Brainwaves

For patients who survive cardiopulmonary arrest, but do not wake up, neurologists are called to the bedside to prognosticate. And the question of 'How much will this patient recover?' is not unlike 'What is the benefit of aggressive therapy to await possible recovery?' In that way, you might consider neurologists to be the actuaries of hospital medicine. In this week's program, we review the clinical and diagnostic data that neurologists incorporate into their model for outcome prediction following anoxic brain injury. IF YOU'RE TAKING YOUR NEUROLOGY BOARDS, and not sure how to prepare, check out the 2019 Penn Neurology Board Review Course at https://upenn.cloud-cme.com/default.aspx?P=5&EID=54399. BrainWaves' listeners get $150 off their enrollment fee using the promo code 'WAVES2019'. Produced by James E. Siegler. Music courtesy of Swelling, Soft and Furious, Rafael Archangel, Lovira, and Dark Room. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for m

In medicine, less is more. Sometimes. In this week's program, Dr. Igor Rybinnik of the Rutgers Robert Wood Johnson Medical School shares what he's learned when it comes to overtreating patients. IF YOU'RE TAKING YOUR NEUROLOGY BOARDS, and not sure how to prepare, check out the 2019 Penn Neurology Board Review Course here [https://upenn.cloud-cme.com/default.aspx?P=5&EID=54399]. BrainWaves' listeners get $150 off their enrollment fee using the promo code 'WAVES2019'. Produced by James E. Siegler and Igor Ribynnik. Music courtesy of Chris Zabriskie, Kevin McLeod, Mystery Mammal, Hyson, Fabian Measures, and Scott Holmes. 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 Silveira MJ, Kim SY and Langa KM. Advance directives and outcomes of surrogate decision making before death. The

When it comes to managing patients with epilepsy, there isn't a one-size-fits-all approach. And it would be wrong to assume you could treat a woman the same way you would treat a man. There are a number of special considerations to keep in mind--especially birth control and pregnancy. Not to mention the increase risk of seizures during menses for some women. In this week's program, we revisit one of the earliest shows we put together in 2016 on the special considerations when it comes to women with epilepsy. Dr. Danielle Becker--an epileptologist at Penn--joins Jim Siegler for the discussion. Produced by James E. Siegler. Music courtesy of Josh Woodward. 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. IF YOU'RE TAKING YOUR NEUROLOGY BOARDS, and not sure how to prepare, check out the 2019 Penn

A low salt diet can reduce your risk of hypertension. A low carb diet can reduce your risk of diabetes. But is there a diet out there which can lower your risk of neurologic disease? Specifically, dementia? The answer is...maybe? This week on the program we work our way up the food chain describing the vital micronutrients, food groups, and fad diets out there which may promote brain health--and could even lower your risk of dementia. Sit back, grab some blueberries, and enjoy! IF YOU'RE TAKING YOUR NEUROLOGY BOARDS, and not sure how to prepare, check out the 2019 Penn Neurology Board Review Course at https://upenn.cloud-cme.com/default.aspx?P=5&EID=54399. BrainWaves' listeners get $150 off their enrollment fee using the promo code 'WAVES2019'. Produced by James E. Siegler. Music courtesy of Axeltree, Chris Zabriskie, John Pazdan, Josh Woodward, Kevin McLeod, and Pachyderm. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and s

Nobody is getting any younger. Which is too bad. Muscle cramping...fatigue...stiffness... you'll be dealing with it more and more. 'It's probably nothing,' you tell yourself. But what if it's not? Every once in a while, you might come across a case of myotonia. And you won't want to miss it. This week on BrainWaves, Dr. Noah Levinson provides a brief overview to myotonia and the conditions that are associated with it. IF YOU'RE TAKING YOUR NEUROLOGY BOARDS, and not sure how to prepare, check out the 2019 Penn Neurology Board Review Course here [or here: https://upenn.cloud-cme.com/default.aspx?P=5&EID=54399]. BrainWaves' listeners get $150 off their enrollment fee using the promo code 'WAVES2019'. Produced by James E. Siegler. Music courtesy of Yshwa, Steve Combs, MMFFF, and Scott Holmes. 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 @brainw

