A daily word-guessing game. Final answers are all related to neurology or neuroscience. Be careful... proper nouns, plurals, and abbreviations are fair game!
Neurdle, April 22, 2023:
Paul Broca (1824-1880) described an area in the frontal lobe of the dominant hemisphere, usually the left, important for production of speech. Lesions of the area result in an expressive aphasia.
Neurdle, May 11, 2023:
Spanish anatomist Ramón y Cajal won the Nobel Prize in 1908 for his work describing ‘mossy fibres’ in the hippocampus and the cerebellum. Read about those here () or just enjoy Cajal's beautiful artwork here ()
Neurdle, August 7, 2023:
Guest Neurd Maria Xiang from
@OHSUDoernbecher
:
Myelin oligodendrocyte glycoprotein antibody disease can cause a constellation of symptoms. Complicating the picture, the serum MOG antibody is not always specific for the disease:
Neurdle, May 2, 2023:
Leigh syndrome: a rare progressive genetic neurodegenerative disorder of children with a deficiency in thiamine triphosphate, also called subacute necrotizing encephalomyelopathy. Named after Archibald Leigh, who described it in 1951.
Happy birthday to us, Neurds! 🎈🎈🎈 It's the 100th day of Neurdle... and we have so many more 5-letter words for you.
Respond here with your favorite Neurdle word so far - and why - and you'll be entered in a drawing to win a Neurdle print.
Neurdle, May 12, 2023:
CN X: what doesn't it do? Vagal nerve stimulation has been used to decrease seizure frequency and more recently in migraine, depression, IBD, and rehab. Read about VNS for seizures here () and migraine ()
Neurdle, May 13, 2023:
The Weber test: Put a tuning fork in the center of the skull. With a CONDUCTIVE hearing loss, the sound is LOUDER in the affected ear. A patient can use a vibrating cell phone for the test during a telemedicine consult:
This Neurdle was made in consultation with Eseosa Ighodaro,
@Dr_Ighodaro
, who wrote this incredible opinion piece on the need for representation of people of color in medical textbooks - a need we feel extends to online educational word games
Neurdle, May 12, 2023:
CN X: what doesn't it do? Vagal nerve stimulation has been used to decrease seizure frequency and more recently in migraine, depression, IBD, and rehab. Read about VNS for seizures here () and migraine ()
Neurdle, May 16, 2023:
What should we bolus? Tenecteplase, a new tPA (tissue-type plasminogen activator) for thrombolysis in acute ischemic stroke. When should we bolus it? NOW, don't just stand there, time is brain!
Neurdle, July 7, 2023:
The uncus (meaning hook) is the anterior part of the hippocampal gyrus.
You never think about it until ICP rises and the uncus herniates over the tentorial notch, presses against the brainstem, and affects the 3rd cranial nerve.
Neurdle, May 3, 2023
The word epilepsy is derived from the Greek word epilambanein, meaning "to seize." A person having a seizure was thought to be seized from themselves. For an excellent history of epilepsy from ancient times, read more here:
Neurdle, May 15, 2023:
The hippocampus has 3 subfields: CA1, CA2 and CA3 - using the old name for the organ, "cornu ammonis" - and contributes to memory, navigation and cognition. Here are some smart people chatting about it in Nature Neurosci in 2017:
Neurdle, May 17, 2023:
The sympathetic nervous system causes the pupil to dilate, allowing more light in. The parasympathetic nervous system causes the pupil to constrict, allowing less light in. More on David Bowie here (I got you, fam): )
Neurdle, May 9, 2023:
Prednisone seems to improve outcomes in adults with acute 7th cranial nerve palsy; acyclovir doesn't help. Do you still prescribe both? (There's really no evidence for either in children!)
We are so close to 1000 followers! Today, let's look back at some of our most challenging Neurdles - and all our amazing guest Neurds (we❤️you!):
(Remember our birthday word, April 22?)
