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Most recents (20)
Biggest thing to ever come out of my little group. Pls help spread this finding!
We found clean, CAUSAL evidence that the shingles vaccine prevents a good chunk of dementia cases. So, could a virus cause Alzheimer’s->YES!
Hear me out & see preprint: bit.ly/3MVqXU9
🧵1/
We found clean, CAUSAL evidence that the shingles vaccine prevents a good chunk of dementia cases. So, could a virus cause Alzheimer’s->YES!
Hear me out & see preprint: bit.ly/3MVqXU9
🧵1/
There’s recently been ⬆️ interest in the possibility that a virus may be involved in the causal pathways of dementia. Most attention has been on herpesviruses, incl the VZV that causes chickenpox and shingles, partly because of their lifelong latency (bit.ly/3nibvYk).
2/
2/
In Wales starting in Sept 2013, the shingles vaccine was rolled out using an exact DOB cutoff. Those born on or after Sept 2 1933 were eligible, while those born earlier weren’t and remained ineligible for life. We analyzed EHR data for all of Wales with DOB exact to the week.
3/
3/
Welcome to #NeudrawlogyMigraineEdition, part 7! 🤕🧠
CRGP = Calcitonin gene-related peptide plays an important role on the pathophysiology of migraine
💊Their antagonists can be used for either migraine prophylaxis or acute treatment of a headache episode
Part 8 tomorrow!
CRGP = Calcitonin gene-related peptide plays an important role on the pathophysiology of migraine
💊Their antagonists can be used for either migraine prophylaxis or acute treatment of a headache episode
Part 8 tomorrow!
Part 1:
Part 2:
1/ Cluster headache is the most common trigeminal autonomic cephalalgia,
#clusterheadache #primaryheadachedisorder #MedEd #medicaleducation #neurology #NeuroTwitterNetwork #neurotwitter #neurophobia #neurophilia
#clusterheadache #primaryheadachedisorder #MedEd #medicaleducation #neurology #NeuroTwitterNetwork #neurotwitter #neurophobia #neurophilia
2/ and presents with excruciating unilateral orbital, supraorbital, and/or temporal pain that lasts 15-180 minutes if left untreated. Patients also have ipsilateral autonomic symptoms during a cluster attack.
3/ Although the exact pathophysiology is unclear, the trigeminovascular pathway is important for the unilateral trigeminal distribution of pain, the trigeminal-autonomic reflex is important for producing ipsilateral cranial autonomic symptoms,
1/ Step 1 - Don’t
👉Shut anything off
👉Touch the vent
👉Remove restraints
👉Pause sedation
if you have not explicitly asked permission to do so.
[This is a survival thing! For the pt… (and you 😉)]
A #tweetorial @medtweetorial about critical care things for #neurologists
👉Shut anything off
👉Touch the vent
👉Remove restraints
👉Pause sedation
if you have not explicitly asked permission to do so.
[This is a survival thing! For the pt… (and you 😉)]
A #tweetorial @medtweetorial about critical care things for #neurologists
2/
Vibe check for the #neurologists out there. Do you like doing ICU consults?
#MedEd #NeuroTwitter #NeuroTwitterNetwork #EmoryNCCTweetorials
Vibe check for the #neurologists out there. Do you like doing ICU consults?
#MedEd #NeuroTwitter #NeuroTwitterNetwork #EmoryNCCTweetorials
3/
Tip 1⃣: Induction meds for intubation have different hemodynamic profiles.
In emergent situations, explicitly tell whoever is intubating the patient’s BP goals.
For ex: AIS = ⬆️ BP good; induction with propofol (frequently = hypotension) is suboptimal.
Reminders are 🔑
Tip 1⃣: Induction meds for intubation have different hemodynamic profiles.
In emergent situations, explicitly tell whoever is intubating the patient’s BP goals.
For ex: AIS = ⬆️ BP good; induction with propofol (frequently = hypotension) is suboptimal.
