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Welcome to the latest bulletin from the Primary Care Neurology Society
Limited progress made in the provision of neurological services
Despite the various recommendation made by the House of Commons Public Accounts Committee (PAC) in 2012, which were designed to improve the care of people with neurological conditions, unfortunately, the progress made against these recommendations has been uneven and several key objectives have not been met – according to the new report from the NAO. To read more about the report click here.
Parkinson's Life
If you have people with Parkinson's under your care you may want to know and also let them know about a new online resource called Parkinson's Life which you can access at www.parkinsonslife.eu. It is an online ‘lifestyle’ magazine for people affected by Parkinson’s disease, developed by the European Parkinson's Disease Association and designed to be "a voice for the international Parkinson’s community, which means anyone with an interest in the disease including people with Parkinson’s and their families, carers and healthcare professionals." One interesting article recently released talks about the link between Parkinson's, dopamine and increased creativity which you can read here.
Clinical News
New epilepsy treatment launched.
Fycompa® (perampanel), a once-daily epilepsy treatment, has been launched in the United Kingdom, for primary generalised tonic-clonic (PGTC) seizures in adults and adolescents with idiopathic generalised epilepsy (IGE). Perampanel is the first new treatment for PGTC seizures in IGE in five years. It has now also been approved for use in generalised seizures that affect both sides of the brain at once
Epilepsy and Pregnancy - new findings
A study published in the Lancet has reported that a small but significant association of epilepsy, exposure to antiepileptic drugs, and adverse outcomes exists in pregnancy. This is an important factor that should be taken into consideration when consulting with patients. To read more about the study click here.
Risk of seizures and antipsychotic drugs
A study published in CNS Drugs concluded that "current use of medium-to-high potency first-generation antipsychotic drugs was associated with a 2.5-fold increased risk of seizures compared with non-use of antipsychotic drugs in patients with affective disorders." They also found that in patient with dementia, current and past use of a antipsychotic drugs was associated with an increase risk of seizures. Further details on the study and the antipsychotics that were researched can be found here.
Dietary therapy and epilepsy
The ketogenic diet has become a well recognised and established non drug treatment of epilepsy and Felton et al "believe that ketogenic dietary treatment is the best option for children and adults with refractory nonsurgical epilepsy due to its efficacy, rapid seizure reduction, synergistic effects with other antiseizure treatments, known and treatable side effects, potential to treat comorbid medical conditions, and worldwide availability." To read more about this article click here. However, in another paper by Vaccarezza et al, which you can read about here, they explain "not only the difficulties of the ketogenic diet (KD) as a therapeutic option for refractory epilepsy but also the benefits of other therapeutic strategies, which, in many cases, have proven to have better efficacy than the KD itself". Perhaps the jury is still out on the role of the ketogenic diet in epilepsy?
Statin treatment and poststroke seizures
Statins may reduce the risk of poststoke early onset seizures, particularly in the acute phase of a stroke. This was the conclusion of a recent study published in Neurology that also concluded that "statin treatment may prevent the progression of initial poststroke seizure-induced neurodegeneration into chronic epilepsy" . To read about this study click here.
Positive result with epilepsy drug for Parkinson's disease
Findings from a recent phase 3 study have confirmed that Zonisamide, an established treatment for epilepsy, is well tolerated and efficacious in the treatment of advanced Parkinson's disease. For further details click here.
Migraine and risk of stroke
Migraine when combined with smoking has been found to increase the risk of a stroke compared to migraine alone. This was the finding from a study of 1,292 participants (mean age 68 ± 9 years) with migraine data followed prospectively for vascular events where 262 patients (20%) had migraine and 75 (6%) had migraine with aura and published in Neurology. Further details can be found here.
Headache Management - Pharmacological Approaches
This is a two part review published and with open access from Practical Neurology. Aimed at the busy clinician it provides an overview of headache management, emerging therapeutic strategies and an accessible interpretation of clinical guidelines. The full article is available to read from here.
Relapses in multiple sclerosis
This is a review that explores the recognition and management of MS relapses for the GP. It covers a number of issues included factors affecting relapse, differential diagnoses including symptom fluctuations, paroxysmal symptoms and pseudo relapses. Further details about the article can be found here.
