MedLink Neurology Podcast

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: May 16, 2019

It would be an understatement to say that endovascular thrombectomy has revolutionized acute stroke management. As of 2018, the American Heart Association recommends treatment up to 24 hours after time last seen normal for select patients. This week on the BrainWaves podcast, Dr. Tudor Jovin--PI for the DAWN and REVASCAT clinical trials--summarizes the history of thrombectomy trials and what it is about our current strategies that have breathed new life into a technique that has historically fizzled.

Produced by James E Siegler and Jesse Thon. Music courtesy of Cuicuitte, Coldnoise, Medyn, Jon Watts, Lee Rosevere, and Mystery Mammal. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Campbell BC, Majoie CB, Albers GW, et al. Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data. Lancet Neurol 2019;18(1):46-55. Erratum in: Lancet Neurol 2019 Mar;18(3):e2. PMID 30413385

Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet 2016;387(10029):1723-31. PMID 26898852

Gross BA, Jadhav AP, Jankowitz BT, Jovin TG. The ongoing revolution in thrombectomy: expanding inclusion criteria to larger cores. World Neurosurg 2018;120:393-94. PMID 30292027

Heit JJ, Wintermark M. Perfusion computed tomography for the evaluation of acute ischemic stroke: strengths and pitfalls. Stroke 2016;47(4):1153-8. PMID 26965849

Jadhav AP, Molyneaux BJ, Hill MD, Jovin TG. Care of the post-thrombectomy patient. Stroke 2018;49(11):2801-07. PMID 30355218

Konstas AA, Goldmakher GV, Lee TY, Lev MH. Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 2: technical implementations. AJNR Am J Neuroradiol 2009;30(5):885-92. PMID 19299489

Nogueira RG, Jadhav AP, Haussen DC, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med 2018;378(1):11-21. PMID 29129157

Román LS, Menon BK, Blasco J, et al. Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data. Lancet Neurol 2018;17(10):895-904. PMID 30264728

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 20, 2018

This week, part 2 of our two-part primer on Huntington disease. Treatment. From tried-and-true therapies to the latest-and-greatest compounds being studied in clinical trials. Enjoy!

Produced by James E Siegler and Steven Aradi. Music by Mike Durek, Jesse Spillane, Lee Rosevere, Jason Shaw, and Dr. Turtle. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bates GP, Dorsey R, Gusella JF, et al. Huntington disease. Nat Rev Dis Primers 2015;1:15005. PMID 27188817

Claassen DO, Carroll B, De Boer LM, et al. Indirect tolerability comparison of Deutetrabenazine and Tetrabenazine for Huntington disease. J Clin Mov Disord 2017;4:3. PMID 28265459

Paulsen JS, Nehl C, Hoth KF, et al. Depression and stages of Huntington's disease. J Neuropsychiatry Clin Neurosci 2005;17(4):496-502. PMID 16387989

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 22, 2018

Of the "reversible" causes of dementia, normal pressure hydrocephalus may be the most controversial. But there is something to be said about how surgical intervention alters the physiology of patients who present with gait impairment, ventriculomegaly, and normal CSF pressure. This week on the show, we discuss the clinical features and the controversy behind this diagnosis.

Produced by James E Siegler. Music by Ghost, Jon Watts, Julie Maxwell, Komiku, and Kevin McLeod. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Gallia GL, Rigamonti D, Williams MA. The diagnosis and treatment of idiopathic normal pressure hydrocephalus. Nat Clin Pract Neurol 2006;2(7):375-81. PMID 16932588

Kazui H, Miyajima M, Mori E, Ishikawa M; SINPHONI-2 Investigators. Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol 2015;14(6):585-94. PMID 25934242

Klassen BT, Ahlskog JE. Normal pressure hydrocephalus: how often does the diagnosis hold water? Neurology 2011;77(12):1119-25. PMID 21849644

Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM. Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery 2005;57(3 Suppl):S4-16; discussion ii-v. PMID 16160425

Williams MA, Relkin NR. Diagnosis and management of idiopathic normal-pressure hydrocephalus. Neurol Clin Pract 2013;3(5):375-85. PMID 24175154

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 6, 2018

You may be able to recognize chorea. But what does it make you think of besides Huntington disease? In this two-part series, we'll cover the clinical manifestations, differential diagnosis, and management of Huntington disease. In part 1, Dr. Travis Lewis (University of Pennsylvania) creates a framework for hyperkinetic movement disorders and Huntington disease. Part 2 will focus on the current and future therapeutics of this neurodegenerative condition.

Produced by Travis Lewis and James E Siegler. Music by Azevedo Silva, Chris Zabriskie, Cullah, John Bartmann, and Nuno Adelaida. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bates GP, Dorsey R, Gusella JF, et al. Huntington disease. Nat Rev Dis Primers 2015;1:15005. PMID 27188817

Ghosh R, Tabrizi SJ. Huntington disease. Handb Clin Neurol 2018;147:255-78. PMID 29325616

Reilmann R, Leavitt BR, Ross CA. Diagnostic criteria for Huntington's disease based on natural history. Mov Disord 2014;29(11):1335-41. PMID 25164527

Walker RH. Chorea. Continuum (Minneap Minn) 2013;19(5 Movement Disorders):1242-63. PMID 24092289

Wild EJ, Tabrizi SJ. The differential diagnosis of chorea. Pract Neurol 2007;7(6):360-73. PMID 18024776

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: October 25, 2018

Every time you order an MRI with contrast, you should think to yourself, "Why do I need contrast?"

Then, "If I need contrast, what are the risks?" This week’s show is all about the risks of routine neuroimaging.

Produced by James E Siegler. Music by Little Glass Men, Loyalty Freak Music, and Kevin McLeod. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

McDonald RJ, McDonald JS, Kallmes DF, et al. Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 2015;275(3):772-82. PMID 25742194

Pullicino R, Radon M, Biswas S, Bhojak M, Das K. A review of the current evidence on gadolinium deposition in the brain. Clin Neuroradiol 2018;28(2):159-69. PMID 29523896

Rogosnitzky M, Branch S. Gadolinium-based contrast agent toxicity: a review of known and proposed mechanisms. Biometals 2016;29(3):365-76. PMID 27053146

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

It is April 1st, 2017. Otherwise known as April Fools Day. But it doesn't have to be April 1st for you to be tricked by your neurology patient. In this week's episode of BrainWaves, we go over some of the ways to avoid being fooled the next time around. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 8, 2018

A patient comes into the emergency department. They've got a headache. You get some basic labs, a chest x-ray, and a CT scan. And then you get a drug screen. But does this information even help you? And could it hurt the patient?

This week on the BrainWaves podcast, Dr. Emily Rosenthal shares her experience with Dr. Kelley Humbert on the ethics of toxicology "screening" and how she manages patients with a substance use disorder.

Produced by Emily Rosenthal, Kelley Humbert, and Jim Siegler. Music by Montplaisir, Lee Rosevere, and Kevin McLeod. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bates GP, Dorsey R, Gusella JF, et al. Huntington disease. Nat Rev Dis Primers 2015;1:15005. PMID 27188817

Eisen JS, Sivilotti ML, Boyd KU, Barton DG, Fortier CJ, Collier CP. Screening urine for drugs of abuse in the emergency department: do test results affect physicians' patient care decisions? CJEM 2004;6(2):104-11. PMID 17433159

Jones HE, Kaltenbach K, Heil SH, et al. Neonatal abstinence syndrome after methadone or buprenorphine exposure. N Engl J Med 2010;363(24):2320-31. PMID 21142534

Lager PS, Attema-de Jonge ME, Gorzeman MP, Kerkvliet LE, Franssen EJ. Clinical value of drugs of abuse point of care testing in an emergency department setting. Toxicol Rep 2017;5:12-17. PMID 29270362

Silver B, Miller D, Jankowski M, et al. Urine toxicology screening in an urban stroke and TIA population. Neurology 2013;80(18):1702-9. PMID 23596074

Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R. A single-question screening test for drug use in primary care. Arch Intern Med 2010;170(13):1155-60. PMID 20625025

Tenenbein M. Do you really need that emergency drug screen? Clin Toxicol (Phila) 2009;47(4):286-91. PMID 19514875

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: October 11, 2018

As the name suggests, "evidence-based medicine" is dependent on published evidence to support our clinical practice and medical decision-making. Implicit in this is the notion that all published evidence reflects the truth that underlies the biology, pathophysiology, and pharmacology of our health.

This is not the case.

Clinical research and published findings can be extremely limited, and what you read in Lancet and NEJM should be interpreted with caution. In this week's episode of the "I wonder" series, where Jim Siegler speaks with Ali Hamedani on various topics in medicine and neurology, the speakers review the major biases inherent to the practice and interpretation of clinical research.

Produced by James E Siegler. Music by Jahzzar, Kai Engel, and Lee Rosevere. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Anonymous. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet 1988;2(8607):349-60. PMID 2899772

Kazui H, Miyajima M, Mori E, Ishikawa M; SINPHONI-2 Investigators. Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol 2015;14(6):585-94. PMID 25934242

Montalban X, Hauser SL, Kappos L, et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med 2017;376(3):209-20. PMID 28002688

Smith GC, Pell JP. Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 2003;327(7429):1459-61. PMID 14684649

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 19, 2018

Some have estimated the annual cost of chronic back or neck pain in the US to exceed $200 billion per year. And the economic burden is almost as unbearable as the pain faced by patients. This week on the program, we discuss the clinical and radiographic aspects of structural spine disease--or spondylosis--and expert recommendations on how to manage it.

Produced by James E Siegler. Music by Steve Combs and Scott Holmes. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making, especially not for back surgery.

REFERENCES

Baron EM, Young WF. Cervical spondylotic myelopathy: a brief review of its pathophysiology, clinical course, and diagnosis. Neurosurgery 2007;60(1 Supp1 1):S35-41. PMID 17204884

Farrokhi MR, Ghaffarpasand F, Khani M, Gholami M. An evidence-based stepwise surgical approach to cervical spondylotic myelopathy: a narrative review of the current literature. World Neurosurg 2016;94:97-110. PMID 27389939

Rindler RS, Chokshi FH, Malcolm JG, et al. Spinal diffusion tensor imaging in evaluation of preoperative and postoperative severity of cervical spondylotic myelopathy: systematic review of literature. World Neurosurg 2017;99:150-8. PMID 27939797

Stino AM, LoRusso SJ. Myelopathies due to structural cervical and thoracic disease. Continuum (Minneap Minn) 2018;24(2, Spinal Cord Disorders):567-583. PMID 29613900

Witiw CD, Tetreault LA, Smieliauskas F, Kopjar B, Massicotte EM, Fehlings MG. Surgery for degenerative cervical myelopathy: a patient-centered quality of life and health economic evaluation. Spine J 2017;17(1):15-25. PMID 27793760

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 2, 2018

How visual information transforms from pixels into people is more complex than dots becoming lines, lines becoming shapes, and shapes becoming faces. Your brain makes assumptions about all kinds of sensory information--even without you knowing it. Dr. Geoffrey Aguirre, a neuroscientist who specializes in vision processing, explains how we know what we can't really explain.

Produced by James E Siegler and Geoff Aguirre. Music by Cullah, Jon Watts, Lovira, Loyalty Freak Music, and Scott Holmes. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Psalta L, Young AW, Thompson P, Andrews TJ. The Thatcher illusion reveals orientation dependence in brain regions involved in processing facial expressions. Psychol Sci 2014;25(1):128-36. PMID 24264941

Thompson P. Margaret Thatcher: a new illusion. Perception 1980;9(4):483-4. PMID 6999452

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 27, 2018

When is eye pain an ophthalmological issue, and when is it a neurologic issue? This week, neuro-ophthalmologist and glaucoma specialist Dr. Ahmara Ross simplifies ocular pain for the day-to-day neurologist.

Produced by James E Siegler and Ahmara Ross. Music by Yan Terrien, Unheard Music Concepts, Steve Combs, and Scott Holmes. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWave saudio for the latest updates to the podcast.

REFERENCES

Fiore DC, Pasternak AV, Radwan RM. Pain in the quiet (not red) eye. Am Fam Physician 2010;82(1):69-73. PMID 20590074

Friedman DI. The eye and headache. Continuum (Minneap Minn) 2015;21(4 Headache):1109-17. PMID 26252594

Lee AG, Al-Zubidi N, Beaver HA, Brazis PW. An update on eye pain for the neurologist. Neurol Clin 2014;32(2):489-505. PMID 24703541

Waldman CW, Waldman SD, Waldman RA. A practical approach to ocular pain for the non-ophthalmologist. Pain Manag 2014;4(6):413-26. PMID 25494693

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 5, 2018

In 2017, neuroimmunology experts revised the criteria with which we diagnose multiple sclerosis. They encouraged more aggressive treatment, and now they have introduced novel therapeutic agents into our pharmacologic armamentarium. Dr. Christopher Perrone explains how these newer agents work and how effective they are in patients with demyelinating disease.

Produced by James E Siegler. Music by Steve Combs, Pachyderm, and Lee Rosevere. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Hauser SL, Bar-Or A, Comi G, et al. Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis. N Engl J Med 2017;376(3):221-34. PMID 28002679

Hauser SL, Waubant E, Arnold DL, et al. B-cell depletion with rituximab in relapsing-remitting multiple sclerosis. N Engl J Med 2008;358(7):676-88. PMID 18272891

Hemmer B, Nessler S, Zhou D, Kieseier B, Hartung HP. Immunopathogenesis and immunotherapy of multiple sclerosis. Nat Clin Pract Neurol 2006;2(4):201-11. PMID 16932551

Maloney DG, Grillo-López AJ, White CA, et al. IDEC-C2B8 (Rituximab) anti-CD20 monoclonal antibody therapy in patients with relapsed low-grade non-Hodgkin's lymphoma. Blood 1997;90(6):2188-95. PMID 9310469

Montalban X, Hauser SL, Kappos L, et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med 2017;376(3):209-20. PMID 28002688

Selter RC, Hemmer B. Update on immunopathogenesis and immunotherapy in multiple sclerosis. Immunotargets Ther 2013;2:21-30. PMID 27471685

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: June 14, 2018

As a pupil of neurology and medicine, I feel like it is my responsibility to cover this topic at least once on the podcast. This topic came to me in a vision. But not one of phosphenes or impaired stereopsis--both of which we'll cover today. This week, we're discussing inflammation of the optic nerve, from the historical aspects to current concepts. And while you're listening, there's no need to lash out at my puns. You can stop rolling your eyes now.

Produced by James E Siegler. Music by Lee Rosevere, Kevin McLeod, Steve Combs, and Unheard Music Concepts. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Balcer LJ. Clinical practice. Optic neuritis. N Engl J Med 2006;354(12):1273-80. PMID 16554529

Beck RW, Cleary PA, Anderson MM Jr, et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med 1992;326(9):581-8. PMID 1734247

Hickman SJ, Dalton CM, Miller DH, Plant GT. Management of acute optic neuritis. Lancet 2002;360(9349):1953-62. PMID 12493277

Liu GT, Volpe NJ, Galetta SL. Neuro-Ophthalmology: Diagnosis and Management. 2nd Ed. Elsevier, 2010.

O'Doherty M, Flitcroft DI. An unusual presentation of optic neuritis and the Pulfrich phenomenon. J Neurol Neurosurg Psychiatry 2007;78(8):906-7. PMID 17635984

Toosy AT, Mason DF, Miller DH. Optic neuritis. Lancet Neurol 2014;13(1):83-99. PMID 24331795

Volpe NJ. Optic neuritis: historical aspects. J Neuroophthalmol 2001;21(4):302-9. PMID 11756864

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: June 7, 2018

Depression and dementia are, unfortunately, two very common disorders in mental health. But the fact that they occur together is not explained by their overall prevalence. The relationship is a bit more complicated. Joan Dietz joins Jim Siegler in a discussion on how she counters these common conditions.

Produced by James E Siegler. Music by Lee Rosevere, Jason Shaw, Chris Zabriskie, Kai Engel, and Scott Holmes. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Alexopoulos GS, Murphy CF, Gunning-Dixon FM, et al. Microstructural white matter abnormalities and remission of geriatric depression. Am J Psychiatry 2008;165(2):238-44. PMID 18172016

Byers AL, Yaffe K. Depression and risk of developing dementia. Nat Rev Neurol 2011;7(6):323-31. PMID 21537355

Dotson VM, Beydoun MA, Zonderman AB. Recurrent depressive symptoms and the incidence of dementia and mild cognitive impairment. Neurology 2010;75(1):27-34. PMID 20603482

Korczyn AD, Halperin I. Depression and dementia. J Neurol Sci 2009;283(1-2):139-42. PMID 19345960

Lee CW, Lin CL, Sung FC, Liang JA, Kao CH. Antidepressant treatment and risk of dementia: a population-based, retrospective case-control study. J Clin Psychiatry 2016;77(1):117-22; quiz 122. PMID 26845268

Sachdev PS, Smith JS, Angus-Lepan H, Rodriguez P. Pseudodementia twelve years on. J Neurol Neurosurg Psychiatry 1990;53(3):254-9. PMID 2324757

Saczynski JS, Beiser A, Seshadri S, Auerbach S, Wolf PA, Au R. Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology 2010;75(1):35-41. PMID 20603483

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: May 10, 2018

There is a nationwide epidemic happening right now. And it's not some terrible virus, it's not because of anything we've had to eat or drink. It is an occupational hazard of the hospital environment: Physician suicide. Dr. Pamela Wible, Founder of the Ideal Medical Care Movement, shares her unique approach to this preventable plague.

Produced by James E Siegler. Music by Andrew Sacco, Damiano Baldoni, Kevin McLeod, Jason Shaw, and Rafael Archangel. Voiceover by Patrick Green. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Goldman ML, Shah RN, Bernstein CA. Depression and suicide among physician trainees: recommendations for a national response. JAMA Psychiatry. 2015 May;72(5):411-2. doi: 10.1001/jamapsychiatry.2014.3050. PMID 25738529

Kesselheim AS, Austad KE. Residents: workers or students in the eyes of the law? N Engl J Med 2011;364(8):697-9. PMID 21226569

Schernhammer E. Taking their own lives -- the high rate of physician suicide. N Engl J Med 2005;352(24):2473-6. PMID 15958803

Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry 2004;161(12):2295-302. PMID 15569903

Sen S, Kranzler HR, Krystal JH, et al. A prospective cohort study investigating factors associated with depression during medical internship. Arch Gen Psychiatry 2010;67(6):557-65. PMID 20368500

Witte TK, Fitzpatrick KK, Joiner TE Jr, Schmidt NB. Variability in suicidal ideation: a better predictor of suicide attempts than intensity or duration of ideation? J Affect Disord 2005;88(2):131-6. PMID 16054227

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 26, 2018

Forget what you did 5 minutes ago? What if this happened every 5 minutes...for an entire day? In this week's program, Dr. Laura Mainardi shares her family's experience with a day that will never be forgotten. But never remembered.

Produced by James E Siegler and Laura Mainardi-Villarino. Music by Pablo Pavan, Azevedo Silva, Montplaisir, and Kevin McLeod. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making.

REFERENCES

Arena JE, Rabinstein AA. Transient global amnesia. Mayo Clin Proc 2015;90(2):264-72. PMID 25659242

Hainselin M, Quinette P, Juskenaite A, et al. Just do it! How performing an action enhances remembering in transient global amnesia. Cortex 2014;50:192-9. PMID 24268322

Noël A, Quinette P, Hainselin M, et al. The still enigmatic syndrome of transient global amnesia: interactions between neurological and psychopathological factors. Neuropsychol Rev 2015;25(2):125-33. PMID 25868986

Quinette P, Guillery-Girard B, Dayan J, et al. What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain 2006;129(Pt 7):1640-58. PMID 16670178

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 19, 2018

What do Shel Silverstein, Bruce Willis, and French philosophy have in common? At least one thing. This week on the BrainWaves podcast we discuss the Cotard delusion and the legacy of the neurologist who described it. Produced by James E Siegler. Music by Andrew Sacco, Damiano Baldoni, Squire Tuck, Montplaisir, and Rafael Archangel. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Pearn J, Gardner-Thorpe C. Jules Cotard (1840-1889): his life and the unique syndrome which bears his name. Neurology 2002;58(9):1400-3. PMID 12011289

Sahoo A, Josephs KA. A Neuropsychiatric analysis of the cotard delusion. J Neuropsychiatry Clin Neurosci 2018 Winter;30(1):58-65. PMID 28641497

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 29, 2018

What does a brain look like in a patient with a functional movement disorder? Pretty normal, it turns out. But beneath the normal anatomy is a storm of aberrant signaling. Dr. Mark Hallett, Chief of the Human Motor Control Section of the NIH, describes the underlying neurophysiology in this spectrum of disorders.

Produced by James E Siegler. Music by Damiano Baldoni, Kevin MacLeod, Ondrosik, and the Philadelphia String Quartet. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Maurer CW, LaFaver K, Ameli R, Epstein SA, Hallett M, Horovitz SG. Impaired self-agency in functional movement disorders: a resting-state fMRI study. Neurology 2016;87(6):564-70. PMID 27385746

Nahab FB, Kundu P, Gallea C, et al. The neural processes underlying self-agency. Cereb Cortex 2011;21(1):48-55. PMID 20378581

Vuilleumier P, Chicherio C, Assal F, Schwartz S, Slosman D, Landis T. Functional neuroanatomical correlates of hysterical sensorimotor loss. Brain 2001;124(Pt 6):1077-90. Erratum in: Brain 2016;139(Pt 5):e29. PMID 11353724

DISCLOSURES

Dr. Hallett receives funding from the Intramural program of the National Institute of Neurological Disorders and Stroke. No relevant conflicts of interest are present. He serves as Chair of the Medical Advisory Board for and receives honoraria and funding for travel from the Neurotoxin Institute. He may accrue revenue on US Patent: Immunotoxin (MAB-Ricin) for the treatment of focal movement disorders, and US Patent: Coil for Magnetic Stimulation and methods for using the same (H-coil); in relation to the latter, he has received license fee payments from the NIH (from Brainsway) for licensing of this patent. Supplemental research funds have been granted by BCN Peptides, S.A., for treatment studies of blepharospasm; Medtronics, Inc., for studies of deep brain stimulation; UniQure for a clinical trial of AAV2-GDNF for Parkinson Disease; Merz for treatment studies of focal hand dystonia; and Allergan for studies of methods to inject botulinum toxins. Jim is lucky enough to have no relevant competing financial interests.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 8, 2018

Cigarettes can offset Parkinson disease. Alcohol can reduce the risk of heart attack. Can the case be made that marijuana has health benefits too?

Produced by James E Siegler. Music by Montplaisir and Kevin McLeod. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Or, if you're a patient with seizures, this doesn't mean you should start smoking pot now. Be smart.

REFERENCES

Brodie MJ, Ben-Menachem E. Cannabinoids for epilepsy: What do we know and where do we go? Epilepsia 2018;59(2):291-6. PMID 29214639

Cunha JM, Carlini EA, Pereira AE, et al. Chronic administration of cannabidiol to healthy volunteers and epileptic patients. Pharmacology 1980;21(3):175-85. PMID 7413719

Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. N Engl J Med 2017;376(21):2011-20. PMID 28538134

Maa E, Figi P. The case for medical marijuana in epilepsy. Epilepsia 2014;55(6):783-6. PMID 24854149

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: February 22, 2018

Risk factors for amyotrophic lateral sclerosis: family history, male sex, and serving in the US military? Dr. Colin Quinn shares his experience working with American veterans and summarizes the evidence for this unusual relationship.

