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BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology and medicine. Follow us on Twitter @brainwavesaudio, or just tune in every Thursday for the latest shows! **NOT FOR CLINICAL DECISION MAKING**

BrainWaves: A Neurology Podcast Jim Siegler, MD | Neurologist | Father | Friend of dogs

    • 課程

BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology and medicine. Follow us on Twitter @brainwavesaudio, or just tune in every Thursday for the latest shows! **NOT FOR CLINICAL DECISION MAKING**

    #156 Off-label clobazam in drug-resistant epilepsy

    #156 Off-label clobazam in drug-resistant epilepsy

    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
    Schmidt D, Rohde M, Wolf P and Roeder-Wanner U. Clobazam for refractory focal epilepsy. A controlled trial. Archives of neurology. 1986;43:824-6. Keene DL, Whiting S and Humphreys P. Clobazam as an add-on drug in the treatment of refractory epilepsy of childhood. Can J Neurol Sci. 1990;17:317-9. Remy C. Clobazam in the treatment of epilepsy: a review of the literature. Epilepsia. 1994;35 Suppl 5:S88-91. Montenegro MA, Cendes F, Noronha AL, Mory SB, Carvalho MI, Marques LH and Guerreiro CA. Efficacy of clobazam as add-on therapy in patients with refractory partial epilepsy. Epilepsia. 2001;42:539-42. Ng YT and Collins SD. Clobazam. Neurotherapeutics. 2007;4:138-44. Montenegro MA, Arif H, Nahm EA, Resor SR, Jr. and Hirsch LJ. Efficacy of clobazam as add-on therapy for refractory epilepsy: experience at a US epilepsy center. Clin Neuropharmacol. 2008;31:333-8. Mahmoud SH and Rans C. Systematic review of clobazam use in patients with status epilepticus. Epilepsia Open. 2018;3:323-330. Bresnahan R, Martin-McGill KJ, Williamson J, Michael BD and Marson AG. Clobazam add-on therapy for drug-resistant epilepsy. The Cochrane database of systematic reviews. 2019;10:CD004154. YOUTUBE EXCERPTS (shared via fair use)
    Kathryn Davis, MD (Hospital of the University of Pennsylvania): https://www.youtube.com/watch?v=XInZ7Y0lgKg
    Patty McGoldrick, NP, MPA (Beth Israel Deaconness Medical Center/Roosevelt Hospital): https://www.youtube.com/watch?v=sE2BkYXqxJs&t=14s

    • 13 分鐘
    #155 Teaching through clinical cases: Handed the diagnosis

    #155 Teaching through clinical cases: Handed the diagnosis

    In a patient with isolated, progressive hand numbness and weakness, there is a much to be learned about the clinical exam. Often, its all you need. This week, Dr. Aakriti Kothiwal (Cooper University Hospital) presents this week's clinical case and helps localize the lesion.
    Produced by James E. Siegler and Aakriti Kothiwal. Music courtesy of Jazzar, Lee Rosevere, and Loyalty Freak Music. 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
    Gross PT and Jones HR, Jr. Proximal median neuropathies: electromyographic and clinical correlation. Muscle Nerve. 1992;15:390-5. Gross PT and Tolomeo EA. Proximal median neuropathies. Neurol Clin. 1999;17:425-45, v. Peters N, Muller-Schunk S, Freilinger T, During M, Pfefferkorn T and Dichgans M. Ischemic stroke of the cortical "hand knob" area: stroke mechanisms and prognosis. Journal of neurology. 2009;256:1146-51. Bouche P. Compression and entrapment neuropathies. Handbook of clinical neurology. 2013;115:311-66. Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P and Hobson-Webb LD. Carpal tunnel syndrome: clinical features, diagnosis, and management. The Lancet Neurology. 2016;15:1273-1284. Aamodt WW, Siegler JE and Elman L. Teaching NeuroImages: Acute infarction of the left medial lemniscus masquerading as a peripheral neuropathy. Neurology. 2017;88:e178. Hobson-Webb LD and Juel VC. Common Entrapment Neuropathies. Continuum (Minneap Minn). 2017;23:487-511.

