An important syndrome of bipolar disorder is the cognitive impairment that is observed in the patients it must be considered as a part of the illness. Bipolar disorder is a high priority research field, due to its pervasiveness, and high economic and personal (suicidality, impaired function, quality of life) costs, and the limited evidence base to inform therapeutics. Mood stabilizers and second-generation antipsychotics are partially effective regarding cognitive impairment of mood disorders. What is read in literature are descriptions of mood elevation that reflect symptoms of high energy, lessened need for sleep, feelings of euphoria, grandiosity, impulsivity, elevated libido, etc. But when patients are on the depressed end of the mood spectrum, they are presenting with low energy, low self-esteem, feelings of sadness, loss or emptiness, suicidal ideation, pervasive pessimism, low motivation, and all the other experiences we associate with feeling depressed.

The use of Gabapentin for management of spasticity has become part of clinical guidelines despite a lack of objective scientific data. This is due to the problems associated with user dependent and insensitive to change clinical assessment tools. We sought to redress this using the Wartenberg’s pendulum test. This is objective and sensitive to detect changes in spasticity. All patients had stable disease and did not have any changes to their medications within 30 days of the trial. If the patients were on muscle relaxants (namely Baclofen and tizanidine), these were stopped 10 days prior to the study. Patients were randomized to receive a single dose of either placebo (Ascorbic Acid), Gabapentin 300mg or Gabapentin 900mg, each at weekly intervals in a crossover manner. We found no evidence of any effect on spasticity at either dosage when compared with placebo. Our data does not support the use of Gabapentin for management of spasticity in patients with Multiple Sclerosis.

Haemorrhage in intracranial tumours is usually associated with malignant primary brain tumours or metastases and rarely with grade 1 meningiomas. We present the case of a 64-year-old woman, who presented acutely and was found to have a convexity meningioma with intratumoral and subdural haemorrhage. A review of the literature has been performed to look at all published cases of meningiomas with haemorrhages, particularly in relation to their subtypes.The association of meningiomas with different types of intracranial haemorrhage has been discussed. Various factors potentially responsible for haemorrhage and association with subtypes has also been discussed.

Lewy Body Dementia (LBD) is a frequent and complex neurodegenerative pathology, shorter in duration than Alzheimer’s disease. Many advances have been made both pathophysiologically and imaging, allowing earlier diagnosis. Although there are few double-blind clinical studies on drug therapies, the place of anticholinesterase inhibitors, L-dopa and new antipsychotics is slowly emerging.