This issue of Annals of Indian Academy of Neurology presents interesting papers on a variety of subjects. Publication trends in neurology in physicians’ journal are discussed by K. V. S. Hari Kumar and colleagues. It is good to know that neurology gets a fair representation in the premier physicians’ journal of India. With only a thousand neurologists carrying the burden of neurological health care, positive interaction with the physicians seems the order of the day. Benny and Shetty discuss the split hand sign, leading to the diagnosis of motor neuron disease. With the Indian situation requiring rapid analysis of patients’ illness, such clinical pointers to shorten the differential diagnosis hold value.
Harpreet Singh et al. describe one more unrewarding neuroprotection trial despite the presumed theoretical benefits attributed to magnesium. Kashyap et al. also look at acute strokes to search prognostic biomarkers. This paper is a preliminary report based on earlier work of the group where they described a novel protein, inter-α trypsin inhibitor heavy chain 4 (ITIH4), and pointed out the similarities of behavior in this protein and interleukins. Their current observations indicate a possibility that selected interleukins could have prognostic value in acute stroke. While on the subject of stroke, the paper by Mingfeng He and colleagues discusses the validation of a stroke scale – the ROSIER scale in pre-hospital setting. Even though the study is done in China, most of the comments are applicable to Indian setting as well, where stroke recognition and awareness has not reached optimal levels. The simple scale seems useful in the primary health care setting. Kalita et al. provide systematic analysis of thyrotoxic periodic paralysis vis-à-vis idiopathic variety. Thyrotoxic periodic paralysis is believed to be common in Asians and Orientals, and this paper not only documents the percentage to about 17% of all periodic paralysis, but also points out the similarities rather than the differences. It would seem that the two can be distinguished by tests alone. Yildirim et al. compare a simple to administer Alberta infant motor scale to the better established ones and find it comparable. Again, in the Indian setting, this may be helpful to the busy practitioners of pediatrics and neurology.
There are many interesting case reports in the issue, ranging from Charcot arthropathy, paraneoplastic cerebellar degeneration in Hodgkin's lymphoma, the rare occurrence of recurrent and reversible posterior encephalopathy, a hereditary neuropathy that looked like a myopathy due to hip dislocation, a neat description of a family with megalencephalic leukoencephalopathy in a nonclassical setting, unusual cryptococcal meningitis, painless orbital myositis, Klinefelter syndrome, and a very unusual case of long incubation period in rabies. The Resident's Corer gives a superb demonstration of eye signs in Wilson's disease.
I wish to mention that the journal receives far more case reports than can be published and that most case reports are based on rarity. I strongly urge our readers to submit only those single cases that open new vistas in disease mechanisms and therapy. Letters to the editor are always good to see, as they reflect the interest of our expert readers. Please do write your impressions and comments on the published work; it helps everyone.
This issue comes to you little ahead of the Annual Conference of Indian Academy of Neurology. Let us have a stimulating and refreshing conference at Ahmedabad.