Welcome to a new edition of the ACNR and thanks to everyone that has returned their reader questionnaires and the hundreds of you who have visited the web-site. It is good to know that the journal is popular and being read, both in the UK and internationally.

In this issue we have two contrasting review articles. John Scadding presents a beautiful account of the common problem of neuropathic pain, based on his extensive experience and knowledge of the literature. This article helpfully updates us on the new and emerging concepts in this field, including helpful definitions - so that you should no longer diagnose reflex sympathetic dystrophy but a complex regional pain syndrome (CRPS). Indeed this article explores the pathophysiological mechanism underlying the genesis of pain syndromes and then gives an extremely helpful summary of what is known and not known about therapies for this difficult group of conditions. This is a really helpful practical guide, based on sound scientific principle. This is nicely complemented by one of our reviews on the use of opiates in neuropathic pain.

The second review article is by Professor Patrick Maxwell and Dr Peter Hill on the very rare von-Hippel-Lindau disease. Slightly unusually for ACNR, the authors are renal physicians; their article is helpful in updating us on this syndrome and its aetiology. In this last respect insights from the gene product causing this disease on the cellular response to hypoxia has wide-reaching implications to biology in general including neuroscience - including for example the genesis of dopaminergic neurons from stem cells (see e.g. Studer L et al (2000) J Neurosci. 20(19):7377-83). Thus both these major articles bridge science and medicine, in a way that is the hallmark of this journal.

We embark on a new management topic in this issue, with David Burn giving us the benefit of his expertise on the approach to a patient with a movement disorder. This will be the first in a series of articles exploring different aspects of this complex field, and will hopefully provide a practical and informed account of the recognition, aetiology and therapeutic options for a range of movement disorders (in a similar fashion to that which we have done previously for epilepsy and muscle disease)

We also have a very exciting rehabilitation topic - Dasher; a novel way of communication. This new device has great potential, and is a reminder of the impact that modern technology can have on the development of better therapies for patients with disability. The article by the inventor of the system, David MacKay, invites you to have a go via the web site (it’s free) and then feedback your comments.

Brain McNamara continues his neurophysiological voyage, this time targeting the ulnar nerve. This has the usual Brian common sense approach and is very helpful in distinguishing the site of lesion in this commonly affected nerve.

We also have two historical articles in this issue of ACNR. Andrew Larner takes a different perspective on the work of Edward "smallpox" Jenner and John Pearce guides through an extensive literature on altered awareness in his article on Dreamy States.

So there it is, another issue, which we hope you enjoy and continue to support - but remember we are always keen to hear about suggestions for changes and topics, so don’t just sit there and complain: let us know!!

Roger Barker
AdvancesinCNR@aol.com