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Focal, generalised epilepsy or both? 局灶性、全身性癫痫还是两者兼有？
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2024-004290
Aidan Neligan, Umesh Vivekananda, Josemir W Sander
{"title":"Focal, generalised epilepsy or both?","authors":"Aidan Neligan, Umesh Vivekananda, Josemir W Sander","doi":"10.1136/pn-2024-004290","DOIUrl":"10.1136/pn-2024-004290","url":null,"abstract":"<p><p>A 29-year-old woman presented with a witnessed convulsion, with semiology consistent with a focal-to-bilateral tonic-clonic seizure. Routine EEG supported a syndromic diagnosis of idiopathic generalised epilepsy with photosensitivity. We discuss the clinical utility of seizure semiology, highlighting the caveat that over-reliance or sole reliance on the ictal semiology may result in an erroneous diagnosis of focal epilepsy in someone with a generalised epilepsy.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"349-351"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tetrodotoxin toxicity: an increasing threat. 河豚毒素中毒：威胁与日俱增。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2024-004368
Emily Burton, Alastair Ward, Lachlan Tamlin, Shaddy El-Masri, Rudy Goh, Roula Ghaoui, Stephen Bacchi
{"title":"Tetrodotoxin toxicity: an increasing threat.","authors":"Emily Burton, Alastair Ward, Lachlan Tamlin, Shaddy El-Masri, Rudy Goh, Roula Ghaoui, Stephen Bacchi","doi":"10.1136/pn-2024-004368","DOIUrl":"10.1136/pn-2024-004368","url":null,"abstract":"<p><p>A man aged in his sixties presented to the emergency department with vomiting, dizziness and generalised weakness preceded by perioral and peripheral paraesthesias for several hours. He did not speak English and was visiting from overseas. Examination revealed multidirectional nystagmus, subtle bilateral ptosis, marked bilateral upper limb dysmetria and heel-shin ataxia, with mild proximal limb weakness. Brain imaging was unremarkable. Further history revealed the man had gone fishing and eaten a fish he had caught earlier that day. He was subsequently diagnosed with tetrodotoxin toxicity from pufferfish ingestion. He was managed supportively and made a complete recovery. Tetrodotoxicity has been hitherto considered rare outside of Southeast Asia, but rising water temperatures and human interventions have facilitated the migration of marine species containing tetrodotoxin to a wider geographical range.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"377-379"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Minor head trauma precipitating acute syndromes in neurogenetic disease. 神经遗传疾病中轻微头部创伤引发急性综合征。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2024-004312
Mitchell Joseph Lycett, Kishore Raj Kumar, Robert Boland-Freitas, Karl Ng
{"title":"Minor head trauma precipitating acute syndromes in neurogenetic disease.","authors":"Mitchell Joseph Lycett, Kishore Raj Kumar, Robert Boland-Freitas, Karl Ng","doi":"10.1136/pn-2024-004312","DOIUrl":"10.1136/pn-2024-004312","url":null,"abstract":"<p><p>Most minor head injuries have no immediate neurological sequelae. We present a case where acute neurological symptoms followed a very minor head injury, and an underlying genetic cause was identified. We highlight the role that head injuries, even when innocuous, may have in precipitating and worsening a neurogenetic disorder.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"370-372"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Susac's syndrome: diagnostic challenges. 苏萨克综合征：诊断挑战。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2024-004462
Khuloud Elsabbagh, Mai Elrayes, Amit Herwadkar, Amira Stylianides, David Gosal, Nazar Sharaf
{"title":"Susac's syndrome: diagnostic challenges.","authors":"Khuloud Elsabbagh, Mai Elrayes, Amit Herwadkar, Amira Stylianides, David Gosal, Nazar Sharaf","doi":"10.1136/pn-2024-004462","DOIUrl":"10.1136/pn-2024-004462","url":null,"abstract":"<p><p>A 39-year-old woman presented with headaches, slurred speech, facial weakness and brief altered sensations, together with non-specific visual disturbances, unsteadiness and falls. Despite initial treatment with intravenous methylprednisolone, her condition worsened with cognitive decline, confusion, ataxia and incontinence. We diagnosed Susac's syndrome having excluded other causes. Her management was difficult, taking 4 months to achieve remission with corticosteroids, rituximab, cyclophosphamide and intravenous immunoglobulin (Ig). She continues to be on aspirin, intravenous Ig and mycophenolate mofetil to maintain remission, with cyclophosphamide planned for possible relapses.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"352-355"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Convexity subarachnoid haemorrhage from a cerebral dural arteriovenous fistula presenting with low back pain. 脑膜动静脉瘘引起的凸出性蛛网膜下腔出血，表现为腰痛。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2024-004339
Jasmin Chau Minh Le, Jeng Swen Ng, Stephen Bacchi, Michael J Waters, Thomas Kimber
{"title":"Convexity subarachnoid haemorrhage from a cerebral dural arteriovenous fistula presenting with low back pain.","authors":"Jasmin Chau Minh Le, Jeng Swen Ng, Stephen Bacchi, Michael J Waters, Thomas Kimber","doi":"10.1136/pn-2024-004339","DOIUrl":"10.1136/pn-2024-004339","url":null,"abstract":"<p><p>Convexity subarachnoid haemorrhage (SAH) has many possible causes. A 76-year-old man presented with back pain, left leg weakness, and hypertension. His brain imaging showed convexity SAH, with additional intraventricular blood and extensive spinal SAH from T3-S2. Following deterioration from a probable further haemorrhage, with development of left foot myoclonus, a spinal digital subtraction angiogram was normal but cerebral angiogram identified a cerebral dural arteriovenous fistula, which was successfully embolised. Convexity SAH has a heterogeneous clinical presentation and dural arteriovenous fistula is a potential cause.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"363-365"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurological aspects of electrolyte disorders. 电解质紊乱的神经学方面。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2023-003801
