Aida Suárez-González, Nathalie Bier, Hélène Sauvageau, Victoria S Pelak, Samrah Ahmed
Posterior cortical atrophy is an uncommon type of dementia often caused by Alzheimer's disease and characterised by progressive loss of visuospatial and perceptual abilities. Although there is no curative treatment, patients may benefit from a range of symptom-based techniques and strategies to address visuospatial deficits and apraxia, and to reduce disability. Specific techniques based on visual and tactile cues, adapted and assistive equipment, environmental modifications and skill training may help people with posterior cortical atrophy continue to carry on activities that are important to them. We share vignettes from patients treated in our clinics to illustrate the practical delivery and potential impact of these therapies.
{"title":"Cognitive rehabilitation in posterior cortical atrophy.","authors":"Aida Suárez-González, Nathalie Bier, Hélène Sauvageau, Victoria S Pelak, Samrah Ahmed","doi":"10.1136/pn-2024-004259","DOIUrl":"10.1136/pn-2024-004259","url":null,"abstract":"<p><p>Posterior cortical atrophy is an uncommon type of dementia often caused by Alzheimer's disease and characterised by progressive loss of visuospatial and perceptual abilities. Although there is no curative treatment, patients may benefit from a range of symptom-based techniques and strategies to address visuospatial deficits and apraxia, and to reduce disability. Specific techniques based on visual and tactile cues, adapted and assistive equipment, environmental modifications and skill training may help people with posterior cortical atrophy continue to carry on activities that are important to them. We share vignettes from patients treated in our clinics to illustrate the practical delivery and potential impact of these therapies.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"40-44"},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630220","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}
Alvaro Urbaneja, David Gimeno, Carlos Velasquez, Ruben Martin, Patricia Lopez Gomez
{"title":"Bulbar oedema complicating surgery for Chiari malformation.","authors":"Alvaro Urbaneja, David Gimeno, Carlos Velasquez, Ruben Martin, Patricia Lopez Gomez","doi":"10.1136/pn-2024-004245","DOIUrl":"10.1136/pn-2024-004245","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"78-79"},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141322","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}
Gabriela Petersen, Mónica Edith Salmerón-Mercado, Karla Madrigal-Rentería, Alexandra Díaz-Alba, Víctor García-Navarro
A middle-aged man had classical clinical and radiographical features of spontaneous intracranial hypotension, refractory to conservative management. His medical history included antiphospholipid syndrome, autoimmune thrombocytopenia and recurrent thrombotic events. To reduce his risk from epidural blood patching, we stopped his anticoagulation, but he developed thrombosis. Despite therapeutic challenges, we performed a fluoroscopically guided epidural blood patch successfully at multiple levels, with significant symptom and radiological improvement maintained at 9 months. We review the place of epidural blood patching in people with spontaneous intracranial hypotension who either take anticoagulants or have coexisting blood disorders.
