Focus on Neurology and Psychiatry

Latest Episodes:

Occipital Nerve Stimulation for Patients With Intractable Cluster Headache Feb 18, 2009

Show notes

Guest: Peter Goadsby, MD, PhD
Host: Mary Leuchars, MD

Occipital Nerve Stimulation has recently emerged as a novel form of therapy for patients with intractable cluster headaches. Could it be the hallmark of a new era in stimulation therapies for primary headache syndromes? Joining host Dr. Mary Leuchars to share insights on this subject is neurologist Dr. Peter Goadsby, director of UCSF's Headache Center and a world expert on trigeminal autonomic cephalgias, or TACs.

Migraines and Beyond: Narcotic Therapy and Pain Control Feb 16, 2009

Show notes

Guest: Joel Saper, MD
Host: Mark Nolan Hill, MD

Many physicians today feel overburdened by the task of pain management. The current state of pain management stands in sharp contrast to years past, when our options were once relatively limited in the treatment of pain associated with headaches and other ailments. When is it appropriate to prescribe narcotics, if at all, for these conditions? Dr. Joel Saper, director of the Michigan Head Pain and Neurological Institute in Ann Arbor, Michigan, recounts how physicians' sensitivities have changed over the years. Are we now too sensitive to pain control? Dr. Mark Nolan Hill hosts.

When to Prescribe Opioid Therapy for Headaches Feb 16, 2009

Show notes

Guest: Joel Saper, MD
Host: Mark Nolan Hill, MD

Though many therapies exist for the treatment of headaches, some chronic headache cases do not respond to prescribed therapies. In a portion of these cases, opioid medications are offered to help patients find relief. But prescription of opioids can present additional problems, including increasingly recurrent headaches. This leads us to the question: which of our patients should receive opioid therapy for their headaches?Dr. Joel Saper, director of the Michigan Head Pain and Neurological Institute in Ann Arbor, Michigan, examines this critical question and much more with host Dr. Mark Nolan Hill. Which patient populations are most vulnerable to the potential problems associated with narcotic therapy? Are we properly advising our patients on the risks of narcotic misuse and overuse, as well as the importance of dose limitations--and if not, how can we improve …

Managing Trigeminal Autonomic Cephalgias Feb 16, 2009

Show notes

Guest: Peter Goadsby, MD, PhD
Host: Mary Leuchars, MD

Trigeminal autonomic cephalgias, or TACs, and their classifications are enough to give any clinician a headache. How can physicians better appreciate this condition to enhance clinical practice? Dr. Peter Goadsby, director of the Headache Center at the University of California, San Francisco, Medical Center and a world expert on TAC, joins host Dr. Mary Leuchars to update listeners on this unique group of headache conditions.

Benefits of Prazosin Use for PTSD Patients Feb 16, 2009

Show notes

Guest: Murray Raskind, MD
Host: Lee Freedman, MD

The sleep disruptions and irritability that often affect patients with post-traumatic stress disorder (PTSD) can be challenging to treat with traditional psychotherapy or pharmacologic treatments. Host Dr. Lee Freedman welcomes Dr. Murray Raskind, professor and vice-chairman in the department of psychiatry and behavioral sciences at the University of Washington School of Medicine, to discuss the benefits of using prazosin to treat PTSD symptoms.

Considering Cognitive-Enhancing Drugs for the Healthy Feb 12, 2009

Show notes

Guest: Henry T. Greely, JD
Host: Cathleen Margolin, PhD

How might society best respond to the growing demand for cognitive-enhancing drugs by healthy individuals? That's the overriding question posed in a recent article published in Nature, written by a team of authors led by Henry Greely, professor of law and director of the Center for Law and the Biosciences at Stanford University. Mr. Greely joins host Dr. Cathleen Margolin to evaluate the appeal and the risks of drug-propelled cognitive enhancement, from safety considerations for healthy individuals using such medications, to the fairness of comparing the achievements of those who use versus those who do not, and the potential for coercion by superiors aiming, in theory, for enhanced performance from subordinates. One other question they will consider: is there a moral difference between cognitive enhancement through pharmaceuticals versus enhancement through sleep or nutritionally beneficial food products?

Complex Regional Pain Syndrome Feb 11, 2009

Show notes

Host: Michael Greenberg, MD
Guest: Anne Louise Oaklander, MD, PhD

How is complex regional pain syndrome (CRPS) distinguished from chronic or phantom limb pain? Can something as simple as a fracture or blood drawing trigger this condition? Dr. Anne-Louise Oaklander, associate professor of neurology at Harvard Medical School, joins host Dr. Michael Greenberg to discuss the intricacies of neuropathic pain. Since CRPS is rare, at what point should a physician suspect CRPS, and can this condition be treated?

Sensation and the Brain: Case Study of an Itch Feb 11, 2009

Show notes

Host: Michael Greenberg, MD
Guest: Anne Louise Oaklander, MD, PhD

An HIV-positive patient developed shingles. After the shingles healed, this patient began experiencing a very severe unremitting itch, which caused her to scratch through her own skull while sleeping one night. How is this possible, and what are the mechanics of itch that would allow a patient to feel no pain from scratching? Dr. Anne Louise Oaklander, associate professor of neurology at Harvard Medical School, reveals the pathophysiology of neurological itch. Is itch really just low-level firing of pain neurons, or is itch entirely distinct? Dr. Michael Greenberg hosts.

The Role of Neurosurgery for Patients With Refractory Depression Feb 10, 2009

Show notes

Guest: Aviva Abosch, MD, PhD
Host: Leslie P. Lundt, MD

Increasingly, depression is viewed a systems-level disorder. For patients who are refractory to the all traditional therapies, surgery on the brain may be answer. What are the benefits, and how is psychosurgery different than it was 50 years ago? Dr. Leslie Lundt is joined by Dr. Aviva Abosch, director of the Epilepsy and Functional Neurosurgery Program, and assistant professor in the department of neurosurgery, at the University of Minnesota Medical School in Minneapolis.

Psychoanalysis, Dynamic Psychotherapy Make a Comeback Feb 09, 2009

Show notes

Guest: Raymond Levy, PsyD
Host: Lee Freedman, MD
Guest: John Stuart Ablon, PhD

Psychoanalysis and dynamic psychotherapy have been criticized as too time-consuming, costly and even ineffective. Dr. Raymond Levy and Dr. Stewart Ablon, of the Psychotherapy Research Program at Massachusetts General Hospital, discuss their recent evidence-based research into these long-term therapies. What differentiates psychoanalysis and dynamic psychotherapy from other types of therapy, and are these therapies more effective for specific disorders? Dr. Lee Freedman hosts.