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Acute hand dystonia and action myoclonus unveiling diabetic striatopathy: The critical role of hyperglycemia.
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-04-01 DOI: 10.1177/14782715251332317
Subhankar Chatterjee, Ritwik Ghosh, Shambaditya Das, Samya Sengupta, Debaleena Mukherjee, Alak Pandit, Rana Bhattacharjee, Julián Benito-León, Souvik Dubey
{"title":"Acute hand dystonia and action myoclonus unveiling diabetic striatopathy: The critical role of hyperglycemia.","authors":"Subhankar Chatterjee, Ritwik Ghosh, Shambaditya Das, Samya Sengupta, Debaleena Mukherjee, Alak Pandit, Rana Bhattacharjee, Julián Benito-León, Souvik Dubey","doi":"10.1177/14782715251332317","DOIUrl":"https://doi.org/10.1177/14782715251332317","url":null,"abstract":"<p><strong>Background: </strong>Diabetic striatopathy is a rare complication of diabetes mellitus characterised by movement disorders secondary to hyperglycemia. While most commonly associated with chorea and ballism, it may also present with other hyperkinetic manifestations, including, albeit rarely, isolated dystonia and myoclonus. We report a case of a patient with poorly controlled diabetes mellitus who developed acute hand dystonia and action myoclonus, highlighting the broader spectrum of hyperglycemia-induced movement disorders.</p><p><strong>Case report: </strong>A 64-year-old male with poorly controlled type 2 diabetes mellitus presented with acute dystonic posturing of the right hand and action myoclonus of the right forearm. On admission, his blood glucose was 648 mg/dL, with a glycated hemoglobin of 13.5%. Neurological examination revealed these motor abnormalities, while brain magnetic resonance imaging showed global cortical atrophy without acute lesions. Following the initiation of insulin therapy, abnormal movement disorders resolved within 6 h as blood glucose levels decreased to 253 mg/dL.</p><p><strong>Discussion: </strong>This case highlights the importance of prompt recognition and treatment of hyperglycemia in patients with new-onset movement disorders. Diabetic striatopathy should be considered in the differential diagnosis, even in the absence of chorea or ballism, as glycemic control can lead to rapid symptom resolution. Although isolated dystonia and myoclonus in diabetic striatopathy are rare, their occurrence broadens the spectrum of hyperglycemia-induced movement disorders. Early diagnosis and management of hyperglycemia are essential for optimising patient outcomes. Further research is needed to characterise the spectrum and underlying mechanisms of diabetic striatopathy fully.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251332317"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755066","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
A neuroradiology e-mail service for a district general hospital in the COVID-19 era.
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-20 DOI: 10.1177/14782715251329141
Mary T McCullagh, Ferghal McVerry, Peter Flynn, Niall MacKenzie, Gillian Thompson, Mark O McCarron
{"title":"A neuroradiology e-mail service for a district general hospital in the COVID-19 era.","authors":"Mary T McCullagh, Ferghal McVerry, Peter Flynn, Niall MacKenzie, Gillian Thompson, Mark O McCarron","doi":"10.1177/14782715251329141","DOIUrl":"https://doi.org/10.1177/14782715251329141","url":null,"abstract":"<p><strong>Background: </strong>Hospital care for most neurological patients occurs in district general hospitals (DGHs). The COVID-19 pandemic displaced our DGH weekly neuroradiology meeting to an email service.</p><p><strong>Methods: </strong>Neuroradiological discrepancies among selected neurological patients were compared between face-to-face (f2f) meetings and an e-mail service.</p><p><strong>Results: </strong>Among 734 consecutively selected patients there was no statistically significant differences in outcomes - frequency of clinically unimportant discrepancies (10.3% e-mail vs 12.8% f2f, <i>p</i> = 0.300) or frequency of clinically important discrepancies (16.0% e-mail vs 15.6% f2f, <i>p</i> = 0.889). Among all imaged patients assessed by a neurologist, clinically important discrepancies were estimated to be 4.2% (95% CI: 3.5%-5.0%), with little annual variation (Chi-square for trend, <i>p</i> = 0.156).</p><p><strong>Conclusion: </strong>This study shows that DGH general radiology provides good quality reporting of neuroimaging, and neurologists provide a pivotal role in identifying patients who require neuroradiology second opinions. During the COVID-19 pandemic, an e-mail service maintained neuroimaging quality assurance in a DGH.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251329141"},"PeriodicalIF":1.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665065","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
The skin deep truth: Why pulse oximeters may be misleading.
