Andrew Lees @ajlees Twitter profile

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Andrew Lees

@ajlees

1 year

I saw a patient with early Parkinson’s disease a few weeks ago whose first symptom was an inability to spread butter evenly over his morning toast. i am still collecting and fascinated by new clinical presentations after all these years

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Andrew Lees

@ajlees

4 years

I need 60 minutes and an informative GP's letter to see a new patient. It takes me 15 mins. to take a history, 5-15 to do the focused examination,15 to give the diagnosis and arrive at an agreement on the best treatment and 15 to chat about the patient's life and interests.

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Andrew Lees

@ajlees

1 year

Low dose amitryptiline (10-20mg) is another oldie but goody on the Parkinson's disease smorgasbord. It is much better than SSRIs for depression, it can help nocturia and also is excellent for associated disturbances of gastro-intestinal motility. For now its also very affordable

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Andrew Lees

@ajlees

11 months

Neurology is different from other internal medical specialities in that the examination is still often indispensable . Instead of salivating over new tests neurologists should enthuse over the beauty of high touch medicine and challenge payers to reimburse it appropriately

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Andrew Lees

@ajlees

3 years

There are now many wonderful researcher-neurologists. but very few neurologist-researchers. The 'little individuals ' who build their research around their practice are crying out for help. If something is not done they will vanish with the ghosts of Holmes and Critchley. @UCLIoN

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Andrew Lees

@ajlees

6 years

A clinical mistake leading to a missed diagnosis, an unusual presentation of a common disorder, a new clinical sign that may aid diagnosis and save money should all be written up. Case reports are back even if the editorial popes and H index narcissists don't like it

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Andrew Lees

@ajlees

6 months

When I was a junior doctor we rated our teachers not by their impact factors or research prowess but by their teaching skills and clinical acumen. You cant leave medical training to educationalists and scientists who have never cared for patients

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Andrew Lees

@ajlees

5 years

A neurologist should have wide-ranging curiosity, inventiveness and an eagerness to find something new. To be an innovator one must risk making a fool of oneself and be prepared to admit error in public.

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Andrew Lees

@ajlees

10 months

I have found amitryptiline followed by propranolol to be the most effective drugs for migraine prophylaxis when lifestyle changes have failed. Patient preference is of course important but it seems to be another clinical neuropharmacological area where old and cheap is better?

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Andrew Lees

@ajlees

6 months

This week I saw a patient with Parkinson's disease whose partner told me that when he talks in his sleep his speech returns to how it was before the illness began ten years ago. The dreaming voice was both loud and crystal clear I have never heard this story before @basbloem

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Andrew Lees

@ajlees

3 years

I let them take away the doctor’s mess, dismantle medical firms, prevent the ward sister from joining rounds, take away the places where I could discuss intimate details with patients. Instead I got to use a computer, clock in and out like a shift worker My greatest regrets.

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Andrew Lees

@ajlees

4 years

Be a Fitzgerald not a Hemingway. Imagine you are under house arrest but for now still allowed to go for lonely walks in the wakening woods

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Andrew Lees

@ajlees

3 years

During the 20 years I worked as a NHS consultant I used free time to do clinical research, rather than attend committees, see patients in 'for profit' hospitals, or write grants. It kept me curious and free of burnout. How about 1 paid session for research in NHS contracts?

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Andrew Lees

@ajlees

6 years

Advice to young neurologists. Be silent rather than flippant. Do everything in your power to reduce a patient’s fear even if it requires a little drama. Don’t be afraid of asking a colleague for help.

