{"title":"Cognitive screening instruments: reasons to be cheerful.","authors":"Timothy David Griffiths","doi":"10.1136/pn-2024-004389","DOIUrl":"https://doi.org/10.1136/pn-2024-004389","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630222","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}
{"title":"Cognitive screening instruments: time for retirement.","authors":"Andrew J Larner","doi":"10.1136/pn-2024-004371","DOIUrl":"https://doi.org/10.1136/pn-2024-004371","url":null,"abstract":"<p><p>Cognitive screening instruments are used daily in clinics devoted to the assessment of cognitive disorders and also in general neurology clinics where patients with complaints of memory disorder may be encountered. However, these instruments have significant theoretical and practical shortcomings that are generally overlooked or ignored. In pursuit of biological rather than nosological diagnosis, and in light of these shortcomings, I recommend that cognitive screening instruments should now be abandoned.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630225","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}
{"title":"Prolonged disorder of consciousness: giving a second opinion on the best interests of a person.","authors":"Derick T Wade","doi":"10.1136/pn-2024-004273","DOIUrl":"https://doi.org/10.1136/pn-2024-004273","url":null,"abstract":"<p><p>Patients with a prolonged disorder of consciousness have a neurological disorder. Few neurologists undertake assessment and management after the acute phase of the person's illness, even though some of their patients with progressive neurological disorders become persistently unconscious. Their clinical evaluation and deciding on their best interests require full use of a neurologist's expertise, which is intellectually, emotionally and clinically challenging. I will cover essential aspects of giving such an expert second opinion based on at least 200 cases where I have done so (and over 500 patients seen clinically).</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630237","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}
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":"https://doi.org/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":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-05","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}
{"title":"Varicella zoster vasculopathy causing recurrent ischaemic strokes in an immunocompetent patient.","authors":"Ariana Barreau, Jeffrey Lu, Blake Weis, Fadi Mikhail","doi":"10.1136/pn-2024-004335","DOIUrl":"https://doi.org/10.1136/pn-2024-004335","url":null,"abstract":"<p><p>A 66-year-old woman reported 10 days of generalised weakness, falls and memory 'glitches'. She had developed left-sided ophthalmic herpes zoster 3 months before but was otherwise well. MR scan of brain showed acute left-sided ischaemic strokes and CT cerebral angiogram identified marked stenoses of the left anterior and middle cerebral arteries. We suspected varicella-zoster virus vasculopathy, confirmed by cerebrospinal fluid analysis. Initially she had further ischaemic strokes despite intravenous acyclovir, prednisone, aspirin and clopidogrel. However, after prolonged acyclovir and prednisone, there were no new infarcts though imaging of left anterior and middle cerebral artery vessel walls showed persistent inflammation. Varicella zoster vasculopathy can cause recurrent ischaemic strokes, even in immunocompetent people with no cardiovascular risk factors, and despite long-term antiviral therapy.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584182","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}
{"title":"Neurological letter from Lithuania.","authors":"Kristijonas Puteikis, Rūta Mameniškienė","doi":"10.1136/pn-2024-004282","DOIUrl":"https://doi.org/10.1136/pn-2024-004282","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548156","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}