Pn Podcast

Space, the final frontier. A new domain for the podcast opens, as we learn how astronauts are preparing for Mars transit by lying in bed. But first - the ophthalmology department refers a patient with a swollen optic disc. When is it papilloedema, and when is it not? And what does that have to do with Martian vistas? In this editors' choice podcast, PN podcast editor Dr. Amy Ross Russell interviews Prof. Susan Mollan¹ ², last author of the paper, "How to diagnose papilloedema", published in the August 2026 edition of the journal. From crashing visual loss to pulsatile tinnitus, they discuss the signs in a patient history which can build a picture of their condition. There's a practical walkthrough of the key elements of the eye exam, as well as discussion of the modern tools that are available to assist. Sometimes backup is needed, and Prof. Mollan explains when it's the right time to call the ophthalmologists back, and how to buy yourself extra time on a late Friday shift. Links: Fundoscopy: to dilate or no

The latest highlights from the journal will deliver confidence when managing complex everyday presentations. In this podcast for the August 2026 issue of Practical Neurology, co-editors Phil Smith and Geraint Fuller present the key highlights from a cracking 100-page edition spanning the full spectrum of neurological care. They examine how to accurately diagnose papilloedema and distinguish swollen optic discs from pseudo-swelling or other mimics. Next, they discuss a comprehensive guide to the Parkinson's disease follow-up consultation, focusing on non-motor symptoms, lifestyle advice, and long-term management. The editors also explore a structured approach to assessing neurogenic bladder, bowel, and sexual dysfunction, before covering the key clinical clues and investigations for evaluating pulsatile tinnitus. They also review the intricate link between chronic kidney disease and cognitive impairment, and finish with a critical look at the practical uses and limitations of subhairline EEG monitoring in neur

In this special episode coming live from the Association of British Neurologists (ABN) annual meeting in Birmingham, Practical Neurology co-editors Phil Smith and Geraint Fuller join hosts Ruth Wood and Babak Soleimani to discuss the perennial clinical and educational value of case reports in which, in a rare event, the patients are actually referred to directly by their first names. The team discusses two compelling, patient-centered narratives. They look at a complex case of refractory focal epilepsy from 2024 where the patient actively partnered in the high-stakes decision to balance seizure freedom against a predicted post-surgical motor deficit.  A review of a poignant "Me and My Neurological Illness" piece written in 2016 by a prominent epileptologist is a reflection on his subtle subacute presentation of autoimmune encephalitis,  how a doctor's baseline cognitive reserve can mask complex focal seizures, and the unique clinical and personal challenges faced when dealing with medical colleagues who lack

What's the real difference between a night owl and a morning lark? The Editors' Choice paper for the June 2026 issue of Practical Neurology is a review of all the ways sleep intersects with neurological practice. Last author Prof. Guy Leschziner¹ joins PN podcast editor Dr. Amy Ross Russell to the wide variety of sleep-related disorders: insomnia, hypersomnolence, and sleep-related movement disorders. Each category contains pitfalls to be avoided when treating, like overlooking critical signs or reaching for drugs too eagerly. You'll also learn about "sleep reactivity", teenage sleep patterns in the animal kingdom, and diagnostic insight that can be gained from partners. Sleep neurology: pearls and pitfalls 1. Sleep Disorders Centre, Guy's and St Thomas’ Hospitals NHS Trust, London, England, UK Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest episodes. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) o

The latest highlights from the journal are set to give confidence when trying something new. In this podcast for the June 2026 issue of Practical Neurology, co-editors Phil Smith and Geraint Fuller bring a distillation of the wisdom found in the journal's pages. They explain the crucial role of a Zeitgeber for healthy sleep cycles, question the involvement of drugs like SSRIs in seizures, and share a transatlantic follow-up to the ABN myasthenia gravis guidelines which provides an approach to optimising over all patient well-being.  There's also a guide to recent treatment of Parkinson's using foslevodopa-foscarbidopa infusion, also known as Produodopa. Then the editors explore the structure of the retina while touching on optic neuritis, and finish with limb-shaking transient ischaemic attacks, an early warning signal for stroke. Listen to the very end for some editorial insight into practical uses for the podcast itself! Read the issue: https://pn.bmj.com/content/26/3/205 Please subscribe to the Practical

