203 episodes

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

    • Courses
    • 4.7, 141 Ratings

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**

    #169 The interictal EEG

    #169 The interictal EEG

    The electroencephalogram is a nearly 100-year old neurodiagnostic instrument. And yet, we learn new things from it every day. This week on the BrainWaves podcast, Dr. Tracey Milligan (Mass General Brigham) reviews the indications and utilization of a routine scalp EEG. Also discussed:
    Limitations of scalp EEG Brain surgery Non-epileptic events Why YOU should consider becoming an epileptologist Produced by James E. Siegler and Tracey Milligan. Music courtesy of Steve Combs, Lee Roosevere, Siddhartha, Soft and Furious, Patches, and Magic in the Other. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. James Siegler reports having received consulting fees from Ceribell, which produces a bedside scalp EEG with automated seizure detection. However, there is no specific reference to this device or company, nor was this episode sponsored by Ceribell. 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       
    Wiebe S, Blume WT, Girvin JP, Eliasziw M, Effectiveness and Efficiency of Surgery for Temporal Lobe Epilepsy Study G. A randomized, controlled trial of surgery for temporal-lobe epilepsy. The New England journal of medicine. 2001;345:311-8. Cascino GD. Clinical indications and diagnostic yield of video-electroencephalographic monitoring in patients with seizures and spells. Mayo Clinic proceedings. 2002;77:1111-20. Pillai J and Sperling MR. Interictal EEG and the diagnosis of epilepsy. Epilepsia. 2006;47 Suppl 1:14-22. Bouma HK, Labos C, Gore GC, Wolfson C and Keezer MR. The diagnostic accuracy of routine electroencephalography after a first unprovoked seizure. European journal of neurology : the official journal of the European Federation of Neurological Societies. 2016;23:455-63. Debicki DB. Electroencephalography after a single unprovoked seizure. Seizure. 2017;49:69-73.

    • 22 min
    #168 (Mis)understanding the locked-in state

    #168 (Mis)understanding the locked-in state

    The locked-in syndrome is a rare clinical consequence following many types of neurologic injury. In general, the locked-in patient is fully paralyzed, with perhaps minimal function of the fingers, the eyes, or the mouth. What's more, the gross motor dysfunction is enormously disproportional to the cognitive function of the individual. The locked-in patient is conscious and completely aware of their surroundings. They can often hear, see, smell, and feel just as any other person would. But because of their profound physical disability, they have a very limited means of communicating even the simplest thoughts. "I feel hot." "My head hurts." "My cheek itches."
    It may surprise you that the patient's perspective of their condition is wholly different from how the healthcare provider or caregiver imagines it to be. This week on the program, Dr. Lauren Elman (Pennsylvania Medical Center ALS Multi-disiplinary Clinic) reviews this discrepancy. Dr. Elman also shares her experience  managing this inevitable consequence of ALS when all life-sustaining measures are desired.
    REFERENCES
    Patterson JR and Grabois M. Locked-in syndrome: a review of 139 cases. Stroke; a journal of cerebral circulation. 1986;17:758-64. Trail M, Nelson ND, Van JN, Appel SH and Lai EC. A study comparing patients with amyotrophic lateral sclerosis and their caregivers on measures of quality of life, depression, and their attitudes toward treatment options. Journal of the neurological sciences. 2003;209:79-85. Rousseau MC, Baumstarck K, Alessandrini M, Blandin V, Billette de Villemeur T and Auquier P. Quality of life in patients with locked-in syndrome: Evolution over a 6-year period. Orphanet J Rare Dis. 2015;10:88. Kuzma-Kozakiewicz M, Andersen PM, Ciecwierska K, Vazquez C, Helczyk O, Loose M, Uttner I, Ludolph AC and Lule D. An observational study on quality of life and preferences to sustain life in locked-in state. Neurology. 2019;93:e938-e945. Niedermeyer S, Murn M and Choi PJ. Respiratory Failure in Amyotrophic Lateral Sclerosis. Chest. 2019;155:401-408.

