Neurology 2015
Leading-Edge Neurology
for the Practising Clinician
Presented by the
UCL Institute of Neurology
March 26-27 2015
Logan Hall, Institute of Education
20 Bedford Way, London WC1H 0AL
Download course book at: www.tiny.cc/neur15book
or scan the barcode with your smartphone
2015
Neurology
UCL Institute of Neurology
London
March 26-27
InstituteAofANeurologyADirector
ProfessoróMichaelóGóHanna
A special thanks to Dr Suraj Rajan, MSc, MD for
his work on the title logo for Neurology 2015
InstituteASecretary
MróRobertóWalkeró
Editors
Mr Daniel CotfasóLó
MróDavidóBlundred
Neurology 2015 Lead Organiser
ProfessoróSimonóShorvon
This meeting is sponsored by the Pharmaceutical Industry with the
presence of exhibition stands. There has been no Pharmaceutical
Industry input to the scientific content of the meeting.
TheóeditorsóareógratefulótoótheóQueenóSquareóLibrary:óWellcome Images, UCL
Images Store and theóMedicalóIllustration Departmentóforósupplyingómanyóofó
theóimagesóincludedóinóthisóbookletMóAllórightsóreservedM
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óóóóóóóQ&B5:óUCLóInstituteóofóNeurology:óLondon
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ChairAofANeurology
ProfessoróMaryóReilly
Director,ANHNN
ProfessoróJohnóDuncan
HeadAofAEducationAUnitA
DróCarolineóSelaió
HeadAofATeachingAandALearningASupportAA
Mr David Blundredó
SeniorAUnitAAdministratorAA
MissóJeanóReynolds
ó
WELCOME TO NEUROLOGY 2015:
Leading-edge Neurology
for the Practising Clinician
March 2015
Dear Colleagues,
On behalf of the Executive Committee of UCL Institute of Neurology, it is a pleasure to welcome
you to the Neurology 2015 course
The aim of the course is to provide an update on the practical hospital management of common
neurological diseases, with an emphasis on modern techniques and therapies. Its purpose is to be
didactic, but also entertaining and informative.
This programme book contains abstracts of the talks and also additional material provided by the
speakers. The paper version also includes reprinted (with permission) full-text article.
We hope the course will prove instructive, and we are keen to have feedback, so please do not hesitate
to contact the organisers with any comments or suggestions. It is an annual event and your comments
will be very helpful for planning for the future.
Many people have been involved in assisting with the organization. Particular thanks go to Daniel
Cotfas, David Blundred and Jean Reynolds in the Education Unit at the UCL Institute of Neurology
for their contribution to the logistical aspects and the production of this programme. A special thanks
go to all the speakers and presenters. We would also like to gratefully acknowledge the support of our
sponsors (listed at the end of the programme book) which has made this conference possible.
We have also added a selection of historical photographs as a visual survey of the history of Queen
Square. These are kindly provided by the Department of Medical Illustration, the Queen Square
Archives, Wellcome Images, UCL Image Store, Suraj Rajan, Barney Bryson, Bernadett Kalmar, David
Werring, Kim Chisholm, Marija Sajic and Ken Smith.
With best wishes,
Simon Shorvon
(On behalf of the UCL Institute of Neurology Executive Committee)
Neurology 2015 Programme
Thursday 26 – Friday 27 March 2015
Venue: Logan Hall, Institute of Education, Bedford Way, London
Thursday, the 26th of March, 2015
Time
Title
Speaker
Welcome
Professor M Hanna
8.45 –
11.00
8.45
Topic 1: Leading edge therapy in acute neurology
Chair: Professor S Shorvon
What's new in Guillain Barré?
Dr R Howard
9.30
The modern treatment of meningitis in hospital
practice
Advances in therapy of acute seizures and status
epilepticus
Coffee Break
Dr S Farmer
Nobel lecture: Membrane fusion and its
implications for neurology
Video Session: Eye movements and their disorders
Professor J Rothman
8.00 –
8.40
8.40
10.15
11.00 –
11.30
11.30
12.05 –
12.45
12.45 –
13.45
13.45 –
16.00
13.45
Registration and coffee
Professor S Shorvon
Dr G Plant
Lunch
Topic 2: Clinical approach to neuromuscular
disease
Approach to diagnosis and management of peripheral
neuropathy
Approach to diagnosis and management of muscle
disease
Approach to diagnosis and management of diseases of
the neuro-muscular junction
Tea Break
Chair: Professor D Kullmann
Topic 3: Advanced therapy of headache and
Parkinson’s Disease
Management of migraine and other chronic headache
syndromes
Chair: Dr M Matharu
17.10
A pragmatic approach to treatment issues in early and
late Parkinson’s Disease
Professor K Bhatia
17.50
Reception
14.30
15.15
16.00 –
16.30
16.30 –
17.50
16.30
Professor M Reilly
Professor M Hanna
Professor D Kullmann
Dr M Matharu
Neurology 2015 Programme
Thursday 26 – Friday 27 March 2015
Venue: Logan Hall, Institute of Education, Bedford Way, London
Friday, the 27th of March, 2015
Time
8.00 –
8.45
8.45 –
11.00
8.45
9.30
10.15
Title
Speaker
Topic 4: Where decisions about therapy are difficult
Chair: Dr J Chataway
Balancing risk in the drug treatment of multiple
sclerosis
The place of surgery, chemotherapy and radiotherapy in
the management of glioma
Modern treatment of aneurysms and AVM
Dr J Chataway
Coffee
Dr J Rees
Miss J Grieve
11.00 –
11.30
11.30 –
12.05
Coffee
Queen Square Town Hall meeting: Commissioning in
Neurology
Professor S Shorvon (chair),
Dr C Mummery,
Prof G Venables
12.05
CPC
Dr M Lunn
12.45 –
13.45
13.45 –
16.00
13.45
Lunch
14.30
15.15
Topic 5: Neuropsychiatry and dementia
Chair: Professor E Joyce
Assessing dementia in clinical practice
Professor M Rossor
Neuropsychiatric disorders in Parkinson’s Disease and
their management
Prion disease - public health, CJD and therapy
Professor E Joyce
16.00 –
16.30
16.30 –
17.50
16.30
Tea
17.10
Professor J Collinge
Topic 6: Advances in Stroke
Chair: Dr D Werring
Advances and challenges in Stroke
Dr D Werring
Optimal management of TIA and stroke secondary to
carotid atherosclerosis
Professor M Brown
What’s new in Guillain Barré?
