When you have finish reading Practical Neurology, and lay this edition aside—to get out of the bath or pour yourself another glass of something refreshing, or whatever—what do we hope to have achieved? To have kept your interest—certainly; to make you think—yes; but most of all, we would like you to think about doing things differently and maybe even to have changed your mind.

In this issue, Martin Prevett explores the approach to patients with epilepsy in sub-Saharan Africa (see page 14). Surely this poses dramatically different challenges to those encountered in the UK? Yet, all is not so rosy …