Released 25 Sep 2025

History taking in neurology

This video begins by reviewing the importance of optimal history taking in clinical neurology, along with associated history-taking pearls and pitfalls, before exploring the ordering and components of the history. It then progresses to an in-depth discussion of the history of the presenting complaint, systems review, past medical history, family history, medications and allergies, and the psychosocial history, as they pertain to a range of general and subspecialty neurology presentations including epilepsy/seizures, stroke, headache/migraine, movement disorders/Parkinson's disease, neuroimmunology/multiple sclerosis, and neuromuscular conditions such as myopathies.

https://open.spotify.com/episode/7jxQZbdfsS6q8yeCqa72Gj?si=TNzlduwySqaWVJWbADPk_w

Released 25 Sep 2025

Seizure definition & classification

This video explores the ways in which seizures can be pathophysiologically, clinically and electrographically defined, and considers the various possible clinical manifestations of seizures, before scrutinising the current 2025 International League Against Epilepsy (ILAE) classification of seizures, encompassing focal, generalised and unknown-onset seizures, followed by a comparison of this current schema with their previous iterations. The video then takes a deep dive into the distinction between unprovoked seizures vs. provoked/acute symptomatic seizures vs. reflex seizures, and by extension the distinction between precipitating, provoking and triggering factors for a seizure. The video then concludes with a detailed discussion of the clinical definitions of convulsive (generalised and focal) and non-convulsive status epilepticus (NCSE).

https://open.spotify.com/episode/4AiGwpFh3gzvaPUEhEq1hQ?si=3joSrINGSMq73c1JFjih1Q

Released 26 Sep 2025

Epilepsy definition & classification

This video first explores the clinical definition of epilepsy, why diagnosing epilepsy is important, and the fundamental steps required to make an accurate diagnosis. It then discusses the relationship between seizure classifications and epilepsy classifications, and the core clinical and electrographic components that constitute an epilepsy syndrome. It then provides a detailed overview of the specific epilepsy syndromes as defined by the International League Against Epilepsy (ILAE), divided into age of onset (neonates/infants, children, and juveniles/adults/variable age of onset), including a closer look at Lennox-Gastaut Syndrome (LGS) in particular. It then addresses the relationship between the Genetic Generalised Epilepsies (GGEs), Idiopathic Generalised Epilepsies (IGEs) and Developmental and/or Epileptic Encephalopathies (DEEs), before concluding with a discussion regarding how making a specific epilepsy syndromic and/or aetiological diagnosis can positively influence management including treatment choices, along with a cautionary discussion regarding the use of sodium channel blocker antiseizure medications (ASMs) in the context of myoclonic epilepsies.

Corrections (in video): 31:50 Apologies, West syndrome is actually encompassed by EISS, not by EIDEE as was written; 1:04:55 Apologies, West syndrome is actually encompassed by EISS, not by EIDEE as was written.

https://open.spotify.com/episode/580hQq1eJdlZLzz1eC3Dr5?si=RIH1RcSDSoi1TEAes1W0jQ

Released 28 Sep 2025

Is it a seizure? Distinguishing seizures, convulsive syncopes & psychogenic non-epileptiform spells (PNESs)

This episode discusses how to distinguish a bilateral tonic-clonic seizure (of generalised, focal or unknown onset) from a convulsive syncope and from a psychogenic non-epileptiform spell/seizure (PNES, as part of functional neurological disorder, FND). To do so, we focus on key aspects of the semiology of the episode in addition to other relevant historical factors in the systems review, past medical history, epilepsy risk factors, family history and psychosocial history, along with important discriminatory examination and investigation findings. The episode then discusses how to weigh all of this information together in order to formulate a provisional diagnosis, and then concludes by discussing cases of co-diagnosis of epilepsy and syncope, and co-diagnosis of epilepsy and FND.

https://open.spotify.com/episode/78vz39ozLqdK61XSVtGQgd?si=cOmAG_wNSqun5UQz0gYR0Q

Released 30 Sep 2025

Explaining our logo!

