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Alexia without agraphia: from infarctions to malignancies. 无书写障碍的 Alexia：从脑梗塞到恶性肿瘤。
IF 2.4 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-23 DOI: 10.1136/pn-2024-004235
Ruben Jauregui, Julia Greenberg, Philip Kuball, Dillan J Newbold, Riddhi Patel, Robert Staudinger

Alexia without agraphia is a neurological syndrome characterised by an acquired inability to read with a preserved ability to write. It is caused by the combined effect of two lesions: in the splenium of the corpus callosum and in the occipital lobe of the dominant hemisphere. Splenial lesions disconnect the language areas in the temporal and parietal lobes of the dominant hemisphere from the visual areas in the occipital cortex of the contralateral side, while lesions in the dominant occipital lobe cause homonymous hemianopia. We describe two patients with lesions affecting the splenium and dominant occipital lobe, with different causes. Together, these cases highlight the importance of performing a thorough language evaluation in patients presenting with homonymous visual field deficits, as otherwise, clinicians may overlook impairments in writing (agraphia) or reading (alexia).

无书写障碍性阅读障碍是一种神经系统综合症，其特征是后天丧失阅读能力，但书写能力得以保留。它是由胼胝体的脾脏和优势半球的枕叶这两种病变共同造成的。脾脏病变会使优势半球颞叶和顶叶的语言区与对侧枕叶皮层的视觉区分离，而优势半球枕叶的病变则会导致同向偏盲。我们描述了两名病变影响脾叶和显性枕叶的患者，他们的病因各不相同。这些病例共同强调了对出现同侧视野缺损的患者进行全面语言评估的重要性，否则临床医生可能会忽视患者在书写（书写障碍）或阅读（阅读障碍）方面的障碍。
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引用次数: 0
Brain fog. 脑雾
IF 2.4 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-20 DOI: 10.1136/pn-2024-004112
Laura McWhirter

'Brain fog' is a term that patients use increasingly frequently in the neurology clinic. We may think that we know what patients are talking about but at least some of the time we are likely to be getting it wrong. Patients use the term 'brain fog' to describe a wide range of subjective phenomena and symptoms. This paper suggests useful lines of questioning, and discusses the clinical correlates of a range of common 'brain fog' experiences.