Reminders are 🔑
It's here! After many years of working on this 2nd edition, it's amazing to finally see and hold it!
I learned so much revising and updating this book, a 🧵
#MedEd #MedTwitter #neurotwitter #NeuroTwitterNetwork @NMatch2023 @caseyalbin @DxRxEdu
I learned so much revising and updating this book, a 🧵
#MedEd #MedTwitter #neurotwitter #NeuroTwitterNetwork @NMatch2023 @caseyalbin @DxRxEdu
One of the most fun things to write was the preface, reflecting on how much has changed and evolved in #neurology in just a few years since the 1st edition. More on why I love neurology here:
For example the antiseizure medication table has expanded from 1 page to two...
#NeudrawlogyMigraineEdition, part 5! 🤕 🧠
Here goes a review of the preventive treatments for migraine! 🧵 (1/10)
✅ Learn here:
🎯 Indications;
💊 General recommendations about the treatment.
#NeuroTwitterNetwork #NeuroTwitter #FOAMed #MedEd #MedTweetorial
Here goes a review of the preventive treatments for migraine! 🧵 (1/10)
✅ Learn here:
🎯 Indications;
💊 General recommendations about the treatment.
#NeuroTwitterNetwork #NeuroTwitter #FOAMed #MedEd #MedTweetorial
1/❓But first, a question:
A 28-year-old woman with migraine without aura has 2 attacks/month lasting 8h, and her episodes are relieved by NSAIDs. Would you prescribe her a preventive migraine treatment?
A 28-year-old woman with migraine without aura has 2 attacks/month lasting 8h, and her episodes are relieved by NSAIDs. Would you prescribe her a preventive migraine treatment?
2/❓Let’s suppose the same person has hemiplegic migraine with 1 attack/year. Would you treat her?
1/
We often check SPEP and/or immunofixation in patients with neuropathy. Why bother, and what should I do with the results?
Welcome to Paraproteinemic Neuropathy: A #tweetorial for neurologists who order tests they have no business interpreting.
We often check SPEP and/or immunofixation in patients with neuropathy. Why bother, and what should I do with the results?
Welcome to Paraproteinemic Neuropathy: A #tweetorial for neurologists who order tests they have no business interpreting.
2/
For starters, let's clear the air about terminology. These are all synonyms:
- Paraproteinemia
- Monoclonal gammopathy
- M-protein
- M component
They all mean identical plasma cells are overproducing identical copies of the same immunoglobulin or immunoglobulin fragments.
For starters, let's clear the air about terminology. These are all synonyms:
- Paraproteinemia
- Monoclonal gammopathy
- M-protein
- M component
They all mean identical plasma cells are overproducing identical copies of the same immunoglobulin or immunoglobulin fragments.
3/
Paraproteinemia is common as we age. It's usually benign (MGUS) and asymptomatic, but can be associated with almost ANY neuropathy syndrome.
(PSA: If you do a Google image search for Stocking and Glove looking for neuropathy pics, be prepared to find a bunch of S&M sites.)
Paraproteinemia is common as we age. It's usually benign (MGUS) and asymptomatic, but can be associated with almost ANY neuropathy syndrome.
(PSA: If you do a Google image search for Stocking and Glove looking for neuropathy pics, be prepared to find a bunch of S&M sites.)
It gives my great pleasure to announce the release of THE PLEXUS, a new strategy card game about peripheral nervous system localization.
Folks, this may be our only hope to #endplexusphobia!
Click here ➡️theplexusgame.com
And open the 🧵for more surprises.
1/5
Folks, this may be our only hope to #endplexusphobia!
Click here ➡️theplexusgame.com
And open the 🧵for more surprises.