{"title":"Epidural blood patching in an anticoagulated patient with intracranial hypotension.","authors":"Gabriela Petersen, Mónica Edith Salmerón-Mercado, Karla Madrigal-Rentería, Alexandra Díaz-Alba, Víctor García-Navarro","doi":"10.1136/pn-2024-004218","DOIUrl":"10.1136/pn-2024-004218","url":null,"abstract":"<p><p>A middle-aged man had classical clinical and radiographical features of spontaneous intracranial hypotension, refractory to conservative management. His medical history included antiphospholipid syndrome, autoimmune thrombocytopenia and recurrent thrombotic events. To reduce his risk from epidural blood patching, we stopped his anticoagulation, but he developed thrombosis. Despite therapeutic challenges, we performed a fluoroscopically guided epidural blood patch successfully at multiple levels, with significant symptom and radiological improvement maintained at 9 months. We review the place of epidural blood patching in people with spontaneous intracranial hypotension who either take anticoagulants or have coexisting blood disorders.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"60-62"},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141325","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}
Maria Eduarda Slhsessarenko Fraife Barreto, João Victor Cabral Correia, Marianna P M de Moraes, Nathália Lopes da Silva, José Luiz Pedroso, Orlando G P Barsottini
{"title":"Acute spinal cord compression due to extramedullary haematopoiesis.","authors":"Maria Eduarda Slhsessarenko Fraife Barreto, João Victor Cabral Correia, Marianna P M de Moraes, Nathália Lopes da Silva, José Luiz Pedroso, Orlando G P Barsottini","doi":"10.1136/pn-2024-004270","DOIUrl":"10.1136/pn-2024-004270","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"82-83"},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366843","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":"Stroke is not optional for neurologists.","authors":"Matthew C Kiernan, Stephen M Davis","doi":"10.1136/pn-2024-004230","DOIUrl":"10.1136/pn-2024-004230","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"2-3"},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440945","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}
Viva Levee, Karthikeyan Sivaganesh, Andrew Schaeffer, Kushan Karunaratne
A 21-year-old woman developed explosive new-onset refractory status epilepticus when 18 weeks pregnant. She had been previously well with no history of seizures and a normal developmental history. She had initially presented with focal impaired awareness seizures but subsequently developed status epilepticus requiring intensive care unit admission and was successfully treated with multiple anti-seizure medications. Once stabilised she was stepped down to the inpatient neurology ward and then transferred to the tertiary centre for a planned late termination of pregnancy, which was the patient's choice. Following transfer, she again developed refractory status epilepticus, requiring intensive care readmission. Subsequent investigations identified a compound heterozygous POLG genetic mutation. We discuss the challenges in the acute clinical situation and important considerations in the diagnosis and management of POLG-related epilepsy.
{"title":"POLG epilepsy presenting as new-onset refractory status epilepticus (NORSE) in pregnancy.","authors":"Viva Levee, Karthikeyan Sivaganesh, Andrew Schaeffer, Kushan Karunaratne","doi":"10.1136/pn-2024-004232","DOIUrl":"10.1136/pn-2024-004232","url":null,"abstract":"<p><p>A 21-year-old woman developed explosive new-onset refractory status epilepticus when 18 weeks pregnant. She had been previously well with no history of seizures and a normal developmental history. She had initially presented with focal impaired awareness seizures but subsequently developed status epilepticus requiring intensive care unit admission and was successfully treated with multiple anti-seizure medications. Once stabilised she was stepped down to the inpatient neurology ward and then transferred to the tertiary centre for a planned late termination of pregnancy, which was the patient's choice. Following transfer, she again developed refractory status epilepticus, requiring intensive care readmission. Subsequent investigations identified a compound heterozygous POLG genetic mutation. We discuss the challenges in the acute clinical situation and important considerations in the diagnosis and management of POLG-related epilepsy.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"56-59"},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113094","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":"What is rehabilitation?","authors":"Siobhan M Leary, Valerie L Stevenson","doi":"10.1136/pn-2024-004384","DOIUrl":"10.1136/pn-2024-004384","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":"4-5"},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630174","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}
Sowmya Saravanan, Rajeswari Aghoram, Sunil K Narayan, Jayaram Saibaba, R Madhan
Young people with stroke require detailed investigation because uncommon causes are more likely. A 19-year-old woman presented with multiple cortical and subcortical infarcts, arterial aneurysms, anaemia and hypertension. Further evaluation identified a systemic vasculopathy secondary to a deficiency of adenosine deaminase 2, a rare treatable monogenic disorder.
{"title":"Central nervous system vasculopathy: inherited or acquired? The DADA2 conundrum.","authors":"Sowmya Saravanan, Rajeswari Aghoram, Sunil K Narayan, Jayaram Saibaba, R Madhan","doi":"10.1136/pn-2024-004441","DOIUrl":"https://doi.org/10.1136/pn-2024-004441","url":null,"abstract":"<p><p>Young people with stroke require detailed investigation because uncommon causes are more likely. A 19-year-old woman presented with multiple cortical and subcortical infarcts, arterial aneurysms, anaemia and hypertension. Further evaluation identified a systemic vasculopathy secondary to a deficiency of adenosine deaminase 2, a rare treatable monogenic disorder.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956446","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}
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