THURSDAY – 8:45AM
by Dr Robin Howard
Guillain Barré syndrome (GBS) remains an important neurological cause
of severe, prolonged and often permanent disability and carries a
significant mortality. It is increasingly recognised that GBS is a descriptive
term for a group of acute immune demyelinating neuropathies that share
overlapping sensory, motor and autonomic clinical features and
characteristic laboratory and electrophysiological abnormalities. Over
recent years there have been considerable advances in understanding the
pathogenesis of acute demyelinating neuropathy which carries
considerable implications for management. Whilst there are proven and
effective treatments to reduce the effects of acute GBS, residual deficits are
common and effective management encompasses both short-term
immuno-modulation and longer term intensive care and rehabilitation.
Dr Robin Howard
Consultant Neurologist
Senior Lecturer
UCL Institute of Neurology
Dr Howard is Consultant Neurologist at the National Hospital, Queen
Square and St. Thomas’ Hospital, and Senior Lecturer at The Institute of
Neurology, University College and King’s College.
He qualified from Cambridge University and the Middlesex Hospital in
1980, undertook training in Oxford and London and was appointed to his
present post in 1992. He is Head of Service for a large general
neurological practice at St. Thomas’ and neurologist to 3 intensive care
units. His major specialty interests are intensive care neurology and
neuromuscular diseases including myasthenia gravis, motor neurone
disease, post-polio syndrome and sleep disorders.
Selected Publications
‒ Wakerley BR, Yuki N. Mimic and chameleons in Guillain Barre and
Miller Fisher Syndromes. Pract Neurol 2014;0:1–10.
‒ Robin S Howard, S Veronica Tan, Werner J Z’Graggen. Weakness on
the intensive care unit. Pract Neurol 2008; 8: 280–295
For more information visit:
www.tiny.cc/rhoward
or scan the QR code
robin.howard@ucl.ac.uk
THURSDAY – 9:30AM
The modern treatment of meningitis
in hospital practice
by Dr Simon Farmer
Bacterial Meningitis has a world wide incidence of between 1 and 4 per
100,000 of the population with a mortality of 35%. A significant number
of survivors are left with serious neurological sequelae of the disease. With
vaccination, improved nutrition and public health its incidence in
developed countries is falling but it remains in modern hospital practice a
serious cause of neurological mortality and morbidity, especially in
immune suppressed patients. Rapid diagnosis and treatment of the
meningitis is the main determinant of outcome. The strategies for rapid
diagnosis and intensive treatment will be reviewed.
Dr Farmer qualified from Bristol University in 1986. He trained in
neurology and general medicine at the Royal London Hospital, NHNN
and at St Mary’s Hospital, London. He was appointed consultant
neurologist between St Mary’s Hospital and the National Hospital in
1996, and is on the staff of King Edward VII Hospital in London. His
dominant neurological practice is general neurology. He covered acute in
patient neurology at St Mary’s Hospital and at the National Hospital. He
consulted on HIV positive patients and on immune suppressed patients at
St Mary’s. He also provided neurology input to the paediatric meningitis
unit at St Mary’s Hospital. He is a principal investigator at the Institute of
Neurology and Associate Clinical Director for Neurology at NHNN. He
has published over 100 articles in clinical and basic neuroscience and has
contributed to several neurology text books
Selected Publications
‒ Karen Edmond, Andrew Clark, Viola S Korczak, Colin Sanderson, Ulla
K Griffiths, Igor Rudan. Global and regional risk of disabling sequelae
from bacterial meningitis: a systematic review and meta-analysis. Lancet
Infect Dis 2010; 10: 317–28
‒ Natalie G Martin, Manish Sadarangani, Andrew J Pollard, Michael J
Goldacre. Hospital admission rates for meningitis and septicaemia
caused by Haemophilus influenzae, Neisseria meningitidis, and
Streptococcus pneumoniae in children in England over five decades: a
population-based observational study. Lancet Infect Dis 2014; 14
‒ Russell M Viner, Robert Booy, Helen Johnson, W John Edmunds, Lee
Hudson, Helen Bedford, Ed Kaczmarski, Kaukab Rajput, Mary
Ramsay, Deborah Christie. Outcomes of invasive meningococcal
serogroup B disease in children and adolescents (MOSAIC): a casecontrol study. Lancet Neurol 2012; 11: 774–83
Dr Simon Farmer PhD FRCP
Consultant Neurologist and Associate
Clinical Director
National Hospital for Neurology &
Neurosurgery (NHNN)
For more information visit:
www.tiny.cc/sfarmer
or scan the QR code
simon.farmer@uclh.nhs.uk
THURSDAY - 10:15AM
Advances in therapy of acute seizures
and status epilepticus
by Professor Simon Shorvon
In recent years, there have been significant advances in the treatment of
acute seizures and status, and these will be reviewed in this talk. In acute
seizures and the early phase of status epilepticus, new buccal,
intramuscular and intra-nasal therapies have been developed and have
replaced the use of intravenous or rectal therapies in out-of-hospital
settings. The advantages and characteristics of these are now well
established and will be discussed. At the other end of the spectrum, the
concept of super-refractory status epilepticus has been recently established,
referring to status which does not respond to initial anaesthetic therapy in
the ITU setting. This is a not uncommon clinical situation, with high
morbidity and mortality. Therapy is empirical and unsatisfactory. This is
also the subject of a global audit. The talk will focus on these points.
Simon Shorvon was appointed Consultant Neurologist at the National
Hospital for Neurology and Neurosurgery, Queen Square, London in
1983. He has held various posts including the Chair in Clinical
Neurology, Head of the Department of Clinical Neurology, Head of the
Epilepsy Research Group and is also Clinical Sub-Dean at the Institute of
Neurology. He is Chairman of the Medical Committee at the National
Hospital Queen Square, Harveian Librarian at the Royal College of
Physicians and until 2014, President of the British Branch of the
International League Against Epilepsy (ILAE). He served as a member of
the international Executive Committee of the ILAE for 16 years,
previously as ILAE Vice-President and as co-Editor-in-Chief of
EPILEPSIA. He is recipient of lifetime achievement awards for work in
epilepsy including 2008 European Epileptology Award, 2010 Lennox
Prize of the American Epilepsy Society and the TS Shrinivasan award.
Status epilepticus is one of his interests and he has written a monograph
on the subject and organises the biannual status epilepticus colloquia, the
next one of which is in London in April 2015.
Selected Publications
‒ Anderson GD, Saneto RP. Current oral and non-oral routes of
antiepileptic drug delivery. Adv Drug Deliv Rev. 2012 ;64(10):911-8.
‒ Shorvon S, Ferlisi M. The treatment of super-refractory status
epilepticus: a critical review of available therapies and a clinical
treatment protocol. Brain. 2011 Oct;134(Pt 10):2802-18.