    • 26 min
    #167 The role of sinovenous stenosis in IIH

    #167 The role of sinovenous stenosis in IIH

    Webster defines ‘idiopathic’ as “arising spontaneously or from an obscure or unknown cause”. By definition, this means idiopathic intracranial hypertension (IIH) has no proximate cause. But that’s not exactly true. This week on the podcast, we explore the recent evidence behind the theory that transverse sinus stenosis may contribute to this condition.
    Disclaimer: No chicken or eggs were harmed in the making of this episode.
    Produced by James E. Siegler. Music courtesy of Squire Tuck, Swelling, Three Chain Links, and Unheard Music Concepts. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. 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
    Martins AN. Resistance to drainage of cerebrospinal fluid: clinical measurement and significance. Journal of neurology, neurosurgery, and psychiatry. 1973;36:313-8. Gjerris F, Soelberg Sorensen P, Vorstrup S and Paulson OB. Intracranial pressure, conductance to cerebrospinal fluid outflow, and cerebral blood flow in patients with benign intracranial hypertension (pseudotumor cerebri). Annals of neurology. 1985;17:158-62. Orefice G, Celentano L, Scaglione M, Davoli M and Striano S. Radioisotopic cisternography in benign intracranial hypertension of young obese women. A seven-case study and pathogenetic suggestions. Acta Neurol (Napoli). 1992;14:39-50. Karahalios DG, Rekate HL, Khayata MH and Apostolides PJ. Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology. 1996;46:198-202. King JO, Mitchell PJ, Thomson KR and Tress BM. Manometry combined with cervical puncture in idiopathic intracranial hypertension. Neurology. 2002;58:26-30. Farb RI, Vanek I, Scott JN, Mikulis DJ, Willinsky RA, Tomlinson G and terBrugge KG. Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology. 2003;60:1418-24. Rohr A, Dorner L, Stingele R, Buhl R, Alfke K and Jansen O. Reversibility of venous sinus obstruction in idiopathic intracranial hypertension. AJNR American journal of neuroradiology. 2007;28:656-9. Sinclair AJ, Kuruvath S, Sen D, Nightingale PG, Burdon MA and Flint G. Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review. Cephalalgia. 2011;31:1627-33. Riggeal BD, Bruce BB, Saindane AM, Ridha MA, Kelly LP, Newman NJ and Biousse V. Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis. Neurology. 2013;80:289-95. Satti SR, Leishangthem L and Chaudry MI. Meta-Analysis of CSF Diversion Procedures and Dural Venous Sinus Stenting in the Setting of Medically Refractory Idiopathic Intracranial Hypertension. AJNR American journal of neuroradiology. 2015;36:1899-904. Dinkin MJ and Patsalides A. Venous Sinus Stenting in Idiopathic Intracranial Hypertension: Results of a Prospective Trial. J Neuroophthalmol. 2017;37:113-121. Mohammaden MH, Husain MR, Brunozzi D, Hussein AE, Atwal G, Charbel FT and Alaraj A. Role of Resistivity Index Analysis in the Prediction of Hemodynamically Significant Venous Sinus Stenosis in Patient With Idiopathic Intracranial Hypertension. Neurosurgery. 2020;86:631-636.

    • 16 min
    #166 Not just a headache

    #166 Not just a headache

    It’s more than just a headache. Migraine is a disturbance of normal neurological function, and as you are aware, it causes more than just severe head pain. This week on BrainWaves, Dr. Deborah Friedman (UT Southwestern) shares her experience evaluating and managing the unusual neurologic manifestations of migraine that aren’t just the misery from recurrent attacks.
    Produced by James E. Siegler & Deborah Friedman. Music courtesy of Josh Woodward, Kevin McLeod and Lee Rosevere. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. 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
    Bianchin MM, Londero RG, Lima JE and Bigal ME. Migraine and epilepsy: a focus on overlapping clinical, pathophysiological, molecular, and therapeutic aspects. Curr Pain Headache Rep. 2010;14:276-83. Dreier JP, Reiffurth C, Woitzik J, Hartings JA, Drenckhahn C, Windler C, Friedman A, MacVicar B, Herreras O and group Cs. How spreading depolarization can be the pathophysiological correlate of both migraine aura and stroke. Acta neurochirurgica Supplement. 2015;120:137-40. Goadsby PJ. Unique Migraine Subtypes, Rare Headache Disorders, and Other Disturbances. Continuum (Minneap Minn). 2015;21:1032-40. Orr SL, Friedman BW, Christie S, Minen MT, Bamford C, Kelley NE and Tepper D. Management of Adults With Acute Migraine in the Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies. Headache. 2016;56:911-40. Rozen TD, Niknam RM, Shechter AL, Young WB and Silberstein SD. Cluster headache in women: clinical characteristics and comparison with cluster headache in men. Journal of neurology, neurosurgery, and psychiatry. 2001;70:613-7. Shah DR, Dilwali S and Friedman DI. Migraine Aura Without Headache [corrected]. Curr Pain Headache Rep. 2018;22:77. Solomon S, Grosberg BM, Friedman DI and Lipton RB. Retinal migraine. J Neuroophthalmol. 2007;27:243-4; author reply 244-5. Tippin J, Corbett JJ, Kerber RE, Schroeder E and Thompson HS. Amaurosis fugax and ocular infarction in adolescents and young adults. Annals of neurology. 1989;26:69-77. Viana M, Tronvik EA, Do TP, Zecca C and Hougaard A. Clinical features of visual migraine aura: a systematic review. J Headache Pain. 2019;20:64.

