Practical Neurology Podcast

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 diagnostic insight into their own condition.

Archive papers discussed in this episode:

Case Report 1: Complicated epilepsy surgery: importance of balancing benefit and deficit.

https://pn.bmj.com/content/24/5/393

Case Report 2: Me and my neurological illness. Autoimmune limbic encephalitis due to VGKC-Ab. Thanks for the memory. Leo Robin (Title of song, 1937). 

https://pn.bmj.com/content/16/2/162

 

Read the full papers on Practical Neurology.

 

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) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.

Production and editing by Brian O'Toole, Letícia Amorim and Pritesh Kapadia. Thank you for listening.

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) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.

This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.

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 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 Brian O'Toole. Thank you for listening.

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.

https://pn.bmj.com/content/26/2/157 

 

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 the April 2026 issue of the journal.

(1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital.
(2) Clinical Lecturer in Neurology at the Institute of Cognitive Neuroscience, University College London, and an Honorary Neurology SpR at the National Hospital for Neurology and Neurosurgery.
(3) Clinical Research Fellow, Oxford Laboratory for Neuroimmunology and Immunopsychiatry, Nuffield Department of Medicine, University of Oxford

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://bit.ly/4aXF46i). We'd love to hear your feedback on social media - @PracticalNeurol.

Production and editing by Brian O'Toole. Thank you for listening.

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 practical guide.

(1) St Vincent’s University Hospital, Dublin; University College Dublin, Ireland

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) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol.

This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Amy Ross Russell and  Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.