Professor Simon Shorvon
Consultant Neurologist
Professor of Clinical Neurology
UCL Institute of Neurology
For more information visit:
www.tiny.cc/sshorvon
or scan the QR code
s.shorvon@ucl.ac.uk
THURSDAY – 11:30AM
Nobel lecture: Membrane fusion
and its implications for neurology
by Professor James Rothman
Information is passed between nerve cells and synaptic connections by
neurotransmitters, which must be released synchronously with electrical
activity. Synchronous release is due to just three proteins. SNARE proteins
fuse the synaptic vesicles which store neuro-transmitters at nerve endings
with the nearby nerve surface membrane. Complexin acts as a clamp to
block SNAREs half-way through the fusion process by cross-linking
them. The calcium ion sensor Synaptotagmin reverses the clamp and
facilitates fusion but only when it binds calcium, which enters the presynaptic nerve in response to the electrical signal, synchronizing release to
electrical action potentials. Recent results provide a structural biochemical
basis for this vital physiological process.
Professor Rothman, the Wallace Professor of the Biomedical Sciences at
Yale University, is one of the world's most distinguished biochemists and
cell biologists. He is Chairman of the Yale School of Medicine’s
Department of Cell Biology and is the Director and founder of the
Nanobiology Institute at Yale, and is a research professor at UCL.
Professor James Rothman
Visiting Research Professor
UCL Institute of Neurology
He is renowned for discovering the molecular machinery responsible for
transfer of materials among compartments within cells. In so doing, he
provided a unified conceptual framework for understanding such diverse
and important processes as the release of insulin into the blood,
communication between nerve cells in the brain, and the entry of viruses
to infect cells. Numerous kinds of tiny membrane-enveloped vesicles ferry
packets of enclosed cargo. Each type of vesicle must somehow deliver its
specialized cargo to the correct destination among the maze of distinct
compartments that comprise the cytoplasm of a complex animal cell. The
delivery process, termed membrane fusion, is fundamental for physiology
and medicine, as pathology in this process can cause metabolic,
neuropsychiatric and other diseases.
He has received numerous awards and honors in recognition of his work,
notably the Nobel prize for Physiology or Medicine (2013). He is a
member of the National Academy of Sciences (1993) and its Institute of
Medicine (1995), and a Fellow of the American Academy of Arts and
Sciences (1994).
Selected Publications
‒ http://www.nobelprize.org/nobel_prizes/medicine/laureates/2013/roth
man-lecture.html
For more information visit:
www.tiny.cc/jrothman
or scan the QR code
james.rothman@ucl.ac.uk
THURSDAY – 12:05PM
Video session: Eye movements and their disorders
by Dr Gordon Plant
Disorders of the central nervous system often cause abnormalities of eye
movements. I will present a system for assessing such disorders at the
bedside (excluding disorders of the III, IV and VI nerves and nystagmus).
The patient is first of all asked to fix on a distant target and the eyes
observed for stability of fixation – are there saccadic intrusions or
nystagmus? An accommodative target is then introduced and near fixation
examined to test the vergence system and the near response. Fixation
should then be held with the eyes in various eccentric gaze positions to
examine for nystagmus. The patient is then asked to follow the same target
to examine smooth pursuit in the four cardinal directions (vertical, up and
down; horizontal, left and right). A second target is now introduced and
the patient instructed to look from one target to the other thus generating
saccadic eye movements, again in the four cardinal directions. It may be
useful to examine saccades of larger and smaller amplitude. The
optokinetic drum may be used as an additional means of examining
smooth pursuit and saccades. Lastly the oculocephalic reflex, the head
thrust test and change in the orientation of the head in relation to gravity
should be used to test the integrity of the vestibular influence on the
ocular motor system.
Dr Plant trained at Cambridge and St Thomas’, and further trained in
Neurology at Queen Square attending clinics at Moorfields throughout to
obtain experience in Ophthalmology. After a year as an MRC Travelling
Fellow in San Francisco at the Smith Kettlewell Eye Research Institute and
UCSF he took up, in 1991, his present post as Consultant Neurologist at
Queen Square, Moorfields and St Thomas’. A Fellow of the Royal College
of Physicians and Royal College of Ophthalmologists, Senior Lecturer at
UCL and Visiting Professor at City University in London and Wills Eye
Institute in Philadelphia. He is editor-in-chief of Neuro-Ophthalmology,
founder of the UK Neuro-Ophthalmology Special Interest Group and a
past President of the Clinical Neurosciences section of the Royal Society of
Medicine. He has given numerous named lectures and published over 300
peer reviewed research papers. His clinical and research interests
encompass most areas of the Neurology of Vision. He is particularly
interested in promoting research and training in Medical Ophthalmology.
Selected Publications
‒ Pau D, Al Zubidi N, Yalamanchili S, Plant GT, Lee AG. Optic neuritis.
Eye (Lond). 2011 Jul; 25(7):833-42. doi:10.1038/eye.2011.81.
Dr Gordon Plant
Consultant Neurologist
Senior Lecturer
UCL Institute of Neurology
For more information visit:
www.tiny.cc/gplant
or scan the QR code
gordon.plant@uclh.nhs.uk
THURSDAY – 1:45PM
Approach to diagnosis and management
of peripheral neuropathy
by Professor Mary Reilly
The diagnosis of a peripheral neuropathy relies heavily on a detailed
clinical examination whereas the diagnosis of the cause of the neuropathy
is refined by both the history and the examination. Slowly progressive
longstanding length dependent neuropathies suggest a hereditary cause
such as Charcot Marie Tooth disease (CMT) whereas a more rapid
progression of a patchy neuropathy often points to an inflammatory cause
such as chronic inflammatory polyradiculoneuropathy (CIDP) or, if
painful, vasculitis. Nerve conduction studies and EMG are essential
diagnostically especially in the classification of neuropathies into
demyelinating or axonal, clarifying the presence and degree of motor and /
or sensory involvement and in ascertaining various patterns. As with any
disease the initial diagnostic aim is not to miss a treatable cause and a wide
range of blood tests are used depending on the diagnostic suspicion. Skin
biopsies for epidermal nerve fiber density are increasingly used in the
diagnosis of small fiber neuropathy and the use of nerve and muscle
imaging with both MRI and ultrasound is increasing. Therapies will be
reviewed and range from symptomatic therapies e.g. pain relief, orthosis
etc to immunotherapy and chemotherapy for inflammatory and
myelodysplastic associated neuropathies.
Professor Mary Reilly
Consultant Neurologist
Professor of Clinical Neurology
UCL Institute of Neurology
Mary M. Reilly was appointed a consultant neurologist at Queen Square
in 1998 and a Professor of Clinical Neurology at UCL in 2010. Since
1998, she is head of the peripheral nerve services in the National Hospital
for Neurology and Neurosurgery and has an active research program in
genetic neuropathies. She is co-director of the MRC Centre for
Neuromuscular Diseases in Queen Square, a past president of the British
Peripheral Nerve Society, president elect of the international Peripheral
Nerve Society and a council member of the Association of British
Neurologists. She received her FRCP in 2002 and her FRCPI in 2003.
