Neurology

Stroke medicine is a rapidly evolving field. This commentary will summarise developments in the primary and secondary prevention of stroke in patients with atrial fibrillation, and the latest guidance on intravenous thrombolysis in acute…

Non-motor symptoms such as depression, sleep disturbances or hallucinations are common in Parkinson's disease (PD), but often these are under-recognised and poorly treated. The frequency of non-motor symptoms usually increases with severity…

Coagulopathies cause a predisposition to thrombosis and therefore an increased risk of ischaemic stroke. Although the frequency of coagulopathies in patients with stroke is low, the yield for diagnosing coagulopathies is typically greatest…

The discovery of dopamine deficiency as a cause of the disability of Parkinson's disease has led to an era of successful dopaminergic therapy. Professor Jeremy Playfer provides an overview of the evolution of dopamine agonists and their…

Bilateral stroke is an extremely rare event. In a study of 1,838 patients, bilateral anterior infarctionaccounted for only 0·27% of stroke patients. We report the case of an 84-year-old woman who presentedwith bifrontal haemorrhagically…

Apomorphine was first synthesised in 1869, and has been used in the treatment of Parkinson's disease for morethan 50 years. It is a potent non-selective dopamine agonist. Current use is restricted to patients with advancedParkinson's…

Trigeminal neuralgia is a severe unilateral intermittent facial pain that is unresponsive to normal analgesics. First-line drug treatment is carbamazepine, but side-effects are common. Additionally, several surgical techniques are available…

Alzheimer's disease seems to share the same vascular risk factors as vascular dementia and cardiovasculardisease. The evidence for this, although far from complete, continues to grow, and the potential toprevent and control Alzheimer's…

The classic triad of ataxia, dementia, and urinary incontinence is an increasingly recognised andpotentially reversible cause of dementia seen on geriatric wards. The exact pathogenesis is unknown,although many theories have been proposed…

In older people, sleep disturbances are very common. Changes in sleep patterns may be a normal partof ageing, but many other factors in older people can contribute to sleep problems. Sleep disordersdecrease quality of life in older people…

About a third of surgeries involve elderly patients; however, postoperative cognitive dysfunction is animportant adverse outcome in such patients. Doctors should be aware of this condition and consider therisk€“benefit ratio when referring…

Urinary retention after stroke is common and the mechanism is multifactorial. The management issimilar to its that of any other cause. In the majority of patients, it resolves with time and the overallprognosis seems favourable.

Pain in older patients is often poorly treated. Some patients have a tendency to under-report their symptoms or are unable to communicate their pain. Clinicians do not always adequately investigate pain or are unaware of non-verbal cues of…

Management of behavioural disturbance in the setting of dementia can be challenging. There are many potential causes including poor physical health, prescribed drugs, depression, impaired vision and hearing as well numerous environmental…

The term Mild Cognitive Impairment is being used universally to represent the clinical condition between normal ageing and dementia in which individuals experience cognitive problems to a greater extent than one would expect for age, yet…