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Neurology

In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Glos CCG) and Dr Rob Hampton (Portfolio GP, Leicestershire) discuss the prescribing of medicines associated with dependence and approaches to their withdrawal. Is there a link between deprivation and long-term use of pain medications? What is the role of "sensitisation" in primary pain conditions? What are the particular challenges associated with benzodiazepine withdrawal? What alternatives should we be considering?
In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Sarah Davies (GPwSI in Diabetes, Cardiff) and Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) discuss the interplay between mental health and conditions such as diabetes, dementia and heart disease. What role do lifestyle factors such as diet and physical activity have in modulating such relationships? Most importantly, what can we do to help patients who may be stuck in a vicious cycle whereby physical ailments adversely impact mental health, which can, in turn, make positive lifestyle changes more difficult to achieve.
In this episode, Kevin discusses the case of Lyndsey: a 44-year-old lady who presents to us in primary care with recurrent dizzy episodes over the last month. Lyndsey feels like her head is spinning. She feels nauseated with these episodes, but there is no history of vomiting. Lyndsey can walk unaided but feels very unsteady on her feet during these episodes. The dizziness can last for hours before resolving. There is no clear precipitant to these episodes, and there is no history of headache. Lyndsey denies any hearing loss or tinnitus. What should we do next?
In this episode, Kevin examines some common questions regarding vitamin B12 deficiency. In whom should we suspect it? What investigations should be carried out in primary care? How is it associated with folate deficiency? Once a deficiency in vitamin B12 is detected, how should it be managed? Finally, what approach should be taken during the current COVID-19 pandemic, when intramuscular administration of hydroxocobalamin may be challenging?

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