    • 33 min
    #165 How the other half lives

    #165 How the other half lives

    On rounds, I sometimes joke that the two most important organs in the body are the right and left hemisphere. Only one of many, terrible, dad jokes my poor residents and students have to endure. But what happens when one organ fails, or you have to remove it?
    This week on BrainWaves, we’ll review a unique neurologic condition where such incredible hemispheric dysfunction can only be treated by surgically removing half of the brain. And OMG, a show about pediatrics!
    ** IF YOU’RE TAKING YOUR NEUROLOGY BOARDS THIS SUMMER, CHECK OUT THE PENN NEUROLOGY BOARD REVIEW COURSE AT https://upenn.cloud-cme.com/default.aspx?P=5&EID=65373. AND FOR A DISCOUNTED RATE ON THE ONLINE OR STREAMING RESOURCES, USE PROMO CODE ‘WAVES2020’. **
    Produced by James E. Siegler. Music courtesy of Ars Sonor, Daniel Birch, Jon Watts, and Lish Grooves. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. 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
    Rasmussen T, Olszewski J and Lloydsmith D. Focal seizures due to chronic localized encephalitis. Neurology. 1958;8:435-45. Hart YM, Cortez M, Andermann F, Hwang P, Fish DR, Dulac O, Silver K, Fejerman N, Cross H, Sherwin A and et al. Medical treatment of Rasmussen's syndrome (chronic encephalitis and epilepsy): effect of high-dose steroids or immunoglobulins in 19 patients. Neurology. 1994;44:1030-6. Andrews PI, Dichter MA, Berkovic SF, Newton MR and McNamara JO. Plasmapheresis in Rasmussen's encephalitis. Neurology. 1996;46:242-6. Leach JP, Chadwick DW, Miles JB and Hart IK. Improvement in adult-onset Rasmussen's encephalitis with long-term immunomodulatory therapy. Neurology. 1999;52:738-42. Bien CG, Granata T, Antozzi C, Cross JH, Dulac O, Kurthen M, Lassmann H, Mantegazza R, Villemure JG, Spreafico R and Elger CE. Pathogenesis, diagnosis and treatment of Rasmussen encephalitis: a European consensus statement. Brain. 2005;128:454-71. Varadkar S, Bien CG, Kruse CA, Jensen FE, Bauer J, Pardo CA, Vincent A, Mathern GW and Cross JH. Rasmussen's encephalitis: clinical features, pathobiology, and treatment advances. The Lancet Neurology. 2014;13:195-205. Tan AP, Wong YLJ, Lin BJ, Yong HRC and Mankad K. Clinico-radiological approach to cerebral hemiatrophy. Childs Nerv Syst. 2018;34:2377-2390.

