eLetters

620 e-Letters

  • Botulinum toxin for treatment of migraine: randomized controlled trials versus basic sciences
    Vinod K Gupta, M.D.

    Dear Editor

    Jankovic reviews the expanding list of approved and off-label indications for therapeutic use of botulinum toxin (BT). [1]. One of the prominent off-label indications for use of BT is migraine, the advent of which therapy was serendipitous.

    Use of BT for migraine prevention is gaining momentum through the results of randomized controlled trials (RCT) – both completed and ongoing – and, in th...

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  • Impaired swallowing reflex in dysphagic stroke patients - a reply to Teramoto et al.
    Rainer Dziewas

    Dear Editor

    We appreciate the interesting comment on our paper [1] and the important clinical observations by Teramoto et al.

    In their recent studies the authors have shown that the simple swallowing provocation test (SPT) is able to identify patients being predisposed to aspiration pneumonia.[2,3] Based on their experience, featuring a failure of the SPT in 18 of 26 patients (70%), the authors are rig...

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  • Triphasic effects of organophosphate poisoning, Is it an over simplification?
    Tissa Wijeratne

    Dear Editor

    We read with interest the letter by Teke et al,[1] which described a case of organophosphate (OP) poisoning with atypical features and also the magnetic resonance imaging (MRI) findings. The number of acute pesticide poisoning is estimated at three million a year world wide, resulting in over 200,000 deaths.[2,3] In a survey of deaths due to acute poisoning in the District of Kandy , Sri Lanka f...

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  • Clinical use of paraneoplastic antibodies
    Albert Grueger

    Dear Editor

    How useful is antibody testing for paraneoplastic disease in a patient without known tumour?

    Dr Rees proposes to search for paraneuroplastic antibodies in patients with possible paraneoplastic syndromes. At the same time he points out that the incidence of specific disabling neurological paraneoplastic syndromes is very low. No information on the sensitivity and specifity of an antibody scre...

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  • Drug-induced delirium and elderly
    Enrique Antón

    Dear Editor

    We read with great interest the excellent review about delirium by Burns et al.[1]

    We have noticed the absence of eyedrops containing anticholinergic drugs such as atropine and cyclopentolate in the list of drugs that may cause delirium, showed in Table 5. These drugs are frequently prescribed for the elderl...

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  • Stereotactic modulation of intracerbral energetics
    Richard G Fiddian-Green

    Dear Editor

    The sterotactic neurosurgical techniques being used to treat pain, movement disorders, and [according to The Sunday Times profile on Professor Aziz this week] potentially depression include radiosurgical ablation, deep brain stimulation and microinjections of pharmacological substances.[1-3]

    Might these and other neurocognitive and neuropsychiatric disorders be more sucessfully treated by u...

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  • Authors' reply to Hirata et al.
    Roderick A Mackenzie

    Dear Editor

    We thank Hirata et al. for their thoughtful letter in response to our recent Case of the Month.[1] Their case is another example of covert benzodiazepine administration , perhaps even Munchausen syndrome by proxy, a condition that we suspect is much under-recognised in an adult setting.

    Elsewhere, we have reviewed the concept of endozepine stupor [2] and agreed with the Bologna group's vi...

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  • Reply to Ludger Tebartz van Elst, Dieter Ebert
    Markus Reuber

    Dear Editor

    We thank Ludger Tebartz van Elst and Dieter Ebert for the close reading [1] of our manuscript.[2]

    We concede that it may have been more precise to state that, as a group, patients with psychogenic nonepileptic seizures (PNES), patients with epilepsy and non-clinical controls have personality profiles, which can be distinguished from one another. We did not measure the positive or negative predic...

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  • Intracranial metabolic monitoring: why is it not being exploited?
    Richard G Fiddian-Green

    Dear Editor

    This review confirms that ICP monitoring provides no information about intracerebral tissue energetiics except by inference in extremis.[1]

    This informtion is vital if the management of the disorders listed in this review and many others is to be significantly improved beyond optimal care today. There is an opportunity to obtain this information in conjunction with the ICP with the same ease and...

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  • Post-dural puncture headache: pathophysiological mechanisms
    Vinod K Gupta

    Dear Editor

    Reina and co-workers found no difference in morphological features of mounted cadaveric dura mater and arachnoid membranes punctured by disposable 22 gauge Quincke needle with the bevel either in the parallel or in the transverse position.[1]

    None of the factors linked to post-dural puncture headache (PDPH) including young age, female sex with lower body mass index, pregnancy or previous PDPH hi...

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