Neurdle is 100 days young today! 🎂🧠 Grateful to all our Neurds for making this journey a blast! 🙏
Meanwhile, I think we need a slogan for .
"Friends who Neurdle together... Limb-Girdle together?" Nope. Clearly we need your help. What have you got?
Neurdle, July 13, 2023:
In 1952, Alan Hodgkins and Andrew Huxley described the action potential of the neuron, with experiments performed in the giant axon (0.5 mm in diameter) of the giant squid. They won the Nobel Prize for this work in 1963.
Neurdle, May 25, 2023:
Limen is a beautiful word meaning a threshold or a boundary - the limen of consciousness, the limen of perception (like subliminal perception). Anatomically, the threshold of the insula of the brain is called the limen insulae:
Neurdle, July 21, 2023:
Functional neurological disorders and "spells" present unique challenges for neurologists and patients. Listen to a podcast with Dara Albert, medical director of a multidisciplinary Psychogenic Nonepileptic Events Clinic:
Neurdle, Nov 3, 2023:
#200
!
Hey Neurds! We are excited to introduce a new website for all of Zach London's various games: !
Have you ever thought about making a game? What kind of neurology game would you like to play?
Neurdle, July 29, 2023:
Guest Neurd
@StaceyLClardy
!
The ExTINGUISH Trial for NMDAR Encephalitis is an clinical trial enrolling newly diagnosed NMDAR Encephalitis. Call the 24-hour ExTINGUISH hotline at 844–4BRAIN5 with new NMDAR encephalitis patients for more information.
Neurdle May 18, 2023:
Velum: anatomically, any membranous structure, usually used for the soft palate - but can also be (incorrectly) in the term cavum velum interpositum
Neurdle, April 28, 2023:
In this 1879 article, J. Creighton Browne says arachnoid cysts "are calculated, by their situation, by their glistening surface, their variegated tints, their essentially morbid appearance, to impress and dwell in the memory."
Neurdle, July 9, 2023:
Neuromyelitis optica spectrum disorder is a demyelinating disease of the optic nerves, spinal cord, and area postrema. For many years NMO was considered a subset of MS, but in 2005, Vanda Lennon found antibodies to aquaporin 4:
Hold on to your occipital horns, because it's time for another Neurology Connections puzzle!
Find the four groups of four, and bask in your neurdy glory.
@zach_london
@OligoclonalBand
Neurdle, May 10, 2023:
Central hypoventilation syndrome, known as “Ondine’s curse”, is a congenital condition from a variation in the PHOX2B gene. Who was Ondine, and who was cursed? Read more here:
Hey Neurds, tomorrow's Neurdle is going to be a challenge... so hints will start dropping here tomorrow morning if you get stuck. Look away if you're one of those "no-hint Neurdlers."
I can't believe we did a whole retrospective and forgot to mention my personal favorite painfully challenging Neurdle - criteria for ALS, named after a Japanese island. You don't get more esoterically neuro than that (oh, just wait, we will)
We are so close to 1000 followers! Today, let's look back at some of our most challenging Neurdles - and all our amazing guest Neurds (we❤️you!):
(Remember our birthday word, April 22?)
Neurdle, May 21, 2023:
Dandy-Walker malformation is a specific type of cerebellar hypoplasia with hypoplasia of the cerebellar vermis and expansion of the 4th ventricle. Read more:
Neurdle, August 24, 2023:
EEG: often useful, but measuring electrical dipoles through scalp and skull is prone to error. Here's a history of invasive EEG techniques, with depth electrodes and subdural grids:
Guest Neurd
@gyriandsulci
Neurdle, Oct 1, 2023:
Neuro: I love it, you love it, it's why we're here. But some medical students are scared of it, even after completing a neurology rotation: . How do we improve this (& why is the answer introducing all students to Neurdle)?
An anonymous Neurd points out that we rarely use this verb in neurology - "seizure," "seizing," but not "to seize." What do you think? Is SEIZE a fair Neurdle?
