The one day ABN Autumn Meeting was held at the Royal College of Physicians (RCP) in London. It was preceded by a one day joint meeting between the Association of British Neurologists (ABN) and the RCP tackling acute neurological conditions for the jobbing general physician.
The one day ABN meeting managed to squeeze in cutting edge reviews of diseases spanning the whole nervous system from higher cortical function all the way to muscle disease. Professor David Burn from Newcastle University gave a comprehensive review of clinical features, risk factors, diagnostic biomarkers, pathogenesis and treatment options of cognitive impairment in Parkinson’s disease. Interestingly, although 40% of Parkinson’s disease patients have mild cognitive impairment at presentation, about 25% of Parkinson’s disease patients never develop dementia. Dr Tom Foltynie from the National Hospital for Neurology and Neurosurgery then discussed the challenging topic of managing difficult Parkinson’s disease patients. He gave helpful tips for the management of refractory tremor, fluctuations, dyskinesias, gait freezing and non-motor symptoms. His talk included videos with striking improvement of tremor and dyskinesias following deep brain stimulation, which has become significantly safer with the advent of MRI guided surgery.
Dr Simon Rinaldi from Oxford University followed with a comprehensive review of Guillain Barre Syndrome, including clinical features, accuracy and optimal timing of diagnostic procedures, and evidence based treatments. It was interesting to learn about the role of antibodies towards ganglioside complexes rather than single gangliosides in isolation in the pathogenesis of the disease. Professor Sarah Tabrizi from the National Hospital then gave a superb overview of cutting edge longitudinal research mapping the natural history of Huntington’s disease. This has been vital for the development of robust biomarkers of disease progression when testing potential disease modifying drugs in Huntington’s disease. Professor Rosalie Ferner from Guy’s Hospital gave an excellent overview of the diversity of clinical features of neurofibromatosis types 1 and 2 spanning the central and peripheral nervous system and non-neurological features. This was followed by Dr Kevin Talbot from Oxford University giving an insightful overview of the latest genetics of motor neuron disease with a focus on the recently discovered C9orf72 mutation and its diverse phenotypic presentations.
After a tasty lunch, the first afternoon session kicked off with Dr Benedict Michael from Liverpool University giving a stimulating talk about the value of measuring pro- and anti- inflammatory cytokines in the CSF in order to predict clinical outcome following HSV encephalitis. Afterwards, Professor Neil Scolding from Bristol University outlined the expanding landscape of currently available and emerging disease modifying therapies in multiple sclerosis, each with its distinct advantages, risks and costs. This was nicely followed by Dr Robin Franklin from Cambridge University giving an intriguing talk about the role of cellular pathways, particularly RxRγ in the activation of progenitor cells and remyelination to aid recovery following an acute demyelinating episode.
During the final afternoon session, Professor John Duncan from the National Hospital for Neurology and Neurosurgery gave an excellent overview of the multidisciplinary evaluation process epilepsy patients go through for the consideration of epilepsy surgery. This involves integration of findings from cutting edge neuroimaging and neurophysiological techniques in order to maximise chances of seizure freedom, whilst minimising the risk of neurological deficits as a result of surgery. The last stop of the day’s tour of the nervous system was with muscle disease. Professor Michael Hanna from the National Hospital for Neurology and Neurosurgery gave a comprehensive clinical and pathological overview of inclusion body myositis highlighting the diversity of abnormal protein aggregation, which may aid in identifying potential treatment targets for this inflammatory and degenerative disease.
ACNR. Published online 3/4/14.