How to use neurochecklists as a smartphone app

Neurochecklists is currently a web-based app… But it will soon be a downloadable app. However, you don’t have to wait until then… You can use it as a smartphone app right now. Just follow our easy 3-step process… *** First step: open http://www.neurochecklists.com on your phone *** Second step: click on the highlighted ‘burger’ *** […]

via How to use neurochecklists as a smartphone app — Neurochecklists Updates

15 more creative and catchy neurology headlines for 2019

Regular visitors to this blog know that we love catchy article titles. It is always heartwarming to see how some authors create imaginative and inventive headlines. This skill involves the ability to play with words, and the capacity to be double-edged. This is why this blog keeps a lookout for fascinating neurology titles. And in line with this tradition, and in no particular order of inventiveness, here are 15 more catchy neurology titles!

By Andrikkos – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=33725735

15. Who do they think we are? Public perceptions of psychiatrists and psychologists

This paper, for some unfathomable reason, set out to ask if the public knows the difference between what psychiatrists and psychologists actually do. And the authors discovered that “there is a lack of clarity in the public mind about our roles”. More worryingly, or reassuringly (depending on your perspective), they also found out that “psychologists were perceived as friendlier and having a better rapport“. Not earth-shattering discoveries, but what a great title!

By Laurens van Lieshout – Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2059674

14. OCT as a window to the MS brain: the view becomes slightly clearer

Optical coherence tomography (OCT) is a cool tool which measures the thickness of the retinal fiber layer (RFL). And it has the habit of popping its head up in many neurological specialties. In this case, the specialty is multiple sclerosis, and the subject is how OCT influences its diagnosis and surveillance. Surely a window into the brain is easier to achieve than one into the soul.

Optical coherence tomography of my retina. Brewbooks on Flickr. https://www.flickr.com/photos/brewbooks/8463332137

13. A little man of some importance 

The homonculus is the grotesque representation of the body on the surface or cortex of the brain. This paper reviews how formidable neurosurgeons such as Wilder Penfield worked out the disproportionate dimensions of this diminutive but influential man. He (always a man for some reason) has giant hands, a super-sized mouth, very small legs, and a miniature trunk. The clever brain doesn’t readily allocate its resources to large body parts that perform no complex functions! But be warned, this article is no light-weight reading!

The Homunculus in Crystal Palace (Moncton). Mark Blevis on Flickr. https://www.flickr.com/photos/electricsky/1298772544

12. Brain-focussed ultrasound: what’s the “FUS” all about? 

This title is a play on words around MR-guided focussed ultrasound surgery (MRgFUS), an emerging technique for treating disorders such as essential tremor and Parkinson’s disease (PD). This review looks at the controversial fuss that this technique has evoked.

By Luis Lima89989 – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19162929

11. The Masks of Identities: Who’s Who? Delusional Misidentification Syndromes

This paper explores the interesting subject of delusional misidentification syndromes (DMSs). The authors argue that few concepts in psychiatry can be as confusing as DMSs. And they did an excellent job of clearing our befuddlement around delusions such as Capgras and Fregoli. Very apt title, very interesting read.

no identity. HaPe-Gera on Flickr. https://www.flickr.com/photos/hape_gera/2929195528

 

10. Waking up to sleeping sickness.

This title belongs to a review of trypanosomiasis, aka sleeping sickness. It is a superb play on words, one that evokes several levels of meaning. It is simple and yet complex at the same time. Great imagination.

https://picryl.com/media/the-sleeping-sickness-gordon-ross

09. Brains and Brawn: Toxoplasma Infections of the Central Nervous System and Skeletal Muscle

This paper discusses two parts of nervous system that are affected by toxoplasmosis. Playing on the symbolic  contradiction between intellect and strength, the authors show how toxoplasmosis is an ecumenical abuser: it metes out the same fate to both brain and brawn.

Brain vs. Brawn. Yau Hoong Tang on Flickr. https://www.flickr.com/photos/tangyauhoong/4474921735

08. Shedding light on photophobia

A slightly paradoxical title this one. Ponder on it just a little more! And then explore the excellent paper shedding light on a condition that is averse to light.