This short (and less serious!) episode explains the many hidden details in our intricate logo, with a few perhaps unexpected learning points discussed along the way, including a brief discussion of different ways of acquiring an electroencephalogram (EEG) recording, the four radiological locations for typical multiple sclerosis (MS) lesions, some of the clinical symptoms and signs of idiopathic Parkinson’s disease (iPD), one of the advanced therapy treatment options for migraine, the surface anatomy for performing routine motor nerve conduction studies (NCS) on the median nerve at the wrist in the context of carpal tunnel syndrome (CTS), the most common semicircular canal implicated in benign paroxysmal positional vertigo (BPPV), the anatomical distribution of atrophy in Alzheimer’s disease (AD), and a common vascular site for dominant hemisphere anterior circulation acute ischaemic strokes. The episode also briefly discusses the motor and sensory examination as the groundwork of clinical neurology, the different awareness ribbons and their associated colours for the eight chosen categories of neurological diseases included in our logo, and even two species of flowers associated with two common neurological diseases.

https://open.spotify.com/episode/1zfWRUVpUWVehfubfiC2rl?si=K-r3h2z0TrCefDI2OXM9RA

Released 30 Sep 2025

Nocturnal hypermotor (hyperkinetic) seizures vs. physiological arousals & parasomnias

This episode discusses how to semiologically distinguish nocturnal hypermotor (hyperkinetic) seizures typical of sleep-related hypermotor epilepsy (SHE, formerly nocturnal frontal lobe epilepsy, NFLE) from the two main differential diagnoses for paroxysmal sleep behaviours, namely exaggerated/confusional physiological arousals and various parasomnias (in both NREM and REM sleep, especially night terrors and REM sleep behaviour disorder). The semiological features that we focus on are the frequency, timing and duration of the events, whether the events are triggered and whether they have a discrete offset and result in complete arousal from sleep, whether there is subsequent coherent recall, whether the motor features are stereotyped, and a number of other helpful discriminating phenomenological observable motor characteristics. The episode concludes with a discussion on the benefits and challenges regarding inpatient electroencephalography (EEG) monitoring to further assist in diagnosing difficult cases.

https://open.spotify.com/episode/0r9YM0NoYaxj3kxmugGNJp?si=Zr61silKSLeKoIYFTYsoMw

Released 2 Oct 2025

Cranial nerves examination (theory) with pearls & pitfalls: Part 1

This episode begins with a description of the examinable components of each cranial nerve, and how they are best grouped together for an efficient and logical examination, before taking a deep dive into the specific examination techniques for each cranial nerve, focussing on pearls and pitfalls for optimal testing, along with focussing on linking the examination to relevant neurological pathologies for contextualisation and to aid memorisation. This episode, part 1, focusses on cranial nerves I-IV and VI (the olfactory, optic, oculomotor, trochlear and abducens nerves).

https://open.spotify.com/episode/5J2OSIMiPob2480lH4jvE5?si=MHIRGIRRTZOhewihj8VmIw

Released 4 Oct 2025

Cranial nerves examination (theory) with pearls & pitfalls: Part 2

This episode is part 2 of the session taking a deep dive into the specific examination techniques for each cranial nerve, focussing on pearls and pitfalls for optimal testing, along with focussing on linking the examination to relevant neurological pathologies for contextualisation and to aid memorisation. This episode, part 2, focuses on cranial nerves V and VII-XII (the trigeminal, facial, vestibulocochlear/auditory, glossopharyngeal, vagus, spinal accessory and hypoglossal nerves), before concluding with a slightly condensed and more efficient way to examine the cranial nerves in routine day-to-day neurological practice.

https://open.spotify.com/episode/0Zf9OeCuwB8K2NCWyKExft?si=0HrLPwZ-RRS1iBbb2kZ6jA

Released 12 Oct 2025

Upper limb neurological examination (theory) with pearls & pitfalls

This episode continues our clinical method series by turning to the upper limb examination, focussing on tips and tricks to optimise your examination technique assessing inspection, tone, power, reflexes, sensation and coordination. This episode also introduces some neurophysiological and anatomical principles, and ties these in with key patterns encountered in clinical neurology (such as distinguishing an upper from a lower motor neuron lesion), to assist with consolidation and memorisation.

