Discover and read the best of Twitter Threads about #neuro

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Atypical variants of motor neuron disease.



Does the phenotype matter?

Yes, as prognosis is different in some variants.

1/🧵 Image
a) Spinal-Onset ALS
b) Progressive Muscular Atrophy
c) Progressive Bulbar Palsy/Bulbar-onset ALS
d) Facial onset sensory and motor neuronopathy (FOSMN)
e) Flail-arm syndrome (Vulpian-Bernhardt syndrome): LMN upper limbs and UMN (usually only brisk reflexes in lower limbs)
f) Hirayama disease: monomelic amyotrophy
g) O’Sullivan-McLeod syndrome: slowly progressive distal amyotrophy of the hands and forearms extending over long periods of time
h) Flail-leg syndrome
Read 5 tweets
#Neuro manifestations in #Sjögren’s are common, present in nearly 20% (❗️), and 4M are estimated to have Sjögren’s in the US.

Neuro-Sjögren’s is poorly understood and underrecognized, and you’ll miss it if you aren’t looking for it. 🫣

But how do you find it❓
You’ve got to know the neurologic phenotypes.

What are they? Let’s see how well you know them ⬇️
What’s the most common neurologic manifestation?
Read 11 tweets

Hx: Altered mental status with oral pain.

NO SPOILERS!!! Give hints in the form of GIF or answer attached poll.

Answer in 24 hrs

#Neuro #Neurorad #Erad #radres #FOAMed #FOAMrad #medtwitter #ASNRCOTW Image
What disease process is associated with oral ulcers and enhancing hyperintense T2 signal lesions in the brain and spinal cord?
The answer is: Neuro-Behçet’s disease!
See you next week! ImageImageImage
Read 3 tweets

Hx: 62 y/o male initially found unresponsive on the street presents with bradycardia and anterograde amnesia.

NO SPOILERS!!! Give hints in the form of GIF or answer attached poll.

Answer in 24 hrs

#Neuro #Neurorad #radres #FOAMed #FOAMrad #medtwitter #ASNRCOTW Image
What is the most likely diagnosis given the history and MRI findings in the referenced images?
The answer is: Opioid-associated amnestic syndrome!
See you next week! ImageImageImage
Read 3 tweets
Even before @Dglaucomflecken created The Neurologist — a brilliant parody of how neurologists think we know better than everyone — we were working on a project examining just that…
We even cite him in the paper out now in #NeurologyEd @greenjounal! 🧵
In this project we looked at what makes some neurology consults seem “inappropriate” — as @Dglaucomflecken has demonstrated, neurologists have some *particular* ideas about what other docs do and don’t know about neurology…
In this paper in #NeurologyEd @greenjournal we hypothesized that the perception of inappropriate consults comes down to two fallacies… 🤔
Read 11 tweets
A 6-YO Bedouin ♂️: a limp, headache, left facial nerve palsy, & left hemiparesis.

Blood eosinophil count of 890/μL.

MRI: a brain cyst.

#neurology #pediatric #MedTwitter
Abdominal ultrasound and chest radiography did not reveal additional cysts.
Blood serology (ELISA) for ECHINOCOCCOSIS: ➖

The brain cyst was fully removed surgically.

#neuro #Pediatrics #surgery
Histopathological examination of the brain cyst fluid showed several echinococcal larvae (C and D), confirming CYSTIC ECHOCOCCOSIS diagnosis.

Over the following 4 months, he was treated with albendazole without complications.

#parasitology #microbiology #IDtwitter
Read 8 tweets
Resources to study #Neurology

Adams and Victor’s. By far my favourite textbook.
The book is more clinically oriented, coloured with anecdotes and mental models. Reading it feels like seeing a pt in the ward/OPD

#MedTwitter #neurotwitter
It has elements of philosophy, history and is written eloquently.
Whimsical, yet profound, it’s teachings stay with me. Added bonus, my Guru in Neurology finds mention in the text 🙃 I’d recommend this for #mbbs #md and #dm students
Bradley is the standard #textbook in #neurology. A great book, it’s more like #Harrison. Great for information, latest research and management. Essential for the DM #neurology candidate, but also useful for MD #internalmedicine
Read 11 tweets
4⃣ core brain networks (there are more): expanding the localizationist approach 🧠 🥅🕸️

#Neuro #Neuroanatomy #Neurology #EndNeurophobia


1⃣ Default mode network

🥇 Endogenously mediated activities at rest
🥈 Self-referential and social cognitive processes,

🚫Not active during external goal-oriented processes

1⃣ Default mode network


💠 Posterior cingulate cortex
💠 Medial prefrontal cortex
💠 Precuneus
💠 Inferior parietal and medial temporal cortices

Read 10 tweets
Dementia with Lewy Bodies:

Part 2️⃣ Biomarkers

#Neuro #Neurotwitter #Teaching #Education




What is a biomarker? 🏷🧪️

"A characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention." 🩸🧠


What is the use of biomarkers? 🧠

Diagnostic tool🪓

Tool for staging the disease 🥼

Indicator of prognosis📡

Predic or monitor of clinical response to an intervention🚨

Remember: "tools"should aid clinicians, not be the source of all truth.