In 2016, we heard the results of the MGTX trial--a pivotal investigation that demonstrated the efficacy of thymectomy for select patients with non-thymomatous myasthenia gravis. This spring, we saw the long-term follow-up data from the MGTX investigators. In this week's re-run, we summarize these data, critique it, and reflect on how it may change clinical practice. IF YOU'RE TAKING YOUR NEUROLOGY BOARDS, and not sure how to prepare, check out the 2019 Penn Neurology Board Review Course here [or here: https://upenn.cloud-cme.com/default.aspx?P=5&EID=54399]. BrainWaves' listeners get $150 off their enrollment fee using the promo code 'WAVES2019'. Produced by James E. Siegler. Music courtesy of Scott Holmes and Lee Rosevere. 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 Wolfe

Before it was called epilepsy, it was a falling sickness. A disturbance of consciousness summoned by magic or demonic possession. Although it is less of a mystery today, the Sacred Disease is one neurological condition that continues to pique our curiosity. Join us as we recount the fascinating history of this mystical malady. IF YOU'RE TAKING YOUR NEUROLOGY BOARDS, and not sure how to prepare, check out the 2019 Penn Neurology Board Review Course at https://upenn.cloud-cme.com/default.aspx?P=5&EID=54399. BrainWaves' listeners get $150 off their enrollment fee using the promo code 'WAVES2019'. Produced by James E. Siegler. Music courtesy of Alavedra Montserrat, Joseph Levine, and William McColl, Damiano Baldoni, Kai Engel, Kevin McLeod, Rafael Archangel, and Unheard Music Concepts. 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 @brainwavesaud

Heroin was originally marketed as a cough suppressant in 1898. (Obviously, people have discovered more uses for it since then.) One hundred years later, it has paved the way for a worldwide drug abuse epidemic. Dr. Mike Rubenstein presents this week's clinical case of a very particular type of heroin use and a rare form of neurotoxicity. IF YOU'RE TAKING YOUR NEUROLOGY BOARDS, and not sure how to prepare, check out the 2019 Penn Neurology Board Review Course at https://upenn.cloud-cme.com/default.aspx?P=5&EID=54399. BrainWaves' listeners get $150 off their enrollment fee using the promo code 'WAVES2019'. Produced by James E. Siegler and Mike Rubenstein. Music courtesy of Heftone Banjo Orchestra, John Bartmann, Kai Engel, and Soft and Furious. 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

In the second half of our two-part series on complications of organ transplantation, Dr. Raj Dhar (Neurocritical Care, Washington University in St. Louis) discusses his experience managing the non-infectious complications of organ transplantation--from drug toxicities to multi-disciplinary medical care. Produced by James E. Siegler and Raj Dhar. Music by Steve Combs, Lee Rosevere, and Scott Holmes. 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 Senzolo M, Ferronato C and Burra P. Neurologic complications after solid organ transplantation. Transpl Int. 2009;22:269-78. Dhar R. Neurologic complications of transplantation. Handbook of clinical neurology. 2017;141:545-572. Mateen FJ, Dierkhising RA, Rabinstein AA, van de Beek D and Wijdicks EF. Neurological complications following adu

There is no question that organ transplantation has saved thousands of lives in recent years from fatal conditions. And over time, we've become more and more successful at maintaining the integrity of the graft and increasing longevity of organ transplant recipients. Despite these advances in transplant medicine, it is not an entirely risk-free process. In part 1 of this 2-part series of the BrainWaves podcast, Jim Siegler speaks with Dr. Linda Zhou about the neuroinfectious complications that threaten these patients. Produced by James E. Siegler and Linda Zhou. Music by Jason Shaw, Josh Woodward, and Lee Rosevere. 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 Pruitt AA. Central Nervous System Infections Complicating Immunosuppression and Transplantation. Continuum (Minneap Minn