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-12 DOI: 10.1177/14782715251327240
Sharang Gupta
{"title":"The skin deep truth: Why pulse oximeters may be misleading.","authors":"Sharang Gupta","doi":"10.1177/14782715251327240","DOIUrl":"https://doi.org/10.1177/14782715251327240","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251327240"},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606591","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
Using HINTS in acute vestibular syndrome: A practical guide for the acute care physician.
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-12 DOI: 10.1177/14782715251325585
Steven Aldridge, Kailash Krishnan
{"title":"Using HINTS in acute vestibular syndrome: A practical guide for the acute care physician.","authors":"Steven Aldridge, Kailash Krishnan","doi":"10.1177/14782715251325585","DOIUrl":"https://doi.org/10.1177/14782715251325585","url":null,"abstract":"<p><p>Acute vestibular syndrome (AVS) is a common clinical presentation. Common causes include peripheral, self-limiting labyrinthine disorders, but a significant proportion are caused by posterior circulation stroke (PoCS). Delineating between a peripheral versus central cause in AVS is challenging for acute care physicians, but a simple, three-step bedside test known collectively as the HINTS examination may be useful. Substantial evidence supports the use of the HINTS examination in detection of PoCS in AVS, but it is important that performer is trained and experienced to ensure reliability of the test's results. There is some evidence that video-assisted HINTS examination may help to improve HINTS performance, but further research is needed. This review is a practical guide for acute care physicians in regards to when to perform the HINTS examination, how to interpret its findings, limitations and practical considerations.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251325585"},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606594","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
The hook osteophyte (sign) in hereditary haemochromatosis.
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-12 DOI: 10.1177/14782715251327244
Noor Jawad, Ali Jawad
{"title":"The hook osteophyte (sign) in hereditary haemochromatosis.","authors":"Noor Jawad, Ali Jawad","doi":"10.1177/14782715251327244","DOIUrl":"https://doi.org/10.1177/14782715251327244","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251327244"},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606588","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
Cutaneous pigmentation and sensory ataxia in vitamin B12 deficiency.
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-12 DOI: 10.1177/14782715251325580
Sonika Garg, Biswanath Behera, Vishal Thakur, Shreya K Gowda
{"title":"Cutaneous pigmentation and sensory ataxia in vitamin B12 deficiency.","authors":"Sonika Garg, Biswanath Behera, Vishal Thakur, Shreya K Gowda","doi":"10.1177/14782715251325580","DOIUrl":"https://doi.org/10.1177/14782715251325580","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"14782715251325580"},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606586","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
Avascular necrosis of the hip post radioactive Palladium-103 seed implantation in a patient with prostate cancer. 前列腺癌患者放射性钯-103粒子植入后髋关节缺血性坏死。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2024-12-08 DOI: 10.1177/14782715241304450
Shivanee Vigneswaran, Ali S Jawad
{"title":"Avascular necrosis of the hip post radioactive Palladium-103 seed implantation in a patient with prostate cancer.","authors":"Shivanee Vigneswaran, Ali S Jawad","doi":"10.1177/14782715241304450","DOIUrl":"10.1177/14782715241304450","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"31-32"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796402","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
The reversible absence of brainstem reflexes does not mimic death by neurological criteria. 根据神经学标准，脑干反射的可逆性缺失并不代表死亡。
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2024-12-17 DOI: 10.1177/14782715241308924
Sophie Robinson, Mark A Henderson
{"title":"The reversible absence of brainstem reflexes does not mimic death by neurological criteria.","authors":"Sophie Robinson, Mark A Henderson","doi":"10.1177/14782715241308924","DOIUrl":"10.1177/14782715241308924","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"71"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839954","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
Wild & Tame: Animals in History.
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2025-02-18 DOI: 10.1177/14782715251320853
{"title":"Wild & Tame: Animals in History.","authors":"","doi":"10.1177/14782715251320853","DOIUrl":"10.1177/14782715251320853","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"81"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442431","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
Medical career transparency in the digital age, a British perspective.
IF 1.1
Journal of the Royal College of Physicians of Edinburgh Pub Date : 2025-03-01 Epub Date: 2025-01-29 DOI: 10.1177/14782715251315780
Serena Ramjee, Kwaku Duah-Asante
{"title":"Medical career transparency in the digital age, a British perspective.","authors":"Serena Ramjee, Kwaku Duah-Asante","doi":"10.1177/14782715251315780","DOIUrl":"10.1177/14782715251315780","url":null,"abstract":"","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"76-77"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061050","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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