Neurology

How pain management solves a refractory headache

Conditions

April 16, 2026

As a pain management specialist, I see patients every week who feel like they have tried nearly everything. They come to me after months, or even years, of battling chronic or refractory headaches. Their primary care doctor and neurologist have already walked them through the usual first-line options, yet the pain keeps coming back relentlessly. It steals their focus, disrupts their sleep, and robs them of the simple joys in …

The art of medicine and clinical reasoning: a lesson at the bedside

Fazlur Rahman, MD

Physician

April 2, 2026

An excerpt from The Temple Road: A Doctor’s Journey by permission of Texas Tech University Press. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Throughout my years in medical training, I had heard the maxim, “Medicine is an art.” And yet this notion seemed abstract to me; after all, I had been steeped in science.

Then I came under the …

When the doctor is also the patient’s mom: Navigating severe autism

Joele Tueno Scott

Conditions

April 1, 2026

Today I received a call from my son’s school informing me that he had been suspended for injuring his teacher and hurting another staff member. The week prior, I had received multiple calls requesting that I pick him up early due to escalating behaviors.

My story is not unique. Across the country, parents of children with autism navigate aggressive outbursts, elopement, self-harm, and school suspensions. We juggle IEP meetings, medication adjustments, …

Coprolalia and Tourette syndrome: Understanding involuntary vocal tics

Jerome Lisk, MD, MBA

Conditions

March 30, 2026

When actor John Davidson, who has Tourette’s syndrome, reportedly uttered a racial slur during the British Academy of Film and Television Arts (BAFTA) ceremony, the public reaction was swift and emotionally charged. For many people, the involuntary outburst reflected true feelings or a subconscious racial bias. However, that is not the case with certain forms of Tourette’s.

Coprolalia, the involuntary expression of socially inappropriate or taboo words, is among the most …

Understanding methylation, BDNF, and the ApoE Alzheimer’s gene

Majid Fotuhi, MD, PhD

Conditions

March 30, 2026

An excerpt from The Invincible Brain: The Clinically Proven Plan to Age-Proof Your Brain and Stay Sharp for Life by Majid Fotuhi. Copyright © 2026 by Majid Fotuhi. From Harper Wave, an imprint of HarperCollins Publishers. Reprinted by permission.

Your brain is constantly changing. While the primary structures remain the same, you can grow and shrink your cortex and hippocampus according to what you do. But what about genetics? You …

Why thiamine deficiency is a hidden driver of delirium

Carrie Friedman, NP

Conditions

March 29, 2026

Delirium is one of the most common and most frustrating syndromes we encounter in medicine. It is also one of the most normalized. Up to 30 to 50 percent of hospitalized older adults experience delirium, particularly in intensive care and post-acute settings, yet it is frequently treated as an expected complication rather than a reversible condition with identifiable drivers. We expect it. We document it. We treat around it. And …

Atypical Parkinson disorders vs. Parkinson disease: key differences

Jerome Lisk, MD, MBA

Conditions

March 27, 2026

The terms parkinsonism, Parkinson disorder, and Parkinson syndrome are all synonymous and can be used interchangeably depending on which you prefer. All of these terms refer to the symptoms. To be diagnosed with a Parkinson disorder, you must exhibit two out of three of the following motor symptoms:

unilateral resting tremor
slowness of movement (bradykinesia)
muscle rigidity or stiffness (cogwheel rigidity)

This is with or without postural instability, which usually refers …

How junk food shrinks your brain and fuels depression

Marc Arginteanu, MD

Conditions

March 20, 2026

Let us cut to the chase: Your daily dose of junk food is not just padding your waistline; it is quietly eroding the most complex organ in your body. The evidence is no longer scattered case reports or instinctive hunches. It is an ever-growing stack of human epidemiology, neuroimaging, and mechanistic biology. Ultra-processed foods (UPFs) are associated with depression, a shriveling brain, systemic inflammation (which crosses the blood-brain barrier), gut …

Huntington’s disease gene therapy: FDA reversal delays AMT-130

Meghan Johnston, MPH

Meds

March 17, 2026

At the end of September 2025, a gene therapy company released results from a clinical trial showing that a breakthrough procedure reduced the progression of Huntington’s symptoms by 75 percent over three years. Researchers collected data from 12 participants who received the therapy and compared the data with two types of control groups.

The company’s drug, AMT-130, shows unprecedented outcomes, so why is the FDA slowing …

Health care’s Upside Down: Addressing systemic dysfunction and burnout

Ganesh Asaithambi, MD, MBA

Physician

February 14, 2026

If you have watched Stranger Things, you know the premise: A quiet town appears functional on the surface while a darker, parallel world creeps into everyday life, or the Upside Down. The true danger is not just the monsters but also the refusal of adults in power to believe what is directly in front of them. Modern health care is living in its own Upside Down.