Produced by James E Siegler. Music by Jon Watts, Josh Woodward, Lee Rosevere, Unheard Music Concepts, and The United States Army Old Guard Fife and Drum Corps. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education and entertainment purposes only.

REFERENCES

Al-Chalabi A, Hardiman O. The epidemiology of ALS: a conspiracy of genes, environment and time. Nat Rev Neurol 2013;9(11):617-28. PMID 24126629

Haley RW. Excess incidence of ALS in young Gulf War veterans. Neurology 2003;61(6):750-6. PMID 14504316

Horner RD, Kamins KG, Feussner JR, et al. Occurrence of amyotrophic lateral sclerosis among Gulf War veterans. Neurology 2003;61(6):742-9. Erratum in: Neurology 2003;61(9):1320. PMID 14504315

Kasarskis EJ, Lindquist JH, Coffman CJ, et al. Clinical aspects of ALS in Gulf War veterans. Amyotroph Lateral Scler 2009;10(1):35-41. PMID 18792848

Weisskopf MG, O'Reilly EJ, McCullough ML, et al. Prospective study of military service and mortality from ALS. Neurology 2005;64(1):32-7. PMID 15642900

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 1, 2018

Dystonia refers to a complex spectrum of disturbances in movement, and the differential diagnosis is even more complicated, but Drs. Andres Deik and David Coughlin make it simple. In this week's episode of the BrainWaves podcast, we'll run through the basics of a dystonia differential and approach to managing patients with these complex symptoms.

Produced by James E Siegler and David Coughlin. Music by Lee Rosevere, Rui, and the Freeharmonic Orchestra. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Albanese A, Barnes MP, Bhatia KP, et al. A systematic review on the diagnosis and treatment of primary (idiopathic) dystonia and dystonia plus syndromes: report of an EFNS/MDS-ES Task Force. Eur J Neurol 2006;13(5):433-44. PMID 16722965

Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord 2013;28(7):863-73. PMID 23649720

Skogseid IM. Dystonia--new advances in classification, genetics, pathophysiology and treatment. Acta Neurol Scand Suppl 2014;(198):13-9. PMID 24588501

DISCLOSURES

Andres Deik eceived consulting royalties from Adamas therapeutics, Teva pharmaceuticals, ITF Pharma, and Cynapsus Therapeutics. His research has been funded in part by Cynapsus therapeutics and The Dystonia Coalition. David Coughlin, like Jim Siegler, has no competing financial interests to disclose.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 25, 2018

We expose our soft spot this week on the show. Lindsay Raab and John Best join Jim Siegler in the studio to discuss their own personal struggles with residency and patient care and how they've battled hard to overcome them.

Produced by John Best and Lindsay Raab. Senior producer, Jim Siegler. Music by Daniel Birch, Little Glass Men, The New Valleys, Rod Hamilton, Chris Zabriskie, and Jon Watts. Voiceovers by David Manly, Erika Mejia, and Pat Green. BrainWaves' podcasts and online content are intended for medical education only. If you're in healthcare and feeling burnt out, maybe this episode will be insightful. But please do not misconstrue this as advice.

REFERENCES

Thomas NK. Resident burnout. JAMA 2004;292(23):2880-9. PMID 15598920

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 4, 2018

You've probably heard of the 10,000-hour rule--or maybe the 10-year rule. The time it takes to master a skill. But what is the evidence for this, and was Malcolm Gladwell's interpretation of it (from his book, Outliers) correct? From mindfulness to memory palaces, this week we explore the neuroscience of expertise.

Produced by James E Siegler. Music by Mozart, Brendan Kinsella, Jon Watts, Mike Durek, and Lee Rosevere. Voiceover by David Manly. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Ericsson KA, Krampe RT, Teschromer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev 1993;100:363-406.

Macnamara BN, Hambrick DZ, Oswald FL. Deliberate practice and performance in music, games, sports, education, and professions: a meta-analysis. Psychol Sci 2014;25(8):1608-18. Erratum in: Psychol Sci 2018;29(7):1202-4. PMID 24986855

Raskin E. Comparison of scientific and literary ability: a biographical study of eminent scientists and letters of the nineteenth century. J Abnormal Social Psychol 1936;31:20-35.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: Jan 18, 2018

When it comes to stroke, treatment is dependent on the stroke mechanism. But most patients wind up on aspirin anyway. Or Plavix (clopidogrel). And sometimes both. The question this week is, Why? I hope you're hungry for some fruit because we're comparing a bunch of apples to oranges in this episode of the BrainWaves podcast.

Produced by James E Siegler. Music by William Ross Chernoff's Nomads, Steve Combs, Rui, Little Glass Men, and Peter Rudenko. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making. Even if this episode is all about choosing aspirin or clopidogrel when you're treating stroke patients. Always talk with your doctor, and if you are a doctor, you should rely on institutional policies and your own clinical judgment when treating patients.

REFERENCES

Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324(7329):71-86. Erratum in: BMJ 2002;324(7330):141. PMID 11786451

Bhatt DL, Fox KA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006;354(16):1706-17. PMID 16531616

CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. Lancet 1997;349(9066):1641-9. PMID 9186381

Collaborative overview of randomised trials of antiplatelet therapy--I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Antiplatelet Trialists' Collaboration. BMJ 1994;308(6921):81-106. Erratum in: BMJ 1994;308(6943):1540. PMID 8298418

CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 1996;348(9038):1329-39. PMID 8918275

Diener HC, Bogousslavsky J, Brass LM, et al. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 2004;364(9431):331-7. PMID 15276392

Hong KS, Lee SH, Kim EG, et al. Recurrent ischemic lesions after acute atherothrombotic stroke: clopidogrel plus aspirin versus aspirin alone. Stroke 2016;47(9):2323-30. PMID 27418597

Jauch EC, Saver JL, Adams HP Jr, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013;44(3):870-947. PMID 23370205

Kennedy J, Hill MD, Ryckborst KJ, et al. Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomised controlled pilot trial. Lancet Neurol 2007;6(11):961-9.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 7, 2017

This week on the show, we're discussing the science behind the fiction of George Malley, the protagonist of the 1996 classic, Phenomenon. Specifically, we ask the question, is there a disease out there that incidentally benefits the human organism? Maybe there is...

Produced by James E Siegler. Music by Hyson, Ars Sonor, and Lee Rosevere. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Costanzo JP, Lee RE Jr, Lortz PH. Glucose concentration regulates freeze tolerance in the wood frog Rana sylvatica. J Exp Biol 1993;181:245-55. PMID 8409827

Moalem S, Weinberg ED, Percy ME. Hemochromatosis and the enigma of misplaced iron: implications for infectious disease and survival. Biometals 2004;17(2):135-9. PMID 15088940

Nagasako EM, Oaklander AL, Dworkin RH. Congenital insensitivity to pain: an update. Pain 2003;101(3):213-9.  PMID 12583863

Saloviita T, Ruusila L, Ruusila U. Incidence of Savant syndrome in Finland. Percept Mot Skills 2000;91(1):120-2. PMID 11011882

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released December 21, 2017

Nerve conduction testing should not be as puzzling as it's made out to be. This week, we break it down into individual components and use two case examples to explain how you might interpret this commonly implemented electrodiagnostic assessment.

Produced by James E Siegler. Music by Coldnoise, Jessie Spillane, Loyalty Freak Music, and Yshwa. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making.

REFERENCES

Allen JA. Chronic demyelinating polyneuropathies. Continuum (Minneap Minn) 2017;23(5, Peripheral Nerve and Motor Neuron Disorders):1310-31. PMID 28968364

Kincaid JC. Neurophysiologic studies in the evaluation of polyneuropathy. Continuum (Minneap Minn) 2017;23(5, Peripheral Nerve and Motor Neuron Disorders):1263-75. PMID 28968361

Pareyson D, Scaioli V, Laurà M. Clinical and electrophysiological aspects of Charcot-Marie-Tooth disease. Neuromolecular Med 2006;8(1-2):3-22. PMID 16775364

Preston DC, Shapiro BE. Electromyography and neuromuscular disorders: clinical-electrophysiologic correlations. 3rd ed. London; New York: Elsevier Saunders, 2013.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 23, 2017

This week on BrainWaves, we build on concepts introduced in episode 65 regarding the non-pharmacologic management of drug-resistant epilepsy. In the next two episodes, you'll hear from Dr. Danielle Becker (Penn) and Dr. Myriam Abdennadher (NIH) on the minimally invasive procedures that can drastically impact the lives of patients with refractory seizures.

Produced by James E Siegler. Music by Steve Combs, Jason Shaw, and Josh Woodward. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010;51(6):1069-77. Erratum in: Epilepsia 2010;51(9):1922. PMID 19889013

Nilsson L, Farahmand BY, Persson PG, Thiblin I, Tomson T. Risk factors for sudden unexpected death in epilepsy: a case-control study. Lancet 1999;353(9156):888-93. PMID 10093982

Tomson T, Nashef L, Ryvlin P. Sudden unexpected death in epilepsy: current knowledge and future directions. Lancet Neurol 2008;7(11):1021-31. PMID 18805738

Willie JT, Laxpati NG, Drane DL, et al. Real-time magnetic resonance-guided stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy. Neurosurgery 2014;74(6):569-84; discussion 584-5. PMID 24618797

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 30, 2017

Last week was all about how destroying bad brain can help patients with epilepsy. This week, in a stimulating discussion with Dr. Becker, we're reviewing the ways we can activate the nervous system in order to prevent future seizures: the vagus nerve stimulator, deep brain stimulation, and the responsive neurostimulation system.

Produced by James E Siegler. Music by Chris Zabriskie, Josh Woodward, and Kevin McLeod. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. The Vagus Nerve Stimulation Study Group. Neurology 1995;45(2):224-30. PMID 7854516

Ben-Menachem E. Vagus-nerve stimulation for the treatment of epilepsy. Lancet Neurol 2002;1(8):477-82. PMID 12849332

DeGiorgio CM, Krahl SE. Neurostimulation for drug-resistant epilepsy. Continuum (Minneap Minn) 2013;19(3 Epilepsy):743-55. PMID 23739108

Fisher R, Salanova V, Witt T, et al. Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy. Epilepsia 2010;51(5):899-908. PMID 20331461

Handforth A, DeGiorgio CM, Schachter SC, et al. Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial. Neurology 1998;51(1):48-55. PMID 9674777

Lanska DJ. JL Corning and vagal nerve stimulation for seizures in the 1880s. Neurology 2002;58(3):452-9. PMID 11839848

Morrell MJ; RNS System in Epilepsy Study Group. Responsive cortical stimulation for the treatment of medically intractable partial epilepsy. Neurology 2011;77(13):1295-304. PMID 21917777

Morris GL 3rd, Gloss D, Buchhalter J, Mack KJ, Nickels K, Harden C. Evidence-based guideline update: vagus nerve stimulation for the treatment of epilepsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013;81(16):1453-9. PMID 23986299

Penry JK, Dean JC. Prevention of intractable partial seizures by intermittent vagal stimulation in humans: preliminary results. Epilepsia 1990;31 Suppl 2:S40-3. PMID 2121469

Yuan H, Silberstein SD. Vagus nerve and vagus nerve stimulation, a comprehensive review: Part II. Headache 2016;56(2):259-66. PMID 26381725

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 7, 2017

Reflex testing is an art. And that makes each of us an artist. The nuances of the reflex circuitry and how to interpret reflex testing are the topics of this week's episode, starring medical student Eliana Vasquez from Texas Health Sciences Center.

Produced by Erika Mejia and James E Siegler. Music by Komiku, Jahzzar, and Jason Shaw. BrainWaves podcast and online content are intended for medical education only and should not be used in the routine care of patients. I swear, if someone tries to sue me because their doctor said, "Well, Jim told me I should hit your knee with a hammer," then I'm coming for you.

REFERENCES

Boes CJ. The history of examination of reflexes. J Neurol 2014;261(12):2264-74. PMID 24695995

Walker HK. Deep tendon reflexes. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston, 1990.

Watt D, Lefebvre L. Effects of Altered Gravity on Spinal Cord Excitability. American Institute of Aeronautics and Astronautics, 2001:4939.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 21, 2017

Atrial fibrillation increases your risk of clotting. Anticoagulation increases your risk of bleeding. Surgery increases your risk of both. Dr. Mike Rubenstein speaks with Dr. Jim Siegler this week about how providers weigh the risks and benefits of anticoagulant bridging in the perioperative setting.

Produced by Michael Rubenstein and James E Siegler. Music by Chris Zabriskie, Lee Rosevere, and Jason Shaw. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Garcia DA, Regan S, Henault LE, et al. Risk of thromboembolism with short-term interruption of warfarin therapy. Arch Intern Med 2008;168(1):63-9. PMID 18195197

Raval AN, Cigarroa JE, Chung MK, et al. Management of patients on non-vitamin K antagonist oral anticoagulants in the acute care and periprocedural setting: a scientific statement from the American Heart Association. Circulation 2017;135(10):e604-33. Erratum in: Circulation 2017;135(10 ):e647. Erratum in: Circulation 2017;135(24):e1144. PMID 28167634

Rechenmacher SJ, Fang JC. Bridging anticoagulation: primum non nocere. J Am Coll Cardiol 2015;66(12):1392-403. PMID 26383727

Schulman S, Carrier M, Lee AY, et al. Perioperative management of dabigatran: a prospective cohort study. Circulation 2015;132(3):167-73. PMID 25966905

Steinberg BA, Peterson ED, Kim S, et al. Use and outcomes associated with bridging during anticoagulation interruptions in patients with atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Circulation 2015;131(5):488-94. PMID 25499873

Stroke Prevention in Atrial Fibrillation Study. Final results. Circulation 1991;84(2):527-39. PMID 1860198

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 31, 2017

The asymmetric pupil can be subtle or disturbing, straightforward or perplexing, or even normal or abnormal. But by integrating your eye examination with the neurologic examination, you can figure it out--even if it is an eye examination on a dog.

Produced by James E Siegler. Music by Komiku, Lee Rosevere, and Milton Arias. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making, no matter how physiologic you think those pupils are.

REFERENCES

Liu GT, Volpe NJ, Galetta SL. Neuro-ophthalmology: Diagnosis and Management. 2nd ed. Elsevier, 2010:587-610.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 3, 2017

The most common primary brain tumor that occurs in adults, glioblastoma multiforme, comes with a life expectancy shorter than practically every other form of cancer. But thanks to novel treatment strategies, advanced neuroimaging, and biomarker research, we are learning more and more about how to improve the survival and the quality of life of patients who suffer from this terrible illness.

Produced by James E Siegler and Neena Cherayil. Music by Axle, Coldnoise, Josh Woodward, and Kelly Latimer. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Gately L, McLachlan SA, Dowling A, Philip J. Life beyond a diagnosis of glioblastoma: a systematic review of the literature. J Cancer Surviv 2017;11(4):447-52. PMID 28194640

Grady D. Glioblastoma, John Mccain’s Form of Brain Cancer, Carries Troubling Prognosis. New York Times, July 20, 2017.

Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016;131(6):803-20. PMID 27157931

Scutti S. Sen John McCain has aggressive brain tumor, surgically removed. CNN, July 19, 2017.

Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 2009;10(5):459-66. PMID 19269895

Hegi ME, Diserens AC, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005;352(10):997-1003. PMID 15758010

Thakkar JP, Dolecek TA, Horbinski C, et al. Epidemiologic and molecular prognostic review of glioblastoma. Cancer Epidemiol Biomarkers Prev 2014;23(10):1985-96. PMID 25053711

Weller M, Wick W. Neuro-oncology in 2013: improving outcome in newly diagnosed malignant glioma. Nat Rev Neurol 2014;10(2):68-70. PMID 24419684

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 10, 2017

Spinal cord injury can be a devastating problem for patients. There is often significant weakness and loss of sensation and coordination, and some patients may never walk again. Almost everyone knows this. But what about the other spinal cord functions that we don't often talk about? In this week's episode, we review how the spinal cord controls bladder function and why it's important to know what happens when this circuitry is interrupted.

Produced by James E Siegler. Music by Andy Cohen & Steve Combs. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Samson G, Cardenas DD. Neurogenic bladder in spinal cord injury. Phys Med Rehabil Clin N Am 2007;18(2):255-74. PMID 17543772

Seth JH, Panicker JN, Fowler CJ. The neurological organization of micturition. Handb Clin Neurol 2013;117:111-7. PMID 24095120

de Groat WC, Griffiths D, Yoshimura N. Neural control of the lower urinary tract. Compr Physiol 2015;5(1):327-96. PMID 25589273

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 24, 2017

Fainting spells are surprisingly common--even among United States Marines. This week, we explore the mechanisms underlying loss of consciousness in your everyday patient. And your everyday soldier.

Produced by James E Siegler. Music by Jason Shaw, Andy Cohen, Kai Engel, and Josh Woodward. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Freeman R. Clinical practice. Neurogenic orthostatic hypotension. N Engl J Med 2008;358(6):615-24. PMID 18256396

Grubb BP. Neurocardiogenic syncope and related disorders of orthostatic intolerance. Circulation 2005;111(22):2997-3006. PMID 15939833

Sonnesyn H, Nilsen DW, Rongve A, et al. High prevalence of orthostatic hypotension in mild dementia. Dement Geriatr Cogn Disord 2009;28(4):307-13. PMID 19828952

Wolters FJ, Mattace-Raso FU, Koudstaal PJ, Hofman A, Ikram MA; Heart Brain Connection Collaborative Research Group. Orthostatic hypotension and the long-term risk of dementia: a population-based study. PLoS Med 2016;13(10):e1002143. PMID 27727284

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

We rely heavily on our vision to perceive the world around us. (You wouldn't even be able to read this unless your vision were fully intact.) But what happens when that visual information is registered poorly by the eyes or the information is erroneously translated by a damaged nervous system? Cognitive neuroscientist and visual systems specialist, Dr. Geoff Aguirre joins in this segment on how structural neurologic injury contributes to abnormalities in visual perception.

Produced by James E Siegler & Erika Mejia. Music by MMFFF, Peter Rudenko, Three Chain Links, and Marcos H. Bolanos. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical purposes.

REFERENCES

Barton JJ. Disorders of higher visual processing. Handb Clin Neurol 2011;102:223-61. PMID 21601069

Meadows JC, Munro SS. Palinopsia. J Neurol Neurosurg Psychiatry 1977;40(1):5-8. PMID 845607

Podoll K, Robinson D. Lewis Carroll's migraine experiences. Lancet 1999;353(9161):1366. PMID 10218566

Radoeva PD, Prasad S, Brainard DH, Aguirre GK. Neural activity within area V1 reflects unconscious visual performance in a case of blindsight. J Cogn Neurosci 2008;20(11):1927-39. PMID 18416678

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Dr. Chatterjee returns for this sequel to his prior episode on aphasia. This week, we cover the history and the science of neural networking behind language production and comprehension.

Produced by James E Siegler. Music by Josh Woodward and Andy Cohen. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Ajax ET, Schenkenberg T, Kosteljanetz M. Alexia without agraphia and the inferior splenium. Neurology 1977;27(7):685-8. PMID 559977

Pearce JM. Broca's aphasiacs. Eur Neurol 2009;61(3):183-9. PMID 19129706

Schiff HB, Alexander MP, Naeser MA, Galaburda AM. Aphemia. Clinical-anatomic correlations. Arch Neurol 1983;40(12):720-7. PMID 6625983

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Two weeks ago, Dr. Rubenstein and I discussed one of the difficulties of being a doctor. This week, we're shifting gears, and the focus is now on the patient, particularly the angry patient. Dr. Hamedani shares his experience of being the nicest dude in the world and how he deals with hard-to-deal-with patients.

Produced by James E Siegler and Erika Mejia. Music by Peter Rudenko, Steve Combs, and Lovira. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making. ...But you can probably learn a lot about how to talk with your patients from Dr. Hamedani. So take some notes. He invented the bedside manner.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Not all that shakes are seizures. Last week, we talked about what it's like to have epilepsy. This week, I am joined by Dr. Taneeta "Mindy" Ganguly to discuss what it's like NOT to have epilepsy--meaning to have non-epileptic seizures. But sometimes, you can have both. And this is where it gets tricky for the neurologist.

Produced by James E Siegler. Music by Aitua and Kai Engel. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Reuber M, Elger CE. Psychogenic nonepileptic seizures: review and update. Epilepsy Behav 2003;4(3):205-16. PMID 12791321

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

With the advent of mechanical thrombectomy, some have argued that using intravenous tissue plasminogen activator for stroke is futile. But is it really? Dr. Sheryl Martin-Schild of Dr. Brain, Inc. joins us for today's episode to discuss whether the thrombectomy has killed tPA.

The content in this episode was vetted and approved by Sheryl Martin-Schild. Produced by James E Siegler. Music by Lee Rosevere, Josh Woodward, Kevin McLeod, and Little Glass Men. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Coutinho JM, Liebeskind DS, Slater LA, et al. Combined intravenous thrombolysis and thrombectomy vs thrombectomy alone for acute ischemic stroke: a pooled analysis of the SWIFT and STAR Studies. JAMA Neurol 2017;74(3):268-74. PMID 28097310

Demaerschalk BM, Kleindorfer DO, Adeoye OM, et al. Scientific rationale for the inclusion and exclusion criteria for intravenous alteplase in acute ischemic stroke: a statement for healthcare professionals From the American Heart Association/American Stroke Association. Stroke 2016;47(2):581-641. Erratum in: Stroke 2016;47(11):e262. PMID 26696642

Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet 2016;387(10029):1723-31. PMID 26898852

Hacke W, Kaste M, Fieschi C, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS). JAMA 1995;274(13):1017-25. PMID 7563451

National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995;333(24):1581-7. PMID 7477192

Rai AT, Boo S, Buseman C, et al. Intravenous thrombolysis before endovascular therapy for large vessel strokes can lead to significantly higher hospital costs without improving outcomes. J Neurointerv Surg 2018;10(1):17-21. PMID 28062805

Saver JL, Gornbein J, Grotta J, et al. Number needed to treat to benefit and to harm for intravenous tissue plasminogen activator therapy in the 3- to 4.5-hour window: joint outcome table analysis of the ECASS 3 trial. Stroke 2009;40(7):2433-7. PMID 19498197

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

When it comes to discussions on patient prognosis, it's easy to give bad news. But doing this well, and doing this with tact, is not so easy. It takes poise and preparation and much more experience than you might have previously thought. Dr. Mike Rubenstein shares his approach in this installment of BrainWaves.

Produced by James E Siegler. Music by Andy Cohen, Little Glass Men, and Axeltree. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 2000;5(4):302-11. PMID 10964998

Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine. Lancet 2004;363(9405):312-9. PMID 14751707

Ptacek JT, Eberhardt TL. Breaking bad news. A review of the literature. JAMA 1996;276(6):496-502. PMID 8691562

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. 

Originally released: December 27, 2018

As I'm sitting in a coffee shop in upstate New York this holiday season, procrastinating on the various papers that need writing, bills that need paying, and Christmas cards that need writing, I can't help but feel comforted by the warm relief of a cup of coffee. The rich aroma and jolting heat, which come with the promise of productivity. There's nothing like it. So before resigning to my post-holiday to-do list, I thought I would start the day off re-mastering a prior show we put out in 2017 on the neuroscience behind your morning mocha. Enjoy!

Produced by James E Siegler. Music by Andy Cohen and Little Glass Men. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWavesaudio for the latest updates to the podcast.