1/5
It’s a 2-3 player game that takes about 20 minutes🕓 to play. And here's the kicker: It's actually fun, and you don’t need to be be a master of brachial plexus anatomy to enjoy it. (In fact, my middle school-age son beat me the first time he played.😯)
2/5
2/5
I’m selling these at cost from The Game Crafter, thegamecrafter.com/games/the-plex…
and I will donate $3 to the American Neuromuscular Foundation for every copy sold in 2022! neuromuscularfoundation.org/Home
@AmNmFoundation @AANEMorg @aanem @ShirlynAdkins
3/5
and I will donate $3 to the American Neuromuscular Foundation for every copy sold in 2022! neuromuscularfoundation.org/Home
@AmNmFoundation @AANEMorg @aanem @ShirlynAdkins
3/5
Welcome to the #NeudrawlogyMigraineEdition, part 2! 🤕🧠
Aura is a Greek 🇬🇷 word and deity that means breeze 🌬, and in medicine, it is a symptom that occurs in up to 25% of people with migraine.
A 🧵! 1/7
#NeuroTwitter #NeuroTwitterNetwork #FOAMed #MedEd #MedTwitter
🧠📚🎨
Aura is a Greek 🇬🇷 word and deity that means breeze 🌬, and in medicine, it is a symptom that occurs in up to 25% of people with migraine.
A 🧵! 1/7
#NeuroTwitter #NeuroTwitterNetwork #FOAMed #MedEd #MedTwitter
🧠📚🎨
1/ Like a breeze 🌬 precedes a storm ⛈, the aura usually precedes the headache in up to 60 min.
But not always.
It can also:
- Occurs alone, not followed by any headache
- Occurs during the headache episode
But not always.
It can also:
- Occurs alone, not followed by any headache
- Occurs during the headache episode
2/ 👀 Visual symptoms are the most common. They occur in over 90% of patients with migraine with aura, are bilateral and can be either positive (scintillations, flashes, etc.) or negative (like scotomas).
1/11
Time for a #tweetorial on one of my favorite topics: Wrist Drop. @AANMember @NMatch2022 #neurology #futureneurologist #neurotwitter #neurotwitternetwork @AANEMorg #meded @KoriPoRodri
The first thing you should think of when you see a patient with weak wrist extension is…
Time for a #tweetorial on one of my favorite topics: Wrist Drop. @AANMember @NMatch2022 #neurology #futureneurologist #neurotwitter #neurotwitternetwork @AANEMorg #meded @KoriPoRodri
The first thing you should think of when you see a patient with weak wrist extension is…
2/11
This. Compression of the radial nerve at spiral groove. And usually, we think of it as being caused by...
This. Compression of the radial nerve at spiral groove. And usually, we think of it as being caused by...
3/11
This. And by the way, if you’re ever curious about the surprising origins of the term “Saturday Night Palsy,” read this article. pubmed.ncbi.nlm.nih.gov/12188953/
But I digress. The spiral groove (aka radial groove) is not the only peripheral localization for wrist drop.
This. And by the way, if you’re ever curious about the surprising origins of the term “Saturday Night Palsy,” read this article. pubmed.ncbi.nlm.nih.gov/12188953/
But I digress. The spiral groove (aka radial groove) is not the only peripheral localization for wrist drop.
1/6. This chart shows you everything you need to know about localizing foot drop. But let’s make it even simpler. If dorsiflexion is weak, there is one muscle that really matters: the tibialis posterior, which does ankle INVERSION. Let’s unpack that with a cool mnemonic.
2/6 Common things are common, and most of the time, a foot drop is caused by either:
- A common peroneal neuropathy at the fibular head or
- An L5 radiculopathy.
- A common peroneal neuropathy at the fibular head or
- An L5 radiculopathy.
3/6. The peroneal nerve (which we already know is responsible for dorsiflexion) has two E’s in it. That should remind you that the PERONEAL nerve is responsible for EVERSION, through supplying the peroneus longus.
1/ 🎊 NEURO PROGRAM FEATURE 🎊
Today we are featuring ✨University of Florida Neurology✨
Program: University of Florida (@UFNeuroRes)
Location: Gainesville, Florida
Website: neurology.ufl.edu/education/resi…
Check out this 🧵 to learn more!