https://open.spotify.com/episode/6cv30k1f4V3bhgB4IR8sLq?si=woogISSaRQaS43bXXiBr_A

Released 16 Oct 2025

Lower limb neurological examination (theory) with pearls & pitfalls

This episode further continues our clinical method series by turning to the lower limb examination, focussing on tips and tricks to optimise your examination technique assessing inspection, tone, power, reflexes, sensation, coordination, stance and gait. The diagnostic utility of many of these examination components are critically discussed, and various pearls and pitfalls are highlighted, along with linking the examination to relevant clinical presentations in order to form mental connections and aid memorisation.

https://open.spotify.com/episode/749iSWY4IQ6X15e7VAvxOY?si=f_vqrUluR3-rPoZ8PGuwog

Released 20 Oct 2025

NIHSS hyperacute stroke examination (theory) with pearls & pitfalls

We’re very excited to present the first episode in the stroke and cerebrovascular diseases series! (As an overlap with our ongoing clinical method series). This episode focusses on how to perform a NIHSS hyperacute stroke examination accurately and quickly, and explains the rationale behind each item, how to examine each item correctly, and tips for remembering the NIHSS items, in order to better prepare you for your next stroke call/code stroke.

Correction: 19:30 Visual threat testing is for testing visual fields when the patient isn't properly responding to your initial standard field testing (not for when there is already an established field deficit in a cooperative and responsive patient); Correction: 21:31 Should say "retrochiasmal components" (not "upper motor neuron components", oops!); Correction: 45:56 Same as for my initial correction.

https://open.spotify.com/episode/2mk27kIidaNCCNa9VSKHue?si=t6mKeB0jQuibxUSujjKC4w

Released 23 Oct 2025

How to perform a lumbar puncture (LP) & what tests to order

This is the first episode in the neurological procedures series… drum roll please… you guessed it, it’s the lumbar puncture (LP)! This episode describes at length the many indications for lumbar punctures (a super helpful procedure!), the contraindications and how to evaluate these, how to consent the patient, what equipment is required and recommended, different options for ways to perform the procedure, and then of course a step-by-step how-to guide including invaluable tips and tricks, to hopefully improve all of your abilities in performing this essential procedure. The episode then concludes by providing a logical way of grouping and remembering all of the laboratory tests that may be required on the cerebrospinal fluid (CSF) specimen… and don’t forget the paired serum testing! This episode is appropriate for medical students, junior doctors, physician and neurology trainees, emergency/critical care trainees, and any other health professional wanting to learn how to become awesome at performing lumbar punctures.

https://open.spotify.com/episode/2Kj4GsCQw0HQ30gWhz3QRb?si=2PelLVCMSNSCqvQ9ZEAEeg

Released 27 Oct 2025

Central vertigo (HiNTs+) & Dix-Hallpike/related examinations (theory) with pearls & pitfalls

We’ve got another surprise installed for you today… the first episode in the neuro-otology and vertigo series! (Again as an overlap with our ongoing clinical method series). This episode focuses on the HiNTs+ examination in distinguishing central from peripheral causes of an acute vestibular syndrome, in particular distinguishing a posterior circulation stroke (of the brainstem or the cerebellum and its connections) from vestibular neuritis. The episode then changes tack to discuss the Dix-Hallpike examination and then the horizontal head roll (log roll) tests to diagnose posterior canal and geotropic/ageotropic horizontal canal BPPV (benign paroxysmal positional vertigo), respectively, and it also discusses the Epley manoeuvre and barbeque roll (BBQ roll; Lampert roll) manoeuvre in the treatment of posterior canal and horizontal canal BPPV, respectively. As always, the episode is packed to the brim with helpful tips and tricks to help you perform these examinations and techniques optimally and efficiently, along with suggestions to help remember them! This episode is appropriate for medical students, junior doctors, physician and neurology trainees, neurologists, cardiologists/ general practitioners (family doctors)/emergency and intensive care physicians and their respective trainees, and any other health professional assessing patients presenting with dizziness (who may ultimately have a neurologic, cardiac or another cause for this presenting symptom).