Selected Publications
‒ Neligan A, Reilly MM, Lunn MP. CIDP: mimics and chameleons.
Practical Neurol. 2014 Jul 17.
‒ Rossor AM, Polke JM, Houlden H, Reilly MM. Clinical implications
of genetic advances in Charcot-Marie-Tooth disease. Nat Rev Neurol.
2013 Oct;9(10):562-71.
For more information visit:
www.tiny.cc/mreilly
or scan the QR code
m.reilly@ucl.ac.uk
THURSDAY – 2:30PM
Approach to diagnosis and management
of muscle disease
by Professor Michael Hanna
Muscle diseases impair mobility and not infrequently cause serious
cardiorespiratory complications. Their age of onset and severity is
extremely wide; ranging from neonatal death, through young onset severe
life-long disability to late onset mild phenotypes. About 90 000 people in
the UK have one of the diverse group of genetic or acquired conditions
which make up the primary muscle diseases. A great many more patients
have muscle weakness due to complications of drugs or systemic diseases
such as cancer. The important acquired muscle diseases include the
inflammatory myopathies which are treatable and so the diagnosis must
not be missed (or over diagnosed), as well as the drug-induced
myopathies. There is also an important large number of primary genetic
muscle diseases including dystrophies, congenital myopathies, metabolic
disorders (including mitochondrial) and channelopathies. Some of the
most rapid molecular and post-genomic advances in neurology have
occurred in the field of muscle disease resulting in an advanced
understanding of molecular pathophysiology. This understanding has led
to an increasing number of experimental clinical trials targeting specific
disease mechanisms. It seems most likely that there will be translation of
these advances into new treatments in clinical practice in the next few
years.
Professor Michael Hanna is Director of the UCL Institute of Neurology.
He is Professor of Clinical Neurology and Consultant Neurologist
specialising in neuromuscular diseases at the National Hospital Queen
Square. He is Director of the MRC Centre for translational research in
neuromuscular diseases, which was established in 2008 and renewed in
2013. This joint London- Newcastle MRC Centre links basic science
advances to clinical trials in patients with a range of neuromuscular
diseases. He also leads the Queen Square Centre provision of a nationally
commissioned highly specialised clinical and genetic diagnostic service for
mitochondrial diseases and muscle channelopathies.
Selected Publications
‒ Merrison AF, Hanna MG. The bare essentials: muscle disease.
Pract Neurol. 2009 :54-65. PMID: 19151243.
‒ Rahman S, Hanna MG. Diagnosis and therapy in neuromuscular
disorders: diagnosis and new treatments in mitochondrial diseases.
J Neurol Neurosurg Psychiatry. 2009;80(9):943-53
Professor Michael Hanna
Consultant Neurologist
Professor of Clinical Neurology
UCL Institute of Neurology
For more information visit:
www.tiny.cc/mhanna
or scan the QR code
m.hanna@ucl.ac.uk
THURSDAY – 3:15PM
Approach to diagnosis and management of diseases
of the neuro-muscular junction
by Professor Dimitri Kullmann
Myasthenia gravis is an under-recognised cause of neuromuscular
weakness, especially in the elderly. Seronegative myasthenia can present
diagnostic challenges. Although most cases of myasthenia can be managed
with anticholinesterase medication and immunosuppression, some
refractory cases require intravenous immunoglobulin, plasma exchange or
monoclonal antibody treatment. This talk will also discuss the role of
thymectomy, and the diagnosis and management of Lambert-Eaton
myasthenic syndrome, botulism and congenital myasthenic disorders.
Dimitri Kullmann has a research interest in fundamental mechanisms of
synaptic transmission, circuit neuroscience and gene therapy for epilepsy.
He specializes clinically in myasthenia and neuro-critical care at the
National Hospital for Neurology and Neurosurgery. He established his
own laboratory at the Institute of Neurology in 1992, and has held an
MRC Senior Clinical Fellowship, was Head of the Department of Clinical
and Experimental Epilepsy, and is a Fellow of the Academy of Medical
Sciences. Since 2014 he has been the editor in chief of Brain.
Professor Dimitri Kullman,
FMedSci
Consultant Neurologist
Professor of Neurology
UCL Institute of Neurology
Selected Publications
‒ Spillane J, Beeson DJ, Kullmann DM. Myasthenia and related
disorders of the neuromuscular junction. J Neurol Neurosurg
Psychiatry. 2010 Aug;81(8):850-7.
‒ Spillane, J., Sidle, K. C., Kullmann, D. M., Christofi, G., & Howard,
R. S. (2013). Myasthenia gravis and neuromyelitis optica: A causal link.
Multiple Sclerosis and Related Disorders, 2 (3), 233-237.
doi:10.1016/j.msard.2013.01.003
‒ Schapira, A. H. (2004). Disease of muscle and the neuromuscular
junction. Clinical Neurology, 130-153.
For more information visit:
www.tiny.cc/dkullmann
or scan the QR code
d.kullmann@ucl.ac.uk
THURSDAY – 4:30PM
Management of migraine and other chronic
headache syndromes
by Dr Manjit Matharu
Chronic daily headache (CDH) is a major worldwide health problem that
affects 3–5% of the population and results in substantial disability. Besides
migraine, several other primary headaches can cause CDH including
tension-type headache, new daily persistent headache and the trigeminal
autonomic cephalalgias. The management of these headaches involves
addressing lifestyle factors and treatment with acute and preventive
medical treatments. Recent advances are leading to the introduction of
new therapies for these headache disorders. Advances in the management
of headache disorders have meant that a substantial proportion of patients
can be effectively treated with medical treatments. However, a significant
minority of these patients are intractable to conventional medical
treatments. While a substantial proportion of patients can be effectively
treated with medical treatments, a significant minority of these patients are
intractable to conventional medical treatments. Neurostimulation
therapies that entail non-invasive and invasive peripheral or central
nervous system targets are emerging as very promising approaches.
Dr Manjit Matharu
Consultant Neurologist
Senior Lecturer
UCL Institute of Neurology
Dr Matharu is a Senior Lecturer at the Institute of Neurology and
Honorary Consultant Neurologist at the National Hospital for Neurology
and Neurosurgery, Queen square, London, UK. He is the Academic and
Clinical lead of the Headache Group. His major research interests include
interventional therapies for intractable headaches, trigeminal autonomic
cephalalgias, and functional imaging in primary headaches. He is a
member of the education subcommittee of the International Headache
Society, and the Headache and Pain Subcommittee of The Association of
British Neurologists (ABN). He was a member of the National Institute
for Health and Clinical Excellence (NICE) guideline development group
(GDG) for Headache Disorders.