在神经病学门诊中，"脑雾 "是一个患者使用频率越来越高的术语。我们可能认为自己知道病人在说什么，但至少在某些时候我们很可能搞错了。患者使用 "脑雾 "一词来描述各种主观现象和症状。本文提出了一些有用的提问思路，并讨论了一系列常见 "脑雾 "体验的临床相关性。
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引用次数: 0
Neurological Birdsong by Andrew Lees 神经学鸟鸣》，安德鲁-利斯著
IF 2.8 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-18 DOI: 10.1136/pn-2024-004347
Judith Clarke, Phil E Smith
Cardiff Neurology book club recently met during a working lunchtime; the more informal setting than an evening in a consultant’s home attracting a broader range of seniority and specialty than usual. The book choice, a compendium of tweets (up to 280 characters) also proved more manageable. Professor Lees is best known as a clinical neurologist and researcher into Parkinson’s disease, and for years has been a neurology voice on Twitter (now X). Neurological Birdsong is a selection of these, giving insights, personal anecdotes and professional experiences, all alluding to neurology, and invariably anchored in patient care. The seniors in our group already knew well of Professor Lees’ fascination for neurology, evident throughout the book and his commitment to sound clinical method. His clear passion for and knowledge of literature also shines through, drawing insightful correlations from a wide range of authors and poets …
卡迪夫神经病学读书俱乐部最近在一个工作午餐时间举行了会议；与晚上在顾问家中举行的会议相比，这种非正式的场合吸引了比往常更广泛的资历和专业范围。事实证明，书的选择--推文汇编（最多 280 个字符）--也更容易管理。利斯教授最著名的身份是临床神经学家和帕金森病研究员，多年来一直是推特（现在是 X）上的神经学代言人。Neurological Birdsong》是其中的精选集，内容包括独到见解、个人轶事和专业经验，所有内容都与神经病学有关，并且无一例外地以病人护理为基础。利斯教授对神经病学的痴迷已为我们小组的前辈们所熟知，这一点在全书中显而易见，而他对合理临床方法的坚持也是有目共睹的。他对文学的热情和知识也熠熠生辉，从众多作家和诗人的作品中引申出深刻的关联...
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引用次数: 0
Genetic testing in dementia 痴呆症基因检测
IF 2.8 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-17 DOI: 10.1136/pn-2024-004241
Antoinette O'Connor, Natalie S Ryan, Christopher R S Belder, David S Lynch, Nayana Lahiri, Henry Houlden, Jonathan D Rohrer, Nick C Fox, Sean O'Dowd
There is growing public awareness and concern regarding dementia risk. In addition, genetic testing is increasingly accessible and is at the point of being integrated into routine clinical practice. As a result, there is a pressing need for treating clinicians to have the appropriate knowledge base to request and consent for diagnostic genetic testing in cognitive clinics. We outline our approach to genetic testing in patients with Alzheimer’s disease, frontotemporal dementia, dementia with Lewy bodies and vascular cognitive impairment. We discuss when to consider testing, the consenting process, and the interpretation and communication of genetic test results. No data are available.
公众对痴呆症风险的认识和关注与日俱增。此外，基因检测也越来越容易获得，并且正处于融入常规临床实践的阶段。因此，临床医生迫切需要具备相应的知识基础，以便在认知诊所申请并同意进行诊断性基因检测。我们概述了对阿尔茨海默病、额颞叶痴呆症、路易体痴呆症和血管性认知障碍患者进行基因检测的方法。我们讨论了何时考虑进行检测、同意过程以及基因检测结果的解释和交流。暂无数据。
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引用次数: 0
Localisation of function in the brain: a rethink 大脑功能定位：反思
IF 2.8 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-17 DOI: 10.1136/pn-2023-003773
Michael O'Sullivan
A modular view of brain function dominates the teaching of medical students and clinical psychologists and is implicit in day-to-day clinical practice. This view glosses over a long-standing debate. The extent of one-to-one mappings between region and function remains a controversial topic. For the cortex, localisation of function versus ‘cerebral equipotentiality’ was debated less than 150 years ago, and traces of this debate remain active in systems neuroscience today. The advent of functional brain imaging led to an explosion of evidence on localisation of function studied in vivo, and a gold rush to map an ever-increasing range of ‘functions’. Rapid growth in knowledge was accompanied, to some extent, by a flourishing neuromythology. There are currently few clinical applications of brain mapping techniques, but new areas are emerging. An understanding of the central debate on functional localisation will bring a more nuanced view of problems encountered in clinical practice. No data are available.
在医科学生和临床心理学家的教学中，大脑功能的模块化观点占据主导地位，并隐含在日常临床实践中。这种观点掩盖了一个长期存在的争论。区域和功能之间一一对应的程度仍然是一个有争议的话题。就皮层而言，功能定位与 "脑等同性 "的争论不到 150 年前就已开始，这一争论的痕迹至今仍活跃在系统神经科学领域。脑功能成像技术的出现导致了体内功能定位研究证据的爆炸式增长，以及绘制范围越来越广的 "功能 "地图的淘金热。知识的快速增长在一定程度上伴随着神经选学的蓬勃发展。目前，脑图绘制技术在临床上的应用还很少，但新的领域正在出现。了解关于功能定位的核心争论将为临床实践中遇到的问题带来更细致的看法。暂无数据。
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引用次数: 0
Neurological eponyms? Take your Pick 神经学地名？请选择
IF 2.8 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-17 DOI: 10.1136/pn-2024-004314
Jason D Warren
The neuropsychiatrist Arnold Pick (1851–1924) lent his name to a disease, but in his centenary year, it is timely to ask whether this and the many other eponyms that populate neurology are more help than hindrance. Here, I survey some neurological eponyms, propose criteria for judging their helpfulness (and unhelpfulness) and consider their future prospects in our increasingly mechanistic, contemporary neurological practice. All data relevant to the study are included in the article or uploaded as online supplemental information.
神经精神病学家阿诺德-皮克（Arnold Pick，1851-1924 年）用自己的名字命名了一种疾病，但在他百年诞辰之际，我们应该问一问，这个名字以及神经病学中的许多其他外来语是否更有帮助而非阻碍。在此，我对一些神经病学的外来语地名进行了调查，提出了判断其有用性（和无用性）的标准，并考虑了它们在我们日益机械化的当代神经病学实践中的前景。所有与研究相关的数据均包含在文章中或作为在线补充信息上传。
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引用次数: 0
Acute monocular visual loss: time to call the stroke team? 急性单眼视力丧失：是时候呼叫卒中团队了吗？
IF 2.4 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-13 DOI: 10.1136/pn-2023-003998
Jacob Day, Housam Monla-Haidar, Vasant Raman, Stuart Weatherby