The metric trap

In my practice, …

Music and brain plasticity: How sound rewires your mind

Marc Arginteanu, MD

Conditions

February 11, 2026

Hot off the presses. The latest science proves, yet again, that music benefits your brain, and not in some vague, feel-good way; it physically remodels your brain in ways that make you calmer, sharper, and happier. I’m talking about measurable rewiring, anxiety reduction, and cognitive gains you can actually see on an fMRI.

Three rock-solid studies just landed:

1. Chinese researchers and anxiety reduction

Chinese researchers took a bunch of stressed-out college students …

Autism comorbidities: the hidden link between POTS, GI issues, and hypermobility

Carrie Friedman, NP

Conditions

February 10, 2026

Autism is typically framed as a neurodevelopmental condition defined by differences in social communication, sensory processing, and behavior. This framing is incomplete. In clinical practice, autistic individuals frequently present with a striking burden of systemic symptoms involving the gastrointestinal tract, cardiovascular regulation, immune signaling, connective tissue, and stress physiology. These are not side notes. They reflect the fact that autism lives within a nervous system that innervates the entire body.

The …

Why progression independent of relapse activity is the silent driver of disability in multiple sclerosis

Andreas Muehler, MD, MBA

Conditions

February 7, 2026

For too long, multiple sclerosis (MS) has been described with an air of quiet fatalism, a chronic, debilitating disease managed primarily by reducing relapses, but not fully addressed in terms of its continuous, underlying disability progression. This smoldering process often is not easily visible because of its progressive nature. Patients are told to manage expectations, while clinicians are taught to define success by the absence of magnetic resonance imaging (MRI) …

Post-stroke cognitive impairment: the hidden challenge of recovery

Rida Ghani

Conditions

February 1, 2026

When clinicians think about stroke recovery, attention often focuses on motor deficits, speech impairment, and the risk of recurrent cerebrovascular events. Cognitive outcomes, however, are frequently treated as secondary or inevitable consequences rather than primary targets of intervention. This oversight carries consequences. Post-stroke cognitive impairment (PSCI) is common, persistent, and one of the strongest predictors of long-term disability, institutionalization, and caregiver burden, yet it remains under-recognized in routine care.

As acute …

Genetic mutations and racial disparities in leukemia survival

Kurt Miceli, MD, MBA

Conditions

January 30, 2026

Throughout contemporary medical discourse, health disparities among racial and ethnic groups are often attributed to systemic and structural racism. Furthermore, organizations such as the American Medical Association assert that race itself is a social construct and urge a shift away from viewing race as a “biological risk factor” toward a “deeper understanding of racism as a determinant of health.” Unfortunately, this framing rings hollow and obscures an important …

Psychiatrists are physicians: a key distinction

Farid Sabet-Sharghi, MD

Physician

December 17, 2025

A new patient recently told me, “I’ve already seen two doctors about this.” She meant a life coach with an online certificate and a therapist with a doctorate in education. Neither was a physician. Neither had examined her, ordered labs, or considered medical causes for her rapid cognitive decline.

When I evaluated her, it was immediately clear she needed urgent neurological workup. She wasn’t suffering from “stress.” She had an early …

Valuing non-procedural physician skills

Jennifer P. Rubin, MD

Physician

December 14, 2025

No matter the specialty, the best doctors make it look effortless and “easy.” Whether it’s suturing a jagged laceration, reading an MRI spine with multi-level degeneration, or delivering a ten-pound baby with shoulder dystocia, the most skilled physicians can handle it without breaking a sweat. But we know it took many years of training, proficiency, feedback, and improvement to master their craft.

I’m not going to argue that surgical procedures are …

Read more…

Valuing non-procedural physician skills

Alzheimer’s link with insulin resistance [PODCAST]

The Podcast by KevinMD

Podcast

December 11, 2025

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, “How insulin resistance may cause Alzheimer’s disease.” Muhamad introduces the paradigm-shifting concept of Alzheimer’s as “Type 3 diabetes,” arguing that …

Why police need Parkinson’s disease training

George Ackerman, PhD, JD, MBA

Conditions

December 11, 2025

As innovations and changes develop in the police field, new areas and populations, including PwP, must be included. More than 1 million cases of Parkinson’s disease are predicted in the U.S. by 2030. PD is the fastest-growing neurological disorder in the world. According to the World Health Organization, “globally, disability due to PD is rapidly increasing,” which can precipitate more encounters between law enforcement and PwP worldwide. The current article …

Why not all ADHD generics are created equal

Ronald L. Lindsay, MD

Conditions

November 29, 2025

A 2022 KevinMD article raised concerns about generic formulations of ADHD medications. The author described what many patients and families had already discovered: Not all generics are created equal. For those of us who lived through the substitutions, the difference was not abstract. It was a roller coaster that intruded on daily life, even on vacation.

The generic in question was manufactured by Mallinckrodt. Unlike Concerta, which uses an osmotic-controlled …