{"title":"Editors’ commentary","authors":"Philip Smith, Geraint N Fuller","doi":"10.1136/pn-2024-004348","DOIUrl":null,"url":null,"abstract":"Even experienced neurologists must sometimes step back from a difficult clinical problem, take out the surgical sieve from their metaphorical cupboard, and check they are not missing something. The sieve provides a reminder that alongside the more common explanations we should also consider toxic, environmental and metabolic causes. In this issue, Freddie Vonberg and Peter Blain fill these gaps with a systems-based review of occupational and environmental neurotoxicology (page 357). Neurotoxic syndromes can manifest at all levels of the nervous system, from grey matter encephalopathies and leukodystrophy to myopathies and autonomic neuropathies. They can arise following acute or long-term exposure so may have the full range of clinical time courses. Some have specific treatments, but identifying and removing the exposure is essential for all. Metabolic conditions are rare and an increasing number are treatable. This is illustrated by a patient with arginine:glycine amidinotransferase deficiency (page 413), …","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PRACTICAL NEUROLOGY","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/pn-2024-004348","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Even experienced neurologists must sometimes step back from a difficult clinical problem, take out the surgical sieve from their metaphorical cupboard, and check they are not missing something. The sieve provides a reminder that alongside the more common explanations we should also consider toxic, environmental and metabolic causes. In this issue, Freddie Vonberg and Peter Blain fill these gaps with a systems-based review of occupational and environmental neurotoxicology (page 357). Neurotoxic syndromes can manifest at all levels of the nervous system, from grey matter encephalopathies and leukodystrophy to myopathies and autonomic neuropathies. They can arise following acute or long-term exposure so may have the full range of clinical time courses. Some have specific treatments, but identifying and removing the exposure is essential for all. Metabolic conditions are rare and an increasing number are treatable. This is illustrated by a patient with arginine:glycine amidinotransferase deficiency (page 413), …
期刊介绍：
The essential point of Practical Neurology is that it is practical in the sense of being useful for everyone who sees neurological patients and who wants to keep up to date, and safe, in managing them. In other words this is a journal for jobbing neurologists - which most of us are for at least part of our time - who plough through the tension headaches and funny turns week in and week out. Primary research literature potentially relevant to routine clinical practice is far too much for any neurologist to read, let alone understand, critically appraise and assimilate. Therefore, if research is to influence clinical practice appropriately and quickly it has to be digested and provided to neurologists in an informative and convenient way.
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