Selected Publications
‒ Nagy AJ, Rapoport AM. Update on future headache treatments.
Neurol Sci. 2013 May;34 Suppl 1:S101-8.
‒ Miller S, Matharu M. Trigeminal autonomic cephalalgias: beyond the
conventional treatments. Curr Pain Headache Rep. 2014
Aug;18(8):438
‒ Lambru, G. and M. S. Matharu (2014). "Peripheral neurostimulation
in primary headaches." Neurol Sci 35 Suppl 1: 77-81.
For more information visit:
www.tiny.cc/mmatharu
or scan the QR code
manjit.matharu@ucl.ac.uk
THURSDAY – 5:10PM
A pragmatic approach to treatment issues in early
and late Parkinson’s Disease
by Professor Kailash Bhatia
Parkinson’s Disease is an evolving condition with a number of motor and
non-motor features both related to the disease progression and also to
dopaminergic drug treatments. A number of different drugs are available
for treating the symptoms of Parkinson’s Disease. Hence clinicians require
an outline of different strategies for the management of these motor and
non-motor symptoms. In this regard we will consider the use of
symptomatic dopaminergic drugs including the question of dopamine
agonists versus levodopa. In addition we will look at the use of Mao-B
inhibitors, COMT inhibitors and Amantidine. The management of
levodopa induced dyskinesia and fluctuations will be discussed as well as
issues regarding the use of duodopa and deep brain stimulation surgery for
advanced PD. Finally it’s crucial also to consider the management of
cognitive and neuropsychiatric features in the setting of PD.
Kailash Bhatia is a Professor of Clinical Neurology at the UCL Institute of
Neurology, and Honorary Consultant Neurologist at the affiliated
National Hospital at Queen Square. He obtained his basic medical degree
and neurology training in Mumbai, India and further training in
neurogenetics and movement disorders with the late Professor’s Anita
Harding and David Marsden. He is a Fellow of the Royal College of
Physicians and corresponding Fellow of the American Academy of
Neurology. His main research interest is in movement disorders, merging
clinical, electrophysiological, and genetic methods to study the
pathophysiology of conditions like dystonia and Parkinson’s Disease.
Professor Bhatia has over 480 publications including 380 peer reviewed
papers. He has been an Associate Editor of the Movement Disorders
Journal and is the current editor of Movement Disorders Clinical Practice
Journal. He is a grant reviewer for Telethon, Inserm France, UK PD
society and a medical advisor to the UK Dystonia society. He serves the
scientific board of the Bachman Strauss trust and is on the Executive
Committee of The International Parkinson’s Disease and Movement
Disorders Society.
Selected Publications
‒ Massano J, Bhatia K. Clinical approach to Parkinson's Disease:
features, diagnosis and principles of management. Cold Spring Harb
Perspect Med 2012;2:a008870
Professor Kailash Bhatia,
MD, DM, FRCP
Consultant Neurologist
Professor of Clinical Neurology
UCL Institute of Neurology
For more information visit:
www.tiny.cc/kbhatia
or scan the QR code
k.bhatia@ucl.ac.uk
FRIDAY – 8:45AM
Balancing risk in the drug treatment of multiple
sclerosis
by Dr Jeremy Chataway
There has not been a more exciting time to be involved in the
management of multiple sclerosis (MS). Over the last 20 years has come
an increasing number of agents (disease modifying treatments: DMT)
which can reduce the attack rate in relapsing-remitting MS (RRMS).
These range from first line (beta-interferons/copaxone) which reduce the
rate by 30%; to oral agents (e.g. fingolimod) which can reduce it by 50%:
to monoclonal antibodies (e.g. alemtuzumab) which can reduce it by
nearly 80%. However with the increase in potency has come the increase
in rare, but serious side-effects. These range from Progressive Multifocal
Leukoencephalopathy (PML) to significant thyroid dysfunction to cardiac
dysrthythmias. The debate now, is not whether to use an agent, but
whether an escalation or induction approach is optimal. This talk will
examine these issues.
Dr Jeremy Chataway,
MA, PhD, FRCP
Consultant Neurologist
Honorary Senior Lecturer
UCL Institute of Neurology
Dr Chataway is the clinical lead of the MS group at NHNN (about 3000
patients) and was a member of the 2014 MS NICE panel. He has a
particular interest in clinical trial design and was the Chief Investigator
(CI) of the recently reported MS-STAT trial in secondary progressive MS,
using high dose simvastatin; and is the CI of the recruiting MS-SMART
trial. He sits on the UK MS Society Grant Review Panel for Care and
Services Research and UK MS Society Clinical Trials Network Steering
Group; and works with the Comprehensive Clinical Trials Unit. He is
keen to facilitate both trial design and implementation.
Selected Publications
‒ Multiple Sclerosis: Current and Emerging Disease-Modifying Therapies
and Treatment Strategies: Dean M. Wingerchuk, Jonathan L. Carter:
Mayo Clinic Proceedings. Volume 89, Issue 2, February 2014, Pages
225–240
‒ The new therapeutic landscape in multiple sclerosis: exciting times and
new perspectives: Hartung, Hans-Peter; Kieseier, Bernd C. Current
Opinion in Neurology: June 2014 - Volume 27 - Issue 3 - p 243–245
For more information visit:
www.tiny.cc/jchataway
or scan the QR code
j.chataway@ucl.ac.uk
FRIDAY –9:30AM
The place of surgery, chemotherapy and
radiotherapy in the management of glioma
by Dr Jeremy Rees
Gliomas represent the most common primary intracranial brain tumour
and, with few exceptions, remain incurable. However, improvements in
the safety and delivery of modern treatments have extended the quality of
patients’ lives and, in some cases, their survival. Surgery, radiotherapy, and
chemotherapy still form the cornerstone of management of glioma, and
technical advances in these treatments have led to improvements in
morbidity and survival, particularly over the last decade. In line with other
areas of oncology, there is increasing use of combination therapies,
particularly concomitant chemoradiation to improve survival. Targeted
biological agents, gene therapy, and immunotherapy are under active
investigation but have still not been widely taken up clinically because of
the lack of proven benefit over and above standard therapies. There are
some exciting new treatments, currently being evaluated, which offer hope
for much better survival in malignant glioma
Dr Jeremy Rees
Consultant Neurologist
Honorary Senior Lecturer
UCL Institute of Neurology
Dr Jeremy Rees qualified in 1988 from University College and Middlesex
Medical School with distinctions in Medicine, Surgery and Therapeutics.