A man in his 90s presented with acute monocular loss of vision; the emergency department triage alerted the stroke team. He underwent urgent parallel assessments by the stroke and ophthalmology teams and was diagnosed with central retinal artery occlusion. The ultimate decision was made to manage him conservatively, rather than with intravenous thrombolysis, and his visual function has remained poor. We discuss the current evidence for using intravenous thrombolysis in people with central retinal artery occlusion and use this case to exemplify the practical issues that must be overcome if ongoing randomised clinical trials of central retinal artery occlusion confirm a definite benefit from using intravenous thrombolysis.

一名 90 多岁的男子出现急性单眼视力丧失，急诊科分诊人员向中风小组发出警报。中风小组和眼科小组同时对他进行了紧急评估，诊断为视网膜中央动脉闭塞。最终决定对他进行保守治疗，而不是静脉溶栓，但他的视功能仍然很差。我们讨论了在视网膜中央动脉闭塞患者中使用静脉溶栓治疗的现有证据，并以该病例为例说明，如果正在进行的视网膜中央动脉闭塞随机临床试验证实使用静脉溶栓治疗确实有益，那么就必须克服实际问题。
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引用次数: 0
Methotrexate for the neurologist. 给神经科医生的甲氨蝶呤
IF 2.4 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-13 DOI: 10.1136/pn-2024-004156
Aaron Jesuthasan, Aravindhan Baheerathan, Stephen Auger, Rachel Dorsey, Robina Coker, Nowlan Selvapatt, Stuart Viegas

The use of methotrexate in clinical practice has expanded significantly in recent years, as an effective chemotherapeutic agent as well as disease-modifying treatment for conditions such as rheumatoid arthritis, psoriasis and Crohn's disease. It is also used as a steroid-sparing agent for a range of inflammatory diseases of the central and peripheral nervous systems. Clinical neurologists must, therefore, know how to start and uptitrate methotrexate, its monitoring requirements and its potential toxicities. This review aims first to explore the evidence base for using methotrexate in various neurological diseases and second to discuss important practicalities around its use, ensuring its safe application and appropriate monitoring.

近年来，甲氨蝶呤作为一种有效的化疗药物以及类风湿性关节炎、银屑病和克罗恩病等疾病的改变病情治疗药物，在临床实践中的应用已大大扩展。此外，它还被用作中枢神经系统和外周神经系统一系列炎症疾病的类固醇备用药。因此，临床神经科医生必须了解如何开始和加大甲氨蝶呤的剂量、其监测要求和潜在毒性。本综述的目的首先是探讨在各种神经系统疾病中使用甲氨蝶呤的证据基础，其次是讨论有关甲氨蝶呤使用的重要实际问题，确保其安全应用和适当监测。
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引用次数: 0
General internal medicine: a neurology registrar's guide to making the most of medical attachments. 普通内科：神经病学注册医师充分利用医学实习的指南》。
IF 2.4 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-13 DOI: 10.1136/pn-2024-004204
Neil Watson
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引用次数: 0
Persistent tongue protrusion dystonia after cerebral infarction. 脑梗塞后持续性舌前伸肌张力障碍
IF 2.4 Q2 CLINICAL NEUROLOGY
PRACTICAL NEUROLOGY
Pub Date : 2024-09-13 DOI: 10.1136/pn-2024-004120
Rana Alnasser Alsukhni, Hamsaraj Shetty, Tom A T Hughes
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