News from NICE
Stroke Quality Standard Consultation
NICE have announced that the draft stroke in adults’ quality standard is now available on the NICE website for consultation. The consultation period starts today, Monday 7th September 2015, and finishes at 5pm on Monday 5th October 2015. The draft stroke in adults quality standard, along with the instructions and documents required to submit your comments, can be accessed by following this link:
http://www.nice.org.uk/guidance/indevelopment/gid-qsd119/consultation/stroke-quality-standards-update-quality-standard-consultation
If you would like to comment on the draft quality standard on behalf of the Primary Care Neurology Society, we would be grateful if you could ensure all responses are submitted electronically using the comments proforma (ensuring all relevant fields are completed, including your organisation’s full name, if applicable) available from the link above. We will need to submit the responses to QSconsultations@nice.org.uk by 5pm on Monday 5th October 2015.
Neurology events
How to develop a true 7 Day Stroke Rehabilitation Service, Wed 16 Sept, Maple House, Birmingham
This seminar is your opportunity to address the staffing, resource, funding, patient and outcomes challenges associated with delivering a comprehensive 7 day service. Don’t get left behind, attend this event and ensure you are at the forefront of delivering your stroke rehab service across 7 days. Get £85 of the full price by quoting the code P-CNS85. This offer cannot be used in conjunction with any other offer. For further details and to book click here
Developments in the Management of Hemiplegia, Thurs 17th Sept, St George's Centre, Leeds
All clinical professionals who work with children and adults who have hemiplegia, or who are interested in paediatric neuro-disability are welcome to attend. The early bird rate of £95 is applicable until 17th July and includes lunch and a free copy of the Hemiplegia Handbook. The standard rate of £125.00 plus lunch will apply for all bookings taken from 18th July. For further details and to book click here.
Stroke Rehabilitation Service Delivery, Thur 17 Sept, Maple House, Birmingham
A unique event designed to provide practical solutions to key stroke rehab challenges. Share insights from leading trusts with staffing, discharge and community delivery case studies in order to progress your service delivery. Get £85 of the full price by quoting the code P-CNS85. This offer cannot be used in conjunction with any other offer. For further details and to book click here.
London, South East Neurological Commissioning Network, Inaugural meeting, Tues 22 Sept, Mary Ward House, London from 12.45 (buffer lunch) to 5pm
The conference will be with a focus on National and local priorities for neurology, Understanding how data can improve neurology commissioning. The meeting will be chaired by Dr Waqar Rashid, Consultant Neurologist, Brighton & Sussex University Hospitals, Clinical Lead – Neurological Long Term Conditions and Dr Neil Munro, Consultant Neurologist Canterbury Kent, Clinical Lead – Acute Neurological Conditions, South East Coast Strategic Clinical Network. For further details and to reserve a complimentary place email here
Pain Management: An integrative approach, Wed Sept 23rd, Raphael Medical Centre, Tonbridge, Kent
This workshop will consider the issues of pain management in complex patients. It will look at the assessment of pain across various patient populations and discuss the complexity of assessment. This workshop will consider a holistic approach to pain management and will discuss interventions from psychological, therapeutic, pharmacological and Anthroposophical perspectives. For further details and to book at only £95 click here.
Best Practice, 21st-2nd October, Birmingham NEC
Best Practice, one of the primary care community's favourite events, delivers 16 RCGP CPD points from a world class clinical and practice business training, whilst showcasing innovation and excellence. Best Practice provides content to support the GP, practice managers, Federations, CCGs, Pharmacies with the updates, tools and knowledge they need to succeed in delivering high quality patient care in a challenging NHS environment. Get you complimentary pass courtesy of the P- CNS from here.
PSP Association ‘Improving Quality of Life’ Study Day, Fri 30th Oct, University of Manchester,
This year the PSP Association is offering free places for their healthcare professional conference. The programme focuses on improving quality of life, managing symptoms and the associated challenges, with three interactive workshops to choose from. If you would like to attend, please complete the booking form which you can download from here and email it to debbie.benadie@pspassociation.org.uk.
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
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 access click here.
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