Intended for healthcare professionals

Careers

Liverpool neurological infectious diseases course

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b3916 (Published 30 September 2009) Cite this as: BMJ 2009;339:b3916
  1. Dhanasekhar Kesavelu, specialist registrar in paediatrics
  1. 1Alder Hey Children’s Hospital, Liverpool L12 2AP
  1. dkesavelu{at}doctors.org.uk

Who’s it for?

The Liverpool neurological infectious diseases course is for anyone who has ever struggled with a patient who has meningitis, encephalitis, or another neurological infection and not known how best to manage him or her. The course is the only one of its kind in the United Kingdom, and there were 110 delegates from across the UK when I attended, plus people from Europe, Africa, and Asia.

When did you do it?

I took the course when I was a year 4 specialist registrar, but I wish I had known about it earlier.

Why did you do it?

Patients with neurological infections are common, but their management is often very difficult. The presenting syndromes are elusive, which makes the diagnosis difficult, and determining the best treatment can be hard. Liverpool is the home of the School of Tropical Medicine, and it is also the base for several important institutions such as the Walton Centre for Neurology and Neurosurgery; Alder Hey Children’s Hospital; and the University of Liverpool, where brain infections are a major research focus.

What is the structure?

The course is now in its third year and is delivered through a series of lectures by UK leaders in the field of neurological infections, including neurologists, neuroradiologists, and infectious diseases physicians from adult and paediatric medicine. Most of the talks are interactive and based around common and challenging cases that the speakers have faced in practice. Common problems that are discussed in depth every year include acute bacterial meningitis, encephalitis, tuberculous meningitis, neurological disease in HIV, and imaging of central nervous system infections. Infections affecting the peripheral nervous system and prion disease were also covered.

The talks are broken up by shorter case reports on important, but rare conditions. These vary every year, and this year included diphtheria, cerebral malaria, rabies, botulism, recurrent meningitis, schistosomiasis, and Lyme disease. Previous talks have been on tetanus, cysticercosis, and other viral infections such as cytomegalovirus. The rotating programme of speakers and topics gives the course a fresh feel.

Though the lectures were limited by time, the cases were very interesting and the discussions following them were extensive. The sessions were very well planned and had good continuity between them, avoiding repetition, and there were unhurried coffee and lunch breaks.

The speakers are all part of different research groups with a very strong infectious disease background and have published many papers in peer reviewed journals. Their clinical cases and take home messages at the end of every session were extremely useful.

Some hot topics and longstanding controversies were discussed, such as the use of steroids in bacterial meningitis; the duration of antibiotics for infections; and the role of lumbar puncture. One vital point that was stressed was “history, history, and history.”

Highlights

The highlight of the lectures was the Robert T Johnson state of the art lecture. This gives the audience the opportunity to hear and see cutting edge clinical science in neurological infectious diseases. This year’s lecture was given by Professor Mike Levin from Imperial College London, “Can better understanding of inflammatory mechanisms lead to improved outcome in bacterial meningitis?” The session was enjoyable and absorbing.

The other highlights of the course were:

  • Registrar competition for best case presentation

  • The course dinner, preceded by drinks at the world famous Philharmonic Pub (opened in 1898)

  • A quiz at the end of the course

  • The course photo of more than 100 delegates, with a personal copy for each delegate

  • Comprehensive handouts and a certificate of attendance

  • 12 continuing professional development points awarded by the Royal College of Physicians

  • An opportunity to become a member of the Encephalitis Society (free of charge).

How much did it cost?

The course costs £195 for two days. The course is currently run annually, and the provisional date for next year is 25-26 March 2010.

Was it worth it?

Definitely. The course had high calibre speakers and lived up to my expectations. It will certainly change my practice and my approach to patients with neurological infectious diseases in the inpatient and outpatient setting. The course has been a real eye opener and has made me think about important research questions. It has also made me realise that common things are common, and that a good and clear history goes a long way and is easy to obtain.

Top tips

  • Write down the questions you have always wanted to ask, or take an interesting case presentation along with you

  • Book early: this year there were 110 delegates, and a waiting list

Further information

Doreen Owen, secretary to Professor Tom Solomon (course convenor). Tel: 0151 529 5461; fax: 0151 529 5465; email: d.m.owen{at}liv.ac.uk. Website: www.liv.ac.uk/neuroidcourse.

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