Neurology

Towards the Optimal Care of Parkinson’s Disease – A Guide for GPs

Parkinson’s disease is growing in prevalence and incidence and presents a major healthcare challenge as the population ages. It is no longer ‘just a movement disorder’, but a multisystem condition that requires the attentive and agile collaboration of primary care and neurology. The diagnosis of Parkinson’s disease is still predominantly clinical, and imaging and biomarkers are largely still a research tool. The role of primary care in identifying and helping to manage the many possible manifestations of Parkinson’s disease, especially in later life, is vital to timely and patient focused care.

Modern Medicine – Issue 2 2024

May 6, 2024 by Peter Neurology

Finding Relief for Vertigo Symptoms in Ménière’s Disease

Ménière’s disease (MD) is an idiopathic disorder characterised by recurrent episodes of vertigo, unilateral sensorineural hearing loss, tinnitus and aural fullness. The development of endolymphatic hydrops – an increased fluid within the inner ear organ – is observed (or presumed) in all individuals with MD. Vertigo symptoms can be managed through a combination of dietary salt restriction, stress reduction and medical therapy (betahistine, diuretics, or both).

Modern Medicine – Issue 5 2021

October 13, 2021 by Peter Neurology

Calming Essential Tremor with Deep Brain Stimulation

Essential tremor (ET) is the most common movement disorder.It is characterised by bilateral action tremor of the hands and forearms, the head, and, less commonly, the voice, in the absence of other neurological signs. High-frequency stimulation of the ventral intermediate nucleus (VIM) has been shown to be highly effective in the suppression of tremor.Stimulation provides tremor relief on the side contralateral to the stimulator, completely eliminating tremor in as many as 50% of patients.

Modern Medicine – Issue 5 2019

October 1, 2019 by Peter Neurology

Sound as Part of Cognitive Development and Understanding Brainhearing

Sound as Part of Cognitive Development and Understanding Brainhearing – MM1602

A child’s normal cognitive development is driven by the ability of sensory functions to bring useful information to the brain. By researching the way sensory input affects cognitive development early in life, we are able to provide sound instrumentation that allows sound to be picked up as a dependable source of information for the developing child.

Modern Medicine – February 2016

February 18, 2016 by Peter ENT Neurology

Schizophrenia is at Least Partly a Inflammatory Response

Schizophrenia is at Least Partly a Inflammatory Response – MM1501

Schizophrenia (SZ) is a complex, heterogeneous disease characterised by psychosis, affecting approximately 1% of the population. Core negative symptoms of SZ include cognitive deficits, social avoidance and flat affect; positive symptoms include paranoia, hyperactivity and psychosis. Linkage analyses reflect a high impact of genetics on incidence of SZ, although environmental effects such as life events and prenatal and early development may contribute to the disease.

Modern Medicine – January 2015

January 27, 2015 by Peter Neurology Schizophrenia

Generalised Epilepsy Due to Function Abnormalities

Generalised Epilepsy Due to Function Abnormalities – MM1501

Primary generalised epilepsy, also called idiopathic generalised epilepsy (IGE), refers to an epilepsy syndrome of idiopathic or unknown cause, not attributed to a known underlying condition such as brain tumour, stroke or other neurological disorder. IGE is characterised by bilateral spike–wave epileptiform discharges on electroencephalography (EEG). There are a number of different IGE syndromes. Each syndrome has its own characteristic seizure type(s), typical age of onset, and specific EEG patterns.

Modern Medicine – January 2015

January 27, 2015 by Peter Epilepsy Neurology

Syncope: Simple or Sinister?

Syncope: Simple or Sinister? – MM1411

Syncope is a transient loss of consciousness that can have a benign or serious cause. It can also be the presenting feature of a surgical emergency, as described here.

Modern Medicine – November/December 2014

January 23, 2015 by Peter Cardiology Emergency Medicine Neurology Syncope

Mood Disorders in General Practice

Mood Disorders in General Practice – MM1411

Mood disorders are commonly encountered in general practice. Some patients with mood disorder require referral but all will benefit from careful assessment and specific interventions in general practice.

Modern Medicine – November/December 2014

January 23, 2015 by Peter Neurology Psychiatry

Practical Management of Multiple Sclerosis

Practical Management of Multiple Sclerosis – MM1409

Patients with multiple sclerosis often require high levels of medical input from their GP and treating neurologist. GPs are often their first point of contact about symptoms or complications of their disease or its treatment.

Modern Medicine – September 2014

October 2, 2014 by Peter Multiple Sclerosis Neurology

The Physiology of Chronic Pain The Role of the Inhibitory Interneuron

The Physiology of Chronic Pain The Role of the Inhibitory Interneuron – MM1401

As described in the original article in May 2013, central sensitisation of the dorsal horn cells with facilitated pain processing and transmission can occur after nerve injury, deafferentation of the spinal cord (amputation or nerve section) or due to afferent barrage.
As a result, anatomical and neuro-chemical changes can occur within the central nervous system (CNS) that can persist long after the injury has healed.
This ‘CNS plasticity’ may play an important role in the evolution of chronic, neuropathic pain. The sensitisation of neurons that occurs within the dorsal horn results in spontaneous activity of the dorsal horn neurons, a decreased threshold and an increased responsivity to afferent input, and cell death in the spinal dorsal horn. The cells that die are the inhibitory interneurons.

Modern Medicine – January 2014

January 21, 2014 by Peter Neurology Pain

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