(Pro tip: Do not expect your Neurdle to be fair, and don't forget that we allow plurals, proper nouns and acronyms.)
Neurdle, May 4, 2023:
Jean-Martin Charcot and Pierre Marie described ""Progressive Muscular Atrophy"" in 1886, but localized it to the lower motor neurons. British neurologist Howard Henry Tooth localized CMT to peripheral nerves 3 months later.
Neurdle, August 29, 2023:
The quantitative sudomotor axon reflex test (QSART) can detect small fiber neuropathy when other nerve conduction tests are normal. Abnormalities in the autonomic control of sweat glands can be the 1st sign of a problem.
Neurdle, April 25, 2023:
Neurotoxicity occurs when a substance – naturally occurring in the brain, like amyloid beta, or found in the environment, like tetrodotoxin – damages nervous tissue. Tetrodotoxin is a powerful sodium channel inhibitor:
Neurdle, April 23, 2023:
Axons: stretching out from the cell bodies of neurons to make connections - like us. 💚
Read
@EvaFeldmanMDPhD
on Schwann cell–axon transport in the demyelination and degeneration of sensory neurons of diabetic neuropathy:
Neurdle, May 30, 2023:
In 1892, Jules Dejerine challenged Pierre Marie to an actual duel over the neurology of sensory ataxia. Their friends calmed them & no shots were fired. Please do not consider dueling us over future Neurdle words. For more:
Neurdle, Sept 27, 2023:
Every neurologist needs a reflex hammer (not your stethoscope - but you know that). We may be able to use other tools - like telemedicine - to reduce healthcare disparities:
Neurdle, Sept 25, 2023:
Cranial nerve
#12
, the hypoglossal nerve, is a motor nerve that innervates the muscles of the tongue. CPAP is an uncomfortable way of treating sleep apnea - but maybe we can stimulate the hypoglossal nerve electrically instead:
Neurdle, June 17, 2023:
The brain is the complex organ in the center of the nervous system. Walter Russell Brain (1895-1966) was a neurologist, he wrote Brain's Diseases of the Nervous System, and for a few years he was even editor of the journal Brain.
Is it hot enough for you, or do you have a lesion in the preoptic region of your hypothalamus?
Either way, you probably need a new Neurdle Connections 🎉🎉🎉to get through the week:
Hey Neurds! April 22nd is our birthday 🎉! One whole year of Neurdle!
Don't worry if you didn't get us anything - we got you something, and yes, it's another REALLY HARD NEURDLE.
This one will definitely leave you questioning our mental status....
Neurdle, April 24, 2023:
Poliomyelitis, a vaccine-preventable viral infection contracted through the fecal-oral route, affecting the motor neurons of the ventral horn of the spinal cord. --> flaccid paralysis, primarily of the lower extremities.
Neurdle, May 5, 2023:
Large fiber neuropathies come from damage to the a Aβ fibers, which regulate the proprioceptive signals of vibration and touch. Here's an extremely thorough review of all kinds of neuropathic pain:
Neurdle, Nov 18, 2023:
Yes, MTHFR sounds like an abbreviated curse word, but folic acid and the enzyme that converts it to 5-methyltetrahydrofolate, methylenetetrahydrofolate reductase (MTHFR), are not only important for formation of the neural tube ()...
#Neuroetymology
Word 🔆8
Substantia Nigra
🌟Substantia Nigra finds its origin in Latin, which literally translates to "Black Substance", owing to its appearance being darker than the surrounding areas due to high neuromelanin content. Hint for its location within the brain:
Neurdle, Sept 14, 2023:
I thought that I would never see
A poem about neuropathy
But now for Neurdle (so fantastic!)
I write of POEMS, neoplastic.