REFERENCES

Ferré S. An update on the mechanisms of the psychostimulant effects of caffeine. J Neurochem 2008;105(4):1067-79. PMID 18088379

Martín ED, Buño W. Caffeine-mediated presynaptic long-term potentiation in hippocampal CA1 pyramidal neurons. J Neurophysiol 2003;89(6):3029-38. PMID 12783948

Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. Food Addit Contam 2003;20(1):1-30. PMID 12519715

Park CA, Kang CK, Son YD, et al. The effects of caffeine ingestion on cortical areas: functional imaging study. Magn Reson Imaging 2014;32(4):366-71. PMID 24512799

Pelchovitz DJ, Goldberger JJ. Caffeine and cardiac arrhythmias: a review of the evidence. Am J Med 2011;124(4):284-9. PMID 21435415

Ribeiro JA, Sebastião AM. Caffeine and adenosine. J Alzheimers Dis 2010;20 Suppl 1:S3-15. PMID 20164566

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Last week, we talked about caffeine, and this week we've moved on to cosmetics. But not the outward kind, the inward kind. Dr. Anjan Chatterjee joins us in this segment on how the military and other professions may leverage mind-altering substances in order to enhance performance. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Chatterjee A. Cosmetic neurology: the controversy over enhancing movement, mentation, and mood. Neurology 2004;63(6):968-74. PMID 15452285

Lieberman HR, Tharion WJ, Shukitt-Hale B, Speckman KL, Tulley R. Effects of caffeine, sleep loss, and stress on cognitive performance and mood during U.S. Navy SEAL training. Sea-Air-Land. Psychopharmacology (Berl) 2002;164(3):250-61. PMID 12424548

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

This Thanksgiving, amidst all the turkey, the stuffing, the cranberry sauce, the ham, and the cornucopia of dessert options, you may be inclined to let the food coma sink in. But for those interested in the science behind this fanciful feast, listen to what Dr. Jason Maley has to say about the neurologic complications of some of the common dishes served at your holiday spread.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Caruana M, Cauchi R, Vassallo N. Putative role of red wine polyphenols against brain pathology in Alzheimer's and Parkinson's disease. Front Nutr 2016;3:31. PMID 27570766

Clauss HE, Lorber B. Central nervous system infection with Listeria monocytogenes. Curr Infect Dis Rep 2008;10(4):300-6. PMID 18765103

Garcia HH, Del Brutto OH; Cysticercosis Working Group in Peru. Neurocysticercosis: updated concepts about an old disease. Lancet Neurol 2005;4(10):653-61. PMID 16168934

Hillbom M, Saloheimo P, Fujioka S, Wszolek ZK, Juvela S, Leone MA. Diagnosis and management of Marchiafava-Bignami disease: a review of CT/MRI confirmed cases. J Neurol Neurosurg Psychiatry 2014;85(2):168-73. PMID 23978380

Richard DM, Dawes MA, Mathias CW, Acheson A, Hill-Kapturczak N, Dougherty DM. L-tryptophan: basic metabolic functions, behavioral research and therapeutic indications. Int J Tryptophan Res 2009;2:45-60. PMID 20651948

Sobel J. Botulism. Clin Infect Dis 2005;41(8):1167-73. PMID 16163636

Williams ES. Chronic wasting disease. Vet Pathol 2005;42(5):530-49. PMID 16145200

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

If you have sickle cell disease, you have a 1 in 10 chance of experiencing a stroke before college. And if you don't think that's going to hold you back, you don't know stroke. This week on BrainWaves, Dr. Erica Jones shares her experience with the neurologic complications of sickle cell anemia and the latest guidelines for managing patients with this condition. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Bang OY, Fujimura M, Kim SK. The pathophysiology of Moyamoya disease: an update. J Stroke 2016;18(1):12-20. PMID 26846756

“Data & Statistics." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/datastatistics/index.html. 2016.

Gueguen A, Mahevas M, Nzouakou R, et al. Sickle-cell disease stroke throughout life: a retrospective study in an adult referral center. Am J Hematol 2014;89(3):267-72. PMID 24779035

Lionnet F, Hammoudi N, Stojanovic KS, et al. Hemoglobin sickle cell disease complications: a clinical study of 179 cases. Haematologica 2012;97(8):1136-41. PMID 22315500

Motulsky AG. Frequency of sickling disorders in U.S. blacks. N Engl J Med 1973;288(1):31-3. PMID 4681897

Ohene-Frempong K, Weiner SJ, Sleeper LA, et al. Cerebrovascular accidents in sickle cell disease: rates and risk factors. Blood 1998;91(1):288-94. PMID 9414296

Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Engl J Med 2009;360(12):1226-37. PMID 19297575

Strouse JJ, Lanzkron S, Urrutia V. The epidemiology, evaluation and treatment of stroke in adults with sickle cell disease. Expert Rev Hematol 2011;4(6):597-606. PMID 22077524

Switzer JA, Hess DC, Nichols FT, Adams RJ. Pathophysiology and treatment of stroke in sickle-cell disease: present and future. Lancet Neurol 2006;5(6):501-12. PMID 16713922

Verduzco LA, Nathan DG. Sickle cell disease and stroke. Blood 2009;114(25):5117-25. PMID 19797523

Wang WC, Dwan K. Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease. Cochrane Database Syst Rev 2013;(11):CD003146. PMID 24226646

Ware RE, Helms RW; SWiTCH Investigators. Stroke With Transfusions Changing to Hydroxyurea (SWiTCH). Blood 2012;119(17):3925-32. PMID 22318199

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 14, 2019

In 2016, we heard the results of the MGTX trial--a pivotal investigation that demonstrated the efficacy of thymectomy for select patients with non-thymomatous myasthenia gravis. This spring, we saw the long-term follow-up data from the MGTX investigators. In this week's re-run, we summarize these data, critique it, and reflect on how it may change clinical practice.

Produced by James E Siegler. Music courtesy of Scott Holmes and Lee Rosevere. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWaves audio for the latest updates to the podcast.

REFERENCES

Blalock A, Harvey AM, Ford FR, Lilienthal JL. The treatment of myasthenia gravis by removal of the thymus gland. JAMA 1941;117:1529-33.

Oosterhuis HJ. Observations of the natural history of myasthenia gravis and the effect of thymectomy. Ann N Y Acad Sci 1981;377:678-90. PMID 6951492

Wolfe GI, Kaminski HJ, Aban IB, et al. Randomized trial of thymectomy in myasthenia gravis. N Engl J Med 2016;375(6):511-22. Erratum in: N Engl J Med 2017;376(21):2097. [Dosage error in article text]. PMID 27509100

Wolfe GI, Kaminski HJ, Aban IB, et al. Long-term effect of thymectomy plus prednisone versus prednisone alone in patients with non-thymomatous myasthenia gravis: 2-year extension of the MGTX randomised trial. Lancet Neurol 2019;18(3):259-68. PMID 30692052

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Yes, we have harnessed the power of paralysis. Botulinum toxin, which is produced by a lethal bacterium, Clostridium botulinum, has been bottled and sold to neurologists for decades. And you know this because you've seen people who received Botox to relax their facial muscles. In this week's installment, Dr. Anh-Thu Vu discusses how neurologists utilize this neurotoxic agent. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. The content in this episode was vetted and approved by Anh-Thu Vu.

REFERENCES

Arnon SS, Schechter R, Inglesby TV, et al. Botulinum toxin as a biological weapon: medical and public health management. JAMA 2001;285(8):1059-70. Erratum in: JAMA 2001;285(16):2081. PMID 11209178

Aurora SK, Winner P, Freeman MC, et al. OnabotulinumtoxinA for treatment of chronic migraine: pooled analyses of the 56-week PREEMPT clinical program. Headache 2011;51(9):1358-73. PMID 21883197

Dauer WT, Burke RE, Greene P, Fahn S. Current concepts on the clinical features, aetiology and management of idiopathic cervical dystonia. Brain. 1998 Apr;121 ( Pt 4):547-60. PMID 9577384

Elia AE, Filippini G, Calandrella D, Albanese A. Botulinum neurotoxins for post-stroke spasticity in adults: a systematic review. Mov Disord 2009;24(6):801-12. PMID 19224614

Karp BI. Botulinum toxin treatment of occupational and focal hand dystonia. Mov Disord 2004;19 Suppl 8:S116-9. PMID 15027063

Lotia M, Jankovic J. Botulinum toxin for the treatment of tremor and tics. Semin Neurol 2016;36(1):54-63. PMID 26866497

Naumann M, Dressler D, Hallett M, et al. Evidence-based review and assessment of botulinum neurotoxin for the treatment of secretory disorders. Toxicon 2013;67:141-52. PMID 23178324

Thenganatt MA, Fahn S. Botulinum toxin for the treatment of movement disorders. Curr Neurol Neurosci Rep 2012;12(4):399-409. PMID 22661378

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

I can't imagine a better way to celebrate our FIFTIETH episode than to discuss my favorite subject: large vessel disease. Although we only cover one aspect of this stroke mechanism--atherosclerosis--and technically many of these trials may be somewhat outdated, the matter discussed in this episode remains the most up-to-date in the field. Take a listen. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Chambers BR, Donnan GA. Carotid endarterectomy for asymptomatic carotid stenosis. Cochrane Database Syst Rev 2005;2005(4):CD001923. PMID 16235289

Chaturvedi S, Bruno A, Feasby T, et al. Carotid endarterectomy--an evidence-based review: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2005;65(6):794-801. PMID 16186516

Hosseini AA, Kandiyil N, Macsweeney ST, Altaf N, Auer DP. Carotid plaque hemorrhage on magnetic resonance imaging strongly predicts recurrent ischemia and stroke. Ann Neurol 2013;73(6):774-84. PMID 23463579

Jauch EC, Saver JL, Adams HP Jr, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013;44(3):870-947. PMID 23370205

Kakkos SK, Nicolaides AN, Charalambous I, et al. Predictors and clinical significance of progression or regression of asymptomatic carotid stenosis. J Vasc Surg 2014;59(4):956-967.e1. PMID 24377944

Lovett JK, Coull AJ, Rothwell PM. Early risk of recurrence by subtype of ischemic stroke in population-based incidence studies. Neurology 2004;62(4):569-73. PMID 14981172

Mantese VA, Timaran CH, Chiu D, Begg RJ, Brott TG; CREST Investigators. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): stenting versus carotid endarterectomy for carotid disease. Stroke 2010;41(10 Suppl):S31-4. PMID 20876500

Rothwell PM, Eliasziw M, Gutnikov SA, et al. Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet 2003;361(9352):107-16. PMID 12531577

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Idiopathic intracranial hypertension, also known as the pseudotumor cerebri syndrome, is characterized by elevated intracranial pressure with clinical features of headaches, vision impairment, and occasionally cranial nerve palsies in the absence of a structural lesion on neuroimaging. But that doesn't mean the neuroimaging has to be normal. See what Dr. Anita Kohli has to say about the radiographic correlates of idiopathic intracranial hypertension, their relevance, and their prognostic utility in this week's episode.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Agid R, Farb RI, Willinsky RA, Mikulis DJ, Tomlinson G. Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs. Neuroradiology 2006;48(8):521-7. PMID 16703359

Bidot S, Bruce BB. Update on the diagnosis and treatment of idiopathic intracranial hypertension. Semin Neurol 2015;35(5):527-38. PMID 26444398

Bidot S, Clough L, Saindane AM, Newman NJ, Biousse V, Bruce BB. The optic canal size is associated with the severity of papilledema and poor visual function in idiopathic intracranial hypertension. J Neuroophthalmol 2016;36(2):120-5. PMID 26580295

Bidot S, Saindane AM, Peragallo JH, Bruce BB, Newman NJ, Biousse V. Brain imaging in idiopathic intracranial hypertension. J Neuroophthalmol 2015;35(4):400-11. PMID 26457687

Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 2013;81(13):1159-65. PMID 23966248

Zagardo MT, Cail WS, Kelman SE, Rothman MI. Reversible empty sella in idiopathic intracranial hypertension: an indicator of successful therapy? AJNR Am J Neuroradiol 1996;17(10):1953-6. PMID 8933886

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: October 14, 2018

There is nothing mysterious about the chemistry of the cerebrospinal fluid. Cells. Protein. Glucose. But the interplay of these unique components can give you incredible insight into the state of the central nervous system. This week, we revisit a prior episode where Dr. Mike Rubenstein reviews his approach to interpreting CSF results. And then we have an update at the end regarding recent advances in CSF analysis.

Produced by James E Siegler and Michael Rubenstein. Music by Steve Combs. Sound effects by Mike Koenig and Daniel Simion. Voiceover by Patrick Green (German). BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. If you like what you hear, let us know, and rate the show!

REFERENCES

Deisenhammer F, Bartos A, Egg R, et al. Guidelines on routine cerebrospinal fluid analysis. Report from an EFNS task force. Eur J Neurol 2006;13(9):913-22. PMID 16930354

Frederiks JA, Koehler PJ. The first lumbar puncture. J Hist Neurosci 1997;6(2):147-53. PMID 11619518

Messacar K, Schreiner TL, Van Haren K, et al. Acute flaccid myelitis: a clinical review of US cases 2012-2015. Ann Neurol 2016;80(3):326-38. PMID 27422805

Nagel MA, Cohrs RJ, Mahalingam R, et al. The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. Neurology 2008;70(11):853-60. PMID 18332343

Seehusen DA, Reeves MM, Fomin DA. Cerebrospinal fluid analysis. Am Fam Physician 2003;68(6):1103-8. PMID 14524396

Shah KH, Edlow JA. Distinguishing traumatic lumbar puncture from true subarachnoid hemorrhage. J Emerg Med 2002;23(1):67-74. PMID 12217474

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

In 1959, Adams and colleagues described a few patients who developed a rapid flaccid quadriparesis following fluid resuscitation for malnutrition and chronic alcoholism. Twenty years later, we learned that this occurs as a consequence of rapid correction of hyponatremia. But this isn't the only cause of the osmotic demyelination syndrome. Hear Dr. Joshua VanDerWerf discuss the history and clinical relevance of this unusual critical care scenario.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Adams RD, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. AMA Arch Neurol Psychiatry 1959;81(2):154-72. PMID 13616772

Gocht A, Colmant HJ. Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropathol 1987;6(6):262-70. PMID 3322623

Kleinschmidt-Demasters BK, Rojiani AM, Filley CM. Central and extrapontine myelinolysis: then...and now. J Neuropathol Exp Neurol 2006;65(1):1-11. PMID 16410743

Martin RJ. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes. J Neurol Neurosurg Psychiatry 2004;75 Suppl 3(Suppl 3):iii22-8. PMID 15316041

Menger H, Jörg J. Outcome of central pontine and extrapontine myelinolysis (n = 44). J Neurol 1999;246(8):700-5. PMID 10460448

Siegler JE, Wang AR, Vanderwerf JD. Normonatremic osmotic demyelination in the setting of acquired immune deficiency syndrome and malnutrition: case report and literature review. J Neurovirol 2016;22(6):876-9. PMID 27405987

Wright DG, Laureno R, Victor M. Pontine and extrapontine myelinolysis. Brain 1979;102(2):361-85. PMID 455045

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

The request for a consult is like calling in a favor. You shouldn't actually expect the consultant to do it; you should be polite and helpful in all the ways your grandmother expects you to behave. At least, that's the courtesy I've seen from really spectacular providers. In this week's episode, we review the proper etiquette for calling a consult, and you'll also hear some pearls on the workup for altered mental status.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES: None this week. (Sorry!)

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: June 20, 2019

You might think George Clooney gets his devilishly handsome smile from well-polished genes or a long history of acting lessons. As it turns out, he has mild residual weakness from a remote Bell palsy.

In this week's installment of the BrainWaves podcast, we've got even more factoids about the facial nerve as we revisit a prior show that originally aired in January 2017. We've touched up the audio a bit, so get comfortable and grab a pen; you may want to take notes on this one.

Produced by James E Siegler. Music courtesy of Marcos H. Bolanos, Jon Watts & Lee Rosevere. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWaves audio for the latest updates to the podcast.

REFERENCES

Gaio E, Marioni G, de Filippis C, Tregnaghi A, Caltran S, Staffieri A. Facial nerve paralysis secondary to acute otitis media in infants and children. J Paediatr Child Health 2004;40(8):483-6. PMID 15265194

Gilden DH. Clinical practice. Bell's Palsy. N Engl J Med 2004;351(13):1323-31. PMID xxxxxxx

Habel A. Ueber Fortbestehen von Tic convulsif bei gleichseitiger Hemiplegie. Deutsche Med Wchnschr 1898;24:189.

Sweeney CJ, Gilden DH. Ramsay Hunt syndrome. J Neurol Neurosurg Psychiatry 2001;71(2):149-54. PMID 11459884

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Trauma and hypertension account for the overwhelming majority of cases of intracerebral hemorrhage. Today, we address the minority. In this week's episode, Dr. Steven Messe discusses the atypical causes of intracerebral hemorrhage and how they are managed.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Biffi A, Greenberg SM. Cerebral amyloid angiopathy: a systematic review. J Clin Neurol 2011;7(1):1-9. PMID 21519520

Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol 2009;8(8):731-40. PMID 19608099

Mast H, Young WL, Koennecke HC, et al. Risk of spontaneous haemorrhage after diagnosis of cerebral arteriovenous malformation. Lancet 1997;350(9084):1065-8. PMID 10213548

Ruíz-Sandoval JL, Cantú C, Barinagarrementeria F. Intracerebral hemorrhage in young people: analysis of risk factors, location, causes, and prognosis. Stroke 1999;30(3):537-41. PMID 10066848

Siegler JE, Ichord RN. Teaching neuroimages: multicompartmental intracranial hemorrhage in a pediatric patient. Neurology 2016;87(23):e284. PMID 27920292

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Prions are perhaps some of the most terrifying infectious particles known to man. But did you know that patients with some prion diseases actually shed these contagious proteins in their urine? These and other facts about prion diseases are discussed in this week's episode of BrainWaves.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Zabel MD, Reid C. A brief history of prions. Pathog Dis 2015;73(9):ftv087. PMID 26449713

Rutala WA, Weber DJ. Creutzfeldt-Jakob disease: recommendations for disinfection and sterilization. Clin Infect Dis 2001;32(9):1348-56. PMID 11303271

Glatzel M, Abela E, Maissen M, Aguzzi A. Extraneural pathologic prion protein in sporadic Creutzfeldt-Jakob disease. N Engl J Med 2003;349(19):1812-20. PMID 14602879

Moda F, Gambetti P, Notari S, et al. Prions in the urine of patients with variant Creutzfeldt-Jakob disease. N Engl J Med 2014;371(6):530-9. PMID 25099577

Wieser HG, Schindler K, Zumsteg D. EEG in Creutzfeldt-Jakob disease. Clin Neurophysiol 2006;117(5):935-51. PMID 16442343

Lapergue B, Demeret S, Denys V, et al. Sporadic Creutzfeldt-Jakob disease mimicking nonconvulsive status epilepticus. Neurology 2010;74(24):1995-9. PMID 20445151

Siegler JE, Jacobs DA, Amado D, Adams JL, Berger JR. Rapidly progressive dementia with hypoglycorrhachia. J Clin Neurosci 2015;22(10):1685-7. PMID 26094562

Geschwind MD. Prion diseases. Continuum (Minneap Minn) 2015;21:1612-38. PMID 26633779

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

I am not sure there are many things more terrifying than watching your child experience what looks like “just a cold” and then, over the course of a few hours, become paralyzed. In this episode, Drs. Ana Cristancho and Sarah Hopkins describe what we know about this recent polio-like outbreak in the United States.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. This episode was vetted and approved by Dr. Sarah Hopkins.

REFERENCES

Aliabadi N, Messacar K, Pastula DM, et al. Enterovirus D68 infection in children with acute flaccid myelitis, Colorado, USA, 2014. Emerg Infect Dis 2016;22(8):1387-94. PMID 27434186

Greninger AL, Naccache SN, Messacar K, et al. A novel outbreak enterovirus D68 strain associated with acute flaccid myelitis cases in the USA (2012-14): a retrospective cohort study. Lancet Infect Dis 2015;15(6):671-82. PMID 25837569

Messacar K, Schreiner TL, Van Haren K, et al. Acute flaccid myelitis: a clinical review of US cases 2012-2015. Ann Neurol 2016;80(3):326-38. PMID 27422805

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 24, 2019

In 2016, Dr. Ali Hamedani summarized the basic principles underlying a neurologic evaluation for acute dizziness--the acute vestibular syndrome. We've remastered the prior show, and added a few new factoids for you in this 2019 remake. Enjoy!

Produced by James E Siegler. Music courtesy of John Bartman and Kevin McLeod. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWavesaudio for the latest updates to the podcast.

REFERENCES

Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke 2009;40(11):3504-10. PMID 19762709

Kerber KA. Acute constant dizziness. Continuum (Minneap Minn) 2012;18(5 Neuro-otology):1041-59. PMID 23042059

Kim JS, Zee DS. Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med 2014;370(12):1138-47. PMID 24645946

Lempert T. Vestibular migraine. Semin Neurol 2013;33(3):212-8. PMID 24057824

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

For those of you who've witnessed it, giving levodopa to a patient with idiopathic Parkinson disease is almost a miracle to watch. Unlike practically every other condition afflicting the nervous system, the unmistakable unrest of Parkinson disease essentially surrenders to this tiny tablet. But what did we use before levodopa? In this week's episode of BrainWaves, we recount the history (and serendipity) behind the development of this miracle drug.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Birkmayer W, Hornykiewicz O. [The L-3,4-dioxyphenylalanine (DOPA)-effect in Parkinson-akinesia]. German. Wien Klin Wochenschr 1961;73:787-8. PMID 13869404

Bucy P and Case T. Tremor: Physiologic mechanism and abolition by surgical means. Arch Neurol Psych 1939;41:721-746.

Cotzias GC, Van Woert MH, Schiffer LM. Aromatic amino acids and modification of parkinsonism. N Engl J Med 1967;276(7):374-9. PMID 5334614

Glatstein M, Alabdulrazzaq F, Scolnik D. Belladonna alkaloid intoxication: the 10-year experience of a large tertiary care pediatric hospital. Am J Ther 2016;23(1):e74-7. PMID 24263161

Hornykiewicz O. A brief history of levodopa. J Neurol 2010;257(Suppl 2):S249-52. PMID 21080185

Koranyi EK. A preamble on parkinsonism. J Psychiatry Neurosci 1999;24(4):296-9. PMID 10516795

Parkinson J. An essay on the shaking palsy. 1817. J Neuropsychiatry Clin Neurosci 2002;14(2):223-36; discussion 222. PMID 11983801

Tolosa E, Martí MJ, Valldeoriola F, Molinuevo JL. History of levodopa and dopamine agonists in Parkinson's disease treatment. Neurology 1998;50(6 Suppl 6):S2-10; discussion S44-8. PMID 9633679

Walter BL, Abosch A and Vitek JL. From Neuroscience to Neurology: Molecular Medicine, and the Therapeutic Transformation of Neurology. 2004.

Willis AW, Schootman M, Kung N, Wang XY, Perlmutter JS, Racette BA. Disparities in deep brain stimulation surgery among insured elders with Parkinson disease. Neurology 2014;82(2):163-71. PMID 24336138

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Rio is front and center of the world right now, not just because of the 2016 Olympic games but also because it harbors the Zika virus. In this episode, infectious disease specialist Dr. Jennifer McGuire speaks with Dr. Ana Cristancho about the things every neurologist needs to know about this worldwide outbreak.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was approved and vetted by Jennifer McGuire.