    • 18 分鐘
    #154 All that restricts does not infarct

    #154 All that restricts does not infarct

    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 extra-cellular 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
    Filippi M, Iannucci G, Cercignani M, Assunta Rocca M, Pratesi A and Comi G. A quantitative study of water diffusion in multiple sclerosis lesions and normal-appearing white matter using echo-planar imaging. Archives of neurology. 2000;57:1017-21. Meyer JR, Gutierrez A, Mock B, Hebron D, Prager JM, Gorey MT and Homer D. High-b-value diffusion-weighted MR imaging of suspected brain infarction. AJNR American journal of neuroradiology. 2000;21:1821-9. Roberts TP and Rowley HA. Diffusion weighted magnetic resonance imaging in stroke. Eur J Radiol. 2003;45:185-94. McKinney AM, Short J, Truwit CL, McKinney ZJ, Kozak OS, SantaCruz KS and Teksam M. Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. AJR Am J Roentgenol. 2007;189:904-12. Maier SE, Sun Y and Mulkern RV. Diffusion imaging of brain tumors. NMR Biomed. 2010;23:849-64. Steiner I, Budka H, Chaudhuri A, Koskiniemi M, Sainio K, Salonen O and Kennedy PG. Viral meningoencephalitis: a review of diagnostic methods and guidelines for management. European journal of neurology : the official journal of the European Federation of Neurological Societies. 2010;17:999-e57. Hegde AN, Mohan S, Lath N and Lim CC. Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus. Radiographics. 2011;31:5-30. Aliaga ES and Barkhof F. MRI mimics of multiple sclerosis. Handbook of clinical neurology. 2014;122:291-316. Starkey J, Kobayashi N, Numaguchi Y and Moritani T. Cytotoxic Lesions of the Corpus Callosum That Show Restricted Diffusion: Mechanisms, Causes, and Manifestations. Radiographics. 2017;37:562-576.

    • 21 分鐘
    Best of BrainWaves 2019

    Best of BrainWaves 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 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]
    Kennedy DO, Wightman EL, Reay JL, Lietz G, Okello EJ, Wilde A and Haskell CF. 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;91:1590-7. Devore EE, Kang JH, Breteler MM and Grodstein F. Dietary intakes of berries and flavonoids in relation to cognitive decline. Annals of neurology. 2012;72:135-43. Norton S, Matthews FE, Barnes DE, Yaffe K and Brayne C. Potential for primary prevention of Alzheimer's disease: an analysis of population-based data. The Lancet Neurology. 2014;13:788-94. Morris MC, Tangney CC, Wang Y, Sacks FM, Barnes LL, Bennett DA and Aggarwal NT. MIND diet slows cognitive decline with aging. Alzheimers Dement. 2015;11:1015-22. Valls-Pedret C, Sala-Vila A, Serra-Mir M, Corella D, de la Torre R, Martinez-Gonzalez MA, Martinez-Lapiscina EH, Fito M, Perez-Heras A, Salas-Salvado J, Estruch R and Ros E. Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial. JAMA internal medicine. 2015;175:1094-1103. Newman JC, Covarrubias AJ, Zhao M, Yu X, Gut P, Ng CP, Huang Y, Haldar S and Verdin E. Ketogenic Diet Reduces Midlife Mortality and Improves Memory in Aging Mice. Cell Metab. 2017;26:547-557 e8. Miller MG, Hamilton DA, Joseph JA and Shukitt-Hale B. Dietary blueberry improves cognition among older adults in a randomized, double-blind, placebo-controlled trial. Eur J Nutr. 2018;57:1169-1180. Okkersen K, Jimenez-Moreno C, Wenninger S, Daidj F, Glennon J, Cumming S, Littleford R, Monckton DG, Lochmuller H, Catt M, Faber CG, Hapca A, Donnan PT, Gorman G, Bassez G, Schoser B, Knoop H, Treweek S, van Engelen BGM and consortium O. Cognitive behavioural therapy with optional graded exercise therapy in patients with severe fatigue with myotonic dystrophy type 1: a multicentre, single-blind, randomised trial. The Lancet Neurology. 2018;17:671-680. Radd-Vagenas S, Duffy SL, Naismith SL, Brew BJ, Flood VM and Fiatarone Singh MA. Effect of the Mediterranean diet on cognition and brain morphology and function: a systematic review of randomized controlled trials. Am J Clin Nutr. 2018;107:389-404. Xu W, Wang H, Wan Y, Tan C, Li J, Tan L and Yu JT. Alcohol consumption and dementia risk: a dose-response meta-analysis of prospective studies. Eur J Epidemiol. 2017;32:31-42. Lefevre-Arbogast S, Gaudout D, Bensalem J, Letenneur L, Dartigues JF, Hejblum BP, Feart C, Delcourt C and Samieri C. Pattern of polyphenol intake and the long-term risk of dementia in older persons. Neurology. 2018;90:e1979-e1988. Liu QP, Wu YF, Cheng HY, Xia T, Ding H, Wang H, Wang ZM and Xu Y. Habitual coffee consumption and risk of cognitive decline/dementia: A systematic review and meta-analysis of prospective cohort studies. Nutrition. 2016;32:628-36. [OF

