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  1. Charles Warlow

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    In this issue we review one disorder whichbut maybe should—encephalitis lethargica and head injury respectively. Could encephalitis lethargica return with the widely predicted bird flu epidemic? Well it might, but then the epidemic may not materialise, and it may be that this strange neurological condition was nothing to do with “Spanish flu” in the first part of the 20th century. But, just in case (page 360), Joel Vilensky and Sid Gilman give us some tips on what to look out for, although who knows what we will also see on brain MR, if anything (in the epidemic days neurologists only had their bare hands and skull x rays, not even angiography or EEGs). As for head injuries it is indeed odd that neurologists in so many countries have nothing to do with them, unless perhaps epilepsy develops. In the UK, admitted patients are left to linger on orthopaedic and general surgical wards, not renowned for being able to asses the Glasgow Coma Score or subtle mental problems; if the patients are not admitted, oft times they are just forgotten about. This is not the case in Holland where neurology is so much better organised. So no excuses for the article by Tim Anderson and his colleagues from Christchurch, New Zealand (page 342).

    Did van Gogh poison himself with absinthe? Phil Smith thinks so on page 376. And then we have a quartet of not very common neurological conditions, but they are important to recognise because they are all treatable to a greater or lesser extent—giant cell arteritis on page 384, transient epileptic amnesia on page 368, polychondritis on page 372 and reversible segmental cerebral vasoconstriction on page 382.

    Finally, half apologies for the family connection in the neurological letter (page 392), but electives really are the highlight of the present day medical student’s experience (my generation in London were not let out of our teaching hospitals in case we picked up bad habits for which there are no known vaccines, unlike Japanese encephalitis).

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