Read about POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes):
Neurdle, May 20, 2023:
The musculocutaneous nerve - a terminal branch of the lateral cord of the brachial plexus - supplies the biceps brachii. The biceps tendon can spontaneously rupture in amyloid transthyretin (ATTR) amyloidosis:
Neurdle, June 23, 2023:
Now that it's raining more than ever / I've got high intracranial pressure / you can tell from my empty sella (ella, ella, eh, eh, eh)
Neurdle, May 29, 2023:
Herpes simplex encephalitis is a viral encephalitis that primarily affects the temporal lobes. This is a
@zach_london
video about prior authorizations that went viral online:
Ever play Strands? If you found a neuroloanatomy one, would your life (or at least your day) be complete? Try this!
Find the words to fill the board. They do not overlap.
@zach_london
@OligoclonalBand
Neurdle, May 28, 2023:
If you're looking at head imaging, axial means there's an imaginary line cutting the head in half, top to bottom, through both ears. But actually there are six axial planes used in 3D imaging:
Neurdle, August 19, 2023
The crista galli, or "rooster's crest," of the ethmoid bone separates the olfactory bulbs and attaches to the falx cerebri of the dura mater. This area can becomes air-filled as the sinuses develop:
Guest Neurd
@MikaelaStiver
Neurdle, May 19, 2023:
Stroke Alert is not just one of the worst things to see on your pager at 2 a.m. - it's also the name of the American Heart Association's Stroke journal's podcast. Listen here:
Neurdle August 4, 2023:
William James West described infantile spasms (1793-1848) in his own son in 1841. The triad of infantile spasms, hypsarhythmia on EEG, and developmental regression is called West syndrome. . Art from Guest Neurd David Curfman.
It’s Neurdle Connections Time!
(Abbreviated NCT, but not to be confused with Nashville Children’s Theatre or Nobody Cares, Tracy.)
Be like Goldilocks and tell us if these are too easy, too hard or just right.
@zach_london
@OligoclonalBand
Neurdle, Sept 3, 2023:
Before azoles were available to treat meningitis caused by the fungus Coccidiodes in the 1990s, the best option was intrathecal amphotericin. Read more about CNS coccidiodomycosis infection: Guest Neurd:
@MichaelCosimini
What up Neurds! Today, June 5th, is another Neurdle Day of Difficulty so remember:
-no duels
-acronyms are fair game
-we might throw some hints out, depending on how it's going
-NO DUELS
Neurdle, May 22, 2023:
Glial cells - making up about half the cells of the brain parenchyma - orchestrate CNS formation and function, and are much more than the "glue" of the brain. Read more:
Neurdle, May 6, 2023:
Dorothy Horstmann (1911-2001) was the first to isolate the polio virus from the bloodstream, facilitating Albert Sabin's (1906-1993) creation of the oral polio vaccine.
Neurdle, Sept. 1, 2023:
Moebius syndrome is a rare congenital disorder of heterogenous origin affecting the cranial nerves - most commonly, the 7th (facial) and the 6th (abducens), leading to facial palsy and abnormal eye movements. Guest Neurd Anne Chen
Neurdle, June 24, 2023:
Alpha rhythms (8-13 Hz) are present in most people over the age of 8. The frequency may be increased transiently after eye closure (alpha squeak). Here's a PNES study of cortical and thalamic generation of alpha rhythms:
Neurdle, July 31, 2023:
There are 3 types of cone photoreceptors for color vision. Neural processing is complex: .
Today's Guest Neurd is artist Laura Bundesen, with "That's How The Light Gets In." She celebrates brains and color at
Neurdle, July 26, 2023:
#100
!!!
from Guest Neurd: Idha Sood
@JoyfulAstrocyte
: Substantia Nigra finds its origin in Latin, which literally translates to "Black Substance", owing to its appearance being darker than the surrounding areas due to high neuromelanin content.
Neurdle, March 2, 2024:
Myoclonic epilepsy myopathy sensory ataxia (MEMSA), previously referred to as spinocerebellar ataxia with epilepsy, is a mitochondrial syndrome caused by a variant in the POLG gene, which codes for polymerase gamma....
