Practical Neurology Podcast

‘Query encephalitis’ is a common neurological consultation in hospitalised patients. Identifying the syndrome is only part of the puzzle. Although historically encephalitis has been almost synonymous with infection, we increasingly recognise parainfectious or postinfectious as well as other immune-mediated causes. Encephalitis must also be distinguished from other causes of encephalopathy, including systemic infection, metabolic derangements, toxins, inherited metabolic disorders, hypoxia, trauma and vasculopathies. The paper discussed in this podcast reviews the most important differential diagnoses (mimics) of patients presenting with an encephalitic syndrome and highlight some unusual presentations (chameleons) of infectious encephalitis. Listen to the conversation of Dr Tom Hughes, Practical Neurology Associate Editor, with Dr Nicholas Davies (Department of Neurology, Chelsea and Westminster Hospital, London, UK) and read the paper on the Practical Neurology website: http://dx.doi.org/10.1136/practneurol-2018-002114.

A framework to guide general neurologists in the diagnostic reassessment of people with epilepsy and complex neurological problems of unknown cause is discussed in this podcast. Dr Tom Hughes, Practical Neurology Associate Editor, is joined by Dr Lina Nashef (King’s College Hospital, London, UK), the corresponding author of the paper “Investigating adults with early-onset epilepsy and intellectual or physical disability”, which also addresses imaging, electroencephalography, genetic studies and metabolic testing. Read the paper included on the Practical Neurology April issue here: ttps://pn.bmj.com/content/19/2/115.

The basic principles of B-cell depletion with therapeutic monoclonal antibodies, the available evidence for using rituximab in neurological diseases as well as prescribing advice are discussed in this podcast. Practical Neurology Associate Editor Dr Tom Hughes is joined by Dr Daniel Whittam and Dr Anu Jacob, the authors of the review paper: “Rituximab in neurological disease: principles, evidence and practice”, which is part of the Practical Neurology February issue (https://pn.bmj.com/content/19/1/5).

What do adult neurologists need to know ahead of the likely licensing of Epidiolex for epilepsy in the UK in 2019? It is quite possible that cannabidiol, currently licensed in the USA for treating rare genetic epilepsies, may open the door for the widespread legalisation of recreational cannabis. Dr Rhys Thomas (Neurologist at the Institute of Neuroscience, Newcastle University, UK) tells fellow Practical Neurology Associate Editor Dr Tom Hughes why the arguments about who may benefit from cannabis-derived medicines have to be separate from the discussion about the legalisation of recreational cannabis. They also discuss the distinction between cannabidiol oils and the cannabidiol rigorously tested in clinical trials. Read the review on the Practical Neurology website - https://pn.bmj.com/content/early/2018/10/18/practneurol-2018-002058 - and on the journal's December 2018 issue.

Valproate is now contraindicated in pregnancy and women of child-bearing potential. The new stipulations from the Coordination Group for Mutual Recognition and Decentralised Procedures-Human (CMDh), a regulatory body representing European Union member states, about the use of valproate in women of child-bearing potential states that “Valproate should never be started unless alternative treatments are not suitable”. However, people taking this drug used to treat epilepsy should not stop valproate use abruptly, without consulting their doctor. The new regulations are discussed in this podcast by Professor Sanjay Sisodiya (UCL Institute of Neurology, London), who’s the author of a Practical Neurology editorial on this subject (http://pn.bmj.com/content/early/2018/04/19/practneurol-2018-001955). Other related articles in the Practical Neurology website: ►http://pn.bmj.com/content/early/2018/04/19/practneurol-2018-001932 ► http://pn.bmj.com/content/early/2018/04/19/practneurol-2018-001931

Professor Michael Hanna, Senior Consultant Neurologist at Queen Square, UCL, London, discusses the developments in genetics in neuromuscular diseases with Eric Hoffman, Gordon Holmes lecturer at the ABN meeting 2017, in Liverpool. Professor Eric Hoffman (Binghampton University, USA) describes in this conversation his extensive work on the rare condition of Duchenne’s muscular dystrophy. This is the last of a series of podcasts recorded at the 2017 ABN meeting, held in May, in Liverpool, UK. More on this subject on the Practical Neurology website: http://pn.bmj.com/, where you can find these particular articles as well: "Muscle disease" - http://pn.bmj.com/content/9/1/54; "Muscle diseases: mimics and chameleons" - http://pn.bmj.com/content/14/5/288.

Nodding syndrome affects children from 5 to 15 years old in some parts of the African continent. In this podcast, David Nicholl, Department of Neurology, City Hospital, Birmingham, UK, is joined by Mark Ellul, ABN fellow, University of Liverpool, UK, to discuss the latest research in this epileptic disorder. They talked at the Association of British Neurologists annual meeting, Liverpool, May 2017. http://pn.bmj.com/

Professor Andrew Schwartz (University of Pittsburgh, USA) discusses the latest progress toward high-performance neural prosthetics with Practical Neurology's editor Geraint Fuller. The subject was highlighted at the ABN annual meeting 2017, held in May, in Liverpool, UK. For more content on this topic please visit http://pn.bmj.com/.

At the ABN annual meeting 2017, David Burn interviews Kevin Talbot on the his talk on Antisense treatments in spinal muscular atrophy. The ABN Autumn Meeting took place on Wednesday 3rd May in Liverpool. For more content on this topic please visit: pn.bmj.com/

Based on the ABN's Autumn Meeting, Martin Turner interviews Matthew Wood on the his lecture Antisense treatments in neurological disease. The ABN Autumn Meeting took place on 20th October 2016 in London. For more content on this topic please visit: pn.bmj.com/