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Andrew Lees

@ajlees

2 years

John Walshe discoverer of 3 Wilson’s disease treatments has passed aged 102 We did a joint clinic at the Middlesex Hospital for 13 years where he taught me courage, conviction & that science and good doctoring are compatible ⁦ @UCLIoN ⁩ ⁦ @neurolib ⁩ ⁦ @MDC_IoN_UCL ⁩

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Andrew Lees

@ajlees

3 years

Only the best neurology journals like Brain, Lancet Neurology, JAMA neurology and JNNP have the courage to publish personal viewpoints. The prejudice that clinicians with years of experience have nothing to contribute is both unfair and offensive and needs to change

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Andrew Lees

@ajlees

4 months

Watching a master physician performing the neurological examination is the equivalent of Paganini playing the 24 Caprices. It is a marvel to behold

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Andrew Lees

@ajlees

2 years

A few other myths that are still prevalent among us Selective MAOIB inhibitors are neuroprotective. L-dopa is ineffective against rest tremor, DAT scan is more accurate than expert clinical diagnosis. New longer scales to measure disability are superior to older shorter ones

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Andrew Lees

@ajlees

2 years

Parkinson missed hypomimia or at least didn't describe it clearly, and Charcot despite examining the script of patients with shaking palsy, using a hand lens, failed to detect micrographia.Even 'les visuels' are human: there are still unseen opportunities in clinical medicine

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Andrew Lees

@ajlees

1 year

If allowed to speak freely without interruption patients present their complaints in an average of 7 minutes. Several further thoughtful open ended questions are thenneeded. Some patients find checklists demeaning, tiring and frightening. They are unvalidated I never use them

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Andrew Lees

@ajlees

1 year

There seem to be more and more academic physicians who dislike diagnosing and treating patients and would rather leave patient care to NHS colleagues. This is a big change from 25 years ago when many of the best clinicians were professors

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Andrew Lees

@ajlees

4 years

What has heartened me is how my colleagues in the current emergency have by-passed all that stifling red tape which has blighted our ability to be good doctors for so long, rallied together for society's good and put their lives at risk. They deserve much more than a hand clap.

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Andrew Lees

@ajlees

5 years

As I slowly lost my grip on the medical literature I gradually gained the courage to listen to my patients and at the same time became more and more curious about their lives. I was no longer top dog but I was in greater demand than ever before. #ListeninginMedicine .

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Andrew Lees

@ajlees

2 years

The history is part of the romance. We must keep it close to our souls going forward in science

Sandy Thomson

@DrSandyThomson

2 years

I think I could spend all day listening to @ajlees talk about neurology with a historical perspective, such as today at #MDSCongress #mds2020 Great presentation on Encephalitis lethargica

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Andrew Lees

@ajlees

1 year

It is important to say that most PD patients have no complaints of loss of sense of smell,no REM sleep behaviour disorder, no constipation,no tremor and no late onset depression, at the time of diagnosis. The prodrome is being inflated like so much else and this will cause error

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Andrew Lees

@ajlees

1 year

In medicine and in life I question my actions every day When I’m staring down the barrel of my latest mistake, i gather up the horror of it, understand why, accept it and realise there is something precious there from which I can learn for tomorrow

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Andrew Lees

@ajlees

3 years

A system that denies trainees the opportunity to watch their teachers taking a history and examining at the bedside is second rate. As Osler knew the lecture hall and the library cannot substitute for learning on the job

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Andrew Lees

@ajlees

8 months

To practise medicine is to have a constant feeling that one has forgotten something. There is an inevitable uncertainty which should preclude imperiousness

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Andrew Lees

@ajlees

6 months

Bring your soul and your mind to the clinic Diagnosing and treating are the easiest part of medicine. Healing requires qualities like compassion and feelings that no machine can ever know

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Andrew Lees

@ajlees

2 years

If Freud hadn't been so influential the Encephalitis lethargica pandemic would have united the separating specialities of neurology and psychiatry. Instead we ended up with a conflict of paradigms with parallel terminologies for the same phenomena

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Andrew Lees

@ajlees

4 months

The trio of Lancet papers published last week are open access. Together they provide an excellent resumé of current knowledge and thinking on Parkinson's disease. @TheLancet

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Andrew Lees

@ajlees

2 years

Hope,love and faith-healing forces that the best physicians unconsciously possess. Knowledge is the neurologist’s lodestar but should rarely be evident during the consultation. Truthful kindness is an unquantifiable remedy. Can you put a price on that? #Soulfulneurology

