541 e-Letters

published between 2014 and 2017

  • Interferon-beta and the risk of cancer in MS
    Joep Killestein

    With great interest we have read the research paper by Kingwell et al. on cancer risk with interferon-beta (IFNb) treatment in MS. The authors cautiously conclude that a possible association between IFNb usage and the occurrence of breast cancer should be investigated further. Although the authors interpret their overall finding as reassuring that overall cancer risk does not seem to be increased in IFNb users, they disc...

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  • Long term monitoring in epilepsy: cutting costs yet reaping the benefits
    Nitin K Sethi

    Dear Editor,

    I read with interest the article by Yogarajah et al 1. Working in a comprehensive epilepsy center of a tertiary referral hospital in the United States, I found the cost benefit analysis of long term monitoring (LTM) either by video telemetry (VT) or inpatient ambulatory electroencephalography (aEEG) useful information indeed. I agree with the authors that one of the greatest utility of LTM lies in...

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  • Physiology of the central retinal venous pulsation
    Rolf Meyer-Schwickerath

    Dear Editor

    Baurmann was the first to explain the physilogical conditions of the central retinal venous pulse (collapse). We reassessed the experimental setting by a new technical model. We could confirm the results of Baurmann. The experiment as well as clinical investigations show that venous collapse can be used to exactly measure the intravasal pressure in the outflow vein (therefore we created the term - venou...

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  • Anatomical stenosis of the internal jugular veins : supportive evidence of chronic cerebrospinal venous insufficiency ?
    Andrea Baiocchini

    We write in relation to the editorial commentary from Khan et Tselis (1) who rightly suggest caution to consider chronic cerebrospinal venous insufficiency (CCSVI) as a pathological entity and cast serious doubt on its relevance to multiple sclerosis (MS); they forecast properly designed studies to investigate the relevance of CCSVI to MS, in order to carry out interventional procedures. The absence of extracranial venous...

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  • Dopamine transporter SPECT imaging is not a useful Biomarker in the Diagnostic Workup of Corticobasal Syndrome.
    Roberto Cilia

    An increasing number of clinicopathological studies provides evidence against the accuracy of clinical criteria in the ante mortem diagnosis of corticobasal degeneration (CBD). Recently, Alexander and colleagues applied the new consensus criteria for the clinical diagnosis of CBD in patients with and without CBD pathology at post mortem examination and showed that the rate of misdiagnosis remains high, including false ne...

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  • A case of transient global amnesia after upper gastrointestinal endoscopy
    Yuko Wada

    Dear Editor,

    Transient global amnesia (TGA) is a clinical syndrome characterized by a sudden onset of anterograde and retrograde amnesia in the absence of other neurological signs and symptoms, which is resolved within 24 hours. Although the etiology of TGA remains unknown, recently Lewis 1) suggested that a Valsalva-like action appears to be a common triggering event among patients with TGA. Although TGA follow...

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  • Delirium symptoms: visual spatial or attention?
    Jos F de Jonghe

    Dear Editor,

    Brown et al. (2009) examined visual perceptual deficits in delirium. Neuropsychology of Delirium has not been studied extensively. Though the concept of delirium goes back a very long time, it is not referred to in the authorative handbook Fundamentals of Human Neuropsychology (Kolb & Whishaw, 2003). Why this apparent lack of neuropsychological interest in delirium? Perhaps because delirium is o...

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  • Cancer Risk in Multiple Sclerosis
    Edward J. Needham

    We were interested to read the meta-analysis by Handel and Ramagopalan,1 summarising the body of evidence which points towards a reduction of cancer risk in patients with multiple sclerosis.

    We performed a study investigating the same question, using our hospital's clinical coding database to compare the frequency of cancer in all multiple sclerosis patients admitted over a 10 year period (1090 patients), with...

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  • Reply to “Which EEG for Epilepsy” by Leach et al.
    Donald L. Gilbert

    Dear Editor,

    Leach et al (“Which electroencephalography (EEG) for epilepsy? The relative usefulness of different EEG protocols in patients with possible epilepsy.” Journal of Neurology, Neurosurgery & Psychiatry. 2006;77:1040-2) compared the yield of 3 types of EEGs in 85 patients with epilepsy, diagnosed after two or more generalized tonic clonic seizures (GTCs). The median age of the patients was 17.9 years...

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  • Re:How useful and how safe is a Datscan?
    Nin Bajaj

    We thank Dr Morrish for his letter and comments. We agree that in most cases of possible Parkinsonism, history and examination are sufficient to come to an accurate diagnosis, especially in expert hands. However, not all individuals have access to a Movement Disorders expert, and it is clear that there are more diagnostic errors early on or when signs and symptoms are unusual. The diagnosis does indeed typically become c...

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