REFERENCES

Bogoch II, Brady OJ, Kraemer MU, et al. Anticipating the international spread of Zika virus from Brazil. Lancet 2016;387(10016):335-6. PMID 26777915

Campos GS, Bandeira AC, Sardi SI. Zika virus outbreak, Bahia, Brazil. Emerg Infect Dis 2015;21(10):1885-6. PMID 26401719

Duffy MR, Chen TH, Hancock WT, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 2009;360(24):2536-43. PMID 19516034

Hayes EB. Zika virus outside Africa. Emerg Infect Dis 2009;15(9):1347-50. PMID 19788800

Mlakar J, Korva M, Tul N, et al. Zika virus associated with microcephaly. N Engl J Med 2016;374(10):951-8. PMID 26862926

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 12, 2018

It seems like a new antibody in autoimmune central nervous system disorders is being discovered every day. Well, maybe not that frequently. But autoimmune encephalitis may now be as common as infectious encephalitis. In this week's program, we revisit an episode from 2016 where Dr. Ramani Balu (neurocritical care) shares his experience in evaluating and managing patients with these conditions.

Produced by James E Siegler. Music by Three Chain Links, Lee Rosevere, and Kevin McLeod. Sound effects by Mike Koenig. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Anderson NE, Barber PA. Limbic encephalitis - a review. J Clin Neurosci 2008;15(9):961-71. PMID 18411052

Dubey D, Pittock SJ, Kelly CR, et al. Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis. Ann Neurol 2018;83(1):166-177. PMID 29293273

Irani SR, Michell AW, Lang B, et al. Faciobrachial dystonic seizures precede Lgi1 antibody limbic encephalitis. Ann Neurol 2011;69(5):892-900. PMID 21416487

Lancaster E, Martinez-Hernandez E, Dalmau J. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology 2011;77(2):179-89. PMID 21747075

Rosenfeld MR, Dalmau JO. Paraneoplastic disorders of the CNS and autoimmune synaptic encephalitis. Continuum (Minneap Minn) 2012;18(2):366-83. PMID 22810133

Schmitt SE, Pargeon K, Frechette ES, Hirsch LJ, Dalmau J, Friedman D. Extreme delta brush: a unique EEG pattern in adults with anti-NMDA receptor encephalitis. Neurology 2012;79(11):1094-100. PMID 22933737

Titulaer MJ, McCracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol 2013;12(2):157-65. PMID 23290630

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Abnormal eye movements can be...abnormal. We have already briefly covered efferent dysfunction in an earlier episode ("#9 Teaching through clinical cases: Painless ophthalmoparesis"), but now Dr. Ali Hamedani is back and excited to discuss how we characterize and localize nystagmus in the central nervous system.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. This episode was vetted and approved by Robert Avery.

REFERENCES

Liu GT, Volpe NJ, Galetta SL. Neuro-Ophthalmology: Diagnosis And Management. 2nd ed. Elsevier, 2010:587-610.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Idiopathic Parkinson disease is the second most common cause of neurodegenerative disease following Alzheimer disease. The risk of Parkinson disease increases to nearly 1 in 100 in the elderly, and although we have been pharmacologically treating this disorder since the early nineteenth century, we have no cure and no definite therapy to delay disease progression. In this episode of BrainWaves, Dr. David Coughlin illustrates how some of these therapies have evolved and which classes of medications to choose when managing a patient's symptoms--from tremor to dystonia.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was vetted and approved by Andres Deik.

REFERENCES

Anonymous. A randomized controlled trial comparing pramipexole with levodopa in early Parkinson's disease: design and methods of the CALM-PD Study. Parkinson Study Group. Clin Neuropharmacol 2000;23(1):34-44. PMID 10682229

Elias WJ, Lipsman N, Ondo WG, et al. A randomized trial of focused ultrasound thalamotomy for essential tremor. N Engl J Med 2016;375(8):730-9. PMID 27557301

Fahn S, Oakes D, Shoulson I, et al. Levodopa and the progression of Parkinson's disease. N Engl J Med 2004;351(24):2498-508. PMID 15590952

Hely MA, Reid WG, Adena MA, Halliday GM, Morris JG. The Sydney multicenter study of Parkinson's disease: the inevitability of dementia at 20 years. Mov Disord 2008;23(6):837-44. PMID 18307261

Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. 1967. Neurology 1998;50(2):318-34. PMID 9484345

McIntyre CC, Savasta M, Kerkerian-Le Goff L, Vitek JL. Uncovering the mechanism(s) of action of deep brain stimulation: activation, inhibition, or both. Clin Neurophysiol 2004;115(6):1239-48. PMID 15134690

Olanow CW. Levodopa: effect on cell death and the natural history of Parkinson's disease. Mov Disord 2015;30(1):37-44. PMID 25502620

PD Med Collaborative Group; Gray R, Ives N, et al. Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson's disease (PD MED): a large, open-label, pragmatic randomised trial. Lancet 2014;384(9949):1196-205. Erratum in: Lancet 2014;384(9949):1186. PMID 24928805

Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA 2009;301(1):63-73. PMID 19126811

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 23, 2018

When the heart stops working, the brain stops working. But if the brain stops working, does the heart shut down? In this episode, Dr. David Manly (Duke Cardiology) discusses the pathogenesis and management of the reversible syndromes of neurogenic stress cardiomyopathy. In full disclosure, this is a re-mastered re-run of a prior episode posted June 29, 2016, with some updates at the end.

Produced by James E Siegler. Music by Lee Rosevere. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Banki NM, Kopelnik A, Dae MW, et al. Acute neurocardiogenic injury after subarachnoid hemorrhage. Circulation 2005;112(21):3314-9. PMID 16286583

Bybee KA, Prasad A. Stress-related cardiomyopathy syndromes. Circulation 2008;118(4):397-409. PMID 18645066

Eitel I, von Knobelsdorff-Brenkenhoff F, Bernhardt P, et al. Clinical characteristics and cardiovascular magnetic resonance findings in stress (takotsubo) cardiomyopathy. JAMA 2011;306(3):277-86. PMID 21771988

Finsterer J, Wahbi K. CNS-disease affecting the heart: brain-heart disorders. J Neurol Sci 2014;345(1-2):8-14. PMID 25034054

Grabowski A, Kilian J, Strank C, Cieslinski G, Meyding-Lamadé U. Takotsubo cardiomyopathy--a rare cause of cardioembolic stroke. Cerebrovasc Dis 2007;24(1):146-8. PMID 17565206

Lyon AR, Rees PS, Prasad S, Poole-Wilson PA, Harding SE. Stress (Takotsubo) cardiomyopathy--a novel pathophysiological hypothesis to explain catecholamine-induced acute myocardial stunning. Nat Clin Pract Cardiovasc Med 2008;5(1):22-9. PMID 18094670

Paur H, Wright PT, Sikkel MB, et al. High levels of circulating epinephrine trigger apical cardiodepression in a β2-adrenergic receptor/Gi-dependent manner: a new model of Takotsubo cardiomyopathy. Circulation 2012;126(6):697-706. PMID 22732314

Stiermaier T, Moeller C, Oehler K, et al. Long-term excess mortality in takotsubo cardiomyopathy: predictors, causes and clinical consequences. Eur J Heart Fail 2016;18(6):650-6. PMID 26990821

Yoshimura S, Toyoda K, Ohara T, et al. Takotsubo cardiomyopathy in acute ischemic stroke. Ann Neurol 2008;64(5):547-54. PMID 18688801

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Myasthenia gravis is a disorder characterized by proximal weakness, ptosis, and antibody formation against proteins at the neuromuscular junction. Most commonly, the protein targeted by antibodies is the nicotinic acetylcholine receptor. However, research in the last 2 decades has identified a number of other antibody targets, which we have reviewed here in this BrainWaves brief.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was vetted and approved by Grant T Liu.

REFERENCES

Dalmau J, Rosenfeld MR. Paraneoplastic syndromes of the CNS. Lancet Neurol 2008;7(4):327-40. PMID 18339348

Evoli A, Lancaster E. Paraneoplastic disorders in thymoma patients. J Thorac Oncol 2014;9(9 Suppl 2):S143-7. PMID 25396312

Gilhus NE, Verschuuren JJ. Myasthenia gravis: subgroup classification and therapeutic strategies. Lancet Neurol 2015;14(10):1023-36. PMID 26376969

Hurst RL, Gooch CL. Muscle-specific receptor tyrosine kinase (MuSK) myasthenia gravis. Curr Neurol Neurosci Rep 2016;16(7):61. PMID 27170368

Koneczny I, Cossins J, Vincent A. The role of muscle-specific tyrosine kinase (MuSK) and mystery of MuSK myasthenia gravis. J Anat 2014;224(1):29-35. PMID 23458718

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Although physicians use medications to treat headaches, the mind can become tolerant. In fact, many otherwise helpful medications may even aggravate a pre-existing headache syndrome. In this BrainWaves brief, we discuss the concept of medication-overuse headache and its treatment, which may be counterintuitive and is often challenging for patients.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was vetted and approved by Roderick Spears.

REFERENCES

Diener HC, Limmroth V. Medication-overuse headache: a worldwide problem. Lancet Neurol 2004;3(8):475-83. PMID 15261608

Dodick DW. Clinical practice. Chronic daily headache. N Engl J Med 2006;354(2):158-65. Erratum in: N Engl J Med 2006;354(8):884. PMID 16407511

Tomkins GE, Jackson JL, O'Malley PG, Balden E, Santoro JE. Treatment of chronic headache with antidepressants: a meta-analysis. Am J Med 2001;111(1):54-63. PMID 11448661

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 5, 2019

In 2016, when we first launched the BrainWaves podcast, cryptogenic stroke was a poorly understood concept. Three years later, it remains poorly understood. But we are making progress. In this week's update of episode 10, we review the progress that has been made in the pathogenesis, diagnosis, and management of these patients.

Produced by James E Siegler. The original 2016 version of this show was also produced by Dr. Noah Levinson. Music courtesy of Josh Woodward, Julie Maxwell, Dan Lebowitz, and this group called E’s Jammy Jams. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWavesaudio for the latest updates to the podcast.

REFERENCES

Di Tullio M, Sacco RL, Gopal A, Mohr JP, Homma S. Patent foramen ovale as a risk factor for cryptogenic stroke. Ann Intern Med 1992;117(6):461-5. PMID 1503349

Diener HC, Sacco RL, Easton JD, et al. Dabigatran for prevention of stroke after embolic stroke of undetermined source. N Engl J Med 2019;380(20):1906-17. PMID 31091372

Fonseca AC, Ferro JM. Drug abuse and stroke. Curr Neurol Neurosci Rep 2013;13(2):325. PMID 23299821

Hart RG, Sharma M, Mundl H, et al. Rivaroxaban for stroke prevention after embolic stroke of undetermined source. N Engl J Med 2018;378(23):2191-201. PMID 29766772

Jacobs BS, Boden-Albala B, Lin IF, Sacco RL. Stroke in the young in the northern Manhattan stroke study. Stroke 2002;33(12):2789-93. PMID 12468771

Juul K, Tybjaerg-Hansen A, Steffensen R, Kofoed S, Jensen G, Nordestgaard BG. Factor V Leiden: The Copenhagen City Heart Study and 2 meta-analyses. Blood 2002;100(1):3-10. PMID 12070000

Kaku DA, Lowenstein DH. Emergence of recreational drug abuse as a major risk factor for stroke in young adults. Ann Intern Med 1990;113(11):821-7. PMID 2240897

Li J, Liu J, Liu M, et al. Closure versus medical therapy for preventing recurrent stroke in patients with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack. Cochrane Database Syst Rev 2015;2015(9):CD009938. PMID 26346232

Mas JL, Derumeaux G, Guillon B, et al. Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke. N Engl J Med 2017;377(11):1011-21. PMID 28902593

Overell JR, Bone I, Lees KR. Interatrial septal abnormalities and stroke: a meta-analysis of case-control studies. Neurology 2000;55(8):1172-9. PMID 11071496

Perera KS, Ng KK, Nayar S, et al. Association between low-dose rivaroxaban with or without aspirin and ischemic stroke subtypes: a secondary analysis of the COMPASS Trial. JAMA Neurol 2020;77(1):43-8. PMID 31524941

Saver JL, Carroll JD, Thaler DE, et al. Long-term outcomes of patent foramen ovale closure or medical thera

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Long-term antithrombotic treatment of embolic stroke sounds like a tricky field to navigate. Aspirin is the drug of choice in the acute setting for most patients, but when cardioembolic stroke is suspected, aspirin is inferior to anticoagulation for preventing recurrent stroke. In the age of novel oral anticoagulants, why choose warfarin and risk drug interactions, dietary restrictions, and bleeding risk? In this episode, we discuss the pros and cons of each of the major NOACs for secondary stroke prevention. Enjoy!

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information.

REFERENCES

Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009;361(12):1139-51. Erratum in: N Engl J Med 2010;363(19):1877. PMID 19717844

Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2013;369(22):2093-104. PMID 24251359

Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011;365(11):981-92. PMID 21870978

Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011;365(10):883-91. PMID 21830957

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 1, 2021

Even before the release of the 2015 film, Concussion, there has been a rising concern about mild traumatic brain injury in athletes in recent years. In this week's episode of BrainWaves, we discuss the history of mild traumatic brain injury and the clinicopathologic concept of chronic traumatic encephalopathy as it pertains to football players. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Giza CC, Kutcher JS, Ashwal S, et al. Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013;80(24):2250-7. PMID 23508730

Guskiewicz KM, Marshall SW, Bailes J, et al. Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery 2005;57(4):719-26; discussion 719-26. PMID 16239884

Montenigro PH, Corp DT, Stein TD, Cantu RC, Stern RA. Chronic traumatic encephalopathy: historical origins and current perspective. Annu Rev Clin Psychol 2015;11:309-30. PMID 25581233

Stamm JM, Bourlas AP, Baugh CM, et al. Age of first exposure to football and later-life cognitive impairment in former NFL players. Neurology 2015;84(11):1114-20. PMID 25632088

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date. 

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

With so many disease-modifying therapies out there, how do you decide which drug to use in your patient with multiple sclerosis? BrainWaves makes it simple. In this interview with Dr. Christopher Perrone, we review the US FDA-approved therapies for relapsing-remitting multiple sclerosis, their mechanisms of action, side effects, and benefits. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was approved and vetted by Salim Chahin.

REFERENCES

Torkildsen O, Myhr KM, Bo L. Disease-modifying treatments for multiple sclerosis - a review of approved medications. Eur J Neurol 2016;23(Suppl 1):18-27. PMID 26563094

Wingerchuk DM, Carter JL. Multiple sclerosis: current and emerging disease-modifying therapies and treatment strategies. Mayo Clin Proc 2014;89(2):225-40. PMID 24485135

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Once heralded as "benign" essential tremor, this movement disorder is anything but. And you can see this when you talk with your neurology patients about the difficulties they encounter with dressing, eating, and even speaking--not to mention the social stigmata and cognitive dysfunction. In this BrainWaves episode, we start by describing the fundamentals of tremor and move on to the clinical features, pharmacology, and prognosis of essential tremor. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information.

REFERENCES

Deuschl G, Raethjen J, Hellriegel H, Elble R. Treatment of patients with essential tremor. Lancet Neurol 2011;10(2):148-61. PMID 21256454

Louis ED. Diagnosis and management of tremor. Continuum (Minneap Minn) 2016;22(4 Movement Disorders):1143-58. PMID 27495202

Sandvik U, Koskinen LO, Lundquist A, Blomstedt P. Thalamic and subthalamic deep brain stimulation for essential tremor: where is the optimal target? Neurosurgery 2012;70(4):840-5; discussion 845-6. Erratum in: Neurosurgery 2021;88(3):707. PMID 22426044

Zesiewicz TA, Elble R, Louis ED, et al. Practice parameter: therapies for essential tremor: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2005;64(12):2008-20. PMID 15972843

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

The Landry-Guillain-Barre-Strohl Syndrome, aka Guillain-Barre Syndrome, is classically thought of as a painless ascending weakness with areflexia that typically follows an infectious prodrome. But there are a dozen variants with unusual clinical presentations, from back pain to pandysautonomia. And sometimes Guillain-Barre Syndrome follows a vaccination rather than a viral infection. In this BrainWaves episode, we discuss these and other unique facts regarding the history, clinical manifestations, and treatment of this polyneuropathy. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information.

REFERENCES

Afifi AK. The Landry-Guillain-Barré Strohl syndrome 1859 to 1992 a historical perspective. J Family Community Med 1994;1(1):30-4. PMID 23008532

Asbury AK. Guillain-Barré syndrome: historical aspects. Ann Neurol 1990;27 Suppl:S2-6. PMID 2194421

Bril V, Katzberg HD. Acquired immune axonal neuropathies. Continuum (Minneap Minn) 2014;20(5 Peripheral Nervous System Disorders):1261-73. PMID 25299281

Dimachkie MM, Saperstein DS. Acquired immune demyelinating neuropathies. Continuum (Minneap Minn) 2014;20(5 Peripheral Nervous System Disorders):1241-60. PMID 25299280

Iodice V, Sandroni P. Autonomic neuropathies. Continuum (Minneap Minn) 2014;20(5 Peripheral Nervous System Disorders):1373-97. PMID 25299288

Lehmann HC, Hartung HP, Kieseier BC, Hughes RA. Guillain-Barré syndrome after exposure to influenza virus. Lancet Infect Dis 2010;10(9):643-51. PMID 20797646

Tam CC, O'Brien SJ, Petersen I, Islam A, Hayward A, Rodrigues LC. Guillain-Barré syndrome and preceding infection with campylobacter, influenza and Epstein-Barr virus in the general practice research database. PLoS One 2007;2(4):e344. PMID 17406668

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

This week, we are taking a break from educational neurology and will be stressing the importance of collaboration between patients and physicians. Physicians are critical to healthcare because of their expertise and experience, but medical management is a team sport. It is equally important to incorporate the patient's needs and opinions into the equation. But this leaves us with the concept of "therapeutic privilege," specifically how much does the physician need to tell the patient about his or her own health? In this episode, Jim Siegler steps into the shoes of one of his good friends who has faced a recent cancer diagnosis.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Patrick Green, the patient in this episode, has consented to the discussion of his medical care for the purpose of this broadcast and we are sincerely grateful for his contribution.

REFERENCES

Epstein RM, Korones DN, Quill TE. Withholding information from patients--when less is more. N Engl J Med 2010;362(5):380-1. PMID 20130252

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 13, 2017

It's a throwback Thursday on the podcast. This week, we revisit an old but familiar topic of neuroimaging. What does it tell you about a person, and how does it compare to a photograph? Featuring Salim Chahin (Washington University) and Ali Mendelson (UCSD).

Produced by James E Siegler. Music by Ars Sonor, Lee Rosevere, and Kevin McLeod. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

From the "Gilded Age" to the "germ theory", Dr. Joshua VanDerWerf (physician, historian, humanitarian), illustrates the birth of American neurology. You may recognize the names Chiari, Wernicke, and Broca, but what about William Alexander Hammond or Silas Weir Mitchell? These figures, among others, and their contributions to neurology are the subject of this week's BrainWaves episode. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Goetz CG, Chmura TA, Lanska D. Part 1: the history of 19th century neurology and the American Neurological Association. Ann Neurol 2003;53 Suppl 4:S2-26. PMID 12722087

Koehler PJ, Lanska DJ. Mitchell's influence on European studies of peripheral nerve injuries during World War I. J Hist Neurosci 2004;13(4):326-35. PMID 15545104

Lanska DJ. Characteristics and lasting contributions of 19th-century American neurologists. J Hist Neurosci 2001;10(2):202-16. PMID 11512433

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

In this BrainWaves brief, we review the major infections of the spinal cord with anatomic localization of disease and clinical management. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. This episode was vetted and approved by Colin Quinn.

REFERENCES

Cho TA, Vaitkevicius H. Infectious myelopathies. Continuum (Minneap Minn) 2012;18(6 Infectious Disease):1351-73. PMID 23221845

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Quick tutorial to help you navigate through the causes of foot drop. Check it out!

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was vetted and approved by Colin Quinn for broadcast.

REFERENCES

Preston DC, Shapiro BE. Electromyography and Neuromuscular Disorders. 3rd ed. Saunders, 2013.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

In this episode of BrainWaves, Dr. Joseph Berger discusses the complications of HIV literally from head to toe. From neuropathy to myelopathy to neurocognitive disorders as well as the myriad of opportunistic infections. Definitely worth your time.

BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. The content in this episode was vetted and approved by Joseph Berger for broadcast.

REFERENCES

Boissé L, Gill MJ, Power C. HIV infection of the central nervous system: clinical features and neuropathogenesis. Neurol Clin 2008;26(3):799-819. PMID 18657727

Di Rocco A, Simpson DM. AIDS-associated vacuolar myelopathy. AIDS Patient Care STDS 1998;12(6):457-61. PMID 11361993

Dore GJ, Law MG, Brew BJ. Prospective analysis of seizures occurring in human immunodeficiency virus type-1 infection. J NeuroAIDS 1996;1(4):59-69. PMID 16873179

Ellis R, Langford D, Masliah E. HIV and antiretroviral therapy in the brain: neuronal injury and repair. Nat Rev Neurosci 2007;8(1):33-44. PMID 17180161

Garg RK. HIV infection and seizures. Postgrad Med J 1999;75(885):387-90. PMID 10474720

Murdoch DM, Venter WD, Van Rie A, Feldman C. Immune reconstitution inflammatory syndrome (IRIS): review of common infectious manifestations and treatment options. AIDS Res Ther 2007;4:9. PMID 17488505

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

There's more to epilepsy than AED titration. (Shocking, I know.) Especially in women, management is undeniably complex. For example, the same enzymatic machinery used to metabolize AEDs is also used to break down estrogen-containing oral contraceptives--an interaction that could literally open a Pandora's box of complications. These and other issues affecting the management of women with epilepsy are addressed by Dr. Danielle Becker in this week's BrainWaves podcast. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. This episode was vetted and approved by Danielle Becker.

REFERENCES

Crawford P. Best practice guidelines for the management of women with epilepsy. Epilepsia 2005;46 Suppl 9:117-24. PMID 16302885

Harden CL, Hopp J, Ting TY, et al. Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology 2009;73(2):126-32. PMID 19398682

Herzog AG, Fowler KM, Smithson SD, et al. Progesterone vs placebo therapy for women with epilepsy: a randomized clinical trial. Neurology 2012;78(24):1959-66. PMID 22649214

Meador K, Reynolds MW, Crean S, Fahrbach K, Probst C. Pregnancy outcomes in women with epilepsy: a systematic review and meta-analysis of published pregnancy registries and cohorts. Epilepsy Res 2008;81(1):1-13. PMID 18565732

Meador KJ, Baker GA, Browning N, et al. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr 2014;168(8):729-36. PMID 24934501

Reiter SF, Bjørk MH, Daltveit AK, et al. Life satisfaction in women with epilepsy during and after pregnancy. Epilepsy Behav 2016;62:251-7. PMID 27513352

Taubøll E, Sveberg L, Svalheim S. Interactions between hormones and epilepsy. Seizure 2015;28:3-11. PMID 25765693

Velíšková J, Desantis KA. Sex and hormonal influences on seizures and epilepsy. Horm Behav 2013;63(2):267-77. PMID 22504305

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Yeah, we talk about Bell's palsy here. A lot, actually. But there's also hemifacial spasm, blepharospasm, facial myokymia, and pathologic sialorrhea as it pertains to neurodegenerative disease--not to mention the facial nerve anatomy! Sit down and buckle up; you may want to take notes on this one. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information.