It's the return of Merlin. Not the birdsong identification app this time, but the Rolls-Royce Merlin - engine of the historic Supermarine Spitfire warplane. The Case Reports trio are faced with another set of patient puzzles to work through in this latest episode. In the first case (1:25), a 68-yo man, retired from farming, presents with a 6-year history of behavioural changes. Most notably, he had developed a sense of great pleasure in listening to engine sounds, like those of the historic aircraft flying over his house. He had become increasingly emotionally detached and ritualistic, and gained a sweet tooth. MR scans of the brain revealed an uncommon syndrome. https://pn.bmj.com/content/26/2/169 The second case (21:15) relates to a 47-yo woman who developed abnormal movements in all of her limbs. She had undergone a complex cardiac surgery 12 years before, and another prolonged cardiac surgery within recent weeks. The case discusses the longterm follow-up of her treatment for these involuntary movements. h

What should a neurologist do when a routine MRI for migraine reveals incidental white matter lesions that look remarkably like Multiple Sclerosis (MS), despite the patient having no neurological symptoms? The Editors' Choice paper for the April 2026 issue of Practical Neurology is a practical guide to the clinical diagnosis and management of radiologically isolated syndrome (RIS). Author Dr. Audrey Reynolds¹ joins PN podcast editor Dr. Amy Ross Russell to discuss her work on how updated diagnostic criteria and advanced imaging markers now enable a more proactive, biological approach to the disease. Their discussion highlights the importance of risk stratification - using tools like CSF analysis and spinal imaging - to identify those most likely to benefit from early intervention with disease-modifying therapies. They also examine the delicate balance between preventing future disability and avoiding misdiagnosis in this rapidly evolving area of neurology. Read the paper: Radiologically isolated syndrome: a p

In this Practical Neurology bonus international podcast linked to the February issue, host Alasdair Coles (Cambridge, UK) is joined by movement disorder specialist Dr. Ashley Paul (Johns Hopkins, US) and epilepsy expert Dr. Lata Vadlamudi (Brisbane, Australia) to discuss the integration of bone health into neurology clinics. They discuss the identification of osteoporosis in patients on steroids or anti-seizure medications and evaluate the use of FRAX assessment tools for neurological populations. They also address the implementation of screening protocols and checklists to prevent fragility fractures. Read the related paper: Osteoporosis and fracture risk: a practical guide for neurologists Participants: Professor Alasdair Coles is Head of Department for Clinical Neuroscience and also Co-Director of the Cambridge Centre for Myelin Repair, UK. Associate Professor Lata Vadlamudi, Senior Staff Specialist in Neurology at the Royal Brisbane and Women's Hospital, Australia. Dr. Ashley Paul, Assistant Professor

As with any Darwinian subject, neurology is under constant evolution. This podcast for the April 2026 issue of Practical Neurology has co-editors Phil Smith and Geraint Fuller taking a look at some intriguing specimens from the neurological field. Populating the menagerie for this episode are the "reversed clock phenomenon", a new study on brain problems in retired sportspersons, a practice guide for biosimilar drugs, and a look at GLP-1 drugs. Also found inside are the "nocebo effect", radiologically isolated syndrome for multiple sclerosis identification, and a weighing up of stenting vs shunting. Read the issue: https://pn.bmj.com/content/26/2/103   Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by B

What unsuspecting dangers lie within a garden compost bin? The Case Reports team are back to uncover a new pair of neurological mysteries. The first case this episode (1:24) comes from Edinburgh, centred on an 88-yo woman who presents with headache and eye-pain on her right side. She receives an early diagnosis of migraine, but returns a few weeks later with intermittent vomiting and subsequent progressive visual loss. https://pn.bmj.com/content/26/1/83  The second case (19:51) from Wessex features a common presentation of tingling feet, with a 62-yo man who develops gait instability. More curious are a significant drop in his weight, as well as a scaly patch on his chest. https://pn.bmj.com/content/26/1/63   The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Babak Soleimani³ for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in th

