This issue of ACNR contains review articles on inflammatory neuropathies by Michael Lunn, and the intracellular processes underlying neurodegenerative disorders by Sarah Tabrizi and Mark Kristiansen.

In his clinical review article, Michael Lunn concentrates on GBS and discusses the variants of this disease and their possible aetiologies, including immunopathogenesis. In particular he discusses the relative contributions of antibodies and T-cells in these different types of GBS and concludes with a section on treatment. This succinct account by Michael is based on his extensive research and is complimented by a recent case report of an unusual case of GBS, which can be found here on the website.

In the second review article, Sarah Tabrizi and Mark Kristiansen give us a state of the art account of the mechanisms that underlie cell death in neurodegenerative disorders. They focus on prion diseases, Huntington’s and Parkinson’s disease and make the valuable point that whilst mechanisms of cell death in these diseases may have similarities they may also be multifactorial, and that these factors may be different in each of the conditions. Furthermore they tackle the thorny issue of the role of the UPS in neurodegeneration and in particular discuss whether dysfunction of this pathway is a primary pathogenic process, or a consequence of a cell loaded with misfolded abnormal proteins. Peter Whitfield, in his series on neurosurgery, leads us through modern developments in frameless stereotactic techniques for tackling brain lesions. This is a clear account of an emerging technology that may be familiar to those involved in surgery, but is certainly a real education to those outside this discipline.

The link between art and neurology is a strong one, both historically and in the present age. Thus I review Ian McEwans latest novel, whilst Andrew Larner takes us back to the novels of Jane Austen and the plays of Anton Chekhov. Once more Andrew displays his impressive literary knowledge in another unique account, which has clearly involved a close reading of the text.Whilst we are discussing this, don’t forget the competition we advertised in the last issue of ACNR, which invites you to contribute to this fascinating area, by writing about a novel which deals with some aspect of neuroscience.

In the neuropathology article, Federico Roncaroli takes us on an extensive tour of MS pathology, touching on pathogenic mechanisms and different types of this disease. This includes discussing curious entities such as Balo’s concentric sclerosis and Schilder’s disease. These are conditions with which we are familiar, although in reality I have often struggled to know how they relate to MS.

Thomas Bak engages with the issue of aphasia or dysphasia in the Cognitive Primer series.We are very fortunate to have such an expert discuss this aspect of language, and the article is a real education in the problems and issues underlying the different types/forms of dysphasia. This article highlights not only areas of contention but is of immense practical help to everyone involved in the neurological assessment of patients with language deficits.

In the rehabilitation section, Clare Fowler and colleagues have written a very interesting account on the novel use of botulinum toxin in treating bladder detrusor overactivity. This is not only very practical in its content, but it shares with us the very latest data on this innovative technique from the leading Uro-neurological service in the UK.

The conference reports in this issue have a heavy PD influence and together they provide an excellent update on the recent advances in this disease - especially as there is also a sponsored article on somnolence in PD by Doug McMahon. Furthermore, we have an entertaining account of the latest ABN meeting from Chris Allen and Andrew Larner.

Finally we have our journal reviews and the first in a new series on famous names in neurology by Professor Alan Emery. This account is a very personal one, reliving how he first came across and described the muscular dystrophy that is named after him and Dreifuss. This is a fascinating, inspiring and yet human account and in many ways encapsulates the very essence of what ACNR hopes to convey in its articles and approach to neurology and neuroscience.

Roger Barker
Roger@acnr.co.uk