After postgraduate training, including a period at Memorial Sloan
Kettering Hospital, New York, in 1999 he was appointed as Honorary
Senior lecturer in Neuro-oncology and Consultant Neurologist at the
National Hospital for Neurology and Neurosurgery. He specializes in the
management of low-grade brain tumours and neurological complications
of cancer.
He has been the Clinical Lead for the Brain Tumour Unit at NHNN and
is the Pathway Director for Brain Cancer at London Cancer, an Integrated
Cancer System. He has carried out extensive research into multimodality
imaging of Low Grade Gliomas, has edited a textbook on Neurooncology, and written numerous peer-reviewed research papers and
chapters on Brain Tumours.
Selected Publications
‒ Rees JH. Diagnosis and treatment in neuro-oncology: an oncological
Perspective. The British Journal of Radiology, 84 (2011), S82–S89
‒ Bradley D, Rees J. Updates in the management of high-grade glioma.. J
Neurol. 2014 ; 261:651-4
For more information visit:
www.tiny.cc/jrees
or scan the QR code
jeremy.rees@ucl.ac.uk
Modern treatment of aneurysms and AVM
FRIDAY – 10:15AM
by Ms Joan Grieve
Aneurysms most commonly present following a subarachnoid
haemorrhage, or rarely a focal neurological deficit. Arteriovenous
malformations may present with subarachnoid or intracerebral
haemorrhage, epilepsy or progressive focal deficit. With the advent of
MRI, many aneurysms and arteriovenous malformations are also now
discovered coincidentally. Advances in treatment modalities are occurring
more rapidly than advances in our knowledge of the natural history of
these lesions, especially if presenting prior to haemorrhage. This means
that decision-making regarding optimal management can be extremely
difficult and requires a multidisciplinary approach.
There has been a progressive shift from open surgical procedures to
endovascular approaches as the technology to deal with more complex
lesions has evolved and developed. This has also been driven by patient
choice as well as perceived benefits to health economics. The treatment
modalities available for management of these lesions and the patient,
clinical and radiological factors considered when planning their treatment
will be discussed.
Ms Joan Grieve
Consultant Neurosurgeon
National Hospital for Neurology
and Neurosurgery
Joan Grieve has been a Consultant Neurosurgeon at the National Hospital
for Neurology and Neurosurgery since 2002. She has a particular interest
in vascular and pituitary subspecialties.
She trained at St George's Medical School and undertook her
neurosurgical training at Atkinson Morley's Hospital, Great Ormond
Street Hospital for Children and The National Hospital for Neurology
and Neurosurgery, obtaining FRCS(SN) in 2000. She was successful in
being awarded an MD in 2004 entitled 'Novel Structural and Functional
Imaging Techniques in Cerebral Arteriovenous Malformations' following
2 years of research at Queen Square.
Selected Publications
‒ Advances in endovascular approaches to cerebral aneurysms. Dumont
TM1, Eller JL, Mokin M, Sorkin GC, Levy EI. Neurosurgery. 2014
Feb;74 Suppl 1:S17-31.
‒ Contrast-enhanced magnetic resonance angiography in intracranial
giant aneurysms. H.R.Jäger, H.Ellamushi, E.A.Moore, J.P.Grieve,
W.Taylor, N.D.Kitchen. American Journal of Neuroradiology 2000;
21: 1900-1907.
For more information visit:
www.tiny.cc/jgrieve
or scan the QR code
joan.grieve@uclh.nhs.uk
Clinicopathological conference (CPC)
Presented by: Dr Michael Lunn, Dr Rahul Phadke and others
Discussant: Dr Jeremy Rees, National Hospital for Neurology and Neurosurgery
History
59 year old man was admitted to NHNN for investigation.
He gave a nine month history of left foot beginning with tripping. This was associated with some abnormal
sensation in the 2nd-4th toes of L foot, as if they had been immersed for hours in water. There were some
intermittent spasms and cramps of the left leg which also steadily became weaker. Over the following months
there was progressive weakness of the left foot requiring an AFO. In the 2/12 prior to admission, fasciculation
was described in upper and lower limbs. There was difficulty climbing stairs and rising from chairs in the month
prior to admission. For several weeks he had had urgency of urine with less than 5 minutes notice to pass water,
and had had several incontinence episodes per week.
His hearing, speech and swallowing were normal.
He was emotionally normal with normal cognitive function.
There was no relevant past medical history, no family history, no relevant travel history, medical or social
exposure and he had a normal diet.
Examination
CNs normal: Eye examination was normal, JJ negative, no facial weakness, tongue normal.
No muscle wasting in the limbs
Bilateral deltoid and trapezius fasciculation were seen but there was normal strength. Brisk reflexes including
pectoralis and trapezius jerks. Abdominal jerks absent. Spastic paraparesis with asymmetric L>R proximal and
distal weakness. Brisk knee and ankle jerks, L extensor plantar response and normal vibration, JPS and pinprick
sensation. No cerebellar signs.
General physical examination was normal: weight normal, cardiovascularly normal, skin normal, testes normal.
Investigations
NCS: Sural SNAPs 6uV and 3 uV.
Motor – median DML 4.3ms, amp 6.8mV, CV 47ms-1 F 34ms, ulnar DML 3.2ms, amp 11.1mV, CV 47ms-1
F 36ms, peroneal (EDB) DML 5.0ms, amp 2.0mV, CV 33ms-1 F 63ms. EMG evidence for non-lengthdependent denervation affecting 2 body regions.
MRI brain and spine showed some atrophy
Other investigations were performed to reach a diagnosis.
Clinicopathological conference (CPC)
FRIDAY – 12:05AM
by Dr Michael Lunn
Dr Michael Lunn is a Consultant Neurologist, Clinical Lead in
Neuroimmunology and Honorary Senior Lecturer at the National
Hospital for Neurology, Queen Square.
His clinical and research interests are in the inflammatory neuropathies,
particularly Guillain-Barré syndrome, CIDP, POEMS syndrome and other
paraproteinaemic neuropathies. He also has an interest in clinical trials, in
outcome measures used for measurement in clinical trials of neuropathic
diseases and evidence synthesis and meta-analysis to improve future trial
design and extract more information from trials with inadequate designs
which together can suggest or confirm more significant clinical effects of
therapy.
Dr Michael Lunn
Consultant Neurologist
National Hospital for Neurology
and Neurosurgery
His out-patient practice as part of the Peripheral Nerve Service in the
MRC Centre for Neuromuscular Disease at the National Hospital covers
all inflammatory neuropathies with multidisciplinary support from
neurophysiologists and nurse specialists. He works closely with the ITU
team at the National Hospital
Dr Lunn has published original papers, reviews and book chapters on
aspects of inflammatory peripheral neuropathies, cited over 1100 times
since 2009 and with an H-Index now at 20. He is Coordinating Editor of
the Cochrane Neuromuscular Disease Group, managing, performing and
publishing reviews of evidence based practice across the whole field of
neuromuscular disease.
