PGY-2 @UofUNeuroRes | Husband, father | @TheLongSOM ‘24, @BYU ‘19 | Passion for #MedEd, autoimmune and autonomic neurology | Views are my own/not medical advice
There was a recent suicide of a US medical student after a professionalism violation. Many students feel they have to be perfect, that one blemish on their record will ruin their career. But if you could know the truth about your attendings, you’d know they’ve all made enormous mistakes. I’ve made hundreds over the years. Talk to someone if you’re in despair. And allow yourself to be flawed. Don’t try to be perfect. No one is.
#NeuroPearl: Moyamoya syndrome can be causes by a variety of secondary causes, including prior radiation, genetic conditions (such as Down syndrome), and sickle cell disease.
#MedTwitter#MedX#MedEd#NeuroTwitter#NeuroX
#NeuroPearl: For MS patients on anti-CD20 medications, in addition to giving hepatitis B vaccines, it’s also important to ensure updated tetanus vaccines, as well as Shingles and pneumococcal vaccines.
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#NeuroPearl: Amygdala enlargement on MRIis associated with medically, refractory epilepsy, can be associated with more frequent psychiatric comorbidities, and can often resolve with control of seizures.
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#NeuroPearl: MRI features of leukodystrophies that are atypical in MS include: symmetric, bilateral, confluent WM lesions; progressive lesions. MS typical lesions will usually include: central vein sign, paramagnetic rim lesions; T1 “black holes”; gadolinium enhancement 1/2
It was a short trip, but I loved attending #AANAM this year! Had the opportunity to present our work on #POTS and #Orthostaticintolerance. Grateful to all who provided amazing insights into our work and autonomic conditions. @AANmember@UofUNeurology
#NeuroPearl: If someone has an MRI that appears consistent with MS, but also has positive family history, progressive symptoms, prominent neuropsychiatric symptoms, ANS/PNS involvement, complicated migraine with aura, seizures, myopathy, and/or gonadal dysfunction… 1/3
ONLY paroxysmal hemicrania and hemicrania continua respond absolutely to indomethacin. All of these differ from trigeminal neuralgia by the presence of autonomic symptoms. #MedTwitter#MedX#MedEd#NeuroTwitter#NeuroX 3/3
#NeuroPearl: Trigeminal autonomic cephalgias (TACs) differ from one another based on frequency, duration and indomethacin response. Hemicrania continua is constant and has fluctuations. Paroxysmal hemocrania can occur up to 50 times per day and lasts up to 30 minutes each. 1/3
SUNCT/SUNA can occur hundreds of times per day and last up to 10 minutes each. Cluster headaches can occur up to 8 times per day and last 15-180 minutes each. 2/3
#NeuroPearl: Cluster headache treatments act through various mechanisms: Verapamil and melatonin through the hypothalamus, oxygen and sphenopalatine blocks on autonomic pathways, and CGRPs and triptans on trigeminal pain pathways #MedTwitter#MedX#MedEd#NeuroTwitter#NeuroX
Dear neurology trainees, throughout your career, you will encounter hundreds of patients with presentations you've never seen before. That is when applying the basics becomes most crucial. Define the tempo, localization, and syndrome, then proceed to differential and work up.
#NeuroPearl: suspected tumefactive demyelinating lesions should be evaluated for AQP-4 and MOG antibodies, as these can also present with tumefactive lesions #MedEd#NeuroTwitter