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Andrew Lees

@ajlees

3 years

I never stop marvelling at the advances in imaging, clinical genetics,pathology and physiology that have advanced neurology in the last 40 years. The trick is to combine it with the clinical methods we slowly learned in the first 100 years. Listen, notice, touch- Never forget

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Andrew Lees

@ajlees

3 months

Assessment of gait is a crucial part of the neurological examination. Essential reading (with videos). Hoping for companion articles on psychiatric and orthopaedic gaits @drpedrombarbosa @DiegoKaski @PracticalNeuro @Tim_R_Nicholson #Brainspotting

Neurological gait assessment

Gait disorders are a common feature of neurological disease. The gait examination is an essential part of the neurological clinical assessment, providing valuable clues to a myriad of causes....

pn.bmj.com

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Andrew Lees

@ajlees

4 years

The ideal consultation takes place in a patient's home but this has almost gone.The next best is in a quiet clinic.If nobody objects this may go too. Claims that telemedicine is as good as face to face are based on a false premise. Resist corporate and State Covid opportunists.

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Andrew Lees

@ajlees

9 months

The neurological processions of Marinescu based on the teaching methods of Charcot who demonstrated on several patients with the same signs or syndrome at the same time ⁦ @movedisorder ⁩ #Copenhagen

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Andrew Lees

@ajlees

8 months

You might be hyposmic and have REM sleep disorder, a mildly abnormal DAT scan and a positive synuclein skin biopsy but you aint got Parkinson’s disease.

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Andrew Lees

@ajlees

5 months

A message for the New Year from Paracelsus the great noticer, the keen observer ‘A doctor must seek out old wives, gypsies,sorcerers, wandering tribes, old robbers and such outlaws and take lessons from them. A doctor is a traveller. Knowledge is experience’

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Andrew Lees

@ajlees

7 months

Soulful neurology can embrace music and dance as well as tablets Soulful neurology does not see a person as the disease they are living with Soulful neurology requires you to put the interestsvof your patient above your own. Soulful neurology transcends measurements and data

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Andrew Lees

@ajlees

6 years

Advice to old neurologists. Don't overvalue clinical experience. Don't let your grey hair serve as a decoy for falling aptitude. Be prepared to embrace new technologies and gadgets if they have been shown by evidence to be efficacious

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Andrew Lees

@ajlees

3 years

I would not want to know my ApoE status, even if I were having 'senior moments.' I would never volunteer for a MR head, amyloid and tau scan in an aging study. I do not want colleagues foisting a diagnosis of Alzheimers on me when I have no sign of dementia. Chacun a son goût

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Andrew Lees

@ajlees

3 years

The most important developments in neurology during my lifetime have been non-invasive anatomical imaging (MR) followed by thrombolysis and recanalisation programmes in strokes and then number 3 is the 50 year old dopamine miracle. @JNNP_BMJ @PracticalNeuro @TheLancetNeuro

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Andrew Lees

@ajlees

3 years

Spending more and more time grappling with electronic health records diminishes the joy of being a clinician because it takes you away from being with the living breathing human being who has come to see you with a medical problem

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Andrew Lees

@ajlees

2 years

I have hardened my view about teleconsultation for patients with new neurological symptoms. It is not better than nothing and it is medicolegally indefensible. Doctors who succumb to it or accede to it should question if they are in the right job. @MDCP_Journal @EoinMulroy

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Andrew Lees

@ajlees

1 year

How I agree with Simon Jenkins when he said, ‘In an attempt to make the important measurable we have instead made the measurable important’ The scourge of modern medicine

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Andrew Lees

@ajlees

2 months

Hope all my friends will put their hands in their pockets and buy a copy All royalties as always for Parkinson’s research Thank you Mirabeau. Bless you #TheodoreDalrymple @NottingHillEds @NYRB_Imprints

Mirabeau Press

@MirabeauPress

2 months

Today, Mirabeau Press publishes Neurological Birdsong by @ajlees , in which the celebrated neurologist documents a career’s worth of insights by transforming his most profound tweets into poetic form. Available worldwide on Amazon.