Read 14 tweets
Dementia with Lewy Bodies:

Part 1️⃣ Clinical features and Probable Diagnosis

#Neuro #Neurotwitter #Teaching #Education



Introduction 🥇

DLB belongs to a family of disorders typically known as "synucleinopathies" 🔬

Other members are:

- PD

All of them have abnormal inclusions of α-Synuclein at a pathological level.

"Pathology is not pathogenesis", therefore we shouldn't assume that the presence of these pathological changes are a synonym of "protein toxicity".

Suggested reading ⬇️…

Read 24 tweets
Higher-Level Gait Disorders (HLGD): a brief overview.

#Neuro #Neurotwitter #Neurology #Gait #Movement #Teaching

"It is likely possible to learn more about neurologic status from watching a patient walk than from any other single procedure, and observation of gait should always be part of a neurologic examination."

Gait is a sensory-motor function, which needs the adequate interaction between major systems for:

1⃣ Generating force
2⃣ Orientation in space
3⃣ Refine force
4⃣ Collate and interpret sensory information; select and modify motor programs

Gait in a "nutshell" (sort of) 👇
Read 15 tweets
In November 29, the World Movement Disorders day is celebrated.

#MoveDisorder #Neuro #Teaching #EndNeurophobia

1/🧵 Image
That is a great reason for a small tweetorial on how to approach phenomenology, the key element of this branch in Neurology. 🧠

But first, what is phenomenology?
That is a term that refers to the description of the movement. Instead of trying inmmediately to put a label on what you see, first I suggest start by watching and describing. 🤔


3/🧵 Image
Read 15 tweets
REM Sleep Behavior Disorder (RBD): what Miguel de Cervantes and Cinderella taught us. 😴😴💤🧠🧠👸✍️

A brief tweetorial.

#Neuro #NeuroTwitter #EndNeurophobia #Teaching #NeuroEducation #Sleep #RBD

The following thread has the objective to describe (in a general way) the main features of RBD, for more details, feel free to check the sources that I will add at the end of the tweetorial.

🥇What is REM sleep?
Sleep is divided in 4 phases, each of them is repeated during the 🌕in a cycle.

N1: vertex waves
N2: sleep spindles, k complexes
N3: slow-wave-sleep (restorative phase)
REM: rapid horizontal eye movement occurs, we dream and there is no muscle tone

Read 22 tweets
TBI SAH - diagnosis and management #LIVES2022
Pathophysiology of t-SAH and grading system #LIVES2022
Here we go - recommend use of #neuro #pocus to help guide management of t-SAH @chiara_robba @aartisarwal @ManniWaraich
Read 6 tweets
Neurological Examination in the unconscious patient: there is still plenty to do. 😴🧠
#Neuro #EndNeurophobia #Neurotwitter #Neuroexam

Most of the time we are used to see fully conscious patients in the Neurology Service, nevertheless, there are plenty of situations (especially in the ER) where we need to assess patients with impaired consciousness.🏥

You are not wrong if you think the neuro exam won't be as detailed as with a fully cooperative patient but there is still plenty that we can do to establish an initial diagnosis and hence, propose adequate treatment. 🤔

Read 13 tweets
Taken me several days to answer this, because migraines have long been a gap in my knowledge

Can't feel too bad though, because the science of #migraines is WAY more complex and uncertain than most would have thought

Here's what's known

Strap in, this will get complicated

What is the root cause of migraines? Currently 'TBC', unfortunately.

But evidence suggests it involves neurological, vascular, hormonal and genetic factors are working in concert

Applies to pretty much anything in the brain, it never makes it easy

But if there IS one specific 'root cause' of migraines, most fingers point to Cortical Spreading Depression, CSD

What's that?

It's when a neuron, brain cell, experiences a sudden burst of activity (depolarisation), followed by a period of inactivity, as if it's exhausted

