Practical Neurology Podcast

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the February issue of the journal. Read more on the PN website: https://pn.bmj.com/content/21/1/1 The full issue here: https://pn.bmj.com/content/21/1

Dr Tom Hughes, Department of Neurology, Cardiff, interviews Dr Luis Idrovo, Department of Neurology, Leeds, about one of the most prevalent, disabling and undertreated conditions in neurological clinical practice: headaches. They discuss the administration of peripheral nerve blocks to treat various headache disorders both in the acute and outpatient setting. Please read the related paper, which is the Editor's Choice of the February 2021 issue of the journal: https://pn.bmj.com/content/21/1/30 Please subscribe to the Practical Neurology podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify.

Practical Neurology Editors Phil Smith and Geraint Fuller talk you through the highlights of the December issue of the journal. Read more on the PN website: https://pn.bmj.com/content/20/6/427 The full issue here: https://pn.bmj.com/content/20/6

In the return of the Practical Neurology Podcast, Dr Tom Hughes interviews Dr Saúl Reyes, Consultant Neurologist at the Blizard Institute, and The London School of Medicine and Dentistry, Queen Mary University of London, UK. They discuss the important issues regarding what vaccinations people with MS should have, and when they should have them in relation to their immunosuppressant drugs. Read the accompanying paper on the Practical Neurology's November issue and online at http://dx.doi.org/10.1136/practneurol-2020-002527 Please subscribe via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify.

Essential tremor is the most common form of tremor in humans. In this podcast, Dr Tom Hughes, Practical Neurology Associate Editor, interviews Dr Elan D Louis, Yale Neurology, Division of Movement Disorders, New Haven, CT, who’s the author of a recent paper called, ‘Essential tremor: a nuanced approach to the clinical features’. They discuss this condition, not always easy to diagnose, and the distinction between essential tremor and Parkinson’s disease as well as dystonia. Read the paper on the Practical Neurology website: https://pn.bmj.com/content/19/5/389.

‘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