In this review of recent advances in the sub-specialty, we briefly discuss the current understanding of causes, presentations and evidence-based treatment of the most common disorders seen in clinical neuropsychiatry. Traumatic and acquired brain injury, epilepsy, multiple sclerosis, Parkinson's and Huntington's disease, sleep disorders and delirium are all considered, focusing on the most contentious issues and practical approaches to management and treatment.
IntroductionThe Neurological Alliance Patient Experience Survey 2019/2020 has highlighted the delay to access of neurological care, infrequent monitoring by specialists and a wide regional variation in referral to support services for chronic disease management in patients with neurological diagnosis.AimTo design a patient-held wellbeing app to support longitudinal symptom monitoring and provide signposting of support services for patients.MethodsThe project is led by the South London Neurosciences network, co-designed with its patient advisory group, King’s Health Partners and a medical technology firm (BMI Inc). Together, we identified key attributes which were beneficial to symptom monitoring. The app went through four cycles of devel- opment, and has been launched for public use.ResultsThe NeuroHealth app consists of 4 key sections: mood, sleep, diet and exercise, identified by the patient group as beneficial for daily symptom monitoring. Each section uses illustrations and can be customised to individual needs. Such longitudinal recordings can be shared with health professionals and may help improve joint decision-making.SummaryNeuroHealth app is a co-designed and freely available digital resource which can benefit chronic condition monitoring and self-management.
Objective/Aims Functional Neurological Disorder (FND) affects 10-30% of neurology outpatients. Symptoms commonly include sensory, motor and cognitive changes without structural nervous system damage. Fixed equinovarus dystonia (FEVD) of the foot and ankle is a common feature of FND characterised by plantar flexion and inversion of the foot which cannot be corrected passively. This prevents weightbearing often causing permanent wheelchair dependence. FEVD correction is necessary for patients to walk again. Consensus opinion is that invasive treatments are ill-advised and potentially detrimental in patients with FND. However, we have developed a novel approach that may challenge this opinion for a specific patient group, combining invasive treatments and neuropsychiatry interventions. Methods A patient-led, goal oriented, multidisciplinary approach guided treatment. Treatments included functional electrical stimulation, botulinum toxin, tibial nerve block, serial casting and surgical intervention as an adjunct to specialist physiotherapy, occupational therapy, psychology. Standardised outcome measures of gait and mobility, balance, anxiety and depression were performed on admission and discharge. Patient consent was obtained for photo and video recording.Abstract 30 Table 1 Functional Electrical Stimulation to common peroneal nerve (FES). Botulinum Toxin to posterior tibial muscles (BoNT). Tibial Nerve Block (TNB)
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