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Andrew Lees

@ajlees

3 years

My first ever paper was published in the green rag and two out of my 5 best papers were published here. It is the journal that gives us hope that neurology and psychiatry be one day a single speciality @JNNP_BMJ

Journal of Neurology, Neurosurgery and Psychiatry

@JNNP_BMJ

3 years

JNNP 100: A centenary of publishing #neuroscience achievements | UCL Queen Square Institute of Neurology – University College London | @ucl True impact: Citation classics such as @ajlees - the accuracy of a clinical diagnosis of Parkinson’s Disease #PD

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Andrew Lees

@ajlees

3 years

Suggestions to reduce diagnostic error Bring back the clinical apprenticeship, the teaching autopsy, and bedside teaching. Integrate modern technology into education but keep the patient centre stage. Provide incentives and remuneration for teaching.

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Andrew Lees

@ajlees

1 year

This is Charcot’s final publication which appeared in the New Review in 1893. I reccomend it to all doctors but particularly to those involved in treating functional neurological disorders ‘There are more things in heaven and earth, Horatio Than are dreamt of in thy philosophy

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Andrew Lees

@ajlees

2 years

The paperback is now out making it affordable for those curious to know more about the cradle of British neurology and how it has survived despite numerous challenges ⁦ @neurolib ⁩ ⁦ @UCLIoN ⁩ ⁦ @uclnews ⁩ ⁦⁦ @uclh ⁩

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Andrew Lees

@ajlees

1 year

How I missed my white coat when they were banned by the NHS. Wearing it demanded a committment to science, purity and a weekly visit to the laundry. @petergoadsby and I were the last two rebels to defy the authorities at Queen Square. Then they took away my tie @neurolib @UCLIoN

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Andrew Lees

@ajlees

5 years

I like my scientists to be modest,hesitant, sceptical and have an old school gentility. We still have some fortunately at Queen Square. I dislike the ever increasing number who are expansionists, opportunists and mislead the public for profit or cynical self advancement.

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Andrew Lees

@ajlees

4 years

Are you still curious to investigate the cause of symptoms and find answers for the clinical questions for which you have no answer? Is this still possible as an academic? The research I love has nothing to do with public health, it stems from the patient. Carry on the fight!

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Andrew Lees

@ajlees

1 year

The possible association between Functional Tremor and Parkinson's disease is fascinating. I can recall seeing only a couple of cases so probably missed some. @jonstoneneuro @AlanCarson15 @AlbertoEspay @CoeberghJan @kailashbhatia @KurtisMonica

Functional Movement Disorder in Parkinson's Disease

Functional movement disorders can occur in association with neurological disease.

www.psychologytoday.com

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Andrew Lees

@ajlees

4 years

Functional neurological disorders are one of the main contemporary challenges for neurologists. Anyone who thinks neurosyphilis is extinct needs revalidation. My review explains what neurologists can learn from psychiatrists and vice versa @The_BNPA

Brain

@Brain1878

4 years

La Folie des Grandeurs. @ajlees reviews 'How the brain lost its mind' by Allan Ropper & B.D. Burrell

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Andrew Lees

@ajlees

2 years

For those of you who enjoyed Brainspotting can i recommend another book also written to interest and stimulate enjoyment in neurology by Harry Lee Parker. If you want to know more about this remarkable teacher read the biography and listen to the lecture by ⁦ @ChrisBoesMD ⁩

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Andrew Lees

@ajlees

1 year

All my career I have been aware of the privilege and responsibility being a doctor brings but I cannot do my best in a soulless target driven ambience where every last bit of fun has been rubbed out. I want to feel the desire to ‘take one for the team’ not clock off at 5 pm

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Andrew Lees

@ajlees

6 months

Fisher's rules should be hand outs for all residents starting out in neurology. One of the great masters who like Charcot saw pathological examination as the final component of diagnosis

Andreas Charidimou MD, PhD

@a_charidimou

2 years

@caseyalbin reminded me of the CM Fisher’s rules 🏥🧠👇 @JAMANeuro 🛬17 "rules" summarizing some of the basic principles he has followed in the practice of medicine #MedTwitter #MedStudentTwitter #neurotwitter #MedEd #EndNeurophobia #NeuroTwitter #Neurology

