Practical Neurology 

About: Practical Neurology is an academic journal published by BMJ. The journal publishes majorly in the area(s): Medicine & Population. It has an ISSN identifier of 1474-7758. Over the lifetime, 1707 publications have been published receiving 18232 citations.

Reversible cerebral vasoconstriction syndrome

Abstract: Reversible cerebral vasoconstriction syndrome is characterised by severe headaches with or without seizures and focal neurological deficits, and constriction of cerebral arteries which resolves spontaneously in 1-3 months. It affects females slightly more than males, and mean age of onset is around 45 years. Approximately 60% of cases are secondary, mainly postpartum and after exposure to vasoactive substances. The major complications are localised cortical subarachnoid haemorrhage (22%) and parenchymal ischaemic or haemorrhagic strokes (7%) which may leave permanent sequelae. Diagnosis requires the demonstration of the "string of beads" appearance of cerebral arteries on angiography, with complete or almost complete resolution on repeat angiography 12 weeks after onset. Nimodipine seems to reduce thunderclap headaches within 48 h but has no definite effect on the haemorrhagic and ischaemic complications.

Statistical Parametric Mapping

Abstract: INTRODUCTION Neurologists nowadays regularly encounter statistical parametric mapping in journal articles that report the results of a functional neuroimaging study. The number of such studies has risen dramatically in the last decade, and an understanding of how typical functional MRI (fMRI) experiments are analysed will help the clinician critically reading the literature. Functional imaging studies are typically undertaken to compare brain responses either from a single population in two different conditions (for example, healthy volunteers in the presence vs. the absence of a flickering visual stimulus), or from two populations (for example, neurological patients performing a task vs. control subjects performing the same task). THE BASIC IDEA Brain responses are recorded using an imaging technique such as fMRI, which allows the repeat-ed measurement of brain activity at hundreds of thousands of points, or voxels, throughout the brain (Fig. 1). Each voxel represents physiological responses from a small anatomical portion of

Foot drop: where, why and what to do?

Abstract: Foot drop is a common and distressing problem that can lead to falls and injury. Although the most frequent cause is a (common) peroneal neuropathy at the neck of the fibula, other causes include anterior horn cell disease, lumbar plexopathies, L5 radiculopathy and partial sciatic neuropathy. And even when the nerve lesion is clearly at the fibular neck there are a variety of causes that may not be immediately obvious; habitual leg crossing may well be the most frequent cause and most patients improve when they stop this habit. A meticulous neurological evaluation goes a long way to ascertain the site of the lesion. Nerve conduction and electromyographic studies are useful adjuncts in localising the site of injury, establishing the degree of damage and predicting the degree of recovery. Imaging is important in establishing the cause of foot drop be it at the level of the spine, along the course of the sciatic nerve or in the popliteal fossa; ultrasonography, CT and MR imaging are all useful. For patients with a severe foot drop of any cause, an ankle foot orthosis is a helpful device that enables them to walk better and more safely.

The posterior reversible encephalopathy syndrome: what's certain, what's new?

Abstract: The posterior reversible encephalopathy syndrome is an increasingly recognised disorder. Most patients have several symptoms; seizures are the most frequent, often multiple or status epilepticus. A combination of seizures, visual disturbance and/or headache, in particular, should lead to an early brain MRI to reveal the typical pattern of bilateral hyperintensities on fluid attenuated inversion recovery imaging, predominantly in the parieto-occipital region. There seem to be many possible triggers, including abrupt arterial hypertension, impaired renal function, pregnancy, immunosuppressive therapies and various inflammatory conditions. The clinical outcome is excellent, with recovery within a few days, while the MRI abnormalities resolve much more slowly. Little is known about the best management. Seizures do not normally progress to chronic epilepsy so antiepileptic drugs should be discontinued after about 3 months.

The Mayo Clinic experience.

Abstract: Neurological illness brings pathos and shock but also an element of humanism. Thus, neurological disorders and their vicissitudes—in particular, the more disabling afflictions—speak to the imagination of book and screen writers. We wish to describe our experience of these art forms within the Neurology Book and Film Club at Mayo Clinic, Rochester, USA. Our ‘club’ was initiated in 2010 by neurology residents and is supported and attended by residents, fellows and consultant staff. We hold a monthly event to discuss a book or movie with a neurological theme, suggested and voted upon by attendees (figure 1). Currently, each participant buys or loans the book. The event rotates between residents’ and consultants’ homes. The experience of cinema requires optimal display of sight and sound, and …