For more information visit:
www.tiny.cc/mlunn
or scan the QR code
michael.lunn@ucl.ac.uk
Assessing dementia in clinical practice
Assessing patients with cognitive impairment can be a major challenge in a
busy neurology clinic. Not only can it be time consuming to assess the
different domains of cognitive function but since cognition is very
sensitive to ill health it is necessary to ensure that systemic determinants of
dementia or co-morbidities worsening dementia are not missed. A
structured approach is important. History from a family or friend is
essential and the examination can start while the history is being taken by
careful observation of the patient and informant. The broad categories of
delirium, subcortical dementia and cortical dementia, whilst imprecise,
can provide a useful framework as can the concept of ‘dementia plus’, i.e.
cognitive impairment in the setting of additional neurological deficits. A
structured approach will be discussed with illustrative videos.
FRIDAY – 1:45PM
by Professor Martin Rossor
Professor Martin Rossor
Consultant Neurologist
Professor of Clinical Neurology
UCL Institute of Neurology
Martin Rossor trained in Neurology at the National Hospital, Queen
Square and undertook research into the neurochemistry of degenerative
dementia at the MRC Neurochemical Pharmacology Unit, Cambridge.
He is a Professor of Clinical Neurology at the National Hospital for
Neurology and Neurosurgery, and established a specialist cognitive
disorders clinic which acts as a tertiary referral service for young onset and
rare dementias.
Clinical research interests are in the degenerative
dementias and particularly in familial disease. He was editor of the Journal
of Neurology, Neurosurgery & Psychiatry, and President of the
Association of British Neurologists. Martin is the NIHR National
Director for Dementia Research , Director of the NIHR Queen Square
Dementia Biomedical Research Unit and a NIHR Senior Investigator.
Selected Publications
‒ Martin N Rossor, Nick C Fox, Catherine J Mummery, Jonathan M
Schott, Jason D Warren. Diagnosis of young-onset dementia. Lancet
neurology 2010 9: 793-806.
For more information visit:
www.tiny.cc/mrossor
or scan the QR code
m.rossor@ucl.ac.uk
FRIDAY – 2:30PM
Neuropsychiatric disorders in Parkinson’s Disease
and their management
by Professor Eileen Joyce
It is increasingly recognised that Parkinson's Disease is more than a
movement disorder. Neuropsychiatric manifestations are a prominent
aspect of the syndrome in both the early and late phases of the disease.
These include: mood and anxiety disorders; cognitive impairment and
dementia; psychosis and iatrogenic impulse control disorders. These
symptom clusters and their timing can be explained by the spread of
neuropathology throughout the brain. Alpha-synuclein is deposited early
in brain stem serotonergic and noradrenergic nuclei and thereafter
midbrain dopamine cell bodies, not only in the substantia nigra motor
nucleus but also in the ventral tegmental area. This is followed by
forebrain involvement of basal cholinergic nuclei and limbic and
association cortex. The progressive pathology of Parkinson's Disease
perturbates neural systems known to be dysfunctional in psychiatric
disorders thus explaining symptom development. Understanding the
underlying neuropathology of Parkinson's Disease informs treatment
strategies.
Professor Eileen Joyce
Consultant Neuropsychiatrist
Professor of Psychiatry
UCL Institute of Neurology
Eileen Joyce is Professor of Neuropsychiatry at the UCL Institute of
Neurology and Honorary Consultant Neuropsychiatrist at the National
Hospital for Neurology and Neurosurgery.
Professor Joyce received a degree in psychology from the University of
Cambridge where she also completed her PhD in dopamine
psychopharmacology with Susan Iversen. She went on to study medicine
at Cambridge and trained in psychiatry at the Maudsley Hospital. She
spent her higher clinical and research training in the neuropsychiatry
department of Professor Alwyn Lishman which was followed by a period
of time as a research associate at The National Institute on Alcohol Abuse
and Alcoholism, USA. She returned to the UK in 1991 to take up a senior
lectureship at Imperial College and remained there until 2005 when she
moved to University College London.
Selected Publications
‒ Gallagher DA, Schrag A. (2012) Psychosis, apathy, depression and
anxiety in Parkinson's Disease, Neurobiology of Disease 46: 581–589.
For more information visit:
www.tiny.cc/ejoyce
or scan the QR code
e.joyce@ucl.ac.uk
Prion disease - public health, CJD and therapy
John Collinge is Professor of Neurology and Head of the Department of
Neurodegenerative Disease at the UCL Institute of Neurology, and
Director of the MRC Prion Unit. He also directs the NHS National Prion
Clinic at the adjacent National Hospital for Neurology and Neurosurgery.
Professor Collinge trained in medicine at the University of Bristol and in
neurology at St Mary’s Hospital and the National Hospital for Neurology
and Neurosurgery in London. He is committed to highly
multidisciplinary research and the seamless integration of basic laboratory
and clinical research. He established the MRC Prion Unit at Imperial
College in 1998 where he held the positions of Wellcome Senior Clinical
Fellow and then Wellcome Principal Clinical Fellow. His laboratory
demonstrated in 1996 that the new human prion disease, variant CJD,
was caused by the same prion strain as that causing BSE in cattle and has
been responsible for a number of key advances in the field. Professor
Collinge has served on numerous Government advisory committees on
prion disease at a national, European Union and international level. He is
committed to public communication of the Unit’s research and gives
many media interviews. He is a Founder Fellow of the Academy of
Medical Sciences, a Fellow of the Royal Society and was awarded a CBE
for services to medical research.
Selected Publications
‒ Lloyd SE, Mead S, Collinge J. Genetics of prion diseases. Curr Opin
Genet Dev. 2013 Jun;23(3):345-51.
‒ Thompson A, MacKay A, Rudge P, Lukic A, Porter MC, Lowe J,
Collinge J, Mead S. Behavioral and psychiatric symptoms in prion
disease. Am J Psychiatry. 2014 Mar 1;171(3):265-74.
FRIDAY – 3:15PM
by Professor John Collinge
Professor John Collinge
Professor of Neurology
MRC Prion Unit Director
UCL Institute of Neurology
For more information visit:
www.tiny.cc/jcollinge
or scan the QR code
j.collinge@prion.ucl.ac.uk
Advances and challenges in stroke
The outlook for treating stroke has changed dramatically in recent years.