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Andrew Lees

@ajlees

1 year

Gordon Holmes believed each neurological examination should be as rigorous as a scientific experiment. Its expansion in the late nineteenth century was in part driven by the need to have more objective ways of distinguishing functional neurological disorder from nervous disease

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Andrew Lees

@ajlees

1 year

Neurologists who aspire to become top notch basic scientists inevitably fall between two stools. But clinical research is something we should all be doing

Marcus Pinto, MD, MS

@MarcusVPinto

1 year

What a great read is “Brainspotting” by Professor @ajlees . He preaches about the history of neurology, compassionate care, and the importance of neurologic examination and clinical reasoning. So delightful. Below is one of my favorite quotes from the book. Highly recommend!

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Andrew Lees

@ajlees

1 year

Neurologists, however specialised, should never get cut off from general medicine; it is a cardinal error. In my own field of Parkinson's disease the new developments in the nature and treatment of diabetes mellitus continue after 30 years to be a fertile source of inspiration.

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Andrew Lees

@ajlees

1 year

My post on functional slowness and tremor (parkinsonism). A fascinating if uncommon condition @jonstoneneuro @AlanCarson15 @Tim_R_Nicholson @kailashbhatia @AlbertoEspay

How to Diagnose and Treat Functional Parkinsonism

An integrated approach to treatment offers the best chance of recovery.

www.psychologytoday.com

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Andrew Lees

@ajlees

2 years

Geschwind during his sabbatical at Queen Square told me that he contacted all his patients with epilepsy asking them to write to him about their health. The reply in those he suspected of hypergraphia averaged 5000 words the rest 78. How I miss this sort of study @UCLIoN

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Andrew Lees

@ajlees

7 months

There have been a few occasions where I have suspected Parkinson's disease and then not confirmed it on follow up visit.I believe stress can unmask motor signs which disappear. If you have the slightest doubt about the diagnosis hold back,do nothing & review in 6 months @basbloem

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Andrew Lees

@ajlees

2 years

How often do you invite someone from a different faculty to give a talk in your department? How often do you consider inviting a historian, a sociologist, a novelist, a mathematician or even an anthropologist to give a keynote lecture at a neurology conference you are organising?

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Andrew Lees

@ajlees

3 years

Sitting on a bench in Russell Square close to the Ewan MacColl oak listening to the clatterboard flap of London pigeons and the sound of the gardener’s rake. #Dirtyoldtown

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Andrew Lees

@ajlees

4 years

'Atypical' Parkinson's syndrome is an imprecise term but it is a truthful one. It is not dishonest and I will go on using it when I am unsure.I never want to have to retract another diagnosis of PSP, CBS or MSA. When effective treatment arrives things will change. @MDC_IoN_UCL

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Andrew Lees

@ajlees

3 years

Let us get rid of the term Atypical Parkinsonism. It is no better than Parkinson’s plus and encourages Humpty dumptyism. It has become a monkey on our backs and no longer serves any useful purpose

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Andrew Lees

@ajlees

4 years

Werner Poewe's talk transcended zoom. He was right there marrying the 19th century with the 21st reminding us that Parkinson's disease is a clinical diagnosis and that we will only need imaging and biomarkers in the 15% of undetermined cases. A tour de force. @MDSCongress .

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Andrew Lees

@ajlees

8 months

I would never diagnose Parkinson's disease unless I have picked up a progressive reduction in speed and amplitude on finger or foot taps. The 20 seconds time is crucial-longer and you see fatigue in many normal people. Micrographia correlates poorly with sequence effect

Neurochecklists

@neurochecklists

8 months

@ajlees Soulful Neurology Tweets 167

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Andrew Lees

@ajlees

2 years

This is a nice piece from my colleague David Werring showing how much we appreciate Miller Fisher at Queen Square ⁦ @a_charidimou ⁩ ⁦ @UCLIoN ⁩