REFERENCES

Gaio E, Marioni G, de Filippis C, Tregnaghi A, Caltran S, Staffieri A. Facial nerve paralysis secondary to acute otitis media in infants and children. J Paediatr Child Health 2004;40(8):483-6. PMID 15265194

Gilden DH. Clinical practice. Bell's Palsy. N Engl J Med 2004;351(13):1323-31. PMID 15385659

Sweeney CJ, Gilden DH. Ramsay Hunt syndrome. J Neurol Neurosurg Psychiatry 2001;71(2):149-54. PMID 11459884

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 9, 2017

With the ongoing opioid crisis, not only those using opiates are affected. There has been an exponential rise in the incidence of neonatal abstinence syndrome--the multiorgan dysfunction experienced by newborns of mothers who are using opioid products and other substances. This week, we discuss the manifestations and ramifications of this disease, with a short commentary on the implications of this global epidemic.

Produced by James E Siegler. Music by Little Glass Men, Jason Shaw, and Chris Zabriskie. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. This is no excuse to give your irritable baby opiates in their applesauce.

REFERENCES

Hagan H, McGough JP, Thiede H, Weiss NS, Hopkins S, Alexander ER. Syringe exchange and risk of infection with hepatitis B and C viruses. Am J Epidemiol 1999;149(3):203-13. PMID 9927214

Hudak ML, Tan RC; Committee On Drugs; Committee On Fetus And Newborn; American Academy of Pediatrics. Neonatal drug withdrawal. Pediatrics 2012;129(2):e540-60. PMID 22291123

Jarlenski M, Barry CL, Gollust S, Graves AJ, Kennedy-Hendricks A, Kozhimannil K. Polysubstance use among us women of reproductive age who use opioids for nonmedical reasons. Am J Public Health 2017;107(8):1308-10. PMID 28640680

Kocherlakota P. Neonatal abstinence syndrome. Pediatrics 2014;134(2):e547-61. PMID 25070299

McQueen K, Murphy-Oikonen J. Neonatal abstinence syndrome. N Engl J Med 2016;375(25):2468-79. PMID 28002715

Vlahov D, Des Jarlais DC, Goosby E, et al. Needle exchange programs for the prevention of human immunodeficiency virus infection: epidemiology and policy. Am J Epidemiol 2001;154(12 Suppl):S70-7. PMID 11744532

Wodak A, Cooney A. Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international evidence. Subst Use Misuse 2006;41(6-7):777-813. PMID 16809167

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 2, 2020

Perfusion imaging employs concepts that date back to the early 1830s, and it leverages hardware and software that emerged around the same time as multidetector helical CT scans. But it has only become popular in recent years for thrombectomy decision-making. If I'm being honest, I often never use it for this purpose. So what other purposes might it serve? And how does it work? This week, we review the fundamental concepts of perfusion CT, its utility in stroke care, and how it might prove useful for other neurologic conditions as well.

Produced by James E Siegler. Music courtesy of Julie Maxwell, John Bartmann, Kai Engel, and Pachyderm. Our theme song was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Some of the voices you heard throughout the program were those of Dr. Mathias Prokop, Radbound Medical Center, Netherlands; Terri Yeager, Comprehensive Stroke Program Coordinator at Cooper University Hospital; and a recording that was produced by GE Healthcare, which is freely available on YouTube. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Albers GW, Marks MP, Kemp S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med 2018;378(8):708-18. PMID 29364767

Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet 2000;355(9216):1670-4. PMID 10905241

Boned S, Padroni M, Rubiera M, et al. Admission CT perfusion may overestimate initial infarct core: the ghost infarct core concept. J Neurointerv Surg 2017;9(1):66-9. PMID 27566491

Campbell BC, Christensen S, Levi CR, et al. Comparison of computed tomography perfusion and magnetic resonance imaging perfusion-diffusion mismatch in ischemic stroke. Stroke 2012;43(10):2648-53. PMID 22858726

Campbell BC, Weir L, Desmond PM, et al. CT perfusion improves diagnostic accuracy and confidence in acute ischaemic stroke. J Neurol Neurosurg Psychiatry 2013;84(6):613-8. PMID 23355804

Campbell BCV, Ma H, Ringleb PA, et al. Extending thrombolysis to 4·5-9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data. Lancet 2019;394(10193):139-147. PMID 31128925

Mangla R, Ekhom S, Jahromi BS, Almast J, Mangla M, Westesson PL. CT perfusion in acute stroke: know the mimics, potential pitfalls, artifacts, and technical errors. Emerg Radiol 2014;21(1):49-65. PMID 23771605

Martins N, Aires A, Mendez Bet al. Ghost Infarct core and admission computed tomography perfusion: redefining the role of neuroimaging in acute ischemic stroke. Interv Neurol 2018;7(6):513-21.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 16, 2020

As my wife and I are raising our 9-month-old daughter, and she is eating more solid food, I can't help but think about how important it is for her to keep an open mind to new food groups. But being open-minded is not just a lesson for toddlers. I emphasize it every day on rounds when seeing patients for a "stroke consult" or a consult for "ICU delirium." If you reduce yourself to the same anchoring biases that you've grown accustomed to, you'll never entertain the possibility of other important and treatable conditions. Or tasty foods. This week on the BrainWaves Podcast, Dr. Brian Jankowitz (Cooper University Hospital Vascular Neurosurgeon) joins Jim in a discussion about a rare but treatable cause of myelopathy. A condition you won't want to miss.

Produced by Brian Jankowitz and James E Siegler. Music courtesy of Kevin McLeod, Lee Rosevere, and Loyalty Freak Music. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Alexander MD, Oliff MC, Olorunsola OG, Brus-Ramer M, Nickoloff EL, Meyers PM. Patient radiation exposure during diagnostic and therapeutic interventional neuroradiology procedures. J Neurointerv Surg 2010;2(1):6-10. PMID 21990551

Chen J, Gailloud P. Safety of spinal angiography: complication rate analysis in 302 diagnostic angiograms. Neurology 2011;77(13):1235-40. PMID 21917768

Cifarelli CP, Kaptain G, Yen CP, Schlesinger D, Sheehan JP. Gamma knife radiosurgery for dural arteriovenous fistulas. Neurosurgery 2010;67(5):1230-5; discussion 1235. PMID 20871448

Jellema K, Tijssen CC, van Rooij WJ, et al. Spinal dural arteriovenous fistulas: long-term follow-up of 44 treated patients. Neurology 2004;62(10):1839-41. PMID 15159489

Kim DJ, Willinsky R, Geibprasert S, Krings T, Wallace C, Gentili F, Terbrugge K. Angiographic characteristics and treatment of cervical spinal dural arteriovenous shunts. AJNR Am J Neuroradiol 2010;31(8):1512-5. PMID 20413606

Krings T, Geibprasert S. Spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 2009;30(4):639-48. PMID 19213818

Manninen AL, Isokangas JM, Karttunen A, Siniluoto T, Nieminen MT. A comparison of radiation exposure between diagnostic CTA and DSA examinations of cerebral and cervicocerebral vessels. AJNR Am J Neuroradiol 2012;33(11):2038-42. PMID 22700752

Mull M, Nijenhuis RJ, Backes WH, Krings T, Wilmink JT, Thron A. Value and limitations of contrast-enhanced MR angiography in spinal arteriovenous malformations and dural arteriovenous fistulas. AJNR Am J Neuroradiol 2007;28(7):1249-58. PMID 17698524

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be supersed

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: October 12, 2017

Most people never get meningitis. For those who do, it is rare to experience it more than once. But if it recurs, red flags should be going up. Dr. Jon Rosenberg joins Jim Siegler this week in a discussion about the causes and management of recurrent meningitis.

Produced by James E Siegler. Music by Lee Rosevere, Fatal Injection, and Coldnoise. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Please don't LP every patient with migraine. That's just mean.

REFERENCES

Rosenberg J, Galen BT. Recurrent meningitis. Curr Pain Headache Rep 2017;21(7):33. PMID 28551737

Zunt JR, Baldwin KJ. Chronic and subacute meningitis. Continuum (Minneap Minn) 2012;18(6 Infectious Disease):1290-318. PMID 23221842

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: May 14, 2020

Can you hear that too? You can't? Well, that doesn't mean I'm having auditory hallucinations. It could just be tinnitus, which describes the irritating sound of ringing, buzzing, clicking, or hissing that affects 10% to 20% of the world's population. But is this a ringing in the ears or a ringing in the brain?

Produced by James E Siegler. Music courtesy of Andrew Sacco, Jon Watts, Kai Engel, Lovira, Patches, and Kevin McLeod. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Arenberg IK, Countryman LF, Bernstein LH, Shambaugh GE Jr. Van Gogh had Menière's disease and not epilepsy. JAMA 1990;264(4):491-3. PMID 2094236

Crummer RW, Hassan GA. Diagnostic approach to tinnitus. Am Fam Physician 2004;69(1):120-6. PMID 14727828

Dobie RA. A review of randomized clinical trials in tinnitus. Laryngoscope 1999;109(8):1202-11. PMID 10443820

Han BI, Lee HW, Kim TY, Lim JS, Shin KS. Tinnitus: characteristics, causes, mechanisms, and treatments. J Clin Neurol 2009;5(1):11-9. PMID 19513328

Langguth B, Kreuzer PM, Kleinjung T, De Ridder D. Tinnitus: causes and clinical management. Lancet Neurol 2013;12(9):920-30. PMID 23948178

Lockwood AH. Tinnitus. Neurol Clin 2005;23(3):893-900, viii. PMID 16026681

Lockwood AH, Salvi RJ, Burkard RF, Galantowicz PJ, Coad ML, Wack DS. Neuroanatomy of tinnitus. Scand Audiol Suppl 1999;51:47-52. PMID 10803913

Mattox DE, Hudgins P. Algorithm for evaluation of pulsatile tinnitus. Acta Otolaryngol 2008;128(4):427-31. PMID 18368578

Palomar García V, Abdulghani Martínez F, Bodet Agustí E, Andreu Mencía L, Palomar Asenjo V. Drug-induced otoxicity: current status. Acta Otolaryngol 2001;121(5):569-72. PMID 11583387

Sullivan M, Katon W, Russo J, Dobie R, Sakai C. A randomized trial of nortriptyline for severe chronic tinnitus. Effects on depression, disability, and tinnitus symptoms. Arch Intern Med 1993;153(19):2251-9. PMID 8215728

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date. 

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: June 21, 2018

This week's clinical case features a complex course of hospital-acquired delirium with an in-depth discussion on antipsychotics. Dr. Ayyappan Venkatraman reviews the pertinent psychopharmacology in dopaminergic and nondopaminergic signaling.

Produced by James E Siegler. Music by Unheard Music Concepts, Kevin McLeod, Lee Rosevere, and Steve Combs. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Jeste DV, Caligiuri MP. Tardive dyskinesia. Schizophr Bull 1993;19(2):303-15. PMID 8100643

Lacasse H, Perreault MM, Williamson DR. Systematic review of antipsychotics for the treatment of hospital-associated delirium in medically or surgically ill patients. Ann Pharmacother 2006;40(11):1966-73. PMID 17047137

O'Keeffe ST, Lavan JN. Clinical significance of delirium subtypes in older people. Age Ageing 1999;28(2):115-9. PMID 10350406

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

In our first episode with neurology content, we will discuss my research interest in neurologic deterioration after stroke. Enjoy! BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. The case discussed in this episode is fictional and does not contain any patient health-identifying information.

REFERENCES

Balami JS, Chen RL, Grunwald IQ, Buchan AM. Neurological complications of acute ischaemic stroke. Lancet Neurol 2011;10(4):357-71. PMID 21247806

Kwan J, Hand P. Early neurological deterioration in acute stroke: clinical characteristics and impact on outcome. QJM 2006;99(9):625-33. PMID 16905751

Siegler JE, Boehme AK, Albright KC, et al. A proposal for the classification of etiologies of neurologic deterioration after acute ischemic stroke. J Stroke Cerebrovasc Dis 2013;22(8):e549-56. PMID 23867039

Thanvi B, Treadwell S, Robinson T. Early neurological deterioration in acute ischaemic stroke: predictors, mechanisms and management. Postgrad Med J 2008;84(994):412-7. PMID 18832401

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Things you need to know about the way antiepileptic drugs affect each other, all in one podcast. Take a few minutes here to familiarize yourself with these common and critical complications of seizure management. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was vetted and approved by Danielle Becker.

REFERENCES

Pennell PB, Newport DJ, Stowe ZN, Helmers SL, Montgomery JQ, Henry TR. The impact of pregnancy and childbirth on the metabolism of lamotrigine. Neurology 2004;62(2):292-5. PMID 14745072

Pennell PB, Peng L, Newport DJ, et al. Lamotrigine in pregnancy: clearance, therapeutic drug monitoring, and seizure frequency. Neurology 2008;70(22 Pt 2):2130-6. PMID 18046009

Perucca E. Clinically relevant drug interactions with antiepileptic drugs. Br J Clin Pharmacol 2006;61(3):246-55. PMID 16487217

Petrenaite V, Sabers A, Hansen-Schwartz J. Individual changes in lamotrigine plasma concentrations during pregnancy. Epilepsy Res 2005;65(3):185-8. PMID 16084694

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: October 5, 2017

Dr. David Coughlin returns for this week's Teaching Through Clinical Cases to discuss the management of a delirious patient with a hyperkinetic movement disorder.

Produced by James E Siegler. Music by Hyson, Josh Woodward, Komiku, and Peter Rudenko. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Ables AZ, Nagubilli R. Prevention, recognition, and management of serotonin syndrome. Am Fam Physician 2010;81(9):1139-42. PMID 20433130

Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005;352(11):1112-20. PMID 15784664

Dosi R, Ambaliya A, Joshi H, Patell R. Serotonin syndrome versus neuroleptic malignant syndrome: a challenging clinical quandary. BMJ Case Rep 2014;2014:bcr2014204154. PMID 24957740

Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM 2003;96(9):635-42. PMID 12925718

Lappin RI, Auchincloss EL. Treatment of the serotonin syndrome with cyproheptadine. N Engl J Med 1994;331(15):1021-2. PMID 8084345

Mills KC. Serotonin syndrome. Am Fam Physician 1995;52(5):1475-82. PMID 7572570

Pedavally S, Fugate JE, Rabinstein AA. Serotonin syndrome in the intensive care unit: clinical presentations and precipitating medications. Neurocrit Care 2014;21(1):108-13. PMID 24052457

Radomski JW, Dursun SM, Reveley MA, Kutcher SP. An exploratory approach to the serotonin syndrome: an update of clinical phenomenology and revised diagnostic criteria. Med Hypotheses 2000;55(3):218-24. PMID 10985912

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 3, 2019

For young patients who have no reason to clot, it's good to know which diagnostic tests you should send, when you should send them, and how they can be erroneously interpreted. Dr. Kristy Yuan, a vascular neurologist from the University of Pennsylvania, summarizes her approach in this week's clinical case.

Produced by James E Siegler and Kristy Yuan. Music by Chris Zabriskie, How the Night Came, Doctor Turtle, and Swelling. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Cohn DM, Vansenne F, de Borgie CA, Middeldorp S. Thrombophilia testing for prevention of recurrent venous thromboembolism. Cochrane Database Syst Rev 2012;12(12):CD007069. PMID 23235639

Connors JM. Thrombophilia testing and venous thrombosis. N Engl J Med 2017;377(12):1177-87. PMID 28930509

Garcia D, Erkan D. Diagnosis and management of the antiphospholipid syndrome. N Engl J Med 2018;378(21):2010-21. PMID 29791828

Ho WK, Hankey GJ, Quinlan DJ, Eikelboom JW. Risk of recurrent venous thromboembolism in patients with common thrombophilia: a systematic review. Arch Intern Med 2006;166(7):729-36. PMID 16606808

Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST Guideline and Expert Panel Report. Chest 2016;149(2):315-352. PMID 26867832

Mintzer DM, Billet SN, Chmielewski L. Drug-induced hematologic syndromes. Adv Hematol 2009;2009:495863. PMID 19960059

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

This week's BrainWaves episode features a case of a middle-aged woman with progressive headaches and cranial neuropathies. The diagnosis of aseptic meningitis is made, and a differential diagnosis is illustrated. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information.

REFERENCES

Chamberlain MC, Glantz M. Myelomatous meningitis. Cancer 2008;112(7):1562-7. PMID 18260094

Ginsberg L, Kidd D. Chronic and recurrent meningitis. Pract Neurol 2008;8(6):348-61. PMID 19015295

Hasbun R, Abrahams J, Jekel J, Quagliarello VJ. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med 2001;345(24):1727-33. PMID 11742046

Jolles S, Sewell WA, Leighton C. Drug-induced aseptic meningitis: diagnosis and management. Drug Saf 2000;22(3):215-26. PMID 10738845

Lee BE, Chawla R, Langley JM, et al. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis. BMC Infect Dis 2006;6:68. PMID 16603090

Logan SA, MacMahon E. Viral meningitis. BMJ 2008;336(7634):36-40. PMID 18174598

Negrini B, Kelleher KJ, Wald ER. Cerebrospinal fluid findings in aseptic versus bacterial meningitis. Pediatrics 2000;105(2):316-9. PMID 10654948

Nieuwenhuizen L, Biesma DH. Central nervous system myelomatosis: review of the literature. Eur J Haematol 2008;80(1):1-9. PMID 17961180

Nigrovic LE. Aseptic meningitis. Handb Clin Neurol 2013;112:1153-6. PMID 23622323

Sobol U, Stiff P. Neurologic aspects of plasma cell disorders. Handb Clin Neurol 2014;120:1083-99. PMID 24365373

van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 2004;351(18):1849-59. PMID 15509818

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

The acute vestibular syndrome is easy enough to identify, but it can be a challenge to diagnose. In this week's episode of BrainWaves, Dr. Ali Hamedani tries to simplify the approach to acute, intermittent, and chronic complaints of dizziness. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information.

REFERENCES

Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke 2009;40(11):3504-10. PMID 19762709

Kerber KA. Acute constant dizziness. Continuum (Minneap Minn) 2012;18(5 Neuro-otology):1041-59. PMID 23042059

Kim JS, Zee DS. Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med 2014;370(12):1138-47. PMID 24645946

Lempert T. Vestibular migraine. Semin Neurol 2013;33(3):212-8. PMID 24057824

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 19, 2019

In this week's clinical case, Dr. Mike Bradshaw (Chicago Medical School and Billings Clinic) walks us through the case of a young woman with HSV encephalitis. With a twist. SPOILER ALERT: If you don't want to know the answer, DON'T LOOK AT THE SHOWNOTES!

Produced by James E Siegler and Mike Bradshaw. Music courtesy of Yan Terrien, Unheard Music Concepts, Steve Combs, and Montplaisir. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Armangue T, Leypoldt F, Dalmau J. Autoimmune encephalitis as differential diagnosis of infectious encephalitis. Curr Opin Neurol 2014;27(3):361-8. PMID 24792345

Armangue T, Leypoldt F, Málaga I, et al. Herpes simplex virus encephalitis is a trigger of brain autoimmunity. Ann Neurol 2014;75(2):317-23. PMID 24318406

Armangue T, Spatola M, Vlagea A, et al. Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis. Lancet Neurol 2018;17(9):760-72. PMID 30049614

Bacon TH, Boon RJ, Schultz M, Hodges-Savola C. Surveillance for antiviral-agent-resistant herpes simplex virus in the general population with recurrent herpes labialis. Antimicrob Agents Chemother 2002;46(9):3042-4. PMID 12183267

Dubey D, Pittock SJ, Kelly CR, et al. Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis. Ann Neurol 2018;83(1):166-77. PMID 29293273

Gable MS, Sheriff H, Dalmau J, Tilley DH, Glaser CA. The frequency of autoimmune N-methyl-D-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project. Clin Infect Dis 2012;54(7):899-904. PMID 22281844

Granerod J, Ambrose HE, Davies NW, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis 2010;10(12):835-44. PMID 20952256

Linnoila JJ, Binnicker MJ, Majed M, Klein CJ, McKeon A. CSF herpes virus and autoantibody profiles in the evaluation of encephalitis. Neurol Neuroimmunol Neuroinflamm 2016;3(4):e245. PMID 27308306

Prüss H, Finke C, Höltje M, et al. N-methyl-D-aspartate receptor antibodies in herpes simplex encephalitis. Ann Neurol 2012;72(6):902-11. PMID 23280840

Steiner I, Budka H, Chaudhuri A, et al. Viral meningoencephalitis: a review of diagnostic methods and guidelines for management. Eur J Neurol 2010;17(8):999-e57. PMID 20236175

Venkatesan A, Benavides DR. Autoimmune encephalitis and its relation to infection. Curr Neurol Neurosci Rep 2015;15(3):3. PMID 25637289

We belie

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 21, 2019

Nobody is getting any younger, which is too bad. Muscle cramping...fatigue...stiffness... you'll be dealing with it more and more. “It's probably nothing,” you tell yourself. But what if it's not? Every once in a while, you might come across a case of myotonia. And you won't want to miss it. This week on BrainWaves, Dr. Noah Levinson provides a brief overview of myotonia and the conditions that are associated with it.

Produced by James E Siegler. Music courtesy of Yshwa, Steve Combs, MMFFF, and Scott Holmes. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Miller TM. Differential diagnosis of myotonic disorders. Muscle Nerve 2008;37(3):293-9. PMID 18067134

Okkersen K, Jimenez-Moreno C, Wenninger S, et al. Cognitive behavioural therapy with optional graded exercise therapy in patients with severe fatigue with myotonic dystrophy type 1: a multicentre, single-blind, randomised trial. Lancet Neurol 2018;17(8):671-80. PMID 29934199

Sansone VA. The dystrophic and nondystrophic myotonias. Continuum (Minneap Minn) 2016;22(6, Muscle and Neuromuscular Junction Disorders):1889-1915. PMID 27922499

Thornton CA, Wang E, Carrell EM. Myotonic dystrophy: approach to therapy. Curr Opin Genet Dev 2017;44:135-40. PMID 28376341

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 7, 2019

Before it was called epilepsy, it was a falling sickness. A disturbance of consciousness summoned by magic or demonic possession. Although it is less of a mystery today, the sacred disease is one neurologic condition that continues to pique our curiosity. Join us as we recount the fascinating history of this mystical malady.

Produced by James E Siegler. Music courtesy of Alavedra Montserrat, Joseph Levine, and William McColl, Damiano Baldoni, Kai Engel, Kevin McLeod, Rafael Archangel, and Unheard Music Concepts. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Pierce JM. Disease Once Sacred: A history of the medical understanding of epilepsy. Brain 2002;125:441-2.

Temkin O. The Falling Sickness: A History of Epilepsy from the Greeks to the Beginnings of Modern Neurology. 2nd ed. Baltimore: The Johns Hopkins Press, 1971.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 9, 2020

The common teaching is that restricted diffusion on MRI indicates stroke—acute cerebral infarction--when, more specifically, the changes on DWI and ADC indicate impairment in the random movement of water molecules in a given tissue. With slower movement, as in energy-depleted tissues with failing ATP-dependent sodium/potassium channels, high cellularity, or a highly viscous extracellular space, there is restricted diffusion (of water) and a corresponding bright signal on DWI. These and other considerations are the focus of this week's episode of BrainWaves.