    • 1 小時 23 分鐘
    #153 Neurosarcoidosis: The 21st century great mimicker

    #153 Neurosarcoidosis: The 21st century great mimicker

    In the TV show, HOUSE, it's either lupus or its sarcoidosis. Only, it's never sarcoidosis. That's because sarcoidosis is such a heterogeneous condition and can affect practically any age group. In some patients, this idiopathic inflammatory disorder can also involve the nervous system. Also causing a variety of signs and symptoms ranging from mild headache to a proximal myopathy or even a CNS vasculitis. This week on the BrainWaves podcast, Dr. Jesse Thon reflects on the literature and shares his experience managing patients with this troubling condition.
    Produced by Jesse Thon and James E. Siegler. Music courtesy of Steve Combs, Lovira, and Yakov Goldman. 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
    Petereit HF, Reske D, Tumani H, Jarius S, Markus Leweke F, Woitalla D, Pfister HW and Rubbert A. Soluble CSF interleukin 2 receptor as indicator of neurosarcoidosis. Journal of neurology. 2010;257:1855-63. Agnihotri SP, Singhal T, Stern BJ and Cho TA. Neurosarcoidosis. Semin Neurol. 2014;34:386-94. Bitoun S, Bouvry D, Borie R, Mahevas M, Sacre K, Haroche J, Psimaras D, Pottier C, Mathian A, Hie M, Boutin DL, Papo T, Godeau B, Valeyre D, Nunes H, Amoura Z and Cohen Aubart F. Treatment of neurosarcoidosis: A comparative study of methotrexate and mycophenolate mofetil. Neurology. 2016;87:2517-2521. Gelfand JM, Bradshaw MJ, Stern BJ, Clifford DB, Wang Y, Cho TA, Koth LL, Hauser SL, Dierkhising J, Vu N, Sriram S, Moses H, Bagnato F, Kaufmann JA, Ammah DJ, Yohannes TH, Hamblin MJ, Venna N, Green AJ and Pawate S. Infliximab for the treatment of CNS sarcoidosis: A multi-institutional series. Neurology. 2017;89:2092-2100. Jolliffe EA, Keegan BM and Flanagan EP. Trident sign trumps Aquaporin-4-IgG ELISA in diagnostic value in a case of longitudinally extensive transverse myelitis. Mult Scler Relat Disord. 2018;23:7-8. Wallaert B, Ramon P, Fournier EC, Hatron PY, Muir JF, Tonnel AB and Voisin C. High-dose methylprednisolone pulse therapy in sarcoidosis. Eur J Respir Dis. 1986;68:256-62. Agbogu BN, Stern BJ, Sewell C and Yang G. Therapeutic considerations in patients with refractory neurosarcoidosis. Archives of neurology. 1995;52:875-9. Baughman RP and Lower EE. Infliximab for refractory sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2001;18:70-4. Baughman RP, Drent M, Kavuru M, Judson MA, Costabel U, du Bois R, Albera C, Brutsche M, Davis G, Donohue JF, Muller-Quernheim J, Schlenker-Herceg R, Flavin S, Lo KH, Oemar B, Barnathan ES and Sarcoidosis I. Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Crit Care Med. 2006;174:795-802. Rossman MD, Newman LS, Baughman RP, Teirstein A, Weinberger SE, Miller W, Jr. and Sands BE. A double-blinded, randomized, placebo-controlled trial of infliximab in subjects with active pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2006;23:201-8.

