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Carphology by A Fo Ben

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Helping a B.I.T. for T.B.I.

Amantidine is not as commonly used as an agent to promote recovery following traumatic brain injury (TBI) in the UK as it appears to be in the USA. A multi-national placebo-controlled trial in severe TBI, 4–16 weeks following the event enrolled and randomised 184 adults. Amantidine was associated with a faster recovery at 4 weeks (p=0.007) with the advantages most pronounced for patients enrolled later (as both groups saw improvements over time). These data are promising; however, A Fo Ben awaits the results of more prolonged studies. Functional outcomes, such as independence, may be more meaningful for patients and families.


A new sphere of knowledge

Over 300 years ago, William Molyneaux posed the following question to his friend and fellow philosopher, John Locke: Would a blind subject, on regaining sight, be able immediately to recognise visually an object previously known only by touch? Considered at the time to be a thought experiment, Molyneaux's question formed the basis of a century-long debate between rationalists and empiricists. Modern science has now addressed the question. In a recent paper, researchers working in India treated five patients aged between 8 and 17 years who had congenital corneal opacity and whose visual acuity was limited to light perception. On testing early after successful corneal surgery, they were not able to identify shapes they had previously touched on visual inspection alone. However, one week later, all the three subjects who were re-tested, showed much greater accuracy on the same test. This suggests that, although the answer to Molyneaux's question is ‘no’, neural substrates for such cross-modal interactions probably exist, even in people with no prior visual experience. A score draw for the philosophers?


Me and my neurological illness

Practical Neurology has an occasional article: Me and My Neurological Illness. Many neurological conditions are, however, progressive, disabling, incurable and the last possible disorder one would want to experience personally. Richard Knox Olney, (Emeritus Professor of Neurology at the University of California, San Francisco) dedicated his life to amyotrophic lateral sclerosis (ALS) research and recognised its early signs in himself. His stoical approach to diagnosis—and pragmatic response (enrolling himself as the first participant in a placebo controlled drug trial for ALS)—inspired his colleagues. ‘I had often quoted the statistic in lectures that one in 1000 people are struck at random during their adult life by ALS. I have become one.’

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A modern twist on a telegram from the Queen?

This year, Alan Turing would have celebrated his 100th birthday. The journal Nature celebrated his life and work in a special themed issue. A remarkable man and a polymath, his influence on the field of artificial intelligence cannot be overestimated. Not only integral in the development of modern computing, he profoundly changed the way we interact with machines. The issue contains some wonderful articles; the discussion of the pros and cons of developing artificial intelligence using the human brain as a model is perhaps of particular interest. Perhaps the best answer to that comes from Turing himself: ‘If a machine is expected to be infallible, it cannot also be intelligent,’ a comment still as apt for humans as it is for computers today.

Not irradiating, merely irritating?

We all know that listening to others chat on their mobile in a crowded train is annoying, but might such a conversation actually be dangerous? A Swedish study published last year suggested that the rates of malignant brain tumours were higher in people with high rates of mobile phone usage than in the population as a whole, prompting the International Agency for Research on Cancer to reclassify mobile phone exposure as a ‘possible human carcinogen’. (Carphology 2011;11:202) More recently, a large epidemiological study from the USA has studied the incidence of gliomas from 1992 to 2008, a period during which mobile phone use increased substantially. There were no increased rates of glioma. While the authors are quick to point out that these data could be consistent with modest excess risks from mobile use, the greatly increased risks predicted from the Swedish study do not seem to have materialised.

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The deadly sausage

Wise old neurology heads fail to be astonished by modern trends, fads or scares; they are aware of the cyclic nature of fashion and how even chaos can be limited in its presentation. It, therefore, was no surprise to be made aware that modern BSE scares have a very close parallel in the late-Victorian era. The focus in the late 1800s was on the humble sausage (although cockles, pork and even oysters had their own scandals). The Daily Mail take note—this is a scare story; there is ‘a scarlatina maligna sausage factory in Bethnal Green and … its miasmas were responsible for the death of three children.’ The major concern was the fear that unscrupulous sausage manufacturers were overly reliant on condemned meat as sausage filling.

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