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JNNP Milestones in Neurology List

No.1 – Brain Imaging: The development and application of imaging techniques Presented by: Professor Nick Ward Human brain imaging makes it possible to produce detailed images of the living brain and its innate function. Before the advent of brain imaging, neurologists were wholly reliant on a physical neurological examination to infer compromise in the structure and function of the brain, with diagnoses only confirmed after death. Clinicians and scientists now have a series of tools that allow the human brain to be investigated at a range of scales, from macroscopic to mesoscopic, to help begin to understand the working human brain in life.
No.2 – Stroke: Introduction of thrombolysis and endovascular recanalisation therapy Presented by: Dr Karen Furie The acute management of ischemic stroke has been transformed in the last quarter century. The emergence of intravenous (IV) thrombolysis as an evidence-based therapy within 4.5 hours of stroke symptom onset accelerated stroke systems of care and established the “time is brain” paradigm. More recently, endovascular therapy with mechanical thrombectomy for large artery occlusion has dramatically improved outcomes for the most devastating strokes. Brain and cerebrovascular imaging have become integral to acute decision making. Mobile stroke units can begin evaluation and treatment in the field. Advanced imaging techniques enhance understanding of collateral flow and perfusion and facilitate patient selection for treatment. These advances pave the way for future interventions aimed to prevent or treat distal embolization, couple revascularization with neuroprotection, and reduce acute injury.
No. 3 – Parkinson’s Disease: The efficacy of L-Dopa therapy Presented by: Professor Andrew Lees L-DOPA, the naturally occurring amino acid precursor of dopamine, has transformed the lives of millions of people with Parkinson’s disease in the fifty years since its introduction. Most patients experience sustained benefit with improved quality of life and some improvement in life expectancy and a total lack of therapeutic response should lead to a reconsideration of the diagnosis. There are no other treatments in neurology that can lead to comparable levels of efficacy in the treatment of motor handicap. A considerable amount of research into developing better symptomatic treatments has returned to trying to develop longer acting oral formulations and alternative modes of delivery of dopa to the brain in order to reduce the unwanted long-term complications of motor fluctuations and hyperkinetic abnormal involuntary movements. For the large majority of people with Parkinson’s disease, irrespective of the age of symptom onset, treatment with L-DOPA combined with a peripheral dopa decarboxylase inhibitor (100/25 mg four times a day) is the initial treatment of choice.