Produced by James E Siegler. Music courtesy of Uncanny and Kevin McLeod. Sound effects by Mike Koenig. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Aliaga ES, Barkhof F. MRI mimics of multiple sclerosis. Handb Clin Neurol 2014;122:291-316. PMID 24507523

Filippi M, Iannucci G, Cercignani M, Assunta Rocca M, Pratesi A, Comi G. A quantitative study of water diffusion in multiple sclerosis lesions and normal-appearing white matter using echo-planar imaging. Arch Neurol 2000;57(7):1017-21. PMID 10891984

Hegde AN, Mohan S, Lath N, Lim CC. Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus. Radiographics 2011;31(1):5-30. PMID 21257930

Maier SE, Sun Y, Mulkern RV. Diffusion imaging of brain tumors. NMR Biomed 2010;23(7):849-64. PMID 20886568

McKinney AM, Short J, Truwit CL, et al. Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. AJR Am J Roentgenol 2007;189(4):904-12. PMID 17885064

Meyer JR, Gutierrez A, Mock B, et al. High-b-value diffusion-weighted MR imaging of suspected brain infarction. AJNR Am J Neuroradiol 2000;21(10):1821-9. PMID 11110533

Roberts TP, Rowley HA. Diffusion weighted magnetic resonance imaging in stroke. Eur J Radiol 2003;45(3):185-94. PMID 12595102

Starkey J, Kobayashi N, Numaguchi Y, Moritani T. Cytotoxic Lesions of the corpus callosum that show restricted diffusion: mechanisms, causes, and manifestations. Radiographics 2017;37(2):562-76. PMID 28165876

Steiner I, Budka H, Chaudhuri A, et al. Viral meningoencephalitis: a review of diagnostic methods and guidelines for management. Eur J Neurol 2010;17(8):999-e57. PMID 20236175

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: February 20, 2020

Immune checkpoint inhibitors have revolutionized cancer treatment. Unlike chemotherapy, which essentially includes cellular toxins that can cause widespread and unnecessary tissue damage, checkpoint inhibitors are used to train the body’s natural immune system to fight off cancer. And while they are extraordinarily effective options for patients with malignant disease, they are not without risk. Every day, we are learning more and more about the autoimmune side effects of these novel therapies. This week on the BrainWaves Podcast, Dr. Justine Cohen (University of Pennsylvania) shares her experience managing patients with checkpoint inhibitor neurotoxicity.

Produced by James E Siegler and Justine Cohen. Music courtesy of Jon Watts, Kai Engel, and Kevin McLeod--as well as a cameo appearance by the Checkpoints. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bhatia S, Tykodi SS, Thompson JA. Treatment of metastatic melanoma: an overview. Oncology (Williston Park) 2009;23(6):488-96. PMID 19544689

Cohen JV, Buchbinder EI. The evolution of adjuvant therapy for melanoma. Curr Oncol Rep 2019;21(12):106. PMID 31768772

Cohen JV, Wang N, Venur VA, et al. Neurologic complications of melanoma. Cancer 2020;126(3):477-86. PMID 31725902

Graus F, Dalmau J. Paraneoplastic neurological syndromes in the era of immune-checkpoint inhibitors. Nat Rev Clin Oncol 2019;16(9):535-48. PMID 30867573

Hottinger AF. Neurologic complications of immune checkpoint inhibitors. Curr Opin Neurol 2016 ;29(6):806-12. PMID 27653290

Wick W, Hertenstein A, Platten M. Neurological sequelae of cancer immunotherapies and targeted therapies. Lancet Oncol 2016;17(12):e529-41. PMID 27924751

Zekeridou A, Lennon VA. Neurologic autoimmunity in the era of checkpoint inhibitor cancer immunotherapy. Mayo Clin Proc 2019;94(9):1865-78. PMID 31358366

Zubiri L, Allen IM, Taylor MS, et al. Immune-related adverse events in the setting of PD-1/L1 inhibitor combination therapy. Oncologist 2020;25(3):e398-404. PMID 32162817

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 28, 2017

In this week's clinical case, Dr. John Baird (Stanford) shares the story of a patient he's been following who's experienced a neurologic complication of her hematologic illness. Check it out.

Produced by James E Siegler. Music by Chris Zabriskie, Ian Southerland, Julie Maxwell, Jason Shaw, and Rafael Archangel. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making.

REFERENCES

Bakshi R, Shaikh ZA, Bates VE, Kinkel PR. Thrombotic thrombocytopenic purpura: brain CT and MRI findings in 12 patients. Neurology 1999;52(6):1285-8. PMID 10214762

George JN. Clinical practice. Thrombotic thrombocytopenic purpura. N Engl J Med 2006;354(18):1927-35. PMID 16672704

George JN, Nester CM. Syndromes of thrombotic microangiopathy. N Engl J Med 2014;371(7):654-66. PMID 25119611

Goel R, Ness PM, Takemoto CM, Krishnamurti L, King KE, Tobian AA. Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality. Blood 2015;125(9):1470-6. PMID 25588677

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 4, 2021

As many as 1% of the world has epilepsy, but far more will have a seizure in their lifetime. Not everyone needs a seizure medication, some people are even harmed by them. So who warrants treatment, and what do you start with? Consider today’s program an intro to antiepileptic drug decision-making. For educational purposes only, of course. Not to guide any healthcare provider’s decision-making.

Produced by James E Siegler. Music courtesy of Lee Rosevere, Cellophane Sam, Jon Watts, Josh Woodward, and Rafael Archangel. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Anonymous. Randomized clinical trial on the efficacy of antiepileptic drugs in reducing the risk of relapse after a first unprovoked tonic-clonic seizure. First Seizure Trial Group (FIR.S.T. Group). Neurology 1993;43(3 Pt 1):478-83. PMID 8450987

Bouma HK, Labos C, Gore GC, Wolfson C, Keezer MR. The diagnostic accuracy of routine electroencephalography after a first unprovoked seizure. Eur J Neurol 2016;23(3):455-63. PMID 26073548

Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia 2014;55(4):475-82. PMID 24730690

Fountain NB. Choosing among antiepileptic drugs. Continuum (Minneap Minn) 2010;16(3 Epilepsy):121-35. PMID 22810318

Hauser WA, Rich SS, Annegers JF, Anderson VE. Seizure recurrence after a 1st unprovoked seizure: an extended follow-up. Neurology 1990;40(8):1163-70. PMID 2381523

Hui AC, Tang A, Wong KS, Mok V, Kay R. Recurrence after a first untreated seizure in the Hong Kong Chinese population. Epilepsia 2001;42(1):94-7. PMID 11207791

Koepp MJ, Woermann FG. Imaging structure and function in refractory focal epilepsy. Lancet Neurol 2005;4(1):42-53. PMID 15620856

Krumholz A, Wiebe S, Gronseth GS, et al. Evidence-based guideline: management of an unprovoked first seizure in adults: Report of the Guideline Development Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2015;84(16):1705-13. PMID 25901057

Leone MA, Giussani G, Nolan SJ, Marson AG, Beghi E. Immediate antiepileptic drug treatment, versus placebo, deferred, or no treatment for first unprovoked seizure. Cochrane Database Syst Rev 2016;2016(5):CD007144. Update in: Cochrane Database Syst Rev 2021;5:CD007144. PMID 27150433

Manjunath R, Davis KL, Candrilli SD, Ettinger AB. Association of antiepileptic drug nonadherence with risk of seizures in adults with epilepsy. Epilepsy Behav 2009;14(2):372-8. PMID 19126436

Marson A, J

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 6, 2020

The electroencephalogram is a nearly 100-year-old neurodiagnostic instrument. And yet, we learn new things from it every day. This week on the BrainWaves podcast, Dr. Tracey Milligan (Mass General Brigham) reviews the indications and utilization of a routine scalp EEG. Also discussed: limitations of scalp EEG, brain surgery, nonepileptic events, and why you should consider becoming an epileptologist.

Produced by James E Siegler and Tracey Milligan. Music courtesy of Steve Combs, Lee Roosevere, Siddhartha, Soft and Furious, Patches, and Magic in the Other. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. James Siegler reports having received consulting fees from Ceribell, which produces a bedside scalp EEG with automated seizure detection. However, there is no specific reference to this device or company, nor was this episode sponsored by Ceribell. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bouma HK, Labos C, Gore GC, Wolfson C, Keezer MR. The diagnostic accuracy of routine electroencephalography after a first unprovoked seizure. Eur J Neurol 2016;23(3):455-63. PMID 26073548

Cascino GD. Clinical indications and diagnostic yield of video-electroencephalographic monitoring in patients with seizures and spells. Mayo Clin Proc 2002;77(10):1111-20. PMID 12374255

Debicki DB. Electroencephalography after a single unprovoked seizure. Seizure 2017;49:69-73. PMID 28532713

Pillai J, Sperling MR. Interictal EEG and the diagnosis of epilepsy. Epilepsia 2006;47 Suppl 1:14-22. PMID 17044820

Wiebe S, Blume WT, Girvin JP, Eliasziw M; Effectiveness and Efficiency of Surgery for Temporal Lobe Epilepsy Study Group. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med 2001;345(5):311-8. PMID 11484687

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 23, 2020

Locked-in syndrome is a rare clinical consequence following many types of neurologic injury. In general, the locked-in patient is fully paralyzed, with perhaps minimal function of the fingers, eyes, or mouth. What's more, gross motor dysfunction is enormously disproportional to the cognitive function of the individual. The locked-in patient is conscious and completely aware of their surroundings. They can often hear, see, smell, and feel just as any other person would. But because of their profound physical disability, they have a very limited means of communicating even the simplest thoughts. "I feel hot." "My head hurts." "My cheek itches."

It may surprise you that the patient's perspective of their condition is wholly different from how the healthcare provider or caregiver imagines it to be. This week on the program, Dr. Lauren Elman (Pennsylvania Medical Center ALS Multi-disiplinary Clinic) reviews this discrepancy. Dr. Elman also shares her experience managing this inevitable consequence of amyotrophic lateral sclerosis when all life-sustaining measures are desired.

REFERENCES

Kuzma-Kozakiewicz M, Andersen PM, Ciecwierska K, et al. An observational study on quality of life and preferences to sustain life in locked-in state. Neurology 2019;93(10):e938-45. PMID 31391247

Niedermeyer S, Murn M, Choi PJ. Respiratory failure in amyotrophic lateral sclerosis. Chest 2019;155(2):401-8. PMID 29990478

Patterson JR, Grabois M. Locked-in syndrome: a review of 139 cases. Stroke 1986;17(4):758-64. PMID 3738962

Rousseau MC, Baumstarck K, Alessandrini M, Blandin V, Billette de Villemeur T, Auquier P. Quality of life in patients with locked-in syndrome: evolution over a 6-year period. Orphanet J Rare Dis 2015;10:88. PMID 26187655

Trail M, Nelson ND, Van JN, Appel SH, Lai EC. A study comparing patients with amyotrophic lateral sclerosis and their caregivers on measures of quality of life, depression, and their attitudes toward treatment options. J Neurol Sci 2003;209(1-2):79-85. PMID 12686407

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: February 1, 2018

Mike Rubenstein, from prior episodes on global health and CSF interpretation, returns to discuss the case of a patient with recurrent headaches. But this time he uses big words. Take a listen.

Produced by James E Siegler. Music by Mystery Mammal, Lee Rosevere, Unheard Music Concepts, and Greg Atkinson. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making.

REFERENCES

Bigal ME, Lipton RB. The differential diagnosis of chronic daily headaches: an algorithm-based approach. J Headache Pain 2007;8(5):263-72. PMID 17955166

Dodick DW. Clinical practice. Chronic daily headache. N Engl J Med 2006;354(2):158-65. Erratum in: N Engl J Med 2006;354(8):884. PMID 16407511

Goadsby PJ. Trigeminal autonomic cephalalgias. Continuum (Minneap Minn) 2012;18(4):883-95. PMID 22868548

Halker RB, Hastriter EV, Dodick DW. Chronic daily headache: an evidence-based and systematic approach to a challenging problem. Neurology 2011;76(7 Suppl 2):S37-43. PMID 21321350

Pareja JA, Antonaci F, Vincent M. The hemicrania continua diagnosis. Cephalalgia 2001;21(10):940-6. PMID 11843864

Prakash S, Patell R. Paroxysmal hemicrania: an update. Curr Pain Headache Rep 2014;18(4):407. PMID 24523000

Silberstein SD, Lipton RB. Chronic daily headache. Curr Opin Neurol 2000;13(3):277-83. PMID 10871251

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: May 31, 2018

Unfortunately, stroke is all too common. Nearly 1 million new strokes are diagnosed in the United States each year. And this means that complications of stroke--even if rare--may also be common. One such complication is hemorrhagic transformation. This week, Dr. Ava Liberman reviews a clinical case of hemorrhage following ischemic stroke.

Produced by James E Siegler. Music by Ghost, Kevin McLeod, and Scott Holmes. Voiceover by David Manly. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Benjamin EJ, Virani SS, Callaway CW, et al. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018;137(12):e67-492. Erratum in: Circulation 2018;137(12 ):e493. PMID 29386200

Frontera JA, Lewin JJ 3rd, Rabinstein AA, et al. Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage: A Statement for Healthcare Professionals from the Neurocritical Care Society and Society of Critical Care Medicine. Neurocrit Care 2016;24(1):6-46. PMID 26714677

Prabhakaran S, Gupta R, Ouyang B, et al. Acute brain infarcts after spontaneous intracerebral hemorrhage: a diffusion-weighted imaging study. Stroke 2010;41(1):89-94. PMID 19892994

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 9, 2020

Webster defines “idiopathic” as “arising spontaneously or from an obscure or unknown cause.” By definition, this means idiopathic intracranial hypertension has no proximate cause. But that’s not exactly true. This week on the podcast, we explore the evidence behind the theory that transverse sinus stenosis may contribute to this condition. Disclaimer: No chicken or eggs were harmed in the making of this episode.

Produced by James E Siegler. Music courtesy of Squire Tuck, Swelling, Three Chain Links, and Unheard Music Concepts. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Dinkin MJ, Patsalides A. Venous sinus stenting in idiopathic intracranial hypertension: results of a prospective trial. J Neuroophthalmol 2017;37(2):113-21. PMID 27556959

Farb RI, Vanek I, Scott JN, et al. Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology 2003;60(9):1418-24. PMID 12743224

Gjerris F, Soelberg Sørensen P, Vorstrup S, Paulson OB. Intracranial pressure, conductance to cerebrospinal fluid outflow, and cerebral blood flow in patients with benign intracranial hypertension (pseudotumor cerebri). Ann Neurol 1985;17(2):158-62. PMID 3872097

Karahalios DG, Rekate HL, Khayata MH, Apostolides PJ. Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology 1996;46(1):198-202. PMID 8559374

King JO, Mitchell PJ, Thomson KR, Tress BM. Manometry combined with cervical puncture in idiopathic intracranial hypertension. Neurology 2002;58(1):26-30. PMID 11781401

Martins AN. Resistance to drainage of cerebrospinal fluid: clinical measurement and significance. J Neurol Neurosurg Psychiatry 1973;36(2):313-8. PMID 4541080

Mohammaden MH, Husain MR, Brunozzi D, et al. Role of resistivity index analysis in the prediction of hemodynamically significant venous sinus stenosis in patient with idiopathic intracranial hypertension. Neurosurgery 2020;86(5):631-6. PMID 31384935

Orefice G, Celentano L, Scaglione M, Davoli M, Striano S. Radioisotopic cisternography in benign intracranial hypertension of young obese women. A seven-case study and pathogenetic suggestions. Acta Neurol (Napoli) 1992;14(1):39-50. PMID 1580203

Riggeal BD, Bruce BB, Saindane AM, et al. Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis. Neurology 2013;80(3):289-95. PMID 23269597

Rohr A, Dörner L, Stingele R, Buhl R, Alfke K, Jansen O. Reversibility of venous sinus obstruction in idiopathic intracranial hypertension. AJNR Am J Neuroradiol 2007;28(4):656

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: June 25, 2020

It’s more than just a headache. Migraine is a disturbance of normal neurologic function, and as you are aware, it causes more than just severe head pain. This week on BrainWaves, Dr. Deborah Friedman (UT Southwestern) shares her experience evaluating and managing the unusual neurologic manifestations of migraine that aren’t just the misery from recurrent attacks.

Produced by James E Siegler and Deborah Friedman. Music courtesy of Josh Woodward, Kevin McLeod and Lee Rosevere. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bianchin MM, Londero RG, Lima JE, Bigal ME. Migraine and epilepsy: a focus on overlapping clinical, pathophysiological, molecular, and therapeutic aspects. Curr Pain Headache Rep 2010;14(4):276-83. PMID 20495966

Dreier JP, Reiffurth C, Woitzik J, et al. How spreading depolarization can be the pathophysiological correlate of both migraine aura and stroke. Acta Neurochir Suppl 2015;120:137-40. PMID 25366613

Goadsby PJ. Unique migraine subtypes, rare headache disorders, and other disturbances. Continuum (Minneap Minn) 2015;21(4 Headache):1032-40. PMID 26252589

Orr SL, Friedman BW, Christie S, et al. Management of adults with acute migraine in the emergency department: The American Headache society evidence assessment of parenteral pharmacotherapies. Headache 2016;56(6):911-40. PMID 27300483

Rozen TD, Niknam RM, Shechter AL, Young WB, Silberstein SD. Cluster headache in women: clinical characteristics and comparison with cluster headache in men. J Neurol Neurosurg Psychiatry 2001;70(5):613-7. PMID 11309454

Shah DR, Dilwali S, Friedman DI. Migraine aura without headache [corrected]. Curr Pain Headache Rep 2018;22(11):77. PMID 30225597

Solomon S, Grosberg BM, Friedman DI, Lipton RB. Retinal migraine. J Neuroophthalmol 2007;27(3):243-4; author reply 244-5. PMID 17895829

Tippin J, Corbett JJ, Kerber RE, Schroeder E, Thompson HS. Amaurosis fugax and ocular infarction in adolescents and young adults. Ann Neurol 1989;26(1):69-77. PMID 2774503

Viana M, Tronvik EA, Do TP, Zecca C, Hougaard A. Clinical features of visual migraine aura: a systematic review. J Headache Pain 2019;20(1):64. PMID 31146673

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: May 28, 2020

Lewy body dementia may be the second most common neuropathologic cause of dementia behind Alzheimer disease, but it remains largely a clinical diagnosis with limited treatment options. This week on BrainWaves, Dr. Amy Colcher (Cooper University Hospital) reviews the diagnostic criteria and management strategies for patients and their caregivers who suffer from this condition. Plus, a sort of tribute to Robin Williams.

Produced by James E Siegler and Amy Colcher. Music courtesy of Andrew Sacco, Axletree, Damiano Baldoni, Josh Woodward, and Julie Maxwell. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Armstrong MJ. Lewy body dementias. Continuum (Minneap Minn) 2019;25(1):128-46. PMID 30707190

Desmarais P, Massoud F, Filion J, Nguyen QD, Bajsarowicz P. Quetiapine for psychosis in Parkinson disease and neurodegenerative parkinsonian disorders: a systematic review. J Geriatr Psychiatry Neurol 2016;29(4):227-36. PMID 27056066

Frieling H, Hillemacher T, Ziegenbein M, Neundörfer B, Bleich S. Treating dopamimetic psychosis in Parkinson's disease: structured review and meta-analysis. Eur Neuropsychopharmacol 2007;17(3):165-71. PMID 17070675

Galvin JE, Duda JE, Kaufer DI, Lippa CF, Taylor A, Zarit SH. Lewy body dementia: the caregiver experience of clinical care. Parkinsonism Relat Disord 2010;16(6):388-92. PMID 20434939

Koga S, Aoki N, Uitti RJ, et al. When DLB, PD, and PSP masquerade as MSA: an autopsy study of 134 patients. Neurology 2015;85(5):404-12. PMID 26138942

McKeith IG, Boeve BF, Dickson DW, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology 2017;89(1):88-100. PMID 28592453

McKeith IG. Spectrum of Parkinson's disease, Parkinson's dementia, and Lewy body dementia. Neurol Clin 2000;18(4):865-902. PMID 11072265

Stinton C, McKeith I, Taylor JP, et al. Pharmacological management of Lewy body dementia: a systematic review and meta-analysis. Am J Psychiatry 2015;172(8):731-42. PMID 26085043

Taylor JP, McKeith IG, Burn DJ, et al. New evidence on the management of Lewy body dementia. Lancet Neurol 2020;19(2):157-69. PMID 31519472

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 3, 2020

Myoclonus is the most etiologically nonspecific motor manifestation of neurologic and systemic disease. It’s like slurred speech or altered mental status. But in the appropriate context, it can become a useful clue in your differential diagnosis. Dr. John Caviness of the Mayo Clinic joins Jim Siegler this week for a discussion on this abnormal movement and what it may indicate.

Produced by James E Siegler and John Caviness. Music courtesy of Kevin McLeod and E’s Jammy Jams. “Endings” and “What’s the Angle” were produced by Shane Ivers (https://www.silvermansound.com). The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Caviness JN. Myoclonus and neurodegenerative disease--what's in a name? Parkinsonism Relat Disord 2003;9(4):185-92. PMID 12618052

Caviness JN. Parkinsonism & related disorders. Myoclonus. Parkinsonism Relat Disord 2007;13 Suppl 3:S375-84. PMID 18267267

Caviness JN. Pathophysiology and treatment of myoclonus. Neurol Clin 2009;27(3):757-77, vii. PMID 19555830

Caviness JN. Myoclonus. Continuum (Minneap Minn) 2019;25(4):1055-80. PMID 31356293

Levy A, Chen R. Myoclonus: pathophysiology and treatment options. Curr Treat Options Neurol 2016;18(5):21. PMID 27039330

Zutt R, van Egmond ME, Elting JW, et al. A novel diagnostic approach to patients with myoclonus. Nat Rev Neurol 2015;11(12):687-97. PMID 26553594

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

The second most common cause of parkinsonism is doctors. No, I am not kidding. It's the medications we choose to prescribe. And the neurologist is not the only one at fault. Psychiatrists, cardiologists, and internists are all responsible. In this episode of the Quanta series, Dr. Sneha Mantri describes her experience as a specialist in movement disorders.

Produced by James E Siegler and Erika Mejia. Music by Hyson and Jazzhar. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Alvarez MV, Evidente VG. Understanding drug-induced parkinsonism: separating pearls from oy-sters. Neurology 2008;70(8):e32-4. PMID 18285529

López-Sendón JL, Mena MA, de Yébenes JG. Drug-induced parkinsonism in the elderly: incidence, management and prevention. Drugs Aging 2012;29(2):105-18. PMID 22250585

Shin HW, Chung SJ. Drug-induced parkinsonism. J Clin Neurol 2012;8(1):15-21. PMID 22523509

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 13, 2018

In 2012, more than 13,000 Americans were inadvertently exposed to contaminated medical equipment, resulting in one of the largest fungal outbreaks in United States history. Despite rapid mobilization by the CDC and FDA, 751 patients died from complications of fungal brain infections. But this is more the exception than the rule when it comes to fungal infections of the central nervous system. This week on the BrainWaves podcast, we review the common (and uncommon) clinical, radiographic, and diagnostic features of fungal brain disease. Enjoy!