Read 34 tweets
Dear #hr in #niin #ksom #usc, I know you are busy,but could you spend 8 mins on my emails pls? I sent 6 emails from April to June, and called you every day this week, but I didn’t get any reply. #neuroscience EAD will be expired at 07/10😩@USC @KeckMedUSC @KECKSchool_USC @USCNIIN ImageImageImageImage
Thanks,friends in #twitter in #niin,#ksom, #usc, in #neuroscience, #neuroimaging, #neuroradiology. I really appreciate your support. I got the email this afternoon. It’s my fault. Even leave, leave with pride, grace, and gratitude, no regret. The 4 yrs will be the best memory in Image
my life, although it is also the hardest 4 yrs. Hope other colleagues could take my lessons, and prepare everything earlier in the future.
Read 31 tweets
@euphoniYum @spriter99880 1/3. There is a #Power called "#Evolution" and the #Survival of the best "#Fit".
To #Unite many #Different views into 1 and giving up one's OWN desires for that of the GROUP, Homo Sapiens Sapiens developed #DNA-caused "#Group #Thinking", to change from #Many views to #ONE.
@euphoniYum @spriter99880 2/3. >>But these #Genetics are #Predictable and can be #Manipulated by the #Few.
Mass-Psychologists, in #Think #Tanks of the ruling class in the West, Oligarchs, developed "#NLP" or "#Neuro-#Linguistic #Programming", known as "Marketing", Brain Washing and yes... Propaganda.
@euphoniYum @spriter99880 3/3. >>Key is the presence of "#Fear", "#Uncertainty" & "#Chaos".
An article about this Geopolitical tool used by the #Empire from #SouthFront, blocked by Twitter.
The URL is in the top of the page. That will work.
scroll👇1st page
SouthFront👉👈via Archive
Read 4 tweets
Empathy, as in recognising, understanding, and *sharing* the emotional state/experience of others, is a vital ability of the human brain. It makes us what we are.
However, one problem is, that our own emotions and experiences can distort the process.

Here's more #BrainStuff

A surprising amount of our brain's processes are geared towards detecting, recognising, and recreating the emotions of others. We're constantly, often without realising, broadcasting our inner state, and human brains have evolved to recognise and interpret these cues.

As I say, we often don't even realise this is happening. You ever walked into a room after a huge argument has happened and immediately felt uncomfortable, or noted a 'frosty atmosphere'? That's what's happening there.

Read 21 tweets
Why do we readily remember someone's face, but regularly struggle to remember their name?

What makes names so hard to remember, when far less salient/important/useful stuff is often recalled so readily?

Because @GuitarmoogMusic asked, here's a #BrainStuff thread to explain

@GuitarmoogMusic A big part of why we often struggle to remember someone's name relates to a previous #BrainStuff thread; the v small capacity of the short term memory

Basically, our brains can only take in a small amount of abstract info at once

When you meet someone, they tell you their name. But very rarely is that the only information dispensed by the encounter. A conversation normally ensues, where a lot of basic personal info is exchanged. Their name is a small part of this.

Read 17 tweets
Your patient that is “over breathing” the vent may still be dead by brain criteria.

A #tweetorial #medtweetorial for providers in #criticalcare #EM #neuro #neurocriticalcare. @MedTweetorials
First and foremost, let’s be clear that to be dead by brain criteria, the patient must have cessation of ALL brain function *INCLUDING absence of respiratory drive.*

Thinking "But... I thought you just said...."?
The contradiction here lies in that ventilators are sometimes too sensitive.
Read 13 tweets
Emory Radiology COTD #154

Hx: Gait problem & imbalance, young patient.

Learned something new myself with this case!!

NO SPOILERS!!! Give answers w/ GIFs ONLY or submit to

Answer in 24hrs

#Neuro #Neurorad #FOAMrad #FOAMed #Erad #radres #EmoryRadCOTD ImageImageImage
Answer: JC virus Granule Cell Neuronopathy

This pt had HIV. I didn't remember (or ever learn???) a differential for the "Hot Crossed Bun" sign. Always thought it was multiple system atrophy. #EmoryRadCOTD ImageImageImageImage
There is variant of JC virus that will attack the granule cells in the cerebellum causing a lot of the same symptoms. Here we demonstrate the need for good clinical history & a f%^&* smart neurologist. We see a plethora of PML, IRIS, HIV encephalopathy but this is new one for me
Read 3 tweets
Kitten physical exam: (A thread)
Lymph node exam
#IDtwitter #Peds
Kitten physical exam:
Dysmetria testing
Kitten physical exam:
"Road test"
#Ortho #Geri
Read 12 tweets
Educar sin premios ni castigos es posible, si crees que castigo es pegar y dar premios es equivalente a reforzar.🤦‍♂️ Decir que el condicionamiento es malo por eso, es divulgar sobre algo que se desconoce y hacer una irresponsabilidad como divulgador y como periódico. (Dentro hilo)
Para empezar, dar un premio no es reforzar, y castigar no consiste en hacerle algo desagradable a alguien. Yo puedo darle "un premio" (Y lo pongo entre comillas, porque sería dar algo socialmente considerado como premio, p.e.: un diploma o una Copa) y estar justamente castigando.
El problema esta en considerar que estamos reforzando (procedim. Operante) por dar un premio (social) y confundir castigo (procedim. Operante) con castigar (dar palos). Se entiende que sea difícil de comprender, porque tampoco se han puesto los mejores nombres como p. operante.
Read 11 tweets

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