eLetters

616 e-Letters

  • 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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  • Thecoperitoneal shunts for the treatment of  syringomyelia associated with adhesive arachnoiditis.
    Milind S Deogaonkar

    Dear Editor

    Chang et al.[1] give an excellent analysis of pathophysiology of syringomyelia associated with adhesive arachnoiditis (SAA). This is a complex problem with a very few effective treatment options. In countries like India where tuberculous arachnoiditis is an often seen entity, SAA can frustrate the treating neurosurgeon. As suggested in article subarachnoid bypass is a feasible alternative. We...

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  • Placing nasogastric tubes in stroke patients with dysphagia
    Shinji Teramoto

    Dear Editor

    Because patients who have had an acute stroke often have dysphagia and tube feeding becomes necessary, the simple and comfort method for placing nasogastric tubes by inducing the swallowing reflex is identical.[1,2]

    The "reflex placement" method is originally based on our study. Our reflex method, i.e. simple swallowing provocation test (SPT) is easy, safe, and is independent of the patient's a...

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  • Authors' reply
    Tetsuro Ago

    Dear Editor

    We thank Dr Derakhshan for his comments [1] regarding our report.[2]

    Dr Derakhshan discusses the hypothesis that all movements are initiated from the major hemisphere,[3] which may be closely related to handedness. In neural right handers, the command of movement may originate in the left hemisphere. In cases of left hand movement, the command originated from the dominant hemisphere is once tran...

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  • Personality does not reliably distinguish epileptic from non-epileptic seizures
    Ludger Tebartz van Elst

    Dear Editor

    In their very interesting paper on the assessment of personality in patients with epileptic (ES) and psychogenic non-epileptic seizures (PNES) Reuber and colleagues conclude that maladaptive personality in patients with PNES is common, reminiscent of Borderline Personality Disorder (BPD) in a large subgroup and can be distinguished from non-clinical controls and patients with epilepsy alone.[1]

    H...

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