Shashwat Pokharel

Neurology Resident WSU-DMC. Freethinker. Opinions are not my own, were conditioned by nature AND nurture. #Epilepsy

[Shashwat Pokharel @neurobeing]

Wow Japan! Surprise us all. Hard match don’t know whom to support 🇧🇷🇯🇵 #BrazilJapan

[Wayne State University DMC Epilepsy CNP Fellowship @EpilepsyCNP_WSU]

Congratulations to @MaryamSyedNeuro and Jeongyeon Hwang for presenting on anxiety and depression screening in older adults with epilepsy, an under diagnosed and under treated issue.

#AAN2024 #AANAM

[Wayne State University DMC Epilepsy CNP Fellowship @EpilepsyCNP_WSU]

Wayne State University at #AAN2024 @AANmember

Who says work can’t be fun?

@rohitmarawar @MaryamSyedNeuro @DeeptiZutshiMD @maysaa_basha

[Wayne State University DMC Epilepsy CNP Fellowship @EpilepsyCNP_WSU]

Guess what #EEG finding?
#EEGTweetorial

PDR seen in the occipital leads ✅
Background rhythm is approx between 9-13 Hz ✅
Eye blink artifact seen ✅
No slow waves (Delta/Theta range) ✅
No asymmetry in background amplitude/frequency in contiguous leads ✅

Ans: Normal EEG

[Wayne State University DMC Epilepsy CNP Fellowship @EpilepsyCNP_WSU]

Guess what is shown below?
#EEG #EEGtutorial

Seen during wakefulness
Symmetrical, and reactive alpha rhythm
More prominent in amplitude during relaxed, eyes-closed wakefulness
Decreases in amplitude during eye opening and mental alertness

Ans: Posterior Dominant Rhythm (PDR)

[Wayne State University DMC Epilepsy CNP Fellowship @EpilepsyCNP_WSU]

Week 5 #ASMtweetorial 1/4 #Oxcarbazepine

🛠️ Block voltage-sensitive Na channel

℞ Mono/Adj for focal onset Sz in 4-16yo, and adults. Trigeminal neuralgia.

📈T1/2 9hrs, Rapidly metabolized to a mohohydroxy form. Dose-dependent induction of CYP3 enzyme

#NeuroTwitter #Epilepsy

[Shashwat Pokharel @neurobeing]

This week: Carbamazepine #Tweetorial #Refresher

[Wayne State University DMC Epilepsy CNP Fellowship @EpilepsyCNP_WSU]

Week 4 #ASMtweet 1/4 #Carbamazepine

🛠️ Use-dependent block of voltage-gated Na channels. Also blocks adenosine receptors.

℞ Mono/Adj for focal sz and GTCS. Trigeminal neuralgia.

📈Hepatic. T1/2 18-65hrs. But auto-induces oxidative metabolism with more dose.

#NeuroTwitter

[Shashwat Pokharel @neurobeing]

@ShahBalen Nationalist narcissism. I don’t blame you, since our culture romanticizes borderline narcissistic personality traits. Probably good for votes. One would expect people in power to be at least emotionally stable and wise. This is sheer pettiness. I’m losing respect. Sorry.

[Shashwat Pokharel @neurobeing]

@yashbhattarai_ “Send me on my way” as well

[Ishan Adhikari, MD, FAAN, MS-HCM @IshanAdhikarii]

It's mind boggling to see why NMC examination pass rate has always been less than 50% ? Why do they need to wait 3 months to retake exam if it is already computer based?
Why NMC has not taken any corrective measures to prevent such lost productivity of young medical professionals?

[Daily Stoic @dailystoic]

If you start your day with social media, the news, or email, realize: you're starting your day at the mercy of others.

Social media is others telling you what to think.

The news is others telling you what to read/watch.

Your inbox is others telling you what to do.

[Daily Stoic @dailystoic]

Courage: Face your fears. Do hard things.

Temperance: Do the right amount of things. Resist temptation.

Justice: Do the right thing. Take action for the common good.

Wisdom: The pursuit of truth. The pursuit of learning.

[Daily Stoic @dailystoic]

Don’t think. Don’t overanalyze. Do the work.

[Shashwat Pokharel @neurobeing]

@pippitalks Thank you!

[Shashwat Pokharel @neurobeing]

So excited to be joining the Johns Hopkins Epilepsy department from 2024! Looking forward to exploring Baltimore and the east coast.

Deeply grateful towards everyone who supported me in this journey 🙏🏼 #epilepsy

[Shashwat Pokharel @neurobeing]

@AnilRegmi2020 Thanks bhai

[Shashwat Pokharel @neurobeing]

@drsdahal Thank you!

[Shashwat Pokharel @neurobeing]

@alsherbini_md @drramit29 Will come visit you guys!!!

[Shashwat Pokharel @neurobeing]

@KoiralaSatish Thanks dai!

[Oren Gottfried, MD @OGdukeneurosurg]

Neuroplasticity: This kid had half of her brain removed for refractory seizures from rasmussens at age 3 and now at age 7 she is completely functional and is even bilingual. #seizures #epilepsy #neurology #neurotwitter #neurosurgery #medtwitter