Square One

Elizabeth Loder reports on two important debates at the World Congress on Controversies in Neurology held in Prague last week:

Should patients who have brain microbleeds on MRI be anticoagulated for secondary prevention of cardiovascular or cerebrovascular disease?

Should tissue plasminogen activator (TPA) be given to patients with ischemic stroke beyond 3 hours from onset of symptoms?

Elizabeth’s report is here.

There are also webcasts on debates from last year here. Issues covered in these debates include:

• Is migraine a disease or a syndrome?
• Blood pressure in acute ischaemic stroke
• Enzyme-inducing AEDs should not be used as first-line agents in the treatment of epilepsy
• Epilepsy surgery should be performed in patients with structural lesions even if seizures are controlled by medication
• Cholinesterase inhibitors (ChEI’s) in Alzheimer’s Disease with severe dementia
• Should patients with Parkinson’s Disease already be treated in the premotor phase?

There is an interesting, and rather open ended (making it even more interesting) review of non-documentary films that feature neurological illness here. The review is co-authored by Andrew Larner who writes an engaging and entertaining monthly column in the journal Advances in Clinical Neuroscience and Rehabilitation (ACNR) about the relationship between neurology and the humanities, especially history and literature.

They start off with seizure which has been the object of my research affection lately, lamenting the possible influence of One Flew Over the Cuckoo’s Nest in helping to push electroconvulsive therapy into the closet of disrepute. Then Dostoyevsky, who had epilepsy, and his characters with epilepsy in film version of The Idiot and The Brothers Karamazov.

The list goes on and on, and I suspect they got rather weary along the way, or how else to explain the unwarranted downbeat conclusion: “Should neurologists watch films? What has cinema ever done for neurology?…the majority of filmic portrayals of neurological disease are simply dishonest. Maybe they should carry a health warning.”

Well, that would be interesting, wouldn’t it? “The movie you are about to see may pose certain health risks!”