Neurology
Expert perspectives on neurological conditions, stroke management, movement disorders, and neuromuscular disease.
Recent Discussions
Do you recommend CSF analysis in young patients with imaging findings consistent with progressive supranuclear palsy?
This is a difficult question and I'm not experienced enough to give you a great answer. In the end, it depends on the age of onset (age <50 would give me pause), rate of progression, the inclusion of expected PSP symptomology (supranuclear palsy, akinetic-rigid axial parkinsonism, spontaneous retrop...
Do you see secondary EMG/NCS abnormalities in patients with chronic upper motor neuron dysfunction such as cerebral palsy, myelopathy, or remote stroke?
The short answer is NO. UMN deficits result in low firing rates, leading to fewer activated motor units, but this does not constitute denervation. Nonetheless, the concept of trans-synaptic degeneration has been discussed for over 50 years (I believe Dr. Wilder Penfield, the neurosurgeon from Montre...
How do you counsel patients on migraine "triggers"?
What often triggers headaches or migraines is not just one factor acting alone, but rather a combination of triggers compounding together. Consequently, it's generally more effective and less demanding to prevent triggers from compounding, rather than avoiding them altogether. However, the first ste...