The risks of "bariatric tourism", and photophobia with a pustular rash - Case Reports June 2025
Gastric sleeve surgery is the key feature of a pair of recent cases from the journal, which start this episode (1:17). Both cases feature 25-yo women with presentations in common: paraesthesia and limb weakness, along with disordered eye movement. Their symptoms arose soon after the gastrectomy operation.
https://pn.bmj.com/content/25/3/268
The second report is a "true grey case" (22:14), with a myriad of presenting symptoms in a 27-yo man: fevers, weight loss, lethargy, light sensitivity, and skin plaques around the nose and mouth. Steroid treatment was started with a suspicion of a connective tissue disease, but was halted when his condition soon worsened. Some feathered friends of the podcast shine a light on the diagnosis.
https://pn.bmj.com/content/25/3/253
The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Babak Soleimani³ for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the June 2025 issue of the journal.
(1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital.
(2) Neurology Registrar, University Hospitals Sussex.
(3) Clinical Research Fellow, Oxford Laboratory for Neuroimmunology and Immunopsychiatry, Nuffield Department of Medicine, University of Oxford
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
Production by Amy Ross Russell and Brian O'Toole, editing by Brian O'Toole. Thank you for listening.
--------
42:11
New, complicated and evolving: IgG4-related disease
A neuroinflammatory disorder with the potential to affect virtually any organ in the body, IgG4-related disease is a challenge on many fronts. The latest Editors' Choice paper in the June 2025 issue takes on this systemic disease, presenting a treatment algorithm for its management. This episode, PN's podcast editor Dr. Amy Ross Russell speaks with author Dr. Claire Rice. Hear an overview on the disease background, the signs in presentation, what to look for in the histology, and steroid treatment strategy.
Read the paper: IgG4-related disease in the nervous system
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
Production by Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.
--------
33:02
Nutritional perils, the immunoglobulin paradox, and a flickering candle - Editors' Highlights June 2025
This episode’s theme is new diseases, whether they are newly described, or old diseases back in a new form. We start off with IgG4-related disease, a chronic multisystem disorder that is still being understood. Then there is a genetics paper on repeat expansion disorders, a group of conditions often thought as disparate but with quite a few commonalities. Next along is a fascinating case following gastric sleeve bariatric surgery, highlighting the dangers of travelling for unsupervised surgeries, and raising the question, “Are you getting enough soil in your diet?” There’s also a discussion of what else Hoover’s sign might represent, and the evolution of immunoglobulin use. Closing the episode is a paper offering a masterclass on the assessment of best interests in prolonged disorder of consciousness.
Read the issue: https://pn.bmj.com/content/25/3/199
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
Production and editing by Brian O'Toole. Thank you for listening.
--------
55:05
Fragmented sleep with delusions of theft, and falls after eye shingles - Case Reports April 2025
Two wide open cases from the latest issue of the journal. Starting with a case from Italy (1:18), of a 63-yo man having a history of behavioural and cognitive problems since retiring. His many changes included low mood, significant weight loss, and problems with sleep and temperature regulation. He had a background of type 2 diabetes. Initial treatment was on a suspicion of Alzheimer's, but there was no clinical improvement. https://pn.bmj.com/content/25/2/159
A case from the United States is next (17:36), featuring a 66-yo lady experiencing 10 days of generalised weakness, with episodes of forgetfulness and a series of falls. She had previously been treated for left-sided ophthalmic herpes zoster. Neurological examination showed mild right arm and leg weakness. https://pn.bmj.com/content/25/2/164
The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Babak Soleimani³ for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the February 2025 issue of the journal.
(1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital.
(2) Neurology Registrar, University Hospitals Sussex.
(3) Clinical Research Fellow, Oxford Laboratory for Neuroimmunology and Immunopsychiatry, Nuffield Department of Medicine, University of Oxford
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
Production and editing by Brian O'Toole. Thank you for listening.
--------
36:51
How do new cancer drugs affect our brains? A practical guide to immune checkpoint inhibitors
Immune checkpoint inhibitors can significantly improve cancer survival rates. But resulting immune-related toxicities are common, requiring multidisciplinary cooperation between oncology and neurology.
This episode, PN's podcast editor Dr. Amy Ross Russell speaks with a panel of experts on the balancing act required when treating cancer patients with these new drugs. Oncologist Dr. Heather Shaw is alongside neurologists Dr. Aisling Carr and Dr. Mark Willis, and they are amongst the authors of the editors' choice paper for the latest issue of Practical Neurology.
Read the paper: Neurological complications of immune checkpoint inhibitors: a practical guide
Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.
Production by Letícia Amorim, Brian Kennedy, Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.
The Practical Neurology Podcast is the essential guide for the everyday life of all neurologists. Just like our journal Practical Neurology, this podcast is useful for everyone who sees neurological patients and who wants to keep up-to-date and safe in managing them. In other words, this is a podcast for jobbing neurologists who plough through the tension headaches and funny turns week in and week out.
Subscribe to enjoy deep dives into each journal issue with editors Prof. Philip Smith and Dr. Geraint Fuller, discussions on recent case reports with Prof. Martin Turner, and Editor’s Choice article discussions between authors and Dr. Amy Ross Russell.
Practical Neurology - pn.bmj.com - is included as part of a subscription to JNNP and provided in print to all members of the Association of British Neurologists.
Brasil