Articles: Volume 22.01 January-March 2018

Neurological sleep medicine: a case note audit from a specialist clinic

In this article, the authors report the findings of an audit of patients with neurological sleep disorders seen in a combined cognitive neurology and sleep disorder clinics over a seven-year period, 75 with hypersomnias, 67 with parasomnias and 39 with insomnia. Also, the results of a pilot of a cognitive behavioural therapy service for insomnia undertaken in the same population are analysed

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The gut-brain connection: the developing science of the microbiome

Our commentaries from the Primary Care Neurology Society (P-CNS) provide a primary care perspective on the neurology articles in Progress. Here Dr Bindemann and Dr Ali consider ‘Psychobiotics: bacterial hope for depression’ (see this issue)

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Cladribine tablets and multiple sclerosis: NICE technology appraisal

Cladribine is the first disease modifying treatment for relapsing remitting multiple sclerosis, that progressed straight to a positive final recommendation in the NICE appraisal process. Here, the authors discuss the clinical and economic considerations for cladribine usage

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Psychobiotics: bacterial hope for depression?

Increasing evidence links the microbiome’s composition with several psychiatric and neurological diseases, including autism, schizophrenia, attention deficit hyperactivity disorder, Parkinson’s disease, Alzheimer’s disease and multiple sclerosis – Mark Greener here investigates

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Limbic encephalitis and bipolar affective disorder: a slow awakening

There is increasing evidence for the role of autoimmune encephalitis in the aetiology of psychosis. Here, Dr Lilford and colleagues describe the case of a 74-year-old lady who presented as hypomanic and then developed bizarre stereotyped movements. The authors discuss her treatment with immunosuppressive drugs, which resulted in significant clinical improvement

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Memantine-induced bradycardia – a rare adverse reaction

Behavioural and psychological symptoms of dementia, such as aggression or agitation are very frequent in Alzheimer’s disease with most guidelines recommending memantine as first-line pharmacological treatment. Here, the authors describe a patient who developed bradycardia when prescribed memantine and the subsequent changes required to her medication management to avoid further cardiac adverse reactions

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Letter: Recurrent TGA – link to family history?

Following the publication of the article entitled “Recurrent transient global amnesia: Is there a link to familial history?” in Progress, I received a number of emails inviting me to read more examples on recurrent and familial cases of TGA. Of course, this is a non-systematic method of case ascertainment, but the information received confirms underascertainment of cases of recurrent and familial TGA and adds to the evidence suggesting that family history and recurrence of TGA may be linked

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Autonomic dysreflexia in syringomyelia secondary to Chiari malformation

Autonomic dysreflexia is a serious complication of high level spinal cord injury. Here, the authors present a case of autonomic dysreflexia in a patient with non-traumatic spinal cord pathology and review the incidence of such potentially fatal complications in other neurological conditions involving the high level spinal cord

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Serotonin syndrome in asymptomatic Huntington’s disease

Serotonin syndrome is a rare and serious condition most often resulting from iatrogenic insult. Here, Dr Haffenden and Dr Patel discuss a complex case of serotonin syndrome in a patient with genetically proven, but not yet symptomatic, Huntington’s disease and chronic renal impairment. 

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Letter: Use of mirtazapine in children and adolescents

There is uncertainty about the safety and efficacy of antidepressant medications in the younger population. In this letter the authors discuss the use of mirtazapine in the case of a 16-year-old female presenting with resistant depression and sleep difficulties

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