The Most Illustrative Imaging Cases from the Video Challenge

I trained in neurology during the dark ages without the benefit of modern neuroimaging such as computed tomography and magnetic resonance imaging scan. Early imaging modalities in the primary movement disorders, such as torsion dystonia, Parkinson's disease, and essential tremor, were often normal. However, many inherited and some infectious, neoplastic, and inflammatory disorders manifesting as movement disorders have striking and somewhat characteristic neuroimaging, and in some cases, imaging findings outside the central nervous system. These can be of significant help in guiding the clinician to the correct diagnosis. I have been blessed to be a cohost of the Video Olympics (as the event was called at its inception in 2008) with Anthony Lang. We reviewed a large number of submissions from centers all over the world and selected what we thought would be the most significant and educational cases for the 3‐hour event (that was reduced to 2 hours and the name changed to Video Games and then Video Challenge).

Over the years, we saw cases where the diagnosis was largely clinical (phenomenology of lingual myoclonus, stereotypies in N‐methyl‐d‐aspartic acid antibody‐mediated encephalitis, and myorhythmia in Whipple disease), but we saw a number of cases where the diagnosis was aided by imaging of the brain or of the other body parts (skeletal abnormalities in type 2 GM1 gangliosidosis or patellar dislocation in alpha mannosidosis). We were impressed by the diversity of cases from around the world. Although many were genetic, we also selected acquired disorders such as autoimmune, infiltrative, and infectious disorders. One of the most unforgettable for me was an exotic case of a hemorrhagic pontine gnathostomiasis from Thailand. After a few years, Dr. Lang and I realized that we were sitting on a literal treasure trove of imaging cases. We felt that this teaching material deserved to be disseminated more widely by the creation of an enduring document. Rather than focus on exotic cases, Dr. Lang and his colleagues have worked hard to select cases that have a significant educational value. ¹ , ²

As I retire from my role as a cohost of the Video Challenge, it is heartening to see that the effort put into the preparation of the event during the past 10 years is continuing to bear fruit. I am certain that the audience will find these cases to be valuable, and my hope is that ultimately this will benefit our patients.

Disclosures

Funding Sources and Conflicts of Interest: No funding was received for this work. The author has no conflicts of interest to report.

Financial Disclosures for the Previous 12 Months: Consultant for Neurocrine.

Ethical Compliance Statement: The approval of an institutional review board and informed patient consent was not necessary for this work. The author confirms that they have read the Journal's position on issues involved in ethical publication and affirms that this work is consistent with those guidelines.