Practical Pearls

To ease into questioning about sexual dysfunction, ask about it when bringing up bladder dysfunction. Another way to ask this sometimes tricky question is to include it on patient-completed intake questionnaires. Read More…



Your business is dispensing medical knowledge and skill. The more time you are doing that and the less time you are doing other things, the more productive you can be-the more patients you can care for. Read More…



A month's supply of Axona costs around $80.00. We could wait for more studies or we could try using it for three months as an add-on to the other Alzheimer's medication to see if it affects cognition, activities of daily living, and behavior. Read More…



For neurologists, information about pregnancy and epilpesy gathered by recent studies highlights the importance of pre-pregnancy planning. If the physician works closely with people who are planning to start a family, he or she can minimize the problems that women with epilepsy face during pregnancy. Read More…



There are several useful strategies for an empathetic and unambiguous delivery of the diagnosis of PMD. The specific movement disorder diagnosis based on the primary movement phenomenology (e.g. tremor, dystonia) should be disclosed (thus validating the patient's symptoms), and the underlying etiology (PMD) clearly discussed in layman's terms. The interaction between body and mind should be mentioned and further illustrated with examples outside of PMD, such as the link between stress and gastric ulcers, or anxiety and perspiration. Read More…



It's unclear how PRoFESS data will affect secondary stroke prevention. According to Scott Kasner, MD, "I think the guidelines will have to say that they are all reasonable options, and the decisions among them may depend on issues unrelated to relative efficacy, namely tolerability, convenience, and cost." Read More…



Sildenafil (Viagra, Pfizer) may also have a beneficial therapeutic effect in the treatment of stroke, subarachnoid hemorrhage, dementia, learning, and neurodegenerative disorders by enhancing angiogenesis and neurogenesis. It also favorably influences the nitric oxide-cyclic guanosine monophosphate pathways, which are involved in the pathogenesis of a number of neurological diseases. Read More…



The validity of data obtained by a forensic neurologist may be marginalized by a number of contaminants. These include a patient's malingering of symptoms that may or may not have potential forensic significance, presenting a poor or insufficient effort, a lack of cooperation, and the exaggeration of symptoms. Read More…