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No coincidence between getting a HPV vaccination and the risk of developing Multiple Sclerosis (Paul-Ehrlich Institute 2016)

As our waiting list is becoming longer and longer I would have some advices for adult patients with chronic headaches. Please stop taking any medications containing codeine and opioids as they might help short-term but will lead in the end to chronic headaches and widespread pain syndrome becoming worse and worse. Therefore -  as a first step -  they need to be stopped. Also Triptans being taken more than twice a week need to be discontinued as they lead to chronic headaches after a while. Please talk to your GP about the details how to come of it.

Evidence based treatment for Carpal tunnel syndrome: conservative treatment with splinting, steroid injections works, but operative treatment is treatment of choice. - (American Academy of Orthopedic Surgery 2016) 

Carotid endarterectomy superior and causes less complications in comparison to carotid stenting in cases of significant carotid artery stenosis . 

(Howard et al.; Lancet 2016;387:1305-11)

Multiple antiepileptic drugs during pregnancy increase the risk of foetal malformations. 

Meador KJ, Pennell PB, May RC, et al. Fetal loss and malformations in the MONEAD study of pregnant women with epilepsy. Neurology 2019; Epub 2019 Dec 5.



How to reduce the risk of being exposed to Sars-Cov-2 – aside of the necessity of social distancing, hygiene and wearing mask covering mouth and nose:

As we all have to work together to keep COVID-19 under control and save lives here is something useful I want to publish. I have come across it recently and found it to be very practical for schools, universities and companies and more....

Bad ventilation indoors is one of the biggest problems to be solved as it increases the risk of spreading Sars-Cov-2 and causing morbidity and mortality due to Covid-19.

One way to solve the problem to create a draught.

Another way is to use air-purifiers with modern Hepa-air-filters as we do in our practice but this is very expensive.

The ventilation system as described below is cheap and requires only a visit to a local DIY-store or hardware shop and some helping hands....

Here a recent publication of the Max-Planck-Institute for Chemistry by Dr Frank Helleis et al.:

Ventilation made easy - DECEMBER 01, 2020

A simple ventilation system removes 90 percent of respiratory aerosols which potentially include coronavirus particles, from indoor air

In future, it will be far easier to remove infectious aerosols from the air in classrooms and other spaces. Researchers at the Max Planck Institute for Chemistry have built a ventilation system that can be replicated using materials from a DIY store. …..



Ocrelizumab first licenced drug for secondary progressive MS.

Constipation, reduced ability to smell, REM-sleep-behavioural disorders can be first signs of Parkinson's disease.

Chronic Intake of Proton-Pump-Inhibitors are a risk factor for developing dementia: Gomm et al.;2016;JAMA Neurology;73:410-416

In order to preserve hearing in severe therapy-resistant vertigo due to Meniere's disease intratympanic Methylprednisolone should be tried first before Gentamicin

Pregabalin not working for chronic back pain - Mathieson et al.; 2017;Trial of Pregabalin in acute and chronic sciatica;N Engl J Med;376:1111-20.

Risk factors for unexplained death of Epilepsy - SUDEP: regular Grand-mal-seizures; respiratory problems after seizures;prone position during sleep;non-compliance with therapy.