]>
CT scan of head showed no acute infarction or haemorrhage (
Inconsistency usually refers to inconsistency between movement, sensory or cognitive performance in a voluntary versus an ‘automatic’ scenario. This is the principle of Hoover’s sign of functional leg weakness, the tremor entrainment test for functional tremor and a range of cognitive tests in functional cognitive disorder. It is often helpful to share these tests with patients as they show the potential for improvement, give an insight into the ‘software’ mechanism of FND in the brain and also feed into a range of FND-specific therapies. For example, a physiotherapist might actively use distraction to promote automatic movement and discourage overlearned abnormal patterns of voluntary movement.
Incongruency, on the other hand, refers to a clinical feature that is not present in other superficially similar neurological conditions, or that apparently violates laws of anatomy, biology...]]>
Over the...]]>
A 60-year-old woman, born in Sri Lanka and with long-standing diabetes, developed subacute onset pain. The pain had started in the left lower leg, but within a few weeks extended to all four limbs, thorax and abdomen, though sparing the head. She described the pain as ‘like pin and needles’ with burning sensations. It was constant, with fluctuating intensity over day and night, up to 10 out of 10. There were no associated neurological or systemic symptoms, and no autonomic symptoms. Two months after symptom onset, she was admitted under rheumatology. An exhaustive rheumatological workup was normal, including immunological blood workup, MR scans of all skeletal muscles and sacroiliac joints, and X-rays of hands, knees and feet.
We met her for the first time at our neuromuscular clinic 3 months after symptom onset.
Vital observations and general examination were normal, and cranial nerves were intact. There...]]>
The format of short chapters at first glance appeared to be an ‘easy read’ but after even a second read through,...]]>
The ABN advisory groups are made up from the membership and include a trainee among their 5 to 15 members. They are grouped by specialty to provide opinions on a wide range of conditions and are a vital part of the ABN.
Over the last 12 months these hard-working neurologists have commented on over 50 requests for opinions on new treatments, quality standards and technologies and have provided experts to around 10 meetings. They...]]>
I suspect most PN readers have long enough memories to remember the BSE crisis in the UK and even John Gummer the MP who was pictured feeding his 4 year-old daughter a hamburger at the height of the panic. Therefore any endemic prion based disorder which may jump species to species (particularly in a post-COVID world) is alarming. Chronic wasting disease (CWD) has a predilection the cervid family: deer, elk, moose, caribou and reindeer. It is a fatal neurological disorder that produces drooling, lethargy, with animals emaciated, stumbling and with a blank stare that earned CWD the monicker ‘zombie deer disease’. Yellowstone national park, a byword for unspoiled beauty, has had its first confirmed case of CWD in a deer. How long before there is a spillover event from venison that could be costing us dear?