From the Editors

By Steven L. Lewis, MD, Editor, and Walter Struhal, MD, Co-Editor

Walter Struhal, MD

Steven L. Lewis

We are pleased to welcome you to the March-April 2018 issue of World Neurology, the official publication of the World Federation of Neurology (WFN). In this issue, a number of WFN initiatives are discussed, beginning with the Presidents’ Column where WFN President William Carroll discusses the new steps taken by the new administration of the WFN as outlined at the recent strategy meeting that took place in London.

In this issue, we are also pleased to announce the seventh year that the WFN is offering educational grants to sponsor high impact educational and outcome-based research projects. Interested young investigators should waste no time as the deadline for applications is quickly approaching. Another important announcement in this issue is the invitation for bids from national member societies in the Americas to host the World Congress of Neurology (WCN) in 2023.
The theme for this year’s World Brain Day (July 22, 2018) campaign is also announced in this issue and all neurological societies are encouraged to participate.

John D. England, the editor-in-chief of the Journal of the Neurological Sciences, the official journal of the WFN, announces a special issue devoted to tardive dyskinesia, edited by Dr. Daniel Truong and Dr. Robert Hauser. It is available free online for all readers through 2018.

Dr. Udaya K. Ranawaka reports on the 11th Annual Academic Sessions of the Association of Sri Lankan Neurologists that was held last November. Professor Jan Kuks announces the next examination of the European Board of Neurology that will be taking place on June 15, 2018, at the European Academy of Neurology Congress in Lisbon. Martin Kaddumukasa, MD, reports on his eye-opening visit to St. Josef Hospital in Cochum (University Clinic of Ruhr University) in the department visit program sponsored by the German Neurological Society and the WFN.

In this issue’s history column, Douglas Lanska reports on his interview with Nobel laureate Stanley Prusiner on the origin of the term prion, an article that should be of both historical and medical interest to all readers. Eduardo Wilson provides a biography of Victor Soriano, who is honored by the Soriano lectures held every two years at the World Congress of Neurology. Finally, Nadir Bharucha provides a touching obituary of Professor Eddie Phiroz Bharucha, a pioneer of neurology in India, who passed away in December and whose name will also live on in an endowed lectureship at the World Congresses of Neurology.

We hope you enjoy this issue, and we invite articles from neurologists around the globe to keep us all up to date about news of interest to all neurologists. •

Next European Board Examination in Neurology

The next Exam of the European Board of Neurology (EBN) will take place on Friday, June 15, 2018 at the EAN congress site in Lisbon.

Prof. Wolfgang Grisold from Vienna successfully started this annual event in 2009. This year, we celebrate the 10th examination.

Every year, the number of participants increases. We receive a lot of mostly positive feedback from our candidates, which makes it possible to improve the exam continuously. Many young neurologists consider taking this exam to aid them while preparing for the written tests and writing their contributions for the oral exams.

Candidates at the European Board Examination in Amsterdam.

Candidates at the European Board Examination in Amsterdam.

Participating in the EBN exam is not merely a way of showing success in retrieving information accumulated during training and reading literature, but more than that a demonstration of the ability of sound reasoning, presenting insight and working with accessible knowledge. Candidates are allowed to use external reference sources and prepare work at home that will be judged – and can be modified after personal feedback – before they come up for the real exam.

They can update and expand their knowledge and abilities, take part in a unique academic experience, and get an additional sign of excellence. Thus, they show their commitment for life-long learning. Although the EBN exam has no legislation until now, the title “fellow of the European Board of Neurology” (which does not coincide with “fellow of the EAN”) may enhance the candidate’s possibilities to work in other countries within and outside Europe.
For the next years, the collaboration between EBN and EAN will be intensified in a great way. Using more technical possibilities (as provided by the Swedish Company Orzone) will allow us to extend our questions to imaging, signal analysis, and clinical judgment with the help of movies.
Candidates who are members of EAN’s Resident and Research Fellow Section for at least one year now get a considerable reduction.

More information can be found at www.uems-neuroboard.org.

We sincerely hope to get more European candidates, not only junior neurologists, but also those who are already practicing. •

Prof. Jan Kuks is the chair of the EBN examination committee, and works at the University Medical Center Groningen in the Netherlands.

WFN Invites Bids to Host WCN 2023

The World Federation of Neurology is pleased to invite bids to host the World Congress of Neurology (WCN) in 2023 from national member societies in the Americas.

If your national society would like to be a candidate to host WCN 2023, please write to the WFN Headquarters Office at the address below to express your preliminary interest by July 31, 2018.