#NeuroTwitter #Match2022 #NeuroMatch
Today we are featuring ✨University of Florida Neurology✨
Program: University of Florida (@UFNeuroRes)
Location: Gainesville, Florida
Website: neurology.ufl.edu/education/resi…
Check out this 🧵 to learn more!
#NeuroTwitter #Match2022 #NeuroMatch
2/ 📍What we look for (1/2):
📍We conduct a holistic review to find candidates with inherent curiosity for learning and a passion to serve neurological patients. As our chair Dr. Okun says - “the patient is the sun and we orbit around them”.
📍We conduct a holistic review to find candidates with inherent curiosity for learning and a passion to serve neurological patients. As our chair Dr. Okun says - “the patient is the sun and we orbit around them”.
2/ 📍What we look for (2/2):
A team-focused attitude is also key, as we have a great group of residents and faculty who all support one another.
A team-focused attitude is also key, as we have a great group of residents and faculty who all support one another.
1/ 🎊 NEURO PROGRAM FEATURE 🎊
Today we are featuring ✨ University of Chicago Neurology✨ @NeuroUcmc
Location: Chicago, Illinois
Website: neurology.uchicago.edu
Instagram: instagram.com/uchicagoneurol…
Check out this 🧵 to learn more!
#NeuroTwitter #Match2022 #NeuroMatch
Today we are featuring ✨ University of Chicago Neurology✨ @NeuroUcmc
Location: Chicago, Illinois
Website: neurology.uchicago.edu
Instagram: instagram.com/uchicagoneurol…
Check out this 🧵 to learn more!
#NeuroTwitter #Match2022 #NeuroMatch
2/ What we look for: (1/2)
📍 We look for applicants from diverse backgrounds that are passionate, motivated, and kind-hearted. One of our goals is to mold all of our residents into leaders in the field.
📍 We look for applicants from diverse backgrounds that are passionate, motivated, and kind-hearted. One of our goals is to mold all of our residents into leaders in the field.
2/ What we look for: (2/3)
📍In addition, we take great pride in the fact that our residents work with an underserved population. Our residency stresses the importance of understanding our patients, their circumstances…
📍In addition, we take great pride in the fact that our residents work with an underserved population. Our residency stresses the importance of understanding our patients, their circumstances…
1/🎊PROGRAM FEATURE 🎊
Program: University of Wisconsin
Location: Madison, WI
Website: neurology.wisc.edu/residency-prog…
Twitter: @UW_Neurology
Program: University of Wisconsin
Location: Madison, WI
Website: neurology.wisc.edu/residency-prog…
Twitter: @UW_Neurology
2/ What we look for (1/2):
📍Attitude is more important than test scores!
📍We want to recruit good people who are going to bring a positive attitude and work to enhance our patients' care, engage in learning, and support their colleagues.
📍Attitude is more important than test scores!
📍We want to recruit good people who are going to bring a positive attitude and work to enhance our patients' care, engage in learning, and support their colleagues.
3/ What we look for (2/2):
...In return, we'll treat you with respect and help you become the best neurologist you can be!
...In return, we'll treat you with respect and help you become the best neurologist you can be!
1/ 🎊 NEURO PROGRAM FEATURE 🎊
Today we are featuring ✨UT Houston Neurology✨
Program: UT Houston Neurology
Location: Houston, TX
Website: med.uth.edu/neurology/educ…
Twitter: @UthoustonR
Instagram: @uth.neuro.residents
#NeuroTwitter #Match2022 #NeuroMatch
Today we are featuring ✨UT Houston Neurology✨
Program: UT Houston Neurology
Location: Houston, TX
Website: med.uth.edu/neurology/educ…
Twitter: @UthoustonR
Instagram: @uth.neuro.residents
#NeuroTwitter #Match2022 #NeuroMatch
2/ What we look for (1/2):
📍Our residents thrive because they love spending time with each other and our faculty, are great team players, and enjoy a good work life balance.