https://open.spotify.com/episode/5GY7RT25IQZslnNDyAS026?si=z4jhNdNuS529zUwEokM3YA

Released 30 Oct 2025

Clinical approach to the dizzy patient, & vertigo causes & overview of management

The second episode in the neuro-otology and vertigo series takes a step back to review the clinical approach to the patient presenting with the notoriously misinterpreted symptom of ‘dizziness’, before reviewing the best way to classify common causes of vertigo into either acute persistent vertigo vs. episodic vertigo (which can in turn be triggered vs. non-triggered). It then discusses the diagnosis and management of vestibular neuritis, benign paroxysmal positional vertigo (BPPV, especially the posterior and geotropic/ageotropic horizontal canal variants), Meniere’s disease and migraine with vestibular features, before turning to a discussion of less commonly encountered causes of vertigo so as to provide an exhaustive list of the potential causes of vertigo, so that when you encounter them in clinical practice you are not then hearing about them for the first time. As always, the episode is packed to the rafters with useful tips, tricks and personal and practical insights so as to contextualise the content, in an attempt to aid structured understanding and memorisation. This episode is appropriate for medical students, junior doctors, physician and neurology trainees, neurologists, cardiologists/ general practitioners (family doctors)/emergency and intensive care physicians and their respective trainees, and any other health professional assessing patients presenting with dizziness (who may ultimately have a neurologic, cardiac or another cause for this presenting symptom).

https://open.spotify.com/episode/6PXmgffRTlydhr9cCD9xgs?si=5b4U_wGhS9aSd5ymyuyDjA

Released 4 Nov 2025

Extrapyramidal & Parkinson’s disease examination (theory) with pearls & pitfalls

We’re thrilled to announce the first episode in our movement disorders & Parkinson’s disease series (also continuing our clinical method series), beginning with a discussion of how to perform an extrapyramidal examination, particularly in the context of suspected Parkinson’s disease, progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD; or corticobasal syndrome, CBS), dementia with Lewy bodies (DLB) and normal pressure hydrocephalus (NPH), as well as assessing treatment responses to levodopa and other Parkinsonian therapies to distinguish an excessively ‘on’ or dyskinetic state, from a ‘good on’ state, from an ‘off’ state including a frozen state. As always in Riisfeldt Neurology Education, we provide a clinical focus to help contextualise the information, peppered with tips and tricks to optimise your examination techniques, and hopefully providing a structure to your learning, along with helpful mnemonics in order to aid memorisation. This episode is appropriate for medical students, junior doctors, physician and neurology trainees, and general practitioners (family doctors) and emergency physicians and their respective trainees, and any other health professional assessing patients presenting with extrapyramidal symptoms and signs or with a pre-established diagnosis such as Parkinson’s disease.

https://open.spotify.com/episode/3kKGamt1Xxh5lQxjj6S4Qe?si=Kln3GJofQm6ZHf6ZN_uj1w

Released 11 Nov 2025

Parkinson’s disease: Common ward management dilemmas

In this next episode in the movement disorders and Parkinson’s disease series, we begin with a brief overview of the mechanisms of action of the medications used to treat Parkinson’s disease, before focusing on five common and important ward dilemmas encountered in the management of patients with Parkinson’s disease: (1) the patient is unable to take their oral antiparkinsonian medications, (2) the patient is psychotic or delirious, (3) the patient has autonomic instability/dysregulation with orthostatic hypotension +/- supine nocturnal hypertension, (4) the patient is frozen/in an ‘off’ crisis, and (5) the much-feared Parkinson-hyperpyrexia syndrome. We discuss pragmatic ways to tackle each of these problems, coloured with analogies and detailed explanations to make the content understandable in a structured manner (and hopefully also memorable!). This episode is suitable for anyone caring for patients with Parkinson’s disease, although it should be especially useful for junior doctors covering the wards on evening/night and weekend shifts (and medical students also about to find themselves in this position)!

https://open.spotify.com/episode/6M5fIvVP9r01c8JnsCDqvK?si=dHo6tBFLTg2VQppMC_cBmw