Produced by James E Siegler. Music by Jahzzar, Swelling, The Insider, and Chris Zabriskie. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Baddley JW, Salzman D, Pappas PG. Fungal brain abscess in transplant recipients: epidemiologic, microbiologic, and clinical features. Clin Transplant 2002;16(6):419-24. PMID 12437621

Benedict K, Park BJ. Invasive fungal infections after natural disasters. Emerg Infect Dis 2014;20(3):349-55. PMID 24565446

Brouwer MC, Tunkel AR, McKhann GM 2nd, van de Beek D. Brain abscess. N Engl J Med 2014;371(5):447-56. PMID 25075836

Kainer MA, Reagan DR, Nguyen DB, et al. Fungal infections associated with contaminated methylprednisolone in Tennessee. N Engl J Med 2012;367(23):2194-203. PMID 23131029

McCotter OZ, Smith RM, Westercamp M, et al. Update on multistate outbreak of fungal infections associated with contaminated methylprednisolone injections, 2012-2014. MMWR Morb Mortal Wkly Rep 2015;64(42):1200-1. PMID 26513534

Schwartz S, Kontoyiannis DP, Harrison T, Ruhnke M. Advances in the diagnosis and treatment of fungal infections of the CNS. Lancet Neurol 2018;17(4):362-72. PMID 29477506

Smith RM, Schaefer MK, Kainer MA, et al. Fungal infections associated with contaminated methylprednisolone injections. N Engl J Med 2013;369(17):1598-609. PMID 23252499

Wilson MR, O'Donovan BD, Gelfand Jmet al. Chronic meningitis investigated via metagenomic next-generation sequencing. JAMA Neurol 2018;75(8):947-55. PMID 29710329

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: February 6, 2020

The sole FDA-approved indication for clobazam is as a therapeutic adjunct in Lennox-Gastaut syndrome. But as more and more clinicians publish their experience with the off-label success of certain therapies, we may see new indications for this and other pharmacologic agents in the treatment of neurologic disease.

Produced by James E Siegler. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. Music courtesy of Chris Zabriskie, Milton Arias, and John Bartmann. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bresnahan R, Martin-McGill KJ, Williamson J, Michael BD, Marson AG. Clobazam add-on therapy for drug-resistant epilepsy. Cochrane Database Syst Rev 2019;10(10):CD004154. PMID 31638272

Keene DL, Whiting S, Humphreys P. Clobazam as an add-on drug in the treatment of refractory epilepsy of childhood. Can J Neurol Sci 1990;17(3):317-9. PMID 2207888

Mahmoud SH, Rans C. Systematic review of clobazam use in patients with status epilepticus. Epilepsia Open 2018;3(3):323-330. PMID 30187002

Montenegro MA, Arif H, Nahm EA, Resor SR Jr, Hirsch LJ. Efficacy of clobazam as add-on therapy for refractory epilepsy: experience at a US epilepsy center. Clin Neuropharmacol 2008;31(6):333-8. PMID 19050410

Montenegro MA, Cendes F, Noronha AL, et al. Efficacy of clobazam as add-on therapy in patients with refractory partial epilepsy. Epilepsia 2001;42(4):539-42. PMID 11440350

Ng YT, Collins SD. Clobazam. Neurotherapeutics 2007;4(1):138-44. PMID 17199029

Remy C. Clobazam in the treatment of epilepsy: a review of the literature. Epilepsia 1994;35 Suppl 5:S88-91. PMID 8039479

Schmidt D, Rohde M, Wolf P, Roeder-Wanner U. Clobazam for refractory focal epilepsy. A controlled trial. Arch Neurol 1986;43(8):824-6. PMID: 3089202. PMID 3089202

YOUTUBE EXCERPTS (shared via fair use) 

Kathryn Davis MD (Hospital of the University of Pennsylvania): https://www.youtube.com/watch?v=XInZ7... 

Patty McGoldrick NP MPA (Beth Israel Deaconness Medical Center/Roosevelt Hospital): https://www.youtube.com/watch?v=sE2Bk...

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

This week, I'm handing the mic over to Dr. Laura Mainardi so she can give us some pointers on the evaluation of hand weakness. We're thumbing through a few tips on working up wrist drop in particular. Hoping you give us two thumbs up on this one! ;-) BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

REFERENCES

Preston DC, Shapiro BE. Electromyography and Neuromuscular Disorders. 3rd ed. Saunders, 2013.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: February 8, 2018

Even as a medical professional, it can throw you off to be out in public and find someone acutely unresponsive. It's not like being in the hospital. There are no crash carts, no nursing support, and no diagnostic tests--just you and whatever you have around you. So, what can you do? This week, Dr. Ramani Balu discusses the first 5 minutes of this assessment, with a little twist. You're stuck on an airplane.

Produced by James E Siegler. Music by Andrew Sacco, Ars Sonor, Chris Zabriskie, Lee Rosevere, and Fabian Measures. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. It's just for fun. Remember fun? 

REFERENCES

Gendreau MA, DeJohn C. Responding to medical events during commercial airline flights. N Engl J Med 2002;346(14):1067-73. PMID 11932475

Nable JV, Tupe CL, Gehle BD, Brady WJ. In-flight medical emergencies during commercial travel. N Engl J Med 2015;373(10):939-45. PMID 26332548

Silverman D, Gendreau M. Medical issues associated with commercial flights. Lancet 2009;373(9680):2067-77. PMID 19232708

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

I have my own methods for conceptualizing altered mental status. But you already heard them in episode #46. This week on BrainWaves, take a wider view of this type of consult from the perspective of an internist. Dr. Fima Macheret takes the mic on this case of a young woman with seizures and encephalopathy. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. The content in this episode was approved by Dr. Fima Macheret.

REFERENCES

Aagaard-Tillery KM, Belfort MA. Eclampsia: morbidity, mortality, and management. Clin Obstet Gynecol 2005;48(1):12-23. PMID 15725853

Duley L, Henderson-Smart DJ, Walker GJ, Chou D. Magnesium sulphate versus diazepam for eclampsia. Cochrane Database Syst Rev 2010;2010(12):CD000127. PMID 21154341

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date. 

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 19, 2020

The mental status examination is a keystone of the neurologic assessment. Dr. Andrea Casher (Cooper University Hospital) builds upon this metaphor in our program this week. Making a special appearance is US President Donald Trump, who underwent a mental status examination and recounts his experience.

Produced by James E Siegler and Andrea Casher. Music courtesy of Unheard Music Concepts, Purple Planet Music, Lee Rosevere, and Scott Holmes. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Dong Y, Sharma VK, Chan BP, et al. The Montreal Cognitive Assessment (MoCA) is superior to the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment after acute stroke. J Neurol Sci 2010;299(1-2):15-8. PMID: 20889166

Gorno-Tempini ML, Hillis AE, Weintraub S, et al. Classification of primary progressive aphasia and its variants. Neurology 2011;76(11):1006-14. PMID 21325651

Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53(4):695-9. Erratum in: J Am Geriatr Soc 2019;67(9):1991. PMID 15817019

Ng KP, Chiew HJ, Lim L, Rosa-Neto P, Kandiah N, Gauthier S. The influence of language and culture on cognitive assessment tools in the diagnosis of early cognitive impairment and dementia. Expert Rev Neurother 2018;18(11):859-69. PMID 30286681

Rabinovitz B, Jaywant A, Fridman CB. Neuropsychological functioning in severe acute respiratory disorders caused by the coronavirus: implications for the current COVID-19 pandemic. Clin Neuropsychol 2020;34(7-8):1453-79. PMID 32901580

Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc 1992;40(9):922-35. PMID 1512391

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: February 15, 2018

We've abused the term "idiopathic." Not all clinical conditions have to have an unclear cause. More and more, we are finding out the answers. This week, using transverse myelitis as an example, Dr. Clyde Markowitz shares his experience in working up unknown etiologies of spinal cord inflammation.

Produced by James E Siegler. Music by Quantum Jazz, Rui, and Steve Combs. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Bevan CJ, Cree BA. Fulminant demyelinating diseases of the central nervous system. Semin Neurol 2015;35(6):656-66. PMID 26595866

Cobo Calvo A, Mañé Martínez MA, Alentorn-Palau A, Bruna Escuer J, Romero Pinel L, Martínez-Yélamos S. Idiopathic acute transverse myelitis: outcome and conversion to multiple sclerosis in a large series. BMC Neurol 2013;13:135. PMID 24090445

Greenberg BM, Frohman EM. Immune-mediated myelopathies. Continuum (Minneap Minn) 2015;21(1 Spinal Cord Disorders):121-31. PMID 25651221

Jacob A, Weinshenker BG. An approach to the diagnosis of acute transverse myelitis. Semin Neurol 2008;28(1):105-20. PMID 18256991

Kimbrough DJ, Mealy MA, Simpson A, Levy M. Predictors of recurrence following an initial episode of transverse myelitis. Neurol Neuroimmunol Neuroinflamm 2014;1(1):e4. PMID 25340060

Zalewski NL, Flanagan EP, Keegan BM. Evaluation of idiopathic transverse myelitis revealing specific myelopathy diagnoses. Neurology 2018;90(2):e96-e102. PMID 29247071

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date. 

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.
Originally released: December 17, 2020
I shouldn't have to tell you that traumatic brain injury is a major cause of morbidity and mortality. I shouldn't have to. But I will. And it is. In severe cases of head injury, there can be delayed and irreversible deterioration in the nervous system for which there is no treatment, and the prognosis is grim. This week on the program, Dr. Monisha Kumar (University of Pennsylvania) discusses the worst of the worst of these scenarios, what to look out for, and expert recommendations on what to do when it happens.
Produced by James E Siegler and Monisha Kumar. Music courtesy of Rui, Swelling, Unheard Music Concepts, Jahzzar, Ian Southerland, and TRG Banks. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.
REFERENCES
Adams JH, Graham DI, Murray LS, Scott G. Diffuse axonal injury due to nonmissile head injury in humans: an analysis of 45 cases. Ann Neurol 1982;12(6):557-63. PMID 7159059
Arfanakis K, Haughton VM, Carew JD, Rogers BP, Dempsey RJ, Meyerand ME. Diffusion tensor MR imaging in diffuse axonal injury. AJNR Am J Neuroradiol 2002;23(5):794-802. PMID 12006280
DeKosky ST, Ikonomovic MD, Gandy S. Traumatic brain injury--football, warfare, and long-term effects. N Engl J Med 2010;363(14):1293-6. PMID 20879875
Gentry LR. Imaging of closed head injury. Radiology 1994;191(1):1-17. PMID 8134551
Haghbayan H, Boutin A, Laflamme M, et al. The prognostic value of MRI in moderate and severe traumatic brain injury: a systematic review and meta-analysis. Crit Care Med 2017;45(12):e1280-8. PMID 29028764
Izzy S, Mazwi NL, Martinez S, et al. Revisiting grade 3 diffuse axonal injury: not all brainstem microbleeds are prognostically equal. Neurocrit Care 2017;27(2):199-207. PMID 28477152
Johnson VE, Stewart W, Smith DH. Widespread τ and amyloid-β pathology many years after a single traumatic brain injury in humans. Brain Pathol 2012;22(2):142-9. PMID 21714827
Meythaler JM, Peduzzi JD, Eleftheriou E, Novack TA. Current concepts: diffuse axonal injury-associated traumatic brain injury. Arch Phys Med Rehabil 2001;82(10):1461-71. PMID 11588754
Povlishock JT, Becker DP, Cheng CL, Vaughan GW. Axonal change in minor head injury. J Neuropathol Exp Neurol 1983;42(3):225-42. PMID 6188807
Scheid R, Preul C, Gruber O, Wiggins C, von Cramon DY. Diffuse axonal injury associated with chronic traumatic brain injury: evidence from T2*-weighted gradient-echo imaging at 3 T. AJNR Am J Neuroradiol 2003;24(6):1049-56. PMID 12812926
Schrag M, Greer DM. Clinical associations of cerebral microbleeds on magnetic resonance neu

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 28, 2017

This week on BrainWaves, we go back in time to explore humans' oldest neurosurgical procedure. So carve out some time in your day to learn about the ancient technique of craniotomy.

Produced by James E Siegler. Music by Chris Zabriskie, Kai Engel, Kevin McLeod, The Philadelphia Orchestra, and Sergey Cheremisinov. Voiceover by John Burnett. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical practice. Please do NOT drill into anyone's head without their full and informed consent.

REFERENCES

Assina R, Sarris CE, Mammis A. The history of craniotomy for headache treatment. Neurosurg Focus 2014;36(4):E9. PMID 24684340

Clower WT, Finger S. Discovering trepanation: the contribution of Paul Broca. Neurosurgery 2001;49(6):1417-25; discussion 1425-6. PMID 11846942

Faria MA Jr. Violence, mental illness, and the brain - a brief history of psychosurgery: part 1 - From trephination to lobotomy. Surg Neurol Int 2013;4:49. PMID 23646259

Missios S. Hippocrates, Galen, and the uses of trepanation in the ancient classical world. Neurosurg Focus 2007;23(1):E11. PMID 17961050

Newman WC, Chivukula S, Grandhi R. From mystics to modern times: a history of craniotomy & religion. World Neurosurg 2016;92:148-50. PMID 27150646

Sperati G. Craniotomy through the ages. Acta Otorhinolaryngol Ital 2007;27(3):151-6. PMID 17883195

Tsermoulas G, Aidonis A, Flint G. The skull of Chios: trepanation in Hippocratic medicine. J Neurosurg 2014;121(2):328-32. PMID 24857244

Verano JW, Finger S. Chapter 1: ancient trepanation. Handb Clin Neurol 2010;95:3-14. PMID 19892104

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Posterior reversible encephalopathy syndrome: not always posterior, or reversible, or with associated encephalopathy. These and other clinical and neuroimaging factoids are reviewed in this week's edition of BrainWaves where we discuss the various--and often disparate--features of PRES. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was vetted and approved by Amy Pruitt.

REFERENCES

Bartynski WS. Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features. AJNR Am J Neuroradiol 2008;29(6):1036-42. PMID 18356474

Bartynski WS. Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol 2008;29(6):1043-9. PMID 18403560

Casey SO, Sampaio RC, Michel E, Truwit CL. Posterior reversible encephalopathy syndrome: utility of fluid-attenuated inversion recovery MR imaging in the detection of cortical and subcortical lesions. AJNR Am J Neuroradiol 2000;21(7):1199-206. PMID 10954269

Fugate JE, Rabinstein AA. Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol 2015;14(9):914-25. Erratum in: Lancet Neurol 2015;14(9):874. PMID 26184985

Hefzy HM, Bartynski WS, Boardman JF, Lacomis D. Hemorrhage in posterior reversible encephalopathy syndrome: imaging and clinical features. AJNR Am J Neuroradiol 2009;30(7):1371-9. PMID 19386731

Hinchey J, Chaves C, Appignani B, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med 1996;334(8):494-500. PMID 8559202

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 5, 2018

Machado-Joseph disease, or spinocerebellar ataxia type 3, is one of the few eponyms in medicine whereby the disease is named after the patient and not the physician who originally described it. But someone else's name is missing from the eponym: Thomas. And the alternative title for the condition, "spinocerebellar ataxia," also happens to be a bit of a misnomer. In this week's installment of BrainWaves, we review the history and clinical manifestations of this movement disorder.

Produced by James E Siegler. Music by Ian Southerland, Mike Durek, and Ondrosik. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Ashizawa T, Xia G. Ataxia. Continuum (Minneap Minn) 2016;22(4 Movement Disorders):1208-26. PMID 27495205

Matilla T, McCall A, Subramony SH, Zoghbi HY. Molecular and clinical correlations in spinocerebellar ataxia type 3 and Machado-Joseph disease. Ann Neurol 1995;38(1):68-72. PMID 7611728

Paulson HL. Dominantly inherited ataxias: lessons learned from Machado-Joseph disease/spinocerebellar ataxia type 3. Semin Neurol 2007;27(2):133-42. PMID 17390258

Pedroso JL, França MC Jr, Braga-Neto P, et al. Nonmotor and extracerebellar features in Machado-Joseph disease: a review. Mov Disord 2013;28(9):1200-8. PMID 23775899

Rosenberg RN. Machado-Joseph disease: an autosomal dominant motor system degeneration. Mov Disord 1992;7(3):193-203. PMID 1620135

Shakkottai VG, Fogel BL. Clinical neurogenetics: autosomal dominant spinocerebellar ataxia. Neurol Clin 2013;31(4):987-1007. PMID 24176420

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 25, 2019

A 50-year-old gentleman presents with severe headaches and speech disturbance. The MRI shows acute strokes and multifocal vascular irregularities. Is it reversible cerebral vasoconstriction syndrome or primary angiitis of the central nervous system? Or is it something else entirely?

RCVS and PACNS almost always pose a challenge--even to the most astute neurologist. But, because they are treated entirely differently and their clinical trajectories depend on these treatments, it is worth knowing how experts distinguish the two. This week on the BrainWaves podcast, Dr. Jesse Thon joins Jim Siegler in a discussion about the clinical and radiographic features of these two conditions and shares his experience in managing these patients.

Produced by James E Siegler and Jesse Thon. Music courtesy of Nuno Adelaida, Peter Rudenko on the piano, Squire Tuck on the guitar, Swelling, and Uncanny. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Birnbaum J, Hellmann DB. Primary angiitis of the central nervous system. Arch Neurol 2009;66(6):704-9. PMID 19506130

Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D. Reversible cerebral vasoconstriction syndrome, part 1: epidemiology, pathogenesis, and clinical course. AJNR Am J Neuroradiol 2015;36(8):1392-9. PMID 25593203

Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D. reversible cerebral vasoconstriction syndrome, part 2: Diagnostic work-up, imaging evaluation, and differential diagnosis. AJNR Am J Neuroradiol 2015;36(9):1580-8. PMID 25614476

Rocha EA, Topcuoglu MA, Silva GS, Singhal AB. RCVS2 score and diagnostic approach for reversible cerebral vasoconstriction syndrome. Neurology 2019;92(7):e639-47. PMID 30635475

Singhal AB. Diagnostic challenges in RCVS, PACNS, and other cerebral arteriopathies. Cephalalgia 2011;31(10):1067-70. PMID 21673004

Singhal AB, Topcuoglu MA. Glucocorticoid-associated worsening in reversible cerebral vasoconstriction syndrome. Neurology 2017;88(3):228-36. PMID 27940651

Singhal AB, Topcuoglu MA, Fok JW, et al. Reversible cerebral vasoconstriction syndromes and primary angiitis of the central nervous system: clinical, imaging, and angiographic comparison. Ann Neurol 2016;79(6):882-94. PMID 27043703

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date. 

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

It may come as a surprise to you, but patients who seize...will seize. And in this week's episode, we talk about the fundamentals in working up a patient who presents with status epilepticus. So SEIZE the opportunity to learn from Dr. Chloe Hill as she navigates us through this week's Teaching through Clinical Cases. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. The content in this episode was vetted and approved by Chloe Hill.

REFERENCES 

Claassen J, Hirsch LJ, Emerson RG, Mayer SA. Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam: a systematic review. Epilepsia 2002;43(2):146-53. PMID 11903460

Mayer SA, Claassen J, Lokin J, Mendelsohn F, Dennis LJ, Fitzsimmons BF. Refractory status epilepticus: frequency, risk factors, and impact on outcome. Arch Neurol 2002;59(2):205-10. PMID 11843690

Treiman DM, Meyers PD, Walton NY, et al. A comparison of four treatments for generalized convulsive status epilepticus. Veterans Affairs Status Epilepticus Cooperative Study Group. N Engl J Med 1998;339(12):792-8. PMID 9738086

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 17, 2017

This week's clinical case features Dr. Megha Dhamne, a neuromuscular fellow from the Cleveland Clinic. Two weeks ago, she reviewed some of the antibodies associated with autoimmune myositis. But what happens when you suspect an autoimmune myositis and antibody testing is negative?

Produced by James E Siegler. Music by Chris Zabriski, The New Valleys, and Hyson. Voiceover by Tuyche Smrstik. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Choy EH, Isenberg DA. Treatment of dermatomyositis and polymyositis. Rheumatology (Oxford) 2002;41(1):7-13. PMID 11792873

Gordon PA, Winer JB, Hoogendijk JE, Choy EH. Immunosuppressant and immunomodulatory treatment for dermatomyositis and polymyositis. Cochrane Database Syst Rev 2012;2012(8):CD003643. PMID 22895935

Hill CL, Zhang Y, Sigurgeirsson B, et al. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. Lancet 2001;357(9250):96-100. PMID 11197446

Mammen A. Autoimmune muscle disease. Handb Clin Neurol 2016;133:467-84. PMID 27112692

Suresh E, Wimalaratna S. Proximal myopathy: diagnostic approach and initial management. Postgrad Med J 2013;89(1054):470-7. PMID 23596213

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date. 

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

In this week's episode of Teaching through Clinical Cases, Dr. Michael Rubenstein (episode #17, "The FAME clinic in Tanzania") leads a discussion on the evaluation of a young patient with a rapidly progressive gait difficulty with numbness and paresthesias. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. This episode was vetted and approved by Michael Rubenstein.

REFERENCES

Goodman BP. Metabolic and toxic causes of myelopathy. Continuum (Minneap Minn) 2015;21(1 Spinal Cord Disorders):84-99. PMID 25651219

Kriegstein AR, Shungu DC, Millar WS, et al. Leukoencephalopathy and raised brain lactate from heroin vapor inhalation ("chasing the dragon"). Neurology 1999;53(8):1765-73. PMID 10563626

Kumar N, Elliott MA, Hoyer JD, Harper CM Jr, Ahlskog JE, Phyliky RL. "Myelodysplasia," myeloneuropathy, and copper deficiency. Mayo Clin Proc 2005;80(7):943-6. PMID 16007901

Pema PJ, Horak HA, Wyatt RH. Myelopathy caused by nitrous oxide toxicity. AJNR Am J Neuroradiol 1998;19(5):894-6. PMID 9613506

Stabler SP. Vitamin B12 deficiency. N Engl J Med 2013;368(21):2041-2. PMID 23697526

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date. 

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Clumsiness can be hard to localize. But in a patient with a remote history of cancer, you should be suspicious for a number of things. In this week's clinical case, we discuss a patient who was cured of Hodgkin lymphoma but returns with progressive dysmetria. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. The content in this episode was vetted and approved by Joseph Berger.

