Intended for healthcare professionals



BMJ 2006; 333 doi: (Published 17 August 2006) Cite this as: BMJ 2006;333:404

A woman who had had a traumatic distal fracture of the left radius two years earlier and had undergone left carpal tunnel decompression more recently, had a painful left hand and involuntary movements of her third left finger. Treatment with gabapentin and amitriptyline made the pain worse, and baclofen didn't work. The only thing that helped was wearing a glove, which provided tactile input that suppressed the movements and the pain (Neurology 2006;67: 491-3).

Aggregates of misfolded proteins are commonly seen in neurodegenerative diseases. Researchers studying the “sticky” mutation in mice (Nature online; doi: 10.1038/nature05096), which results in Purkinje cell degeneration, have identified a mutation in the gene encoding alanyl-tRNA synthase. This mutation results in the production of proteins containing aberrant amino acids; these proteins cannot fold properly and accumulate within the neurones, killing them.

Nicotine dependence develops soon after the first puff, according to a study in the Canadian Medical Association Journal (2006; 175: 255-61). Young novice smokers may not realise that once they experience cravings it's almost too late to stop progression to daily tobacco use and that the likelihood of dependence is greatly increased. Interventions designed to help young people stop smoking …

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