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 20, 2018

It's the age of thrombectomy. The DAWN of a new era. But should we give up on intravenous thrombolysis for acute ischemic stroke? In this installment of the Quanta series (typically shorter episodes, this one happens to be 19 minutes), we review the latest data on fibrinolytic agents and anticipate the upcoming paradigm shift in the management of patients with cerebral infarction.

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

REFERENCES

Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT-2) Investigators; Van De Werf F, Adgey J, et al. Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet 1999;354(9180):716-22. PMID 10475182

Campbell BC, Mitchell PJ, Churilov L, et al. Tenecteplase versus alteplase before thrombectomy for ischemic stroke. N Engl J Med 2018;378(17):1573-82. PMID 29694815

Haley EC Jr, Lyden PD, Johnston KC, Hemmen TM; TNK in Stroke Investigators. A pilot dose-escalation safety study of tenecteplase in acute ischemic stroke. Stroke 2005;36(3):607-12. PMID 15692126

Haley EC Jr, Thompson JL, Grotta JC, et al. Phase IIB/III trial of tenecteplase in acute ischemic stroke: results of a prematurely terminated randomized clinical trial. Stroke 2010;41(4):707-11. PMID 20185783

Huang X, Cheripelli BK, Lloyd SM, et al. Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study. Lancet Neurol 2015;14(4):368-76. PMID 25726502

Logallo N, Novotny V, Assmus J, et al. Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial. Lancet Neurol 2017;16(10):781-8. PMID 28780236

Parsons M, Spratt N, Bivard A, et al. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. N Engl J Med 2012;366(12):1099-107. PMID 22435369

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 20, 2018

Apomorphine has a more than 20-year history as a therapeutic adjunct in the management of idiopathic Parkinson disease. And yet, no randomized, placebo-controlled clinical trial to show for it. As of July 2018, now there is. In this week's episode of BrainWaves, Dr. Siegler discusses the relevance, strengths, and weaknesses of the TOLEDO trial.

Produced by James E. Siegler. Music by Ondrosik and Rod Hamilton. 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

Katzenschlager R, Poewe W, Rascol O, et al. Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomised, placebo-controlled trial. Lancet Neurol 2018;17(9):749-59. PMID 30055903

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 22, 2018

Did anyone else catch the 2017 update to the diagnostic criteria for multiple sclerosis? Me neither. Hopefully this episode will catch you up on it.

Produced by James E Siegler. Music by Daniel Birch and Chris Zabriskie. The BrainWaves' podcast and online content are intended for medical education and entertainment purposes only.

REFERENCES

Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011;69(2):292-302. PMID 21387374

Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018;17(2):162-173. PMID 29275977

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 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: 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: 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: 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: 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: 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: 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: 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: 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: 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. Episodes originally aired from 2016 to 2021.

Originally released: September 14, 2017

In 2016, the management of patent foramen ovale was “open” for discussion. Now (2017), consider the case closed. Recent data indicate patent foramen ovales should be closed in certain patients with cryptogenic strokes. But some questions remain unanswered. This week's episode is a follow-up discussion on this frequent topic that troubles stroke units.

Produced by James E Siegler and Chris Favilla. Music by Lee Rosevere and Marcos H. Bolanos. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education purposes only. Jim is not a cardiac surgeon. Just a guy who's trying to bring you all the latest updates on what smarter doctors are doing.

REFERENCES

Kent DM, Dahabreh IJ, Ruthazer R, et al. Device closure of patent foramen ovale after stroke: pooled analysis of completed randomized trials. J Am Coll Cardiol 2016;67(8):907-7. PMID 26916479

Kent DM, Ruthazer R, Weimar C, et al. An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke. Neurology 2013;81(7):619-25. doi: 10.1212/WNL.0b013e3182a08d59. Epub 2013 Jul 17. PMID 23864310

Meier B, Lock JE. Contemporary management of patent foramen ovale. Circulation 2003;107(1):5-9. PMID 12515733

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: 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: 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: 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: 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: 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: 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: 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: 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: December 26, 2019

2019 was a big year. The year of the Mueller report. The American college admissions scandals. Brexit. But it was also the year the US Women's team won the World Cup and lobbied for the equal pay of women and men in sports. It was the year of NMO, in which several pivotal trials showed the benefit of disease-modulating therapy in this condition. The year Will Smith played Genie in Aladdin.

2019 was a great year. And as we wrap up 2019, this week's episode includes some of the highlights. Enjoy!