In 2016, Dr. Ali Hamedani summarized the basic principles underlying a neurologic evaluation for acute dizziness--the acute vestibular syndrome. We've remastered the prior show, and added in a few new factoids for ya in this 2019 remake. Enjoy! Produced by James E. Siegler. Music courtesy of John Bartman and Kevin McLeod. 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 1. Kerber KA. Acute constant dizziness. Continuum (Minneap Minn). 2012;18:1041-59. 2. Lempert T. Vestibular migraine. Semin Neurol. 2013;33:212-8. 3. Kim JS and Zee DS. Clinical practice. Benign paroxysmal positional vertigo. The New England journal of medicine. 2014;370:1138-47. 4. Kattah JC, Talkad AV, Wang DZ, Hsieh YH and Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedsi

For such an thrilling time in a woman's life, pregnancy can be a frightening experience for some. As a physician, I'm always a little more on edge when dealing with these patients. This week on BrainWaves, Dr. Jonathan Edlow (Emergency Medicine) of Beth Israel Deaconness Medical Center shares his experience in treating neuromedical complications in this unique patient population. Produced by Jonathan Edlow and James E. Siegler. Music by Daniel Birch, Ian Southerland, Kevin McLeod, 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 Edlow JA, Caplan LR, O'Brien K and Tibbles CD. Diagnosis of acute neurological emergencies in pregnant and post-partum women. The Lancet Neurology. 2013;12:175-85. Edlow AG, Edlow BL and Edlow JA. Diagnosis of Acute Neurologic Emergencies

For young patients who have no reason to clot, it's good to know which diagnostic tests you should send, when you should send them, and how they can be erroneously interpreted. Dr. Kristy Yuan, a vascular neurologist from the University of Pennsylvania, summarizes her approach in this week's clinical case. Produced by James E. Siegler and Kristy Yuan. Music by Chris Zabriskie, How the Night Came, Doctor Turtle, and Swelling. 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 1. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, Huisman M, King CS, Morris TA, Sood N, Stevens SM, Vintch JRE, Wells P, Woller SC and Moores L. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest. 2016;149:315-352. 2. Ho WK, Hankey GJ, Quinlan DJ and Eikelboom

As I'm sitting in a coffee shop in upstate New York this holiday season, procrastinating on the various papers that need writing, bills that need paying, and Christmas cards that need writing, I can't help but feel comforted by the warm relief of a cup of coffee. The rich aroma and jolting heat which come with the promise of productivity. There's nothing like it. So before resigning to my post-holiday to-do list, I thought I would start the day off re-mastering a prior show we put out in 2017 on the neuroscience behind your morning mocha. Enjoy! Produced by James E. Siegler. Music by Andy Cohen and Little Glass Men. 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 1. Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. Food Addit C

This week, part 2 of our 2-part primer on Huntington Disease. Treatment. From tried-and-true therapies to the latest-and-greatest compounds being studied in clinical trials. Enjoy! Produced by James E. Siegler and Stephen Aradi. Music by Mike Durek, Jesse Spillane, Lee Rosevere, Jason Shaw and Dr. Turtle. Sound effects by Mike Koenig, 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 Claassen DO, Carroll B, De Boer LM, Wu E, Ayyagari R, Gandhi S and Stamler D. Indirect tolerability comparison of Deutetrabenazine and Tetrabenazine for Huntington disease. J Clin Mov Disord. 2017;4:3. Paulsen JS, Nehl C, Hoth KF, Kanz JE, Benjamin M, Conybeare R, McDowell B and Turner B. Depression and stages of Huntington's disease. J Neuropsychiatry Clin Neurosci. 2005;17:496-502. Bates GP, Dorsey R, Gusella JF, Hayden MR, Kay C, Le