    • 34 分鐘
    #10 Cryptogenic stroke: 2019 update

    #10 Cryptogenic stroke: 2019 update

    In 2016, when we first launched the BrainWaves podcast, cryptogenic stroke was a poorly understood concept. 3 years later, it remains poorly understood. But we are making progress. In this week's update of episode 10, we review the progress that has been made in the pathogenesis, diagnosis, and management of these patients.
    Produced by James E. Siegler. The original 2016 version of this show was also produced by Dr. Noah Levinson. Music courtesy of Josh Woodward, Julie Maxwell, Dan Lebowitz, and this group called E’s Jammy Jams. 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
    Siegler JE, Swaminathan B, Giruparajah M, Bosch J, Perera KS, Hart RG, Kasner SE and Investigators EGR. Age disparity in diagnostic evaluation of stroke patients: Embolic Stroke of Undetermined Source Global Registry Project. Eur Stroke J. 2016;1:130-138. Jacobs BS, Boden-Albala B, Lin IF and Sacco RL. Stroke in the young in the northern Manhattan stroke study. Stroke; a journal of cerebral circulation. 2002;33:2789-93. Hart RG, Sharma M, Mundl H, Kasner SE, Bangdiwala SI, Berkowitz SD, Swaminathan B, Lavados P, Wang Y, Wang Y, Davalos A, Shamalov N, Mikulik R, Cunha L, Lindgren A, Arauz A, Lang W, Czlonkowska A, Eckstein J, Gagliardi RJ, Amarenco P, Ameriso SF, Tatlisumak T, Veltkamp R, Hankey GJ, Toni D, Bereczki D, Uchiyama S, Ntaios G, Yoon BW, Brouns R, Endres M, Muir KW, Bornstein N, Ozturk S, O'Donnell MJ, De Vries Basson MM, Pare G, Pater C, Kirsch B, Sheridan P, Peters G, Weitz JI, Peacock WF, Shoamanesh A, Benavente OR, Joyner C, Themeles E, Connolly SJ and Investigators NE. Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source. The New England journal of medicine. 2018;378:2191-2201. Diener HC, Sacco RL, Easton JD, Granger CB, Bernstein RA, Uchiyama S, Kreuzer J, Cronin L, Cotton D, Grauer C, Brueckmann M, Chernyatina M, Donnan G, Ferro JM, Grond M, Kallmunzer B, Krupinski J, Lee BC, Lemmens R, Masjuan J, Odinak M, Saver JL, Schellinger PD, Toni D, Toyoda K, Committee R-SES and Investigators. Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source. The New England journal of medicine. 2019;380:1906-1917. Di Tullio M, Sacco RL, Gopal A, Mohr JP and Homma S. Patent foramen ovale as a risk factor for cryptogenic stroke. Annals of internal medicine. 1992;117:461-5. Overell JR, Bone I and Lees KR. Interatrial septal abnormalities and stroke: a meta-analysis of case-control studies. Neurology. 2000;55:1172-9. Li J, Liu J, Liu M, Zhang S, Hao Z, Zhang J and Zhang C. Closure versus medical therapy for preventing recurrent stroke in patients with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack. The Cochrane database of systematic reviews. 2015;9:CD009938. Mas JL, Derumeaux G, Guillon B, Massardier E, Hosseini H, Mechtouff L, Arquizan C, Bejot Y, Vuillier F, Detante O, Guidoux C, Canaple S, Vaduva C, Dequatre-Ponchelle N, Sibon I, Garnier P, Ferrier A, Timsit S, Robinet-Borgomano E, Sablot D, Lacour JC, Zuber M, Favrole P, Pinel JF, Apoil M, Reiner P, Lefebvre C, Guerin P, Piot C, Rossi R, Dubois-Rande JL, Eicher JC, Meneveau N, Lusson JR, Bertrand B, Schleich JM, Godart F, Thambo JB, Leborgne L, Michel P, Pierard L, Turc G, Barthelet M, Charles-Nelson A, Weimar C, Moulin T, Juliard JM, Chatellier G and Investigators C. Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke. The New England journal of medicine. 2017;377:1011-1021. Saver JL, Carroll JD, Thaler DE, Smalling RW, MacDonald LA, Marks DS, Tirschwell DL and Investigators R. Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Str

    • 23 分鐘

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