📍Our residents thrive because they love spending time with each other and our faculty, are great team players, and enjoy a good work life balance.
2/ What we look for (2/2):
📍If you are passionate about neurology, hardworking, and envision yourself contributing to the field, either locally in Houston, nationally, or globally, consider training with us!
📍If you are passionate about neurology, hardworking, and envision yourself contributing to the field, either locally in Houston, nationally, or globally, consider training with us!
1/Fun fact 4 #neurotwitter
1️⃣Lumbar puncture kit manometers measure the opening pressure in cmH2O.
2️⃣The BTF and other societies talk about concerning intracranial pressures in mmHg (threshold 20-22 mmHg, Guideline dependent).
3️⃣20 cmH2O = ~15 mmHg
4️⃣20 mmHg = ~27 cmH2O
1️⃣Lumbar puncture kit manometers measure the opening pressure in cmH2O.
2️⃣The BTF and other societies talk about concerning intracranial pressures in mmHg (threshold 20-22 mmHg, Guideline dependent).
3️⃣20 cmH2O = ~15 mmHg
4️⃣20 mmHg = ~27 cmH2O
2/
This can get equally confusing in EVDs. At @EmoryNeuroCrit we set the threshold pressures for the EVD (ie EVD @ 5, 10, 15..) in cmH2O.
But, the transducer measures and reports ICP in mmHg.
This can get equally confusing in EVDs. At @EmoryNeuroCrit we set the threshold pressures for the EVD (ie EVD @ 5, 10, 15..) in cmH2O.
But, the transducer measures and reports ICP in mmHg.
3/ Confused? Mind blown? Thought of all the pts you were worried had concerningly elevated ICP because their LP pressure was 20 cmH2O?
Join the club.
Mercury vs. Water: An Analysis of Multi-Institutional Survey Data Asse... sciencedirect.com/science/articl…
Join the club.
Mercury vs. Water: An Analysis of Multi-Institutional Survey Data Asse... sciencedirect.com/science/articl…
1/4
43yr chronic #alcohol user on Liv.52 #Herbal supplement for 1yr. Believes Liv52='hepatoprotective'. Consumes along with to cancel alcohol-toxicity. Diabetes uncontrolled on #Ayurveda. Comes with #jaundice, severe #headache, eyes 'bulged' 2 days, nasal discharge #livertwitter
43yr chronic #alcohol user on Liv.52 #Herbal supplement for 1yr. Believes Liv52='hepatoprotective'. Consumes along with to cancel alcohol-toxicity. Diabetes uncontrolled on #Ayurveda. Comes with #jaundice, severe #headache, eyes 'bulged' 2 days, nasal discharge #livertwitter
2/4
At admission, #seizures, uncontrolled, put on #ventilator. Deep jaundice, comatose. Investigations=acute on #chronic liver failure #aclf
#MRI Brain Part 1👇
Extensive hemorrhagic infarcts, almost all of anterior and mid #brain.
#medicine #MedTwitter #radiology
At admission, #seizures, uncontrolled, put on #ventilator. Deep jaundice, comatose. Investigations=acute on #chronic liver failure #aclf
#MRI Brain Part 1👇
Extensive hemorrhagic infarcts, almost all of anterior and mid #brain.
#medicine #MedTwitter #radiology
3/4
MRI Brain Part 2👇
Both sides cortical venous thrombosis and anterior third of superior saggitsl sinus thrombus.
#imaging #stroke #NeuroTwitter #neurology #NeuroTwitterNetwork
MRI Brain Part 2👇
Both sides cortical venous thrombosis and anterior third of superior saggitsl sinus thrombus.