REFERENCES

Abate G, Corazzelli G, Ciarmiello A, Monfardini S. Neurologic complications of Hodgkin's disease: a case history. Ann Oncol 1997;8(6):593-600. PMID 9261529

Alstadhaug KB, Croughs T, Henriksen S, et al. Treatment of progressive multifocal leukoencephalopathy with interleukin 7. JAMA Neurol 2014;71(8):1030-5. PMID 24979548

Bellizzi A, Anzivino E, Rodio DM, Palamara AT, Nencioni L, Pietropaolo V. New insights on human polyomavirus JC and pathogenesis of progressive multifocal leukoencephalopathy. Clin Dev Immunol 2013;2013:839719. PMID 23690827

Cettomai D, McArthur JC. Mirtazapine use in human immunodeficiency virus-infected patients with progressive multifocal leukoencephalopathy. Arch Neurol 2009;66(2):255-8. PMID 19204164

Felli V, Di Sibio A, Anselmi M, et al. Progressive multifocal leukoencephalopathy following treatment with rituximab in an HIV-negative patient with non-hodgkin lymphoma. A case report and literature review. Neuroradiol J 2014;27(6):657-64. PMID 25489887

García-Suárez J, de Miguel D, Krsnik I, Bañas H, Arribas I, Burgaleta C. Changes in the natural history of progressive multifocal leukoencephalopathy in HIV-negative lymphoproliferative disorders: impact of novel therapies. Am J Hematol 2005;80(4):271-81. PMID 16315252

Hoppe RT, Advani RH, Bierman PJ, et al. Hodgkin disease/lymphoma. Clinical practice guidelines in oncology. J Natl Compr Canc Netw 2006;4(3):210-30. PMID 16507269

Pavlovic D, Patera AC, Nyberg F, Gerber M, Liu M; Progressive Multifocal Leukeoncephalopathy Consortium. Progressive multifocal leukoencephalopathy: current treatment options and future perspectives. Ther Adv Neurol Disord 2015;8(6):255-73. PMID 26600871

Van Assche G, Van Ranst M, Sciot R, et al. Progressive multifocal leukoencephalopathy after natalizumab therapy for Crohn's disease. N Engl J Med 2005;353(4):362-8. PMID 15947080

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 25, 2019

For patients who survive cardiopulmonary arrest but do not wake up, neurologists are called to the bedside to prognosticate. And the question of “How much will this patient recover?” is not unlike “What is the benefit of aggressive therapy to await possible recovery?” In that way, you might consider neurologists to be the actuaries of hospital medicine. In this week's program, we review the clinical and diagnostic data that neurologists incorporate into their model for outcome prediction following anoxic brain injury.

Produced by James E Siegler. Music courtesy of Swelling, Soft and Furious, Rafael Archangel, Lovira, and Dark Room. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Booth CM, Boone RH, Tomlinson G, Detsky AS. Is this patient dead, vegetative, or severely neurologically impaired? Assessing outcome for comatose survivors of cardiac arrest. JAMA 2004;291(7):870-9. PMID 390099PMID: 14970067

Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132(18 Suppl 2):S465-82. Erratum in: Circulation 2017;136(10 ):e197. PMID 390099PMID: 26472996

Jorgensen EO, Holm S. The natural course of neurological recovery following cardiopulmonary resuscitation. Resuscitation 1998;36(2):111-22. PMID 9571727

Nielsen N, Wetterslev J, Cronberg T, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med 2013;369(23):2197-206. PMID 24237006

Sandroni C, D'Arrigo S. Neurologic prognostication: neurologic examination and current guidelines. Semin Neurol 2017;37(1):40-7. PMID 28147417

Sandroni C, Cariou A, Cavallaro F, et al. Prognostication in comatose survivors of cardiac arrest: an advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine. Resuscitation 2014;85(12):1779-89. PMID 25438253

Seder DB. Management of comatose survivors of cardiac arrest. Continuum (Minneap Minn) 2018;24(6):1732-52. PMID 30516603

Seder DB, Sunde K, Rubertsson S, et al. Neurologic outcomes and postresuscitation care of patients with myoclonus following cardiac arrest. Crit Care Med 2015;43(5):965-72. PMID 25654176

Young GB. Clinical practice. Neurologic prognosis after cardiac arrest. N Engl J Med 2009;361(6):605-11. PMID 19657124


We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 4, 2019

A low-salt diet can reduce your risk of hypertension. A low-carb diet can reduce your risk of diabetes. But is there a diet out there, which can lower your risk of neurologic disease? Specifically, dementia? The answer is...maybe? This week on the program we work our way up the food chain describing the vital micronutrients, food groups, and fad diets out there that may promote brain health--and could even lower your risk of dementia. Sit back, grab some blueberries, and enjoy!

Produced by James E Siegler. Music courtesy of Axeltree, Chris Zabriskie, John Pazdan, Josh Woodward, Kevin McLeod, and Pachyderm. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Devore EE, Kang JH, Breteler MM, Grodstein F. Dietary intakes of berries and flavonoids in relation to cognitive decline. Ann Neurol 2012;72(1):135-43. PMID 22535616

Kennedy DO, Wightman EL, Reay JL, et al. Effects of resveratrol on cerebral blood flow variables and cognitive performance in humans: a double-blind, placebo-controlled, crossover investigation. Am J Clin Nutr 2010;91(6):1590-7. PMID 20357044

Lefèvre-Arbogast S, Gaudout D, Bensalem J, et al. Pattern of polyphenol intake and the long-term risk of dementia in older persons. Neurology 2018;90(22):e1979-88. PMID 29703769

Liu QP, Wu YF, Cheng HY, et al. Habitual coffee consumption and risk of cognitive decline/dementia: a systematic review and meta-analysis of prospective cohort studies. Nutrition 2016;32(6):628-36. PMID 26944757

Miller MG, Hamilton DA, Joseph JA, Shukitt-Hale B. Dietary blueberry improves cognition among older adults in a randomized, double-blind, placebo-controlled trial. Eur J Nutr 2018;57(3):1169-80. PMID 28283823

Morris MC, Tangney CC, Wang Y, et al. MIND diet slows cognitive decline with aging. Alzheimers Dement 2015;11(9):1015-22. PMID 26086182

Newman JC, Covarrubias AJ, Zhao M, et al. Ketogenic diet reduces midlife mortality and improves memory in aging mice. Cell Metab 2017;26(3):547-57. PMID 28877458

Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential for primary prevention of Alzheimer's disease: an analysis of population-based data. Lancet Neurol 2014;13(8):788-94. Erratum in: Lancet Neurol 2014;13(11):1070. PMID 25030513

Okkersen K, Jimenez-Moreno C, Wenninger S, et al. Cognitive behavioural therapy with optional graded exercise therapy in patients with severe fatigue with myotonic dystrophy type 1: a multicentre, single-blind, randomised trial. Lancet Neurol 2018;17(8):671-80. PMID 29934199

Radd-Vagenas S, Duffy SL, Naismith SL, Brew BJ, Flood VM, Fiatarone Singh MA. Effect of the Mediterranean diet on cognition and brain morphology and function: a systematic review of randomized contro

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: May 2, 2019

Although he may never have attended university, Leonardo da Vinci (1452-1519) was a true scholar of the Renaissance. His contributions to civil and mechanical engineering, the creative arts, and natural philosophy are nothing short of extraordinary. Less well popularized--although of equal importance--were his accomplishments in the field of anatomy. This week on the BrainWaves Podcast, we delve into his discoveries, his methodology, his handedness, and the message he has left us.

Produced by James E Siegler. Music courtesy of Sergey Chereminisov, Peter Rudenko, Fatal Injection, Andrew Sacco, Alavedra Montserrat, William McColl, and Joseph Levine. Sound effects by Mike Koenig, Mark DiAngelo, and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bowen G, Gonzales J, Iwanaga J, et al. Leonardo da Vinci (1452-1519) and his depictions of the human spine. Childs Nerv Syst 2017;33(12):2067-70. PMID 28283776

Keele KD. Leonardo da Vinci and anatomical demonstration. Med Biol Illus 1952;2(4):226-32. PMID 13012348

Keele KD. Leonardo da Vinci on vision. Proc R Soc Med 1955;48(5):384-90. PMID 14395232

Keele KD. Leonardo Da Vinci's influence on renaissance anatomy. Med Hist 1964;8:360-70. PMID 14230140

Pedretti C, Keele KD. Leonardo Da Vinci: Corpus of the Anatomical Studies in the Collection of Her Majesty the Queen at Windsor Castle. United States: Johnson Reprint Corporation, 1981.

Pevsner J. Leonardo da Vinci's contributions to neuroscience. Trends Neurosci 2002;25(4):217-20. PMID 11998691

Pevsner J. Leonardo da Vinci's studies of the brain. Lancet 2019;393(10179):1465-72. PMID 30967217

Schott GD. Some neurological observations on Leonardo da Vinci's handwriting. J Neurol Sci 1979;42(3):321-9. PMID 390099

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Although you should not confuse this with amaurosis fugax, a transient loss of vision in one eye usually screams vascular event. But not always... Keep an eye out for how the plot thickens in this week's episode of BrainWaves. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. The content in this episode was vetted and approved by Imran Jivraj.

REFERENCES

Biousse V, Trobe JD. Transient monocular visual loss. Am J Ophthalmol 2005;140(4):717-21. PMID 16140247

Kattah JC, Wang DZ, Reddy C. Intravenous recombinant tissue-type plasminogen activator thrombolysis in treatment of central retinal artery occlusion. Arch Ophthalmol 2002;120(9):1234-6. PMID 12215107

Ravits J, Seybold ME. Transient monocular visual loss from narrow-angle glaucoma. Arch Neurol 1984;41(9):991-3. PMID 6477235

Schumacher M, Schmidt D, Jurklies B, et al. Central retinal artery occlusion: local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial. Ophthalmology 2010;117(7):1367-75.e1. PMID 20609991

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 18, 2019

In medicine, less is more. Sometimes. In this week's program, Dr. Igor Rybinnik of the Rutgers Robert Wood Johnson Medical School shares what he's learned when it comes to overtreating patients.

Produced by James E Siegler and Igor Ribynnik. Music courtesy of Chris Zabriskie, Kevin McLeod, Mystery Mammal, Hyson, Fabian Measures, and Scott Holmes. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Coysh T, Breen DP. A nationwide analysis of successful litigation claims in neurological practice. JRSM Open 2014;5(3):2042533313518914. PMID 25057378

DesRoches CM, Rao SR, Fromson JA, et al. Physicians' perceptions, preparedness for reporting, and experiences related to impaired and incompetent colleagues. JAMA 2010;304(2):187-93. PMID 20628132

Klaas PB, Berge KH, Klaas KM, Klaas JP, Larson AN. When patients are harmed, but are not wronged: ethics, law, and history. Mayo Clin Proc 2014;89(9):1279-86. PMID 24993860

Mohr JC. American medical malpractice litigation in historical perspective. JAMA 2000;283(13):1731-7. PMID 10755500

Silveira MJ, Kim SY, Langa KM. Advance directives and outcomes of surrogate decision making before death. N Engl J Med 2010;362(13):1211-8. PMID 20357283

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: June 13, 2019

Things are heating up for BrainWaves this week as we explore an exciting new topic in our digital curriculum: heat-related illness--from the causes to the manifestations of the various causes of hyperthermia, which can ultimately lead to circulatory collapse. But don’t panic. It’s just a podcast.

Produced by James E Siegler. Music courtesy of Ghost, John Bartmann, Kai Engel, and Marco Trovatello. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Al Mahri S, Bouchama A. Heatstroke. Handb Clin Neurol 2018;157:531-45. PMID 30459024

Casa DJ, Armstrong LE, Kenny GP, O'Connor FG, Huggins RA. Exertional heat stroke: new concepts regarding cause and care. Curr Sports Med Rep 2012;11(3):115-23. PMID 22580488

Kenny GP, Wilson TE, Flouris AD, Fujii N. Heat exhaustion. Handb Clin Neurol 2018;157:505-29. PMID 30459023

Morrison SF, Nakamura K. Central neural pathways for thermoregulation. Front Biosci (Landmark Ed) 2011;16(1):74-104. PMID 21196160

Wu X, Brady JE, Rosenberg H, Li G. Emergency department visits for heat stroke in the United States, 2009 and 2010. Inj Epidemiol 2014;1(1):8. PMID 27747667

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 16, 2018

Lesion localization is a critical skill for any neurologist. The so-called "cortical signs" are symptoms or examination findings, which are often associated with cortical neuron injury--aphasia, neglect, gaze preference. But they are also seen after injury to subcortical structures, including white matter tracts, the thalamus, and basal ganglia. In this week's installment of the BrainWaves podcast, we'll attempt to localize subcortical lesions based on these major cortical signs.

Produced by James E Siegler. Music by Aussenseiter, Gnagno, Yshwa, and Kevin McLeod. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Bogousslavsky J, Regli F, Uske A. Thalamic infarcts: clinical syndromes, etiology, and prognosis. Neurology 1988;38(6):837-48. Erratum in: Neurology 1988;38(8):1335. PMID 3368064

Fridriksson J, den Ouden DB, Hillis AE, et al. Anatomy of aphasia revisited. Brain 2018;141(3):848-62. PMID 29360947

Karnath HO, Himmelbach M, Rorden C. The subcortical anatomy of human spatial neglect: putamen, caudate nucleus and pulvinar. Brain 2002;125(Pt 2):350-60. PMID 11844735

Lam YW, Sherman SM. Functional organization of the thalamic input to the thalamic reticular nucleus. J Neurosci 2011;31(18):6791-9. PMID 21543609

Maeshima S, Osawa A. Thalamic lesions and aphasia or neglect. Curr Neurol Neurosci Rep 2018;18(7):39. PMID 29789957

Nadeau SE, Crosson B. Subcortical aphasia. Brain Lang 1997;58(3):355-402; discussion 418-23. PMID 9222518

Tijssen CC. Contralateral conjugate eye deviation in acute supratentorial lesions. Stroke 1994;25(7):1516-9. PMID 8023372

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 11, 2019

In this week's Teaching through Clinical Cases, Dr. Olga Rosenveld Thon (Drexel) walks us through the challenging management decisions that emerge in the care of women with demyelinating disease. Why are women prone to multiple sclerosis? How do pregnancy, breastfeeding, and menopause influence the disease course--and should these events alter the course of their therapy?

Produced by James E Siegler and Olga Thon. Music courtesy of Cellophane Sam, Chris Zabriskie, Jon Watts, Kai Engel, and Lee Rosevere. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

DISCLOSURES

Dr. Rosenveld Thon reports relevant financial interests in Ocrevus, as a consultant.

REFERENCES

Bove R, Chitnis T, Houtchens M. Menopause in multiple sclerosis: therapeutic considerations. J Neurol 2014;261(7):1257-68. PMID 24101131

Bove R, Chitnis T. The role of gender and sex hormones in determining the onset and outcome of multiple sclerosis. Mult Scler 2014;20(5):520-6. PMID 24561324

Bove R. Women's issues in multiple sclerosis. Semin Neurol 2016;36(2):154-62. PMID 27116722

Confavreux C, Hutchinson M, Hours MM, Cortinovis-Tourniaire P, Moreau T. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. N Engl J Med 1998;339(5):285-91. PMID 9682040

Correale J, Farez MF, Ysrraelit MC. Increase in multiple sclerosis activity after assisted reproduction technology. Ann Neurol 2012;72(5):682-94. PMID 23034952

Michel L, Foucher Y, Vukusic S, et al. Increased risk of multiple sclerosis relapse after in vitro fertilisation. J Neurol Neurosurg Psychiatry 2012;83(8):796-802. PMID 22693287

Nielsen NM, Westergaard T, Rostgaard K, et al. Familial risk of multiple sclerosis: a nationwide cohort study. Am J Epidemiol 2005;162(8):774-8. PMID 16120694

Ramagopalan SV, Dobson R, Meier UC, Giovannoni G. Multiple sclerosis: risk factors, prodromes, and potential causal pathways. Lancet Neurol 2010;9(7):727-39. PMID 20610348

Rankin K, Bove R. Caring for women with multiple sclerosis across the lifespan. Curr Neurol Neurosci Rep 2018;18(7):36. PMID 29789964

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 5, 2020

Generalized weakness is a common complaint. Much of the time, we as neurologists don’t even see these patients in the hospital or the clinic. But more often than not, “generalized” weakness may be the only way a patient describes difficulty brushing their hair or climbing stairs. In these situations, it’s not exactly generalized weakness. It’s something else. This week on BrainWaves, we review the major patterns of weakness that characterize the most common muscle disorders. With a quick review of EMG findings. Enjoy!

Produced by James E Siegler. Music courtesy of Jahzzar, Kevin McLeod, Patches, and Montplaisir. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Clark KE, Isenberg DA. A review of inflammatory idiopathic myopathy focusing on polymyositis. Eur J Neurol 2018;25(1):13-23. PMID 28816394

Fayssoil A, Ogna A, Chaffaut C, et al. Natural history of cardiac and respiratory involvement, prognosis and predictive factors for long-term survival in adult patients with limb girdle muscular dystrophies type 2C and 2D. PLoS One 2016;11(4):e0153095. PMID 27120200

Harris E, Bladen CL, Mayhew A, et al. The Clinical Outcome Study for dysferlinopathy: An international multicenter study. Neurol Genet 2016;2(4):e89. PMID 27602406

Preston DC and Shapiro BE. Electromyography and neuromuscular disorders: clinical-electrophysiologic correlations. 3rd ed. London; New York: Elsevier Saunders; 2013.

Suresh E, Wimalaratna S. Proximal myopathy: diagnostic approach and initial management. Postgrad Med J 2013;89(1054):470-7. PMID 23596213

Walter MC, Reilich P, Thiele S, et al. Treatment of dysferlinopathy with deflazacort: a double-blind, placebo-controlled clinical trial. Orphanet J Rare Dis 2013;8:26. PMID 23406536

Wicklund MP. The limb-girdle muscular dystrophies. Continuum (Minneap Minn) 2019;25(6):1599-618. PMID 31794462

rAAVrh74.MHCK7.DYSF.DV for Treatment of Dysferlinopathies. Clinicaltrials.gov: https://www.clinicaltrials.gov/ct2/show/NCT0271050022. Accessed December 2019.

For great video examples of EMG findings in nerve and muscle disease, check out KImura & Kohara's YouTube recordings: https://www.youtube.com/watch?v=6-3PP...

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date. 

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 23, 2020

In a patient with isolated, progressive hand numbness and weakness, there is much to be learned about the clinical exam. Often, it’s all you need. Dr. Aakriti Kothiwal of Cooper University Hospital presents this week's clinical case and helps localize the lesion.

Produced by James E Siegler and Aakriti Kothiwal. Music courtesy of Jazzar, Lee Rosevere, and Loyalty Freak Music. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Aamodt WW, Siegler JE, Elman L. Teaching Neuro Images: acute infarction of the left medial lemniscus masquerading as a peripheral neuropathy. Neurology 2017;88(17):e178. PMID 28438850

Bouche P. Compression and entrapment neuropathies. Handb Clin Neurol 2013;115:311-66. PMID 23931789

Gross PT, Jones HR Jr. Proximal median neuropathies: electromyographic and clinical correlation. Muscle Nerve 1992;15(3):390-5. PMID 1313546

Gross PT, Tolomeo EA. Proximal median neuropathies. Neurol Clin 1999;17(3):425-45, v. PMID 10393747

Hobson-Webb LD, Juel VC. Common entrapment neuropathies. Continuum (Minneap Minn) 2017;23(2, Selected Topics in Outpatient Neurology):487-511. PMID 28375915

Padua L, Coraci D, Erra C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol 2016;15(12):1273-84. PMID 27751557

Peters N, Müller-Schunk S, Freilinger T, Düring M, Pfefferkorn T, Dichgans M. Ischemic stroke of the cortical "hand knob" area: stroke mechanisms and prognosis. J Neurol 2009;256(7):1146-51. PMID 19353229

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: February 21, 2019

Heroin was originally marketed as a cough suppressant in 1898. (Obviously, people have discovered more uses for it since then.) One hundred years later, it has paved the way for a worldwide drug abuse epidemic. Dr. Mike Rubenstein presents this week's clinical case of a very particular type of heroin use and a rare form of neurotoxicity.

Produced by James E Siegler and Mike Rubenstein. Music courtesy of Heftone Banjo Orchestra, John Bartmann, Kai Engel, and Soft and Furious. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Alambyan V, Pace J, Miller B, et al. The Emerging Role of Inhaled Heroin in the Opioid Epidemic: A Review. JAMA Neurol. 2018 Nov 1;75(11):1423-1434. doi: 10.1001/jamaneurol.2018.1693. PMID 29987325

Kriegstein AR, Armitage BA, Kim PY. Heroin inhalation and progressive spongiform leukoencephalopathy. N Engl J Med 1997;336(8):589-90. PMID 9036319

Kriegstein AR, Shungu DC, Millar WS, et al. Leukoencephalopathy and raised brain lactate from heroin vapor inhalation ("chasing the dragon"). Neurology 1999;53(8):1765-73. PMID 10563626

Wolters EC, van Wijngaarden GK, Stam FC, et al. Leucoencephalopathy after inhaling "heroin" pyrolysate. Lancet 1982;2(8310):1233-7. PMID 6128545

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 17, 2020

You know the triad for normal pressure hydrocephalus (NPH). Wet, wobbly, and wacky. And you have probably heard of the Evan’s index—the relative proportion of the lateral ventricles in reference to the inner table of the skull. But you might not have heard of high-convexity tight sulci.

Now you have.

Produced by James E Siegler. Music courtesy of Jason Shaw, Javolenus, and Lee Rosevere, under a Creative Commons License. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWavesaudio for the latest updates to the podcast.

REFERENCES

Allali G, Laidet M, Armand S, et al. A combined cognitive and gait quantification to identify normal pressure hydrocephalus from its mimics: The Geneva's protocol. Clin Neurol Neurosurg 2017;160:5-11. PMID 28605723

Graff-Radford J, Gunter JL, Jones DT, et al. Cerebrospinal fluid dynamics disorders: Relationship to Alzheimer biomarkers and cognition. Neurology 2019;93(24):e2237-46. PMID 31719134

Kitagaki H, Mori E, Ishii K, Yamaji S, Hirono N, Imamura T. CSF spaces in idiopathic normal pressure hydrocephalus: morphology and volumetry. AJNR Am J Neuroradiol 1998;19(7):1277-84. PMID 9726467

Sasaki M, Honda S, Yuasa T, Iwamura A, Shibata E, Ohba H. Narrow CSF space at high convexity and high midline areas in idiopathic normal pressure hydrocephalus detected by axial and coronal MRI. Neuroradiology 2008;50(2):117-22. PMID 17992524


We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: June 27, 2019

In episode 142, Jim Siegler is joined by Dr. Deena Kuruvilla (Yale University School of Medicine) to discuss the 5 trigeminal autonomic cephalalgias--what we know about the pathophysiology, the diagnostic criteria, and current and future management strategies.

Produced by James E Siegler and Deena Kuruvilla. Music courtesy of Ars Sonor, Axletree, Kevin McLeod, Lee Rosevere, and Steve Combs. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWavesaudio for the latest updates to the podcast.

REFERENCES

Akram H, Miller S, Lagrata S, et al. Ventral tegmental area deep brain stimulation for refractory chronic cluster headache. Neurology 2016;86(18):1676-82. PMID 27029635

Goadsby PJ. Trigeminal autonomic cephalalgias. Continuum (Minneap Minn) 2012;18(4):883-95. PMID 22868548

Khan S, Olesen A, Ashina M. CGRP, a target for preventive therapy in migraine and cluster headache: systematic review of clinical data. Cephalalgia 2019;39(3):374-89. PMID 29110503

Lambru G, Matharu MS. SUNCT, SUNA and trigeminal neuralgia: different disorders or variants of the same disorder? Curr Opin Neurol 2014;27(3):325-31. PMID 24792341

McGeeney BE. Cluster headache and other trigeminal autonomic cephalalgias. Semin Neurol 2018;38(6):603-607. PMID 30522134

Miller S, Akram H, Lagrata S, Hariz M, Zrinzo L, Matharu M. Ventral tegmental area deep brain stimulation in refractory short-lasting unilateral neuralgiform headache attacks. Brain 2016;139(Pt 10):2631-40. PMID 27524793

DISCLOSURES
 
Dr. Kuruvilla serves as a consultant for Lilly and Amgen pharmaceuticals.


We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.