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- 6 days ago37 min
Perplexing keladophilia and post-surgical symptoms - Case Reports April 2026
It's the return of Merlin. Not the birdsong identification app this time, but the Rolls-Royce Merlin - engine of the historic Supermarine Spitfire warplane. The Case Reports trio are faced with another set of patient puzzles to work through in this latest episode. In the first case , a 68-yo man, retired from farming, presents with a 6-year history of behavioural changes. Most notably, he had developed a sense of great pleasure in listening to engine sounds, like those of the historic aircraft flying over his house. He had become increasingly emotionally detached and ritualistic, and gained a sweet tooth. MR scans of the brain revealed an uncommon syndrome. https://pn.bmj.com/content/26/2/169 The second case relates to a 47-yo woman who developed abnormal movements in all of her limbs. She had undergone a complex cardiac surgery 12 years before, and another prolonged cardiac surgery within recent weeks. The case discusses the longterm follow-up of her treatment for these involuntary movements. https://pn.bmj.com/content/26/2/157 The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Babak Soleimani³ for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the October 2025 issue of the journal. (1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital. (2) Clinical Lecturer in Neurology at the Institute of Cognitive Neuroscience, University College London, and an Honorary Neurology SpR at the National Hospital for Neurology and Neurosurgery. (3) Clinical Research Fellow, Oxford Laboratory for Neuroimmunology and Immunopsychiatry, Nuffield Department of Medicine, University of Oxford Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://bit.ly/4aXF46i). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Brian O'Toole. Thank you for listening.
- 3 weeks ago30 min
Radiologically isolated syndrome: managing the preclinical phase of MS
What should a neurologist do when a routine MRI for migraine reveals incidental white matter lesions that look remarkably like Multiple Sclerosis (MS), despite the patient having no neurological symptoms? The Editors' Choice paper for the April 2026 issue of Practical Neurology is a practical guide to the clinical diagnosis and management of radiologically isolated syndrome (RIS). Author Dr. Audrey Reynolds¹ joins PN podcast editor Dr. Amy Ross Russell to discuss her work on how updated diagnostic criteria and advanced imaging markers now enable a more proactive, biological approach to the disease. Their discussion highlights the importance of risk stratification - using tools like CSF analysis and spinal imaging - to identify those most likely to benefit from early intervention with disease-modifying therapies. They also examine the delicate balance between preventing future disability and avoiding misdiagnosis in this rapidly evolving area of neurology. Read the paper: Radiologically isolated syndrome: a practical guide. (1) St Vincent’s University Hospital, Dublin; University College Dublin, Ireland Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest episodes. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.
- Mar 27, 202632 min
Bone health in Neurology: managing the fracture risk
In this Practical Neurology bonus international podcast linked to the February issue, host Alasdair Coles (Cambridge, UK) is joined by movement disorder specialist Dr. Ashley Paul (Johns Hopkins, US) and epilepsy expert Dr. Lata Vadlamudi (Brisbane, Australia) to discuss the integration of bone health into neurology clinics. They discuss the identification of osteoporosis in patients on steroids or anti-seizure medications and evaluate the use of FRAX assessment tools for neurological populations. They also address the implementation of screening protocols and checklists to prevent fragility fractures. Read the related paper: Osteoporosis and fracture risk: a practical guide for neurologists Participants: Professor Alasdair Coles is Head of Department for Clinical Neuroscience and also Co-Director of the Cambridge Centre for Myelin Repair, UK. Associate Professor Lata Vadlamudi, Senior Staff Specialist in Neurology at the Royal Brisbane and Women's Hospital, Australia. Dr. Ashley Paul, Assistant Professor of Neurology in the Division of Movement Disorders at Johns Hopkins University, USA. Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Letícia Amorim. Thank you for listening.
- Mar 17, 202641 min
Head knocks in athletes, the clock drawing test, and generic medications - Editors' Highlights April 2026
As with any Darwinian subject, neurology is under constant evolution. This podcast for the April 2026 issue of Practical Neurology has co-editors Phil Smith and Geraint Fuller taking a look at some intriguing specimens from the neurological field. Populating the menagerie for this episode are the "reversed clock phenomenon", a new study on brain problems in retired sportspersons, a practice guide for biosimilar drugs, and a look at GLP-1 drugs. Also found inside are the "nocebo effect", radiologically isolated syndrome for multiple sclerosis identification, and a weighing up of stenting vs shunting. Read the issue: https://pn.bmj.com/content/26/2/103 Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Brian O'Toole. Thank you for listening.