Many patients will affirm seeing clouds shaped like animals or other similar phenomena, which is why confirming pareidolia (seeing meaningful images in meaningless visual stimuli) is such a tricky symptom in dementia with Lewy bodies (DLB). While it may not be exclusive to DLB, placing such symptoms in the context of "the company it keeps" is a key method to narrowing down the diagnosis. The Editors' Choice paper for the February 2026 issue of Practical Neurology is a practical guide to the clinical diagnosis and management of DLB. Authors Dr. Sarah Fullam¹ ² and Dr. Seán O'Dowd¹ ³ join PN podcast editor Dr. Amy Ross Russell to discuss their work. They describe the importance of the initial examination, from the patient's gait to difficulties in word retrieval. They also touch on challenges in the use of biomarkers, which drugs may be helpful, and how to advise patients and their carers. Read the paper: Dementia with Lewy bodies: a practical guide to clinical diagnosis and management Special thanks to The Pod

When a patient says, "I biffed the car," how should that be translated? Puzzles like this represent the gap between description and diagnosis, and are a critical part of neurological practice. In this podcast for the February 2026 issue of Practical Neurology, editors Phil Smith and Geraint Fuller take turns decoding some of the mysteries of everyday neurology. They cover dementia with Lewy bodies, osteoporosis and fracture risk, and anxiety and depression in epilepsy patients, as a sample of some of the published work in the latest journal. There's also a guide to the latest stroke rehabilitation guidelines, freezing of gait, and a farewell to a 'nom de plume'. Read the issue: https://pn.bmj.com/content/26/1/1   Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback o

Eye pain can be a source of serious concern for patients, bringing worries about their eyesight. While uveitis is far from the only source of ocular pain, in many presentations of the condition it is a feature. In this Editors' Choice podcast, ophthalmic surgeon Mr. Harry Petrushkin¹ ² and neurologist Dr. Ruth Dubson³ join forces to explain a comprehensive approach to uveitis treatment. Host Dr. Amy Ross Russell leads the way through a refresher on eye anatomy and the spectrum of uveitis patients neurologists are likely to encounter. These are often the more serious of patients, requiring good working relationships across disciplines. They also speak of the overlap with neuroinflammatory presentations, and the eye manifestations seen in conditions like multiple sclerosis and sarcoidosis. Read the paper: Uveitis for Neurologists (1) Uveitis and Scleritis Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK (2) Rheumatology Service, Great Ormond Street Hospital NHS Trust, London, UK (3) Blizard Ins

Another set of intriguing cases from the latest issue of the journal, pored over by the Case Reports team.  In the first case, a 24-yo man presents acutely with reduced consciousness, following 3 days of right-sided headache. His mother reports sudden behavioural changes with jerky movements and enlarged pupils. He is agitated, not obeying commands and not moving his left-side limbs. He had a history of autism and vascular Ehlers-Danlos syndrome and was on medication for stroke prevention. An MRI scan led to a differential diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES), but the final conclusion came post-discharge after a further review of his scans.  https://pn.bmj.com/content/25/6/549 The second report (19:37) describes two curious instances of functional neurological disorder (FND), both of which improved after the patients were in comatose states. The first patient is a 59-yo man who had developed muscle weakness shortly after at car crash at age 49, and had subsequently been reliant on

Neurology requires some detective work at times, and identifying the patterns of symptoms associated with drug misuse can be a tricky mystery indeed. For this episode, we're receiving a masterclass from Dr. Robin Howard¹ on the wide variety of drugs that bring patients into hospital, as well as the mechanisms they act on. His paper "Neurological aspects of drug misuse" is the Editors' Choice for the October 2025 issue, and he joins PN podcast editor Dr. Amy Ross Russell in the studio. From the new dangers of synthetic psychoactives to the profound consequences of chronic use, the discussion unveils critical clinical presentations every neurologist should recognize. We delve into fascinating phenomena including "punding," compulsive repetitive behaviors seen with stimulant abuse, and the rare but striking CHANTER syndrome, with its signs of disturbed consciousness and extensive cerebellar involvement. Hear too about the distinctive spongiform leukoencephalopathy associated with "chasing the dragon," a dangerou