Photophobia (light sensitivity). Joana Roja on Flickr. https://www.flickr.com/photos/cats_mom/2772386028/

07. No laughing matter: subacute degeneration of the spinal cord due to nitrous oxide inhalation

Nitrous oxide, or laughing gas, is now “the seventh most commonly used recreational drug”. But those who pop it do so oblivious of the risk of subacute combined degeneration. This damage to the upper spinal cord results from nitrous oxide-induced depletion of Vitamin B1 (thiamine). Not a laughing matter at all!

Empty Laughing Gas Canisters. Promo Cymru on Flickr. https://www.flickr.com/photos/promocymru/18957223365

06. To scan or not to scan: DaT is the question

Dopamine transport (DaT) scan is a useful brain imaging tests that helps to support the diagnosis of Parkinson’s disease and other disorders which disrupt the dopamine pathways in the brain. It is particularly helpful in ruling out mimics of Parkinson’s disease such as essential tremor. When to request a DaT scan is however a tricky question in practice. This paper, with its Shakespearean twist, looks at the reliability of DaT scans.

Dopamine. John Lester on Flickr. https://www.flickr.com/photos/pathfinderlinden/211882099

05. TauBI or not TauBI: what was the question?

It should be no surprise if Shakespeare rears his head more than once in this blog post. Not when the wordsmith is such a veritable source of inspiration for those struggling to invent catchy titles. This paper looks at taupathy, a neurodegeneration as tragic as Hamlet. It particularly comments on an unusual taupathy, one induced by traumatic brain injury. Curious.

By Lafayette Photo, London – This image is available from the United States Library of Congress‘s Prints and Photographs divisionunder the digital ID cph.3g06529.This tag does not indicate the copyright status of the attached work. A normal copyright tag is still required. See Commons:Licensing for more information., Public Domain, Link

04. Mind the Brain: Stroke Risk in Young Adults With Coarctation of the Aorta

What better way to call attention to a serious complication than a catchy title like this one. This paper highlights the neurological complications of coarctation of the aorta, a serious congenital cardiovascular disease. And the key concerns here are the risks of stroke and cerebral aneurysms. Cardiologists, mind the brain!

Own work assumed (based on copyright claims)., Public Domain, https://commons.wikimedia.org/w/index.php?curid=803943

03. Diabetes and Parkinson disease: a sweet spot?

This paper reviews the unexpected biochemical links between diabetes and Parkinson’s disease. And this relationship is assuming a rather large dimension. Why, for example, are there so many insulin receptors in the power house of Parkinson’s disease, the substantia nigra? A sweet curiosity.

Insulin bubble. Sprogz on Flickr. https://www.flickr.com/photos/sprogz/5606839532

02. PFO closure for secondary stroke prevention: is the discussion closed?

The foraman ovale is a physiological hole-in-the-heart which should close up once a baby is born. A patent foramen ovale (PFO) results when this hole refuses to shut up. PFOs enable leg clots to traverse the heart and cause strokes in the brain. This paper reviews the evidence that surgically closing PFOs prevents stroke. Common sense says it should, but science demands proof. And the authors assert that they have it all nicely tied up. Hmmm.

By Kjetil Lenes – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=3705964

01. Closure of patent foramen ovale in “cryptogenic” stroke: Has the story come to an end?

Not to be beaten in the catchy title race is another brilliant PFO review article. Why do I feel the answer here is ‘no’? This is science after all.

https://www.flickr.com/photos/fliegender/293340835

 

How does aspirin influence the rupture risk of cerebral aneurysms?

Association between aspirin dose and subarachnoid hemorrhage from saccular aneurysms: a case-control study. Neurology 2018; 91:e1175-e1181. Can A, Rudy RF, Castro VM, et al. Abstract OBJECTIVE: To determine the association between ruptured saccular aneurysms and aspirin use/aspirin dose. METHODS: Four thousand seven hundred one patients who were diagnosed at the Massachusetts General Hospital and Brigham […]

via How does aspirin influence the rupture risk of cerebral aneurysms? — Neurochecklists Updates

What, precisely, is the Alice in Wonderland syndrome?

