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Behavioral Neurology

5 cases on atypical parkinsonism, autonomic pharmacotherapy in MSA, primary progressive aphasia, normal pressure hydrocephalus, and psychosis in Parkinson's disease dementia — choose a case below to open its full multi-voice debate.

NeurologyBehavioral Neurology
Atypical Parkinsonism: Defining an Adequate Levodopa Trial

A single patient with two years of progressive parkinsonism and a levodopa trial that never reached a dose or duration anyone would call definitive. The disagreement isn’t about which drug comes next — it’s about whether this trial has actually been run.

Case 0001
NeurologyBehavioral Neurology
Neurogenic Orthostatic Hypotension in MSA: Droxidopa or Midodrine

A single patient with MSA and disabling orthostatic hypotension, choosing between two comparably effective pressor agents whose real difference shows up only after the patient stands back up — or lies back down.

Case 0002
NeurologyBehavioral Neurology
Primary Progressive Aphasia: Is There a Pharmacologic Role at All?

A single patient with a two-year language decline and a family asking for a prescription. The harder answer is that the drugs available for his likely underlying disease were built for a different symptom entirely.

Case 0003
NeurologyBehavioral Neurology
Normal Pressure Hydrocephalus: A Medical Bridge Before Shunt Surgery

A single patient with the classic NPH triad and a six-week wait before she's a safe surgical candidate. The question is whether a carbonic anhydrase inhibitor can actually bridge that gap, or only sounds like it should.

Case 0004
NeurologyBehavioral Neurology
Refractory Psychosis in Parkinson's Disease Dementia: Choosing Clozapine's Monitoring Burden

A single patient with Parkinson's disease dementia and psychosis severe enough to threaten her safety at home. The best-evidenced drug for this exact problem also carries the heaviest monitoring burden — and this family may not be able to sustain it.

Case 0005
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