Category Archives: Neurology

Multiple sclerosis

(Notes on the BMJ module regarding NICE guidelines) Presentation There wasn’t much on this, but common presentations include: Optic neuritis (loss of/reduction of vision in one eye, associated with aching) Double vision Ascending sensory disturbance (e.g. from feet to abdomen), … Continue reading

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Diagnosing tremor

I wanted to brush up on my knowledge here, so I checked out the BMJ Learning module on Parkinson’s diagnosis, which led me to this BMJ article. I also had to look for more details on some of the points, … Continue reading

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Palliative care in Parkinson’s disease

Sleep disturbances are common, for various reasons (painful spasms, changes in levodopa levels, some anti-Parkinson’s meds acting as stimulants, day-night reversal in dementia). One useful tip is to avoid high-protein meals late in the evening, which can affect levodopa levels. … Continue reading

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Spasticity and pain in multiple sclerosis

Spasticity 1st-line treatments advised by NICE guidelines are Baclofen or Gabapentin (the latter is off-licence; titrate up carefully from the lowest dose). Titrate up until symptoms relieved; up to maximum dose, if necessary and tolerated. If necessary, the two can … Continue reading

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Raised intracranial pressure

(This was from an article in an old BMJ; I read it while doing some catching up.) Symptoms Headache: usually worsens over weeks, but sometimes over hours or days. Note that two-thirds of sufferers will not have the classic ‘worse … Continue reading

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Degenerative cervical myelopathy

This is the new name for the conditon formerly known as cervical spondylotic myelopathy, and is spinal cord dysfunction from compression in the neck due to degenerative change (disc herniation, ligament hypertrophy/ossification, osteophyte formation). Presentation Gradual onset and worsening of … Continue reading

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Migraine in pregnancy

The good news is that pre-existing migraine often gets better in pregnancy, especially migraine without aura and premenstrual migraine. However, it’s important to know a) how to treat it when it occurs and b) how to avoid confusing more dangerous … Continue reading

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