“Recently a great deal has been learned about the response of the axon to demyelination particularly in response to an inflammatory insult and this knowledge has led not only to a deeper understanding of how symptoms can arise in demyelinated axons but also to the possibility of treatment to limit the disability resulting from demyelination and the associated change of the axon itself.” So writes Raj Kapoor and colleagues in their article on the demyelinated axon. This succinct account lays out a clear hypothesis on the sequence of events from demyelination to axonal loss and the relative role of ion fluxes and how this could be modulated by drugs such as lamotrigine.

Our second review article by Angela Vincent and Christian Bien concentrates on paraneoplastic diseases. Within this article are a large number of useful and practical insights, including some brief illustrative cases as well as some incredibly helpful tables. It is a particular pleasure to have this article, as Angela was on of the authors in our first ever issue of ACNR back in March-April 2001.

The repair of a cranial defect or deformation with cranioplasty is often regarded as a relatively straightforward process, but Heinke Pülhorn and Robert Redfern in their article in the Neurosurgery series take us through the history and practice of this procedure. They begin by relating the case of “The first reported cranioplasty… a Russian nobleman who, after receiving a sword blow to the head, had the resultant defect (and his health) restored with a piece of dog's cranium”, and end with a discussion on stem cell derived repair strategies. A real tour de force.

Stephen Casper gives a wonderful account of the origins of the Association of British Neurologists along with a potted biography of the first 5 presidents of this organisation. As he so eloquently writes, this organisation came into existence in 1932 and 75 years on is still thriving, although exactly what format the content of this meeting should take remains contentious (see ACNR 7.3). This highly enjoyable account by such a renowned medical historian is a delight to read.

Talking of the ABN, we have Chris Allen on behalf of the ABN MS panel responding to the recent critique by Neil Scolding on their guidelines in MS, which was the first in our new Controversies in Neurology series.

“Excitability testing involves measuring the threshold current required to stimulate an axon or population of axons, most commonly at a single accessible nerve point in the limb”. This technique with a number of attractions and problems is discussed by Karl Ng and David Burke in their excellent contribution to our Neurophysiology series.

In our Neurogenetics series Paola Giunti and Nick Wood take us through the bewildering array of inherited ataxias. This article lays out the vast explosion of conditions that now live within this family of disorders with some helpful advice on what is common and what is not.

In our Neuropathology series, we have a wonderfully clear account of the pathology of raised intracranial pressure by Antonia Barlow and Willie Stewart. This article presents the pathology with great clarity and includes some extremely helpful tables and illustrative pictures.

In our series on Indian neurology, Dr Subhash Kaul in passing comments on some unusual causes of stroke in India (e.g. viper envenomation) as well as treatment (e.g. a massage with pigeon blood). However the main part of his review deals with the reality that “stroke burden in India is rising in the last few decades, in contrast to developed countries”. The reasons for this are discussed as well as the challenges that this presents for India and its limited health resources.

Following on from this theme, we have the first in what I hope will be a new series on medical electives which attempt to describe the practicalities of how one goes about organising such initiatives, as well as what one learns from these experiences. We are therefore grateful to Catherine Slattery for sharing with us her travels to the neurology departments of St Vincent’s in Melbourne and Queen Square in London, and the contrast in neurological practice (as well as those who attend with patients) in these two countries.

Andrew Larner in his latest contribution to Neurological Literature leads us through a range of cases, from Livingstone and “his clergyman’s throat” to Heidi and her sleep walking. This fascinating account once more highlights how superficially I read most books!

Sadly we have to report the loss of another great British neurologist and neuroscientist, Professor John Newsome-Davis. John sadly was killed in an road traffic accident in August this year, and his loss his huge and will be felt by many in the world of both neurology and neuroimmunology- areas to which he contributed so much.

Roger Barker
Roger@acnr.co.uk