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  1. Charles Warlow

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    Because Practical Neurology is meant to be “practical” we do not usually publish rather speculative review articles, preferring to leave speculation mainly in the editorials. And we have never published any article by a linguist. However, I thought the notion of studying scientifically what we all do intuitively all the time, and so improving on it—judging people by how they say things as well as by what they say—was well worth an airing in the context of making a diagnosis, specifically of non-epileptic attacks. Maybe this approach will turn out to be just as valuable as yet another EEG or MR brain scan, although of course it does not have the hard copy evidence of either of those tests—time and more research will tell. In the meantime have a think about what Leendert Plug and Markus Reuber have to say on page 4, and ponder on whether this applies to your next patient with “are they epileptic attacks, or are they non-epileptic attacks?” There is more on epilepsy by John Paul Leach on page 27, dealing with the familiar problem of what to do when the antiepileptic drugs do not seem to be working. Myelopathies can sometimes be very difficult to sort out and even in Europe one does have to at least think about HTLV-1 infection, so the article by Sarah Cooper and her colleagues on page 16 should be a useful addition to that electronic or paper folder labelled spinal cord infection, or miscellaneous, or “other”. We are keen to encourage more articles on just how we teach neurology, and how to teach it better, of the sort written by Paul Morrish on page 33. Kleine-Levin syndrome is a real neurological rarity (I have only ever seen one case and that was 33 years ago) but you need to know about it, so read Radcliffe Lisk on page 41. B12 deficiency with a normal serum B12 level is a worry because it is treatable; see if you believe in the case described by Martin Turner and Kevin Talbot on page 37, or are you more sceptical like Lionel Ginsberg who reviewed this article, and some of whose comments we have included? Finally, Bare Essentials this time is on muscle disease and Mike Hanna has boiled it all down to 12 pages—no doubt there is more to know, but if you know absolutely everything on those 12 pages you will be doing better than me: I used the proofs to look up something just the other day!

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