Produced by James E Siegler with support from Erika Mejia, Rajat Dhar, and the entire Siegler family. Music courtesy of Axletree, Chris Zabriskie, John Paston, Kevin Mcleod, Josh Woodward, Steve Combs, Lee Rosevere, Scott Holmes, Advent Chamber Orchestra, Coldnoise, 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

[BRAIN FOOD]

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-e1988. 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.e8. 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,

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 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: 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: 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: 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: 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 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: 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. Episodes originally aired from 2016 to 2021.

Originally released: November 28, 2019

Peer review prior to publication of medical data dates back to the 9th century CE but has only really gained steam in the past 70 or 80 years. Ideally, peer review would serve as an initial filter for data that enter a permanent public scientific record. But peer review is not without flaws. In the second installment of the BrainWaves segment, “It’s not over yet…,” we discuss publication as a potential source of bias and highlight the reasons why it should not be the final step of the peer review process.

Produced by James E Siegler. Music courtesy of Cullah, Lee Rosevere, John Bartmann, Kevin McLeod, and Jon Watts. 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

Bingham C, van der Weyden MB. Peer review on the Internet: launching eMJA peer review study 2. Med J Aust 1998;169(5):240-1. PMID 9762058

Godlee F, Gale CR, Martyn CN. Effect on the quality of peer review of blinding reviewers and asking them to sign their reports: a randomized controlled trial. JAMA 1998;280(3):237-40. PMID 9676667

Haffar S, Bazerbachi F, Murad MH. Peer review bias: a critical review. Mayo Clin Proc 2019;94(4):670-6. PMID 30797567

Jefferson T, Alderson P, Wager E, Davidoff F. Effects of editorial peer review: a systematic review. JAMA 2002;287(21):2784-6. PMID 12038911

Jefferson T, Rudin M, Brodney Folse S, Davidoff F. Editorial peer review for improving the quality of reports of biomedical studies. Cochrane Database Syst Rev 2007;2007(2):MR000016. PMID 17443635

Mandavilli A. Peer review: Trial by Twitter. Nature 2011;469(7330):286-7. PMID 21248816

Ware M. Peer review: Benefits, perspectives, and alternatives. Publishing Research Consortium, 2008.

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: 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: 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: 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: 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: 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 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. Episodes originally aired from 2016 to 2021.

Originally released: November 14, 2019

The FDA label for ACTEMRA® (tocilizumab)--the first medication approved for use in giant cell arteritis in 2017--is 40 pages long. Of the information provided in this document, which includes important dosing information, dose adjustments based on leukocyte count, clinical trial and epidemiologic data, there is a box of text on the first page of the insert. "WARNING: RISK OF SERIOUS INFECTIONS," it reads.

What do you make of this warning? And with such a clear and broad-sweeping statement stamped on the medication, how do you mitigate the medico-legal risk of using this drug?

This week on the program we launch into a two-part series focused on some of the events that follow major clinical trials. In part 1, we cover the three major classifications of FDA alerts for medical treatments using two examples from the neurologic pharmacopoeia. In part 2, we emphasize the importance of post-publication peer review. And both are equally instrumental in our medical decision-making.

Produced by James E Siegler with the support of Michael Rubenstein (University of Pennsylvania) and Zachary Newcomer (University of Florida). Music courtesy of Coldnoise, Cuicuitte, Doctor Turtle, Jahzzar, and Peter Rudenko under a CC license. 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. None of what is discussed here should be misconstrued as medical advice, so don't just go prescribing drugs off-label! (Or willy nilly, as my grandmother might say) Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Ballard C, Hanney ML, Theodoulou M, et al. The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol 2009;8(2):151-7. PMID 19138567

Dorsey ER, Beck CA, Darwin K, et al. Natural history of Huntington disease. JAMA Neurol 2013;70(12):1520-30. PMID 24126537

Hubers AA, van Duijn E, Roos RA, et al. Suicidal ideation in a European Huntington's disease population. J Affect Disord 2013;151(1):248-58. PMID 23876196

Moore TJ, Singh S, Furberg CD. The FDA and new safety warnings. Arch Intern Med 2012;172(1):78-80. PMID 22232155

Rose RV, Kass JS. Prescribing antipsychotic medications to patients with dementia: boxed warnings and mitigation of legal liability. Continuum (Minneap Minn) 2019;25(1):254-9. PMID 30707196

Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA 2005;294(15):1934-43. PMID 16234500

Schultz JL, Killoran A, Nopoulos PC, Chabal CC, Moser DJ, Kamholz JA. Evaluating depression and suicidality in tetrabenazine users with Huntington disease. Neurology 2018;91(3):e202-7. PMID 29925548

Shen V, Clarence-Smith K, Hunter C, Jankovic J. Safety and efficacy of tetrabenazine and use of concomitant medications during long-term, open-label treatment of chorea associated with Huntington's an

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 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