Introduction Alcohol misuse and related problems are common in Sri Lanka. The appropriateness of the primary care setting in dealing with alcohol misuse is well recognised, and general practitioners (GPs) constitute an important first contact setting.Methods One hundred and fifty randomly selected GPs practising in the Colombo and Gampaha districts were given a questionnaire to assess how they detect and manage alcohol misuse, and their attitudes towards persons who misuse alcohol.Results Seventy per cent of GPs responded [74 male; mean age 42 years (SD 6.7)]. Our results suggest that although a majority (81%) of GPs were frequently confronted with problems related to alcohol misuse, their efforts to detect the problem and knowledge regarding risk limits of alcohol consumption were poor. Only 25.7% had even heard of CAGE and MAST questionnaires. The majority of GPs felt inadequately trained to deal with alcohol misuse, but only a few made any self-directed efforts to improve their knowledge and skills regarding its management or referred their patients for specialised care. Participation in preventive programmes was minimal, and many GPs expressed negative attitudes towards persons misusing alcohol. ConclusionsThe ability of general practitioners to detect and alcohol misuse appears to be inadequate.

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on both sides involving the vestibulospinal tracts bilaterally (figure C). Patients 2 and 3 also had high intensity areas in the same areas. Apart from lesions in this area, all showed high signal intensity areas in the cerebral white matter.This preliminary study shows that latencies of a vestibulospinal reflex can be prolonged in multiple sclerosis. As in these three patients the VEMPs were remarkably delayed rather than simply abolished as occurs in patients with peripheral vestibular lesions, 2-4 the VEMP delay could be attributed to demyelination either of primary aVerent axons at the root entry zone or secondary vestibulospinal tract axons rather than to lesions involving vestibular nucleus neurons. The MRI findings in these patients were not inconsistent with this proposition. Measurement of VEMPs could be a useful clinical test to evaluate function of the vestibulospinal pathway and for detecting subclinical vestibulospinal lesions in suspected multiple sclerosis.