Want to make a name for yourself? Declare yourself chief of something. Or chief of many things, as Dr. S. A. Kinnier Wilson did. This week on the podcast, we commemorate his legacy and his commitment to neurology. Produced by James E. Siegler. Music by Chris Zabriskie and Mystery Mammal. 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 S. A. Kinnier Wilson (1878-1937) Lenticular-hepatic degeneration. JAMA : the journal of the American Medical Association. 1968;205:871-2. Compston A. Progressive lenticular degeneration: a familial nervous disease associated with cirrhosis of the liver, by S. A. Kinnier Wilson, (From the National Hospital, and the Laboratory of the National Hospital, Queen Square, London) Brain 1912: 34; 295-509. Brain. 2009;132:1997-2001. Trocello JM, Broussolle E,

You may be able to recognize chorea. But what does it make you think of besides Huntington Disease? In this two part series, we'll cover the clinical manifestations, differential diagnosis, and management of Huntington Disease. In part 1, Dr. Travis Lewis (University of Pennsylvania) creates a framework for hyperkinetic movement disorders and HD. Part 2 will focus on the current and future therapeutics of this neurodegenerative condition. Produced by Travis Lewis & James E. Siegler. Music by Azevedo Silva, Chris Zabriskie, Cullah, John Bartmann, and Nuno Adelaida. 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 Bates GP, Dorsey R, Gusella JF, Hayden MR, Kay C, Leavitt BR, Nance M, Ross CA, Scahill RI, Wetzel R, Wild EJ and Tabrizi SJ. Huntington disease. Nat Rev Dis Primers. 2

Of the "reversible" causes of dementia, normal pressure hydrocephalus (NPH) may be the most controversial. But there is something to be said about how surgical intervention alters the physiology of patients who present with gait impairment, ventriculomegaly, and normal CSF pressure. This week on the show, we discuss the clinical features and the controversy behind this diagnosis. Produced by James E. Siegler. Music by Ghost, Jon Watts, Julie Maxwell, Komiku, and Kevin McLeod. Sound effects by Mike Koenig, 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 Relkin N, Marmarou A, Klinge P, Bergsneider M and Black PM. Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005;57:S4-16; discussion ii-v. Gallia GL, Rigamonti D and Williams MA. The diagnosis and treatment of idiopathic normal pressure hydrocep

A patient comes into the emergency department. They've got a headache. You get some basic labs, a chest x-ray, a CT scan. And then you get a drug screen. But does this information even help you? And could it hurt the patient? This week on the BrainWaves podcast, Dr. Emily Rosenthal shares her experience with Dr. Kelley Humbert on the ethics of toxicology "screening" and how she manages patients with a substance use disorder. Produced by Emily Rosenthal, Kelley Humbert, and Jim Siegler. Music by Montplaisir, Lee Rosevere, and Kevin McLeod. Sound effects by Mike Koenig, 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 Bates GP, Dorsey R, Gusella JF, Hayden MR, Kay C, Leavitt BR, Nance M, Ross CA, Scahill RI, Wetzel R, Wild EJ and Tabrizi SJ. Huntington disease. Nat Rev Dis Primers. 2015;1:15005. Silver B, Miller D,

Every time you order an MRI with contrast, you should think to yourself, "Why do I need contrast?" Then, "If I need contrast, what are the risks?" This week, a show all about the risks of routine neuroimaging. Produced by James E. Siegler. Music by Little Glass Men, Loyalty Freak Music, and Kevin McLeod. Sound effects by Mike Koenig, 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 McDonald RJ, McDonald JS, Kallmes DF, Jentoft ME, Murray DL, Thielen KR, Williamson EE and Eckel LJ. Intracranial Gadolinium Deposition after Contrast-enhanced MR Imaging. Radiology. 2015;275:772-82. Rogosnitzky M and Branch S. Gadolinium-based contrast agent toxicity: a review of known and proposed mechanisms. Biometals. 2016;29:365-76. Pullicino R, Radon M, Biswas S, Bhojak M and Das K. A Review of the Current Evidence on Gadolinium D