Major changes in routine care include intravenous thrombolysis for
ischaemic stroke and reconfiguration of stroke services to provide high
quality specialist hyperacute care. The range of patients who benefit from
thrombolysis has extended with evidence from recent trials and pooled
analyses. Although initial studies were neutral, evidence is now emerging
to support endovascular therapy for selected patients with acute ischaemic
stroke. In the field of intracerebral haemorrhage, hyperacute blood
pressure reduction has recently been shown to be safe and to result in
improved outcomes. In the field of secondary stroke prevention, notable
recent advances include the widespread use of non-vitamin K
anticoagulants to prevent ischaemic stroke in non-valvular atrial
fibrillation. This lecture will briefly outline selected recent advances in
stroke care, as well as some challenges for future research.
David Werring is a Reader in Clinical Neurology and Honorary
Consultant Neurologist at UCL Institute of Neurology, Queen Square,
and the National Hospital for Neurology and Neurosurgery (NHNN),
University College Hospitals (UCH) NHS Foundation Trust. At UCH he
has been involved in developing a new hyperacute stroke service and
outpatient services for patients with cerebral haemorrhage. Dr Werring is
leading a research program in stroke, with a particular interest in
neuroimaging and small vessel disease, especially intracerebral
haemorrhage and cerebral amyloid angiopathy. He is Chief Investigator
for the CROMIS-2 (Clinical Relevance of Microbleeds in Stroke) study
(www.ucl.ac.uk/cromis-2), and for studies of new imaging biomarkers and
treatments for cerebral amyloid angiopathy. He is Stroke specialty clinical
lead for the NIHR North Thames Clinical Research Network, and
member of the faculty of the European Stroke Organisation Conference.
FRIDAY – 4:30PM
by Dr David Werring
Dr David Werring
Consultant Neurologist
Reader in Clinical Neurology
UCL Institute of Neurology
Selected Publications
‒ Charidimou A, Gang Q, Werring DJ. Sporadic cerebral amyloid
angiopathy revisited: recent insights into pathophysiology and clinical
spectrum. J Neurol Neurosurg Psychiatry. 2012 Feb;83(2):124-37.
‒ Greenberg SM, Al-Shahi Salman R, Biessels GJ, van Buchem M,
Cordonnier C, Lee JM, Montaner J,Schneider JA, Smith EE, Vernooij
M, Werring DJ. Outcome markers for clinical trials in cerebral amyloid
angiopathy. Lancet Neurol. 2014 Apr;13(4):419-28.
For more information visit:
www.tiny.cc/dwerring
or scan the QR code
d.werring@ucl.ac.uk
FRIDAY – 5:10PM
Optimal management of TIA and stroke secondary
to carotid atherosclerosis
by Professor Martin Brown
The randomised trials, ECST and NASCET, established the benefit of
carotid endarterectomy (CEA) for symptomatic carotid stenosis many
years ago. A risk prediction model based on ECST can be used to select
patients likely to benefit from CEA. Carotid artery stenting (CAS) has
been developed as alternative to CEA, but recent trials have shown higher
procedural non-disabling stroke risk with CAS vs CEA. However, in
patients younger than age of 70 and in patients with less than the average
number of white matter lesions, the risks of stroke are similar. Long-term
follow up has shown similar functional outcomes after CAS and CEA.
Medical therapy has improved since these trials leading to a decline in the
risks of recurrent stroke and the need to repeat old trials with modern
technology. Future selection of patients for revascularisation will
incorporate plaque imaging to identify high and low risk patients.
Professor Martin Brown,
MD, FRCP
Consultant Neurologist
Professor of Stroke Medicine
UCL Institute of Neurology
Martin M Brown qualified in Medicine from Cambridge University and
the Middlesex Hospital Medical School. In 1999, he was appointed as the
foundation Professor of Stroke Medicine at the UCL Institute of
Neurology. He is also Consultant Neurologist at University College
Hospital and the National Hospital for Neurology and Neurosurgery,
Queen Square. His main research contribution has been the organization
of large multicenter clinical trials aimed at improving the prevention of
stroke, particularly from carotid artery narrowing caused by
atherosclerosis. He is a past President of the British Association of Stroke
Physicians and was the Clinical Director of the Thames Stroke Research
Network from 2006 to 2014.
Selected Publications
- Bonati LH, Dobson J, Featherstone RL, et al. Long-term outcomes
after stenting versus endarterectomy for treatment of symptomatic
carotid stenosis: the International Carotid Stenting Study (ICSS)
randomised trial. Lancet Published Online October 14, 2014.
For more information visit:
www.tiny.cc/mbrown
or scan the QR code
martin.brown@ucl.ac.uk
NEUROLOGY 2015:
Leading-edge Neurology
for the Practising Clinician
All articles printed with permission from the journals of Practical
Neurology, Brain, Current opinion in Neurology, Neurology, Neurosurgery
& Psychiatry, Cold Spring Harbor Perspectives in Medicine, Mayo Clinic
Proceedings, The British Journal of Radiology, Neurosurgery, Neurological
Sciences, Lancet Neurology, Lancet Infectious Diseases, Royal Society of
Medicine, Neurobiology of Disease, Current Opinion in Genetics &
Development.
A very special thank you to all
of our Sponsors:
Sponsors
Platinum
• Allergan Ltd
• Eisai Europe Ltd
Gold
• ElectroCore LLC
• Genzyme Therapeutics Ltd
• Novartis Pharmaceuticals UK
Limited
• Delta Surgical Limited
• Lundbeck Ltd
• Teva UK Ltd
A very special thank you to all
of our Sponsors:
UCL INSTITUTE OF NEUROLOGY
FACULTY OF BRAIN SCIENCES
UCL Institute of Neurology MSc / MRes / Diploma Programmes
The UCL Institute of Neurology offers a range of world-class taught and research
1-or 2-year MSc / MRes / Diploma programmes designed to deliver cutting edge
knowledge and research skills to our students. Programmes include:
‒ Advanced Neuroimaging*
‒ Brain & Mind Sciences
‒ Brain Sciences
‒ Neuromuscular Disease
‒ Translational Neurology
‒ Stroke Medicine
‒ Neurology for Clinical
Trainees
‒ Clinical Neuroscience &
Clinical Neurology*
* Distance learning
available
CT perfusion - acute stroke
Courtesy Dr David Werring
T2*-weighted MRI - cerebral
haemorrhage
Clinicians in training at the Leonard
Wolfson Experimental Centre
These full-time courses at the Institute
of Neurology comprise:
Courtesy Dr David Werring
Apply today for SEPTEMBER 2015!
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Learn research skills
‒ Workshops, presentations, group-work
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Start a research career
‒ A supervised research project providing
the opportunity to work with
international leaders and experts
─
Build networks for the future
─
PGCert & PGDip available for CPD for
Allied Health Professionals
‒ Taught modules with between 60 to 100
lectures from clinical and research
experts in clinical neurosciences
For more information visit:
www.ucl.ac.uk/ion/education/ or scan the barcode with your phone
Contact us at: ion.educationunit@ucl.ac.uk
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