Robin S Howard, Aravindhan Baheerathan, Rachel Brown, Jennifer Spillane, Manprit Waraich
{"title":"Neurological aspects of electrolyte disorders.","authors":"Robin S Howard, Aravindhan Baheerathan, Rachel Brown, Jennifer Spillane, Manprit Waraich","doi":"10.1136/pn-2023-003801","DOIUrl":"10.1136/pn-2023-003801","url":null,"abstract":"<p><p>Electrolyte disorders are common in clinical practice and can occur as a consequence of primary neurological disease or as a complication of general medical disorders or critical illness. They may affect fluid shifts, cause disordered transmembrane potential or disrupt neurotransmission. Disorders of sodium, potassium, calcium, phosphate and magnesium metabolism are associated with a range of neurological complications that cause neuromuscular and central neurological disturbance. It is important to distinguish between acute and chronic hyponatraemia because prevention of long-term complications depends on appropriate management. Acute hyponatraemia can rarely cause cerebral oedema, seizures or encephalopathy. Potassium metabolism disorders are associated with cardiac and neuromuscular abnormalities. Calcium derangement can give neurological manifestations that range from mild and non-specific symptoms to encephalopathy. Phosphate and magnesium disturbances are particularly associated with neuromuscular weakness and are important causes of respiratory impairment and failure to wean from ventilatory support in critically ill patients.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"303-312"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Somatosensory evoked potentials: technique, interpretation and clinical applications. 体感诱发电位：技术、解释及临床应用。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2024-004179
Aicee Dawn Calma, James Triplett, Steve Vucic, Con Yiannikas
{"title":"Somatosensory evoked potentials: technique, interpretation and clinical applications.","authors":"Aicee Dawn Calma, James Triplett, Steve Vucic, Con Yiannikas","doi":"10.1136/pn-2024-004179","DOIUrl":"10.1136/pn-2024-004179","url":null,"abstract":"<p><p>Somatosensory evoked potentials (SSEPs) are electrical potentials that measure various parts of the ascending somatosensory pathways. They are elicited through stimulating mixed nerves, with subsequent orthodromic stimulation of sensory nerves. Despite advances in imaging, SSEPs complement both the clinical examination and peripheral neurophysiological studies when assessing the functional integrity of the sensory pathways, being especially helpful when imaging is inconclusive. We describe the technique of performing SSEPs and the anatomical substrates of their waveforms, and we highlight important clinical applications both in central and peripheral nervous system disorders.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"337-344"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sniffed levamisole-adulterated cocaine mimicking acute demyelinating encephalomyelitis. 嗅吸左旋咪唑掺假可卡因模拟急性脱髓鞘性脑脊髓炎。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2024-004343
Joshua Yap, Kayla Ward, Simon Broadley
{"title":"Sniffed levamisole-adulterated cocaine mimicking acute demyelinating encephalomyelitis.","authors":"Joshua Yap, Kayla Ward, Simon Broadley","doi":"10.1136/pn-2024-004343","DOIUrl":"10.1136/pn-2024-004343","url":null,"abstract":"<p><p>A 38-year-old man developed headache, dysarthria and dysphasia after insufflation of cocaine. Brain imaging showed multiple white matter lesions, suggesting acute disseminated encephalomyelitis (ADEM), but the clinical features were atypical for demyelination. These lesions may represent a levamisole-associated vascular endotheliopathy, with a mechanism similar to posterior reversible encephalopathy syndrome. Levamisole is a no longer used chemotherapeutic agent but is a legally acquirable veterinary antihelminthic and is often used to adulterate cocaine. Given the rise in cocaine-related hospitalisations, this case raises awareness of an important ADEM mimic.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"373-376"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assisted reproduction technology in multiple sclerosis. 辅助生殖技术在多发性硬化症中的应用。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2024-004459
Ger Mullan, Stella Hughes, David Rog, Peter Brex, Ruth Dobson
{"title":"Assisted reproduction technology in multiple sclerosis.","authors":"Ger Mullan, Stella Hughes, David Rog, Peter Brex, Ruth Dobson","doi":"10.1136/pn-2024-004459","DOIUrl":"10.1136/pn-2024-004459","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"300-302"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Essential tremor: tips and tricks. 特发性震颤：提示和技巧。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2025-07-14 DOI: 10.1136/pn-2024-004094
José Lapeña-Motilva, Álvaro Sánchez-Ferro, Antonio Méndez-Guerrero, Pablo Rábano-Suárez, Julián Benito-León
{"title":"Essential tremor: tips and tricks.","authors":"José Lapeña-Motilva, Álvaro Sánchez-Ferro, Antonio Méndez-Guerrero, Pablo Rábano-Suárez, Julián Benito-León","doi":"10.1136/pn-2024-004094","DOIUrl":"10.1136/pn-2024-004094","url":null,"abstract":"<p><p>Tremors are a common reason for neurology consultations and can sometimes be a diagnostic challenge. One of the most common causes is essential tremor, which needs to be distinguished from other types of tremors, such as those found in Parkinson's disease, cerebellar disease or dystonic tremor. This categorisation is important as their treatment and prognosis differ. This review focuses on two main characteristics of tremor to help with its differential diagnosis: 'The When', or conditions that enhance the tremor, which include action, postural, intentional components and resting tremor; and 'The Where' or the body location, which includes tremor in the upper limbs, head or voice.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"313-322"},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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