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In the past, neurosurgical training was essentially "See one, do one and teach one". In the current environment with reduction in training hours, less exposure to real operating environment and unusual surgical cases, the need for hands on training in a realistic environment is critical for surgeons and theatre staff. With modern technology using scanned images and 3-D laser printing techniques, it is possible to create near realistic surgical models for trainees to develop surgical skills. This technique also allows assessment of surgical competency by objective scoring to quantify training. We present our early experience in the use of such techniques at the University of Malaya in training residents in image guided neurosurgery.

Pharmacological relief of neuropathic pain is often insufficient. Electrical neurostimulation is efficacious in chronic neuropathic pain and other neurological diseases. European Federation of Neurological Societies (EFNS) launched a Task Force to evaluate the evidence for these techniques and to produce relevant recommendations. We searched the literature from 1968 to 2006, looking for neurostimulation in neuropathic pain conditions, and classified the trials according to the EFNS scheme of evidence for therapeutic interventions. Spinal cord stimulation (SCS) is efficacious in failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS) type I (level B recommendation). High-frequency transcutaneous electrical nerve stimulation (TENS) may be better than placebo (level C) although worse than electro-acupuncture (level B). One kind of repetitive transcranial magnetic stimulation (rTMS) has transient efficacy in central and peripheral neuropathic pains (level B). Motor cortex stimulation (MCS) is efficacious in central post-stroke and facial pain (level C). Deep brain stimulation (DBS) should only be performed in experienced centres. Evidence for implanted peripheral stimulations is inadequate. TENS and r-TMS are non-invasive and suitable as preliminary or add-on therapies. Further controlled trials are warranted for SCS in conditions other than failed back surgery syndrome and CRPS and for MCS and DBS in general. These chronically implanted techniques provide satisfactory pain relief in many patients, including those resistant to medication or other means.

In this paper we present the initial results using an artificial neural network to predict the onset of Parkinson's Disease tremors in a human subject. Data for the network was obtained from implanted deep brain electrodes. A tuned artificial neural network was shown to be able to identify the pattern of the onset tremor from these real time recordings.