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 here either. Tony Marson's editorial describes the first National Audit of Seizure management in Hospitals (NASH), and notes alarming variation in the care provided to patients with seizures in UK emergency departments. Hopefully, this will make you think differently and will act as a spur for improvement.

Rustam Al-Shahi with colleagues from Edinburgh provides the next in the series of mimics and chameleons, this time discussing stroke. Tom Hughes kindly reviewed this article and we were so struck by his comments that we asked him to expand them. Tom suggests that by using the term ‘stroke’ for all sudden onset neurological deficits, we encourage misdiagnosis by advancing the diagnosis further than is justified, often to a point of no return—or correction. Food for thought.

The vascular theme continues with Shelley Renowden's review of normal neuroradiological vascular anatomy, and with a difficult case from Vasilis Liolios.

Difficult cases are a good way to learn, giving a different perspective on the differential diagnosis, and we have an interesting mixture. Tim Wilkinson illustrates the MR changes of transient global amnesia, and Jeremy Cosgrove provides images of an unusual cause of seizures. Saif Huda tells us of an unusual complication of facial pain, as well as of an unusual cause of mononeuritis multiplex, not to miss. Sarosh Irani and colleagues test our diagnostic acumen with a challenging and treatable case of suicidal behaviour.

Most of us have developed our own style and approach to teaching, usually from a combination of limited formal training merged with our own experience; mostly, we then progressed by trial and error. Mark Wiles provides his structured approach to teaching the neurological examination built upon his many years of doing this—along with a rich resource of material available on the website—to support your neurology teaching programmes.

While teaching is becoming more formally taught, most of us have had no training in medicolegal medicine. Colin Mumford provides his personal, practical and insightful view of medicolegal medicine in the UK. We get a reflection of this approach from one of the barristers he works for.

We have a view from abroad in a letter from Brazil from Adrian Wills, and a blast from the past from Gerald Stern; a further insight into neurological massage from Una Jones, as well as our regular insights from A Fo Ben.

And Sarah Linthwaite might persuade you to take milk with your chocolate if you dream of the ultimate academic success. That really is food for thought.