Welcome to the latest bulletin from the Primary Care Neurology Society
To refer or not to refer - that is the dilemma?
This was the question addressed by Dr Wakar Rashid, Consultant Neurologist from Brighton, who addressed a full house of GPs and Practice Nurses, attending this year's Best Practice and Practice Nurse shows at the NEC. Dr Rashid provided a number of useful tips to help answer this question, or more specifically 'When to wait and when to refer" . To view Dr Rashid's full presentation click here. In addition to this presentation, all the videos of our joint neurology study day with the RCGP in July, which includes Dr Rashid's 'Red Flags' talk are now available to view from the members section of our website.
New Neurodigest website goes live.
If you've not received the printed copy of issue 2 of our Neurodigest magazine, you can now access all the articles including those in issue 1 from our new website www.neurodigest.co.uk, which has been developed in partnership with the journal Advances in Clinical Neuroscience and Rehabilitation.
Epilepsy Commissioning toolkit launched to improve services
Two UK epilepsy charities have launched a new web-based toolkit for commissioners. It is designed to provide all the information needed to ensure high quality healthcare services for people with epilepsy. The toolkit was developed and tested with the support of nine CCGs and the project has been endorsed by the Royal College of General Practitioners (RCGP) and the Association of British Neurologists. To find out more about the toolkit click here.
Help with discussing SUDEP with patients
Although NICE guidelines recommend the discussion of sudden unexpected death in epilepsy (SUDEP) in newly diagnosed people with epilepsy, this doesn't appear to be happening as frequently as it should. There is now hope that with the launch of a new mobile app, discussion around SUDEP may become a little easier. To read more about how technology may reduce the harm of epilepsy click here.
MS Society calls for earlier access to disease modifying treatments
A new consensus has been reached on the need for earlier treatment with Disease Modifying Treatments (DMTs). The latest research points to the need to start DMTs as near to diagnosis as possible. To read more about the consensus then click here.
Clinical News
Vitamin D and axonal damage in MS
There is growing evidence for a link between levels of vitamin D and risk of MS. Now a research paper has shown that high levels of serum 25-hydroxy vitamin D is associated with decreased axonal injury.in MS patients. To read more about this work click here.
Sleep disorders in people with MS
Like many patients with a long term condition, patients with MS are at increase risk of sleep disorders. This review is a helpful addition to the literature that summarises the most common sleep disorders experienced by persons with MS, and offers a practical approach to diagnosis and management of insomnia, Restless Leg Syndrome and sleep-disordered breathing.
Botox, migraine and depression
According to a recent study, botox treatment for chronic migraine can improve depression scores. This was found in patients suffering moderate depression. Botox treatment also lead to improved scores in headache and quality of life. To read more about this study click here.
The benefits of Thia massage in chronic tension-type headache
A randomised controlled trial has recently found that traditional Thia massage is an effective treatment when compared to amitriptyline. Outcome measures used included Visual Analog Scale, Pressure Pain Threshold and Heart Rate Variability. To read the full paper click here.
Post-traumatic headache - an update on management
New studies have driven a need to review current management of post-traumatic headache, particular headache arising from whiplash injury. In this paper by Oberman et al, they conclude that "based on current study data, intensified physiotherapy seems not to be superior to standard therapy with simple patient education and can therefore not be recommended considering cost–benefit aspects.
Vitamin D and Simvastatin - can the combination help prevent migraine?
A recent study has found that episodic vitamin D and simvastatin can help to prevent episodic migraine. The study was randomised, double-blind, placebo controlled. To read more about the results click here.
Perampanel: A review in drug resistant epilepsy
We recently reported on the news that Perampenal had been approved for the treatment of primary generalised tonic-clonic (PGTC) seizures in adults and adolescents with idiopathic generalised epilepsy (IGE). In this useful review James Frampton concludes that "on the basis of its overall clinical profile and unique mechanism of action, perampanel is a useful additional adjunctive treatment option for patients with drug-resistant partial onset seizures, with or without secondary generalization, and primary GTCS paper." To read about the full review click here.
Can the prudent diet help to attenuate cognitive decline?
The prudent diet, which is a modification of the Mediterranean diet (read more about it here) has recently been linked to reducing cognitive decline in people aged over 60 (free of dementia). In the study (full details from here) the Mini-Mental State Examination (MMSE) was used to show that highest adherence to the prudent dietary pattern showed lower MMSE decline compared to the highest adherence to the Western dietary pattern.
New epilepsy guidelines released
The East of England SCN and the Strategic Neurology Advisory Group has produced a number of guidelines with respect to management of epilepsy, which can be found here. These guidelines have been produced with a view to informing clinicians, commissioners and stakeholders on the up to date aspects of epilepsy management today. The first guidelines reflect aspects of epilepsy where a need for information has been identified, and the SCN hope they will contribute to assuring a consistent standard of quality in the East of England. The guidelines have been extensively reviewed and approved by the members of the Strategic Neurology Advisory Group, which includes patient representatives, clinicians, and commissioners, as well as by external experts. Anyone interested in using these guidelines outside of the East of England SCN region should contact Victoria Doyle via victoria.doyle@nhs.net
Neurology events
UKABIF 7th Annual Conference, 11th November, RCGP Headquarters, London
Speakers for this year's conference are from the medical and legal world and will present on topics ranging from the future of specialised commissioning, the clinical tools required for neurobehavioural rehabilitation and the issues surrounding acquired brain injury and offending behaviour. More details about the programme and how to register for the conference can be found on the UKABIF website: http://ukabif.org.uk/ukabif-annual-conference-2015
Living with a Brain Injury: Learning from the patient, Wed 25th November, Raphael Medical Centre, Tonbridge, Kent
This one day workshop is case study based and aimed at (1) highlighting difficulties following brain injury and (2) learning from “survivors” and their families. For further details and to book your place at £95 please click here.
e-brain - supporting education in neurosciences
E-brain represents the largest, most comprehensive web-based training multimedia facility in clinical neurosciences to support both training and Continuous Professional Development for those working in relevant fields. For further details and how to get free access click here.
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