    • 23 min
    #164 Lewy Body Dementia

    #164 Lewy Body Dementia

    Lewy Body Dementia may be the second most common neuropathologic cause of dementia behind Alzheimer disease, but it remains largely a clinical diagnosis with limited treatment options. This week on BrainWaves, Dr. Amy Colcher (Cooper University Hospital) reviews the diagnostic criteria and management strategies for patients and their caregivers who suffer from this condition.
    Plus, a sort of tribute to Robin Williams.
    ** IF YOU’RE TAKING YOUR NEUROLOGY BOARDS THIS SUMMER, CHECK OUT THE PENN NEUROLOGY BOARD REVIEW COURSE AT https://upenn.cloud-cme.com/default.aspx?P=5&EID=65373. AND FOR A DISCOUNTED RATE ON THE ONLINE OR STREAMING RESOURCES, USE PROMO CODE ‘WAVES2020’. **
    Produced by James E. Siegler and Amy Colcher. Music courtesy of Andrew Sacco, Axletree, Damiano Baldoni, Josh Woodward, and Julie Maxwell. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. 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
    McKeith IG. Spectrum of Parkinson's disease, Parkinson's dementia, and Lewy body dementia. Neurol Clin. 2000;18:865-902. Frieling H, Hillemacher T, Ziegenbein M, Neundorfer B and Bleich S. Treating dopamimetic psychosis in Parkinson's disease: structured review and meta-analysis. Eur Neuropsychopharmacol. 2007;17:165-71. Galvin JE, Duda JE, Kaufer DI, Lippa CF, Taylor A and Zarit SH. Lewy body dementia: the caregiver experience of clinical care. Parkinsonism Relat Disord. 2010;16:388-92. Koga S, Aoki N, Uitti RJ, van Gerpen JA, Cheshire WP, Josephs KA, Wszolek ZK, Langston JW and Dickson DW. When DLB, PD, and PSP masquerade as MSA: an autopsy study of 134 patients. Neurology. 2015;85:404-12. Stinton C, McKeith I, Taylor JP, Lafortune L, Mioshi E, Mak E, Cambridge V, Mason J, Thomas A and O'Brien JT. Pharmacological Management of Lewy Body Dementia: A Systematic Review and Meta-Analysis. Am J Psychiatry. 2015;172:731-42. Desmarais P, Massoud F, Filion J, Nguyen QD and Bajsarowicz P. Quetiapine for Psychosis in Parkinson Disease and Neurodegenerative Parkinsonian Disorders: A Systematic Review. J Geriatr Psychiatry Neurol. 2016;29:227-36. McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, Aarsland D, Galvin J, Attems J, Ballard CG, Bayston A, Beach TG, Blanc F, Bohnen N, Bonanni L, Bras J, Brundin P, Burn D, Chen-Plotkin A, Duda JE, El-Agnaf O, Feldman H, Ferman TJ, Ffytche D, Fujishiro H, Galasko D, Goldman JG, Gomperts SN, Graff-Radford NR, Honig LS, Iranzo A, Kantarci K, Kaufer D, Kukull W, Lee VMY, Leverenz JB, Lewis S, Lippa C, Lunde A, Masellis M, Masliah E, McLean P, Mollenhauer B, Montine TJ, Moreno E, Mori E, Murray M, O'Brien JT, Orimo S, Postuma RB, Ramaswamy S, Ross OA, Salmon DP, Singleton A, Taylor A, Thomas A, Tiraboschi P, Toledo JB, Trojanowski JQ, Tsuang D, Walker Z, Yamada M and Kosaka K. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017;89:88-100. Armstrong MJ. Lewy Body Dementias. Continuum (Minneap Minn). 2019;25:128-146. Taylor JP, McKeith IG, Burn DJ, Boeve BF, Weintraub D, Bamford C, Allan LM, Thomas AJ and O'Brien JT. New evidence on the management of Lewy body dementia. The Lancet Neurology. 2020;19:157-169.

    • 25 min

Customer Reviews

4.7 out of 5
141 Ratings

141 Ratings

Autumn Leif ,

Fusion of clinical, academic, and artistic excellence and auditory delight

Recommended for both neurologists and neuroenthusiasts as this podcast is just as informative as entertaining! Very well done!

BreezyRoxx ,

Must listen for any neurologist

Terrific in every way!!!

Shelz57 ,

I love this podcast!!

I love listening this this podcast. I work specifically with headaches but getting input about other neurological disorders, assessments, differentials, etc really helps me when ruling out secondary causes for headaches in the clinic. Plus, Jim is very enjoyable to listen to!

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