Alice’s Adventures in Wonderland is a fairy tale that is beyond comparison in its implausible scenarios and outlandish characters. It intrigues and fascinates in equal measure, and it has held generations of children and adults spellbound since its publication in 1865. The fantasy is as fanciful as Lewis Carroll, the pseudonym of the author Charles Lutwidge Dodgson.

Alice in Wonderland. -JvL- on Flickr. https://www.flickr.com/photos/-jvl-/6075178802

As outrageous and as preposterous as it is, the book actually confirms the truism that most works of fiction are grounded in hard reality. In their excellent article, Alice in Wonderland Syndrome: A Historical and Medical Review, Osman Farooq and Edward Fine demonstrated that Alice’s adventures are not a figment of the author’s imagination, but the depiction of his real-life illusory experiences. Lewis Carroll suffered from migraine, and Alice was a perfect incarnation of the visual distortions that accompany this very common and debilitating disorder. Therefore, when lay people read that Alice’s body “had grown too tall or too small”, the stoney-eyed neuroscientists only see macropsia and micropsia, objects appearing larger or smaller than they actually are. When ordinary folks read that “parts of her body were changing shape, size, or relationship to the rest of her body”, the neurologist just sighs and yawns…migraine auras again! What spoilsports they are!

Alice. Danny Pig on Flickr. https://www.flickr.com/photos/dannypigart/114365270

Large and small of course bring to mind another great work of fantastic fiction, Gulliver’s Travels by Jonathan Swift. His Lilliputian and Brobdingnagian hallucinations are in another scale altogether, but did Swift also suffer from migraine? He probably did because the list of artists with probable migraine is fairy long (please don’t miss the intended pun). Some neuroscientist will however pour cold water on the idea that migraineurs are blessed with any creative impulses. Indeed it is not universally accepted that Lewis Crroll suffered from migraine auras. And just when you thought your migraines were worth the suffering! You may read more about art-disease relationships in this excellent article titled Alice in Wonderland Syndrome: A Clinical and Pathophysiological Review.

By Louis Rheadhttp://www.childrensbooksonline.org/Gullivers_Travels/index.htm, Public Domain, Link

But we mustn’t be distracted or derailed from the theme of today, Alice in Wonderland syndrome (AIWS). This fascinating disorder, and a disorder it is according to neurologists, puts us in a circular situation: fiction first mimicked fact to produce Alice, and fact then imitated fiction to produce a real ailment. I know, it all sounds absurd. But what did you expect with this theme!

By RodwOwn work, CC BY-SA 3.0, Link

What then is the cause of these illusory experiences that literally blow the mind? Yung-Ting Kuo and colleagues attribute it all to reduction in blood flow to the visual centers in the brain. And how many disorders may do this? Because this is neurology we are talking about…almost anything. The common culprits however are migraine, epilepsy, LSD, an assortment of  intoxicants, and a menagerie of brain infections. The syndrome has also been reported in a host of psychiatric and organic brain disorders such as Cotard syndrome, Capgras syndrome, depression, and schizophrenia. More worrying however is the association of the syndrome with prescription medications. One such drug is Topiramate, a medicine neurologists prescribe to prevent, among other conditions, migraine! And another, Aripiprazole, is paradoxically an excellent treatment for…hallucinations!

By Polygon data were generated by Database Center for Life Science(DBCLS)[2]. – Polygon data are from BodyParts3D[1]., CC BY-SA 2.1 jp, Link

As bizarre as Alice’s adventures are, Alice in Wonderland syndrome goes much farther: people with the syndrome experience a wider variety of even more grotesque illusory experiences than Lewis Carroll ever imagined. A recent paper in the journal, Neurology Clinical Practice, shows just how grotesque. Titled Clinical Characteristics of Alice in Wonderland Syndrome in a Cohort with Vestibular Migraine, the authors provide an almost endless list of unusual clinical manifestations of AIWS. The prize must however go the illusion that the brain is coming out of the head! There you go Lewis Carroll, you may eat your mad hat: fact will always be stranger than fiction!

Uh-oh. Josh Connell on Flickr. https://www.flickr.com/photos/yhsoj/4636850643/