- Mar 3, 202638 min
Recurring migraine, and unintentional weight loss - Case Reports February 2026
What unsuspecting dangers lie within a garden compost bin? The Case Reports team are back to uncover a new pair of neurological mysteries. The first case this episode comes from Edinburgh, centred on an 88-yo woman who presents with headache and eye-pain on her right side. She receives an early diagnosis of migraine, but returns a few weeks later with intermittent vomiting and subsequent progressive visual loss. https://pn.bmj.com/content/26/1/83 The second case from Wessex features a common presentation of tingling feet, with a 62-yo man who develops gait instability. More curious are a significant drop in his weight, as well as a scaly patch on his chest. https://pn.bmj.com/content/26/1/63 The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Babak Soleimani³ for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the October 2025 issue of the journal. (1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital. (2) Clinical Lecturer in Neurology at the Institute of Cognitive Neuroscience, University College London, and an Honorary Neurology SpR at the National Hospital for Neurology and Neurosurgery. (3) Clinical Research Fellow, Oxford Laboratory for Neuroimmunology and Immunopsychiatry, Nuffield Department of Medicine, University of Oxford Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://bit.ly/4aXF46i). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Brian O'Toole. Thank you for listening.
- Feb 10, 202655 min
A face in the hedge: Dementia with Lewy bodies
Many patients will affirm seeing clouds shaped like animals or other similar phenomena, which is why confirming pareidolia (seeing meaningful images in meaningless visual stimuli) is such a tricky symptom in dementia with Lewy bodies (DLB). While it may not be exclusive to DLB, placing such symptoms in the context of "the company it keeps" is a key method to narrowing down the diagnosis. The Editors' Choice paper for the February 2026 issue of Practical Neurology is a practical guide to the clinical diagnosis and management of DLB. Authors Dr. Sarah Fullam¹ ² and Dr. Seán O'Dowd¹ ³ join PN podcast editor Dr. Amy Ross Russell to discuss their work. They describe the importance of the initial examination, from the patient's gait to difficulties in word retrieval. They also touch on challenges in the use of biomarkers, which drugs may be helpful, and how to advise patients and their carers. Read the paper: Dementia with Lewy bodies: a practical guide to clinical diagnosis and management Special thanks to The Podcast Studios Dublin for their assistance with the recording of this episode. (1) Tallaght Institute of Memory and Cognition, Tallaght University Hospital, Dublin, Ireland (2) Trinity College Dublin School of Medicine, Dublin, Ireland (3) Trinity College Dublin Academic Unit of Neurology, Dublin, Ireland Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest episodes. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.
- Jan 27, 202647 min
Mind the gap, passage hallucinations, and conducting on cue - Editors' Highlights February 2026
When a patient says, "I biffed the car," how should that be translated? Puzzles like this represent the gap between description and diagnosis, and are a critical part of neurological practice. In this podcast for the February 2026 issue of Practical Neurology, editors Phil Smith and Geraint Fuller take turns decoding some of the mysteries of everyday neurology. They cover dementia with Lewy bodies, osteoporosis and fracture risk, and anxiety and depression in epilepsy patients, as a sample of some of the published work in the latest journal. There's also a guide to the latest stroke rehabilitation guidelines, freezing of gait, and a farewell to a 'nom de plume'. Read the issue: https://pn.bmj.com/content/26/1/1 Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Brian O'Toole. Thank you for listening.
- Jan 14, 202641 min
The eye as a snowglobe: Uveitis for neurologists
Eye pain can be a source of serious concern for patients, bringing worries about their eyesight. While uveitis is far from the only source of ocular pain, in many presentations of the condition it is a feature. In this Editors' Choice podcast, ophthalmic surgeon Mr. Harry Petrushkin¹ ² and neurologist Dr. Ruth Dubson³ join forces to explain a comprehensive approach to uveitis treatment. Host Dr. Amy Ross Russell leads the way through a refresher on eye anatomy and the spectrum of uveitis patients neurologists are likely to encounter. These are often the more serious of patients, requiring good working relationships across disciplines. They also speak of the overlap with neuroinflammatory presentations, and the eye manifestations seen in conditions like multiple sclerosis and sarcoidosis. Read the paper: Uveitis for Neurologists (1) Uveitis and Scleritis Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK (2) Rheumatology Service, Great Ormond Street Hospital NHS Trust, London, UK (3) Blizard Institute, Queen Mary University London, London, UK Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production by Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.
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About Practical Neurology Podcast
The Practical Neurology Podcast is the essential guide for the everyday life of all neurologists. Just like our journal Practical Neurology, this podcast is useful for everyone who sees neurological patients and who wants to keep up-to-date and safe in managing them. In other words, this is a podcast for jobbing neurologists who plough through the tension headaches and funny turns week in and week out. Subscribe to enjoy deep dives into each journal issue with editors Prof. Philip Smith and Dr. Geraint Fuller, discussions on recent case reports with Prof. Martin Turner, and Editor’s Choice article discussions between authors and Dr. Amy Ross Russell. Practical Neurology - pn.bmj.com - is included as part of a subscription to JNNP and provided in print to all members of the Association of British Neurologists.* The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for
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