Who do we need to scan? Behind the constant considerations of irradiation risk and resource usage, there is nuance to be found. Parkinson's disease - being a clinical diagnosis - doesn't suggest a need for imaging, yet one case in this issue argues that should not be an absolute rule. Another paper brings in the context of a specific patient: does one man really need 50 CT scans in his life? There's also an unboxing of uveitis, diagnosis of Alexander disease in adults, and an exploration of connections between the microbiome and neurology. This being the fifth(!) Christmas podcast for editors Phil Smith and Geraint Fuller, they finish with the annual crossword and book club update, featuring hot cross buns and hummingbirds. Read the issue: https://pn.bmj.com/content/25/6/501   Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spot

Two new cases from the latest issue of the journal present the podcast team with some rare explanations, and a chance to test yourself on food trivia.   In the first case (1:18), from Malaysia, a 49-yo left-handed woman develops 10 days of recurrent left-sided focal facial seizures. These seizures progressed to epilepsia partialis continua, which is controlled with some difficulty by employing a broad range of six different anti-seizure medications. Further symptoms arose during monitoring, including emotional lability as well as dystonia, left arm dysfunction, dysphasia and dysarthria. EEG imaging showed focal slowing in the right hemisphere. https://pn.bmj.com/content/25/5/475 The second case (22:20) features a Northamptonshire chef in her 60s, who presents to the emergency department with a week-long history of nausea, vomiting, and abdominal pain. This progressed to dysphagia and dypsnoea, as well as a downshift in the pitch of her voice. Her conditioned worsened, with respiratory arrest requiring CPR to

In this special international episode, we explore the 2025 update of the Association of British Neurologists’ guidelines on managing autoimmune myasthenia gravis. Ten years after the previous recommendations, significant changes have been introduced. We emphasise the importance of daily steroids, early thymectomy, rituximab, and emerging targeted therapies transforming patient care. We also examine how these updates influence frontline care in the UK, Australia, and the USA, and why a multidisciplinary approach remains vital in the management of MG.   Participants: Professor Alasdair Coles is Head of Department for Clinical Neuroscience and also Co-Director of the Cambridge Centre for Myelin Repair, UK. Associate Professor Katherine Buzzard, Clinical Lead, Eastern Health Multiple Sclerosis and Neuroimmunology Service, Melbourne, Australia. Dr. Christopher Doughty, MD is a board-certified neurologist, and affiliated with Brigham and Women's Hospital, in Boston, Massachusetts, USA. Read the paper (https://p

Another packed episode for this month's issue of the journal. There's a special emphasis on case reports this time, showing their value as a way to understand the rarely encountered. For the more common conditions there are guidelines, and the editors give you an introduction to the new ABN guidelines on myasthenia gravis, as a preview to an upcoming full episode on the topic. There's a birder's take on the use of EEG for status epilepticus, a review of the benefits and challenges for digital health records, and some deliberation on ophthalmological pronunciation. Plus, an opportunity to test your knowledge on illicit drug slang: do you know your "jeff" from your "khat"? Read the highlights: https://pn.bmj.com/content/25/5/391   Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear

The wonders of the animal kingdom make an absorbing reappearance this episode, so grab your scuba mask before listening - or your chef’s hat. The first case this month is the kind that even an experienced neurologist would be nervous to encounter (1:35). A holidaymaker in his sixties presents to the emergency department with vomiting, dizziness, and an inability to walk, amongst several other symptoms. A suspicion of stroke was quickly replaced by a different hypothesis following discussions with the patient’s family members. https://pn.bmj.com/content/25/4/377   The second case follows a presentation over the span of multiple decades (18:44). A woman first presents in her thirties with extreme lethargy and occasional migraines. She was diagnosed with panhypopituitarism and treated with steroid replacement. Following breast cancer in her late forties, treated by surgery and radiotherapy, the migraines worsened, prompting further investigation. https://pn.bmj.com/content/25/4/359   The case reports discussion