The legacy of C Miller Fisher | ACNR Journal

Dr C Miller Fisher developed and wrote about the key scientific ideas that underpin almost every aspect of modern stroke medicine.

acnr.co.uk

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Andrew Lees

@ajlees

4 years

Samuel Kinnier Wilson teaching in out patients at Queen Square-the founder of Journal of Neurology, Neurosurgery and Psychiatry- the first physician at the hospital to take a special interest in the basal ganglia @JNNP_BMJ @MDCP_Journal @MDC_IoN_UCL @PracticalNeurol @The_BNPA

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Andrew Lees

@ajlees

4 years

As far as clinical medicine is concerned I refuse to regard anecdotal evidence as lowly or suspect. It is easy to learn the few Level 1 guidelines but to acquire clinical judgement and act on uncertainty requires nous, experience and a love of people. @JNNP_BMJ @PracticalNeurol

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Andrew Lees

@ajlees

2 years

I find most neurology residents bright as buttons, sharp as knives and keen to receive more clinical instruction. The problem stems from the increasing distance between some Departmental chairmen and the bedside and the fact many place a very low priority on excellent teaching.

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Andrew Lees

@ajlees

3 years

Three weeks ago i saw a 68 year old man with what i thought was a late onset tremor who had been told he had Parkinsons disease purely on the DAT scan report . There was no bradykinesia, repeat DAT which I felt forced to order was normal. Enormous damage to repair.

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Andrew Lees

@ajlees

1 year

A feeling of trembling inside has many causes including anxiety and caffeine but it is very common in Parkinson’s disease occurring in some people years before bradykinesia, rigidity or rest tremor. An anxious stare, increased perspiration, motor impatience and panic attacks too

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Andrew Lees

@ajlees

1 year

Watch the patient enter the room and walk towards the chair, look at her face,clothes and jewellry, look at the nails and smell the breath. None of this possible with telemedicine

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Andrew Lees

@ajlees

1 year

One thing that has got worse in hospital medicine is that physicians are less interested in the identities of their patients. I try to pick up on the casual asides during a consultation that help me understand what makes patients tick and why they are able to go on.

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Andrew Lees

@ajlees

1 year

My own bias would be for a clinical academic in neurology to spend half the week on patient care and the rest on teaching, clinical research and administration but many now spend less than 10 per cent of their week with patients. Leave the basic science to the professionals

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Andrew Lees

@ajlees

5 years

This year's advice for young neurologists. Never follow the money.The neurological literature began before the new millenium. Modesty and decency are still qualities to be cultivated. @PracticalNeurol @UCLIoN @acmedsci

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Andrew Lees

@ajlees

5 years

This year's advice for old neurologists.Don't bore your colleagues with anecdotes about an imaginary golden age, instead tell them about your worst mistakes. Curb your growing brashness in meetings. Don't try to start all over or envy youth. @PracticalNeurol @UCLIoN @acmedsci

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Andrew Lees

@ajlees

4 years

Never forget who tore down the bronze statue of the man who created neurology in 1942. How could they do such a thing like that? Which is worse re-writing history or forgetting it? "Johnny's in the basement mixing up the medicine".

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Andrew Lees

@ajlees

4 months

I'm putting this out again for those who might be interested showing my longstanding scepticsm to the notion of abnormal alpha synuclein aggregation as the cause of Parkinson's disease @AlbertoEspay An essay on the shaking palsy

An essay on the shaking palsy

Two hundred years ago at the age of 62, James Parkinson wrote a 66 page treatise entitled An Essay on the Shaking Palsy. He believed that he had identified

academic.oup.com

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Andrew Lees

@ajlees

10 months

A hospital is not a factory, a doctor is not a health care worker, a patient is not a phenotype.

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Andrew Lees

@ajlees

2 years

Personalised medicine has been there from the start and was diminished when vested interests hijacked EBM and guideliners stopped doctors thinking for themselves No clinician can be imprecise.We are ‘ deep phenotypers’ trained in the art of healing. Rub out the slogans.