#imaging #stroke #NeuroTwitter #neurology #NeuroTwitterNetwork
A brief refresher about #Antibiotic-associated #Encephalopathy #Twittorial #Tweetorial #AMS
Inspired from today's #NoonConference topic
#MedTwitter #MedStudentTwitter #NeuroTwitter #NeurotwitterNetwork #MedEd @MedTweetorials #NeurologyResident #Neurology #RITEReview
1/
Inspired from today's #NoonConference topic
#MedTwitter #MedStudentTwitter #NeuroTwitter #NeurotwitterNetwork #MedEd @MedTweetorials #NeurologyResident #Neurology #RITEReview
1/
Antibiotics are commonly prescribed medications in the inpatient and outpatient setting and it's important to recognize #AdverseEvents, including idiosyncratic reactions, such as #encephalopathy.
2/
2/
Antibitiotics associated with #Encephalopathy:
- Beta lactams
- #Cephalosporins (#Cefepime is the most common,
Ceftazidime)
- Imipenem
- #Penicillin procaine
- Fluoroquinolones
- Macrolides (clarithromycin)
- TMP-SMX
- #Metronidazole
- Isoniazid
3/
- Beta lactams
- #Cephalosporins (#Cefepime is the most common,
Ceftazidime)
- Imipenem
- #Penicillin procaine
- Fluoroquinolones
- Macrolides (clarithromycin)
- TMP-SMX
- #Metronidazole
- Isoniazid
3/
#MedTwitter #medstudenttwitter #MS3 #MS4 #NeuroMatch2021 #NeuroResidency #IMG #neurotwitternetwork #neurology #Neurotwitter #Match2021 #ERAS #ECFMG #USMLE
@NMatch2021 #Twittorial
Best ways to prepare yourself for the upcoming #virtual Neurology residency application cycle:
1/
@NMatch2021 #Twittorial
Best ways to prepare yourself for the upcoming #virtual Neurology residency application cycle:
1/
- Make an initial list of programs you are interested in applying to.
- Do your #research: curriculum, front loaded?, number of residents, night float?, location, categorical or advanced (needs IM prelim)?
- Start asking for LoRs (May have to remind writer at least once)
2/
- Do your #research: curriculum, front loaded?, number of residents, night float?, location, categorical or advanced (needs IM prelim)?
- Start asking for LoRs (May have to remind writer at least once)
2/
- Start working on your PS
- Have a note or document on your phone/PC for
ideas: You never know when a moment of inspiration
may happen!💡).
- Make as many corrections as needed
- Contact programs with any questions, specially if something is not clear to you
3/
- Have a note or document on your phone/PC for
ideas: You never know when a moment of inspiration
may happen!💡).
- Make as many corrections as needed
- Contact programs with any questions, specially if something is not clear to you
3/
#MedTwitter #neurotwitter #Neurotwitternetwork
It's time for another #tweetorial #twittorial!
Today's topic: Functional Gait Disorders
#FunctionalGait #FND #FMD #Gaitdisorders #Ataxia #MovDis #Medstudenttwitter #neuroresidents #neurology #movementdisorders #FNDHope
1/
It's time for another #tweetorial #twittorial!
Today's topic: Functional Gait Disorders
#FunctionalGait #FND #FMD #Gaitdisorders #Ataxia #MovDis #Medstudenttwitter #neuroresidents #neurology #movementdisorders #FNDHope
1/
Functional Gait disorders ("FGD" for the purpose of this #twittorial) are common and disabling, usually accompanied by other symptoms. FGD are challenging for the non #MovDis physician and it can difficult to determine #inconsistencies and #incongruencies during examination.
2/
2/
A good approach is to identify #clinicalSigns to differentiate a #functional vs #organic cause
#Inconsistency is the variability in gait disorder severity over time.
#incongruency involves a combination of symptoms and sins not seen in organic disorders.
#distractibility
3/
#Inconsistency is the variability in gait disorder severity over time.
#incongruency involves a combination of symptoms and sins not seen in organic disorders.
#distractibility
3/
