Advances in the diagnosis, prevention, treatment and cure of neurological diseases
are based upon scientific discovery. The journey from discovery to treatment is often
arduous and involves both basic and clinical science. Over the ages, multiple intertwined
paths of discovery connect the recognition of distinct diseases of the nervous
system to exquisite diagnostic descriptions, which, when coupled with the scientific
understanding of the disease, have allowed the development of effective treatments
and interventions. This course spans recorded history for virtually all classical neurological
afflictions such as epilepsy, stroke and Parkinson’s disease. For many diseases
of the nervous system, the earliest clinical descriptions are found in the earliest writings
of recorded history, but pathophysiological enlightenment and effective treatments
that follow have happened in only the last century. Despite recent treatments
for many neurological diseases that have in the past been highly refractory to treatment,
such as multiple sclerosis and Parkinson’s disease, to date very few cures have
been discovered. To find more effective ways to prevent, treat or cure neurological
illness remains among the greatest challenges for modern medicine. Fueled in part by
completion of the human genome project, the pace of scientific discovery along with
the advancement of drug development from bench to bedside is increasing. Whether
based upon animal studies, clinical case reports or pilot trial observations, no matter
how elegant the science or promising a given drug or intervention is for treatment of
any neurological disease, the ultimate proof of such benefit is dependent upon evidence
derived from a well-designed and well-executed phase III clinical trial.