In the first of our review articles, Alexandra Sinclair explores the greatly under-investigated, but common, condition of Idiopathic Intracranial hypertension. In this excellent short account she describes the diagnostic criteria for this condition, along with some of the new ideas on aetiology and how best to treat it – weight loss!
In our personal perspective article, Sophie Dow describes the route to finding that their daughter, Annie, had a rare chromosomal abnormality – 46,XX,arr cgh 1p31.1->1p31.3 (RP4-759M20->RP11-261J10) x 1. The discovery of this was made some 10 years after the initial diagnosis and highlights the journey that patients and their families make with scientists and clinicians as diagnostic technologies move forward – sadly much faster than treatments and cures.

A new series in this issue of ACNR, edited by Alan Carson and Jon Stone, attempts to tackle issues of neuropsychiatry through a series of clinical scenarios. This is an innovative approach suggested by Alan and Jon, and judging by the first in the series, should be hugely successful. In this article Jason Warren explores the difficult issue of dementia and MS, and what can be usefully said in a consultation about this issue. Do let us have your feedback on this new format.

Liesl Alcock discusses the features and best management of a common problem in Parkinson’s disease ­– namely orthostatic hypotension. This succinct account reminds us of the plethora of features this condition causes and how it can best be defined and treated.

In the next of our series in paediatric neurology, edited by Anna Maw, Richard Brown takes us through the process of recognising and investigating regression in people over the age of five years old. He concludes “Patients presenting for the first time with apparent loss of skills must be carefully evaluated. The first step is defining the problem. Is this true neurodegenerative disease, with progressive loss of skills and the development of neurological signs? Or is this a pseudo-regression, where the problems derive from non-degenerative causes”.

“One audit of 719 PEG procedures...demonstrated that 19% were futile and of those dying 43% did so within one week of insertion”, so writes Diane Playford in her short summary of a report from a working group on PEGs. This procedure, which is often considered in neurological patients with strokes or neurodegenerative disorders is useful in the right patient at the right time. The challenge is achieving just that as this report highlights.

In a new series of articles edited by Martyn Bracewell, the historical background to the study of motor control is presented. Jonathon O’Brien and Martyn take us from the early work of Sherrington to the present day and mirror neurons!

Andrew Larner gives us another tour de force with his sixth article on headache in neurological literature, whilst also providing us with some wonderful book reviews.
We have our usual summary of conferences and journals, and we again hope you enjoy the mix of articles that is ACNR.

Roger Barker
Roger@acnr.co.uk