Welcome to the fifth year of ACNR. Once more this issue has a variety of articles written by authorative experts both from within the UK and abroad.

The first of our review articles is on the post-polio syndrome by Dr Elisabeth Farbu from Bergen in Norway. This condition is now relatively rare and despite being first described by Raymond and Charcot in 1875, has always been a controversial area. I certainly remember as an SHO the debates that used to rage on the Phipps (now Lane-Fox) respiratory unit at St Thomas’ Hospital as to whether this was a true disorder, or simply the natural ageing of a body with weak muscles. In her article, Dr Farbu lays to rest this controversy by setting out in beautiful clarity the diagnosis (including the strict diagnostic criteria in table 1) and management of this condition. This article is complimented by a case report prepared by Alastair Wilkins of a patient with this syndrome.

Meng Li in her review article reveals the truth about embryonic stem (ES) cells, without any of the hype that often accompanies articles on these, the most versatile, of stem cells. These stem cells have attracted much publicity not only in terms of the ethical issues they raise but their biological utility to reveal answers to normal development as well as their potential therapeutic use in neurological disorders. In this last respect the need to engineer controlled differentiation of ES cells into neurons remains a high priority, as does the need to prevent them from proliferating in an uncontrolled tumourigenic fashion. Meng Li deals with these issues along with the broader topic of using mouse ES cells to make transgenic animals, which has so revolutionised modern biology. This article is succinct, packed with information and a marvellous condensation of this expanding field – an area of neurobiology that will have relevance to all those working in neuroscience and neurology.

Neurosurgery in this issue takes on the subject of intracranial abscesses. Peter Whitfield takes us through this relatively rare condition with its range of presentations and therapies – many of which are surgical and based on the approach of MacEwen from 1881 of “debridement and drainage”. This article, as with all in these series, is steeped in common sense and beautifully illustrated with plenty of relevant radiographic images. This article is a superb accompaniment to the neuropathology article by Daniel du Plessis in ACNR 4(6).

The management of lower urinary tract symptoms is encountered by most neurologists and rehabilitationists, and is typically treated using anti-cholinergic drugs and/or some form of catheterisation. In the article by Simon Harrison and colleagues in this issue,we are given a state of the art discussion on the use of sacral nerve stimulators - a procedure that is not without difficulties, but which also appears to be of great value to some selected groups of patients. Although this technique is expensive and still being developed, the article should at least raise the profile of this procedure which was certainly new to me.

Neuropathology considers head injury (HI), and Colin Smith takes us through the different types of HI and how they evolve over time. This touches upon other topics we have covered in the past, including states of persistently altered consciousness (see Zeman ACNR 3(3)) and dementia. This article contains the usual educational plethora of histological images.

Andrew Larner tells us that no sign in neurology is to be believed!! He discusses the topographical anatomy of false-localising signs, starting with Colliers paper in Brain in 1904, in which he observed that 12.4% of patients with brain tumours had false-localising signs. This short account by Andrew is, as always, beautifully written (unlike most of my editorials) and is a real education.

In the cognitive primer series, Sebastian Crutch discusses Apraxia. This inability to perform purposeful voluntary movements in the presence of intact motor and sensory systems is one of the most fascinating and memorable deficits in neurological practice. This article comprehensively takes us through the range of different types of dyspraxia, and how they can be recognised and tested for along with their neural basis.

In drugs in neurology,Wendy Phillips and myself discuss tetrabenazine – the drug most commonly prescribed for chorea and related movement disorders. This drug, with its long history of use in neurology and psychiatry, is still not especially well-known to many practitioners because of its relatively selective indications.

As usual there are the journal, conference and book reviews. So as ACNR enters 2005, do keep the feedback coming and thanks for all your support and encouragement over the last 4 years with this exciting and evolving project.

Roger Barker
Roger@acnr.co.uk