Bernard Sachs (1858-1944) is often called the father of Child Neurology - - and the GM2 gangliosidosis hexosamindinase-A deficiency is named after him, and the British ophthalmologist Waren Tay (Tay-Sachs disease)
Neurdle, February 19, 2024
Tuberous sclerosis complex (TSC) is a neurocutaneous multisystemic disorder, usually inherited in an autosomal dominant manner. Skin findings include ash leaf spots, Shagreen patches, adenoma sebaceum and ungual fibromas....
Neurdle Hint
#1
, Nov 10
There is no one who hates brand names more than Neurdle creator
@zach_london
.
Except when it comes to Neurdle.
Then all bets are off.
Hear ye! Residents and students on service with me, if you make it one week and only use generic drug names, I will literally shower you with candy.
You are strong, you are proud, you are not under the thumb of Big Pharma, and you shall be rewarded!
#medtwitter
#NeuroTwitter
1/2
Neurdle, April 28, 2024
Optic is a great starting word for Neurdle - some vowels, a C at the end, it's a solid choice. This paper's abstract starts "The optic nerve is the most important cranial nerve," which is a bold statement (vagus, anyone?) ....
Neurdle, August 13, 2023:
Single fiber EMG is the most sensitive test for impaired transmission at the neuromuscular junction, as in myasthenia gravis, Lambert-Eaton syndrome, or botulism:
Neurdle, Nov 11, 2023:
Guest Neurd Maria Xiang: "FIRES stands for febrile infection-related epilepsy syndrome and usually affects school-aged children ranging from 2 years to early adulthood. FIRES affects a previously healthy child after a brief, nonspecific febrile illness...
Neurdle, June 2, 2023:
Pupils Equal, Round, and Reactive to Light - usually an unnecessary abbreviation, and can be confusing, copied forward without thought, and meaningless.
What do you think?
Neurdle, April 29, 2023:
Chairs: furniture you sit on, and also, oddly, people in charge of a dept of neurology. The (brilliant, fun) card game Endowed Chairs: Neurology features 12 women neurologists from history in a hilarious send-up of academia.
Neurdle, May 26, 2023:
Zach London wrote a song about the subservient nature of this organ. "The heart is bound/ The heart is bound/ To serve the mind/ And not the other way around./ You're just a pump,/ When brain says jump/ You say, 'How high?'"
Neurdle, June 4, 2024:
As you get older, you start getting multi-vessel lumens in a single vascular channel in the frontal cortex! Maybe this is a good thing, and a sign of increased wisdom (haha, jk, nothing about brain aging is ever good)
@Dr_Ighodaro
Neurdle, July 23, 2023:
Positive sharp waves (P waves) arise when an EMG needle damages a muscle fiber and spontaneous action potentials propagate up to the needle tip. They are fundamental to the diagnosis of ALS:
Neurdle, June 25, 2023:
Guest Neurd: Connie Tang!
The ictal phase of a seizure is from onset of symptoms, including aura, to the end of seizure. Lateralization can be sussed by the “Figure 4 Sign” - rigid extension of one arm.
Neurdle, June 8, 2023:
Cutaneous mechanoreceptors located in skin detect light brush, stretch, vibration, and noxious pressure. Children with neurodevelopmental disorders often have hyper- or hyposensitivity to touch:
Neurdle, June 4, 2023:
What the hecksin is a neurexin? Neurexins are presynaptic cell adhesion proteins that bind with neuroligin to connect neurons at the synaptic cleft. Precise alignment facilitates neurotransmission.
An anonymous Neurd points out that we rarely use this verb in neurology - "seizure," "seizing," but not "to seize." What do you think? Is SEIZE a fair Neurdle?
(Pro tip: Do not expect your Neurdle to be fair, and don't forget that we allow plurals, proper nouns and acronyms.)
Neurdle, April 30, 2023:
The skull is made up of multiple bony plates, connected by sutures. Early fusing of sutures leads to a skull deformity called craniosynostosis - a major problem that prevents brain growth.