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Andrew Lees

@ajlees

3 months

This is so important and yet so little time is given to its study by contemporary Parkinson disease researchers. It challenges the notion of irreversible degenerative deterioration. #emotionallocomotorsystem @purposeful_pd @basbloem

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Andrew Lees

@ajlees

2 years

To optimise finger tapping as a useful test in the diagnosis of Parkinson’s disease it is essential to perform it for precisely 20 seconds with each hand and ask the patient to sequentially touch each of the four fingers onto the thumb

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Andrew Lees

@ajlees

2 years

Soulful neurology embraces the subjective, the qualitative and the biographical -the essence of a human being. Get rid of 90% of clinical scales a money making racket and record what you hear and see

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Andrew Lees

@ajlees

3 months

I have found that the academics who talk about personalised medicine never mention individual people, only big data, artificial intelligence and algorithms. I wish they would stop it and accept it is impersonalised medicine

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Andrew Lees

@ajlees

26 days

This is important, common and underecognised by neurologists. It can take different forms including feeling ill, symptoms worsening without explanation, brain fog and even momentary unrousability when sitting

Bas Bloem

@basbloem

26 days

33 years after our 1st joint paper, my mentor & friend Gert van Dijk (now retired) and I published new article together. Highly relevant: hypotensive “twilight zone”, often missed in persons with #Parkinson . Timely recognition is important: it is debilitating & treatable.

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Andrew Lees

@ajlees

1 year

A hospital’s atmosphere markedly influences the healing process. I have found that in London small old National Health Service hospitals are the most therapeutic and glossy new American owned factory clinics the least @SalleyVickers @ProfRayTallis

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Andrew Lees

@ajlees

5 years

When we were trying to get people to believe in dopamine dysregulation in 2000 I remembered Dr Gooddy's words he had learned from Walshe about the 3 stages of medical discovery; first its not true, second its not important and finally it was known all the time. #MentoredbyaMadman

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Andrew Lees

@ajlees

2 years

The pleasure that comes from diagnosing a treatable disorder that has been missed is the neurologist's nearest equivalent to scoring a goal but it must be kept to oneself.Humility is an English doctor's favourite form of vanity. #BrainspottingAdventuresinneurology @georgependle

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Andrew Lees

@ajlees

5 years

A neurologist makes the lame walk and the blind see awakens the comatose, abolishes the shakes and vanquishes the Sacred Disease. Then like a good copper he leaves without a fuss. No neurobollocks.

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Andrew Lees

@ajlees

4 years

Psychiatry has plenty to teach neurologists. There have always been a few of us at Queen Square who feel a year of neuropsychiatric training would be of incalculable benefit @Tim_R_Nicholson @a_schrag @The_BNPA

Laura McWhirter

@lauramcw

4 years

Brilliant @bnpa medal lecture by @ajlees - soulful neurology via Sherlock Holmes, William burroughs, and the dream machine 👌 #bnpa2020

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Andrew Lees

@ajlees

2 years

I was inspired by Meige and Feindel’s monograph . Like them I covered tics and those poorly characterised neglected movement disorders on the edgelands of neurology. The book has hardly dated. How I would like to add Tic like movements on social media. ⁦ @ChristosGanos ⁩ ⁦

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Andrew Lees

@ajlees

3 years

The early morning light of Lisboa is a special pleasure I contrast with the rich Bahian blues

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Andrew Lees

@ajlees

25 days

And for the bosses always surround yourself with young people smarter and cleverer than yourself and allow them to fly.

Bas Bloem

@basbloem

25 days

This is definitive proof that you can never outgrow your mentor. Thank you Prof @ajlees for all your inspiration and guidance!

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Andrew Lees

@ajlees

2 years

What continues to give me hope is not just kinesia paradoxica but those miraculous whole days where people with Parkinson’s disease lose all their stiffness, viscosity and shakiness and inexplicably return to how they once were before the malady emerged

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Andrew Lees

@ajlees

5 months

I've just read a paper that used 31 acronyms 162 times. Although each acronym was defined on first use it was impossible for me to remember the meaning of each and at the same time follow the gist of the text. Suggest a maximum of 5 per article? @Brain1878 @TheLancetNeuro

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