Central nervous system inflammation
BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d3142 (Published 27 May 2011) Cite this as: BMJ 2011;342:d3142
This three day course, held at Keele University, covers the various inflammatory disorders affecting the central nervous system. The course content includes discussion of the pathophysiology, clinical manifestations, radiological appearances, and management of these disorders.
Who is it for?
The course is designed for doctors who may have to deal with the various central nervous system inflammatory disorders, such as multiple sclerosis, neuromyelitis optica, central nervous system infections, vasculitis, neuro-Behçet’s disease, and neurosarcoid. The course will be useful for trainees in neurology, radiology, and general medicine. It will also be useful for hospital consultants in these specialties who wish to keep up to date with the latest advances in these disorders.
When did you do it?
I took the course in 2009 as a second year neurology registrar.
Why did you do it?
I used to come across these disorders in my routine practice, and occasionally patients would ask me for the latest developments. With the introduction of many novel immunomodulatory drugs, it was imperative as a trainee that I kept abreast of the new diagnostic criteria and clinical indications for treatment. The clinical knowledge of the various speakers has helped me develop a clear concept of the various neuroinflammatory disease processes.
How is the course structured?
The course was spread over three days, from Friday to Sunday. The speakers included leaders in the various neuroinflammatory disorders from the United Kingdom and other parts of Europe, including neurologists, neuroradiologists, neuropathologists, and also a rheumatologist. There were lecture sessions, case discussions, and neuroradiology slides, with ample opportunity to put questions to the speaker at the end of each talk.
Day 1
The course began on the afternoon of the Friday, giving plenty of time for people to get to the venue. The first lecture was on central nervous system vasculitis and included clinical features, investigation, and management. The next lecture was on the neuropathology of central nervous system infections and also the various antibodies associated with this. This included the cerebrospinal fluid analysis of the various disorders (such as the oligoclonal bands seen in the cerebrospinal fluid of a patient with multiple sclerosis). A lecture on functional disorders included videos highlighting functional symptoms and signs. The last lecture, on neuroradiology, was an interactive session in which the audience discussed the scans with the neuroradiologists.
Day 2
The day started with a lecture on neuromyelitis optica. The speaker discussed the current diagnostic criteria and management. The importance of the discovery of the disease specific antibody NMO-IgG and how this further differentiated the disorder from multiple sclerosis was emphasised. This was followed by a talk on the pitfalls in diagnosing multiple sclerosis, and we received an update on the latest diagnostic criteria. The speaker reflected that a change in the criteria (based on technological advances) meant that certain disorders that had not previously been classified as multiple sclerosis are now labelled as such, while certain others (such as neuromyelitis optica) that were previously classed as multiple sclerosis are no longer, with major implications for management of patients. Later, a discussion of viral encephalitis and its management was followed by a symposium on the various treatment strategies in active multiple sclerosis and a discussion on neuro-Behçet’s disease. The next talk focused on the various inflammatory central nervous system disorders presenting with headache as a symptom and how these could be analysed and investigated. Various speakers from the audience then spoke about interesting cases that they had come across in clinical practice.
Day 3
The final day started with a lecture on neurosarcoidosis. Again, this included the recent advances in the knowledge and management of this disorder. This was followed by a talk on antiphospholipid syndrome (also called the sticky blood syndrome or Hughes syndrome), its updated diagnostic criteria, clinical presentation, and management. The course concluded with discussion on more interesting cases, which were again presented by the various trainees in the audience.
How much does it cost?
The entire course cost £100. This included registration, accommodation in Keele University for two nights, and meals.
Top tips
It is useful to drive to the venue because the accommodation provided may not be close to the lecture theatre. There is ample free parking available on site for delegates.
Was it worth it?
Definitely. The immense knowledge and clinical expertise of the speakers (all of whom have numerous publications to their credit and are leaders in their respective fields), combined with the smooth handling of the course, made it one of the best courses I have attended as a neurology trainee. It helped improve my confidence when evaluating and managing patients with neuroinflammatory disorders.
Further information
Contact Lisa Locklin, secretary to Adnan Al-Araji, Department of Neurology, University Hospital of North Staffordshire, Princes Road, Hartshill, Stoke on Trent, Staffordshire ST4 7LN. Email lisa.locklin{at}uhns.nhs.uk.
Footnotes
Competing interests: None declared.