World Federation of Neurology
Chester House
Fulham Green
81-83 Fulham High Street
London
SW6 3JA
United Kingdom
email: info@wfneurology.org

You will be sent an application form to complete and return by Sept. 18. All applications will be treated in confidence and will be reviewed by the WFN to draw up a short list of possible venues. Those that are short-listed will be notified by mid-December 2018, and a site visit by WFN officers to evaluate the proposed program and facilities on offer will take place in the ensuing three months. A report and recommendation will then be submitted to the Council of Delegates meeting during the WCN 2019 in Dubai, United Arab Emirates, where the final vote will occur.

The WFN looks forward to hearing from any member neurological society that wishes to be considered as the host of WCN 2023. •

XXIII World Congress of Neurology Kyoto Photos

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Report on the Department Visit Program to Canada

Vanessa Benjumea-Cuartas

By Vanessa Benjumea-Cuartas, Medellín, Colombia

During my visit to the Montreal Neurological Institute and Hospital, everything was wonderful from beginning to end. I submitted a special request in order to do my fellowship in the epilepsy department because most of my patients in Colombia have this diagnosis. I really love to help patients and their relatives with epilepsy.

The positive response was immediate, and Dr. Andrea Bernasconi and Dr. Anne-Louise Lafontaine allowed me to spend the entire month in the epilepsy department, doing different types of academic activities.

Dr. Vanessa Benjumea-Cuartas (center) with her mentors Dr. Andrea Bernasconi (left) and Dr. Neda Ladbon-Bernasconi.

These included:

  • Reading EEG and video EEG every day with different physicians and listening to their points of view.
  • Attending the epilepsy meetings to discuss cases of patients admitted to the video/EEG unit.
  • Attending the first International Training Course on Neuroimaging of Epilepsy. For this, I am deeply grateful to Dr. Bernasconi for allowing me to attend the course for free.
  • Attending the academic meeting with the epilepsy fellows every Friday. I had the opportunity to give a lecture about the new classification of epilepsy and seizures proposed by the International League Against Epilepsy, discussing different scenarios and cases.

(From left) Dr. Vanessa Benjumea-Cuartas, Dr. Karina Gonzalez-Otarula, Dr. Eliane Kobayashi, and Dr. Aathi Pathmanathan at the seminar “Discussion of the Position Papers of the ILAE for the Classification of Seizures.”

I met wonderful people who welcomed me with open arms, including the doctors. Those people include Drs. Neda Ladbon-Bernasconi, Bernasconi, Elaine Kobayashi, Francois Dubeau, Jean Gotman, Martin Veilleux, Eva Andermann, and Boris Bernhardt. Others I worked with included epilepsy fellows, EEG technicians, and general people from the hospital, such as the administrative staff and the librarian. It also was a joy to meet people from Asia and South America — mainly from Argentina, the country where I lived for a year while I was doing my epilepsy fellowship.

Having the opportunity to perform training like this opens the mind in terms of academic and social skills. It allowed me to explore different approaches to the clinical questions of patients with epilepsy that arise in the course of daily patient care. It allowed me to learn how countries with a better economic background than mine solve different clinical questions because they have the resources to solve the smallest details. At the end, the real challenge is to come home to try to figure out what do with what we have.

Growing up in less privileged countries, such as Colombia, can be a challenge. However, it is clear to me after all of these years that with effort and dedication I can always achieve what I really want.

My educational pursuits would not be possible without generous support, like this scholarship. Thank you to the WFN and the Canadian Neurological Society for enabling this opportunity! •

Zika Virus Update: Report of the WFN Task Force

By John D. England, MD

John D. England

Government and health officials met June 20-23 in Tegucigalpa, Honduras, to discuss the current global situation regarding the Zika virus and the current situation in the Americas.

Participating were representatives from the Pan American Health Organization (PAHO), UNICEF, Universidad Nacional Autonoma de Honduras (UNAH), the World Health Organization (WHO), and the WFN. They met with government officials from Honduras, health care professionals, public health officials from other countries in Central America, South America, and the Caribbean, and dignitaries from the French government.

Students, residents, and professors from the Medical Sciences of the National Autonomous University of Honduras attended the Zika meeting June 20-23 in Tegucigalpa, Honduras.

Three members of the WFN Task Force on Zika (Dr. Tarun Dua from the WHO, Dr. Marco Medina from UNAH, and I) attended the meeting. The specific countries that were represented at the meeting were Costa Rica, the Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua, and Paraguay.

A large part of the meeting was devoted to developing proactive programs and the dissemination of measures for the care and support of people and families affected by complications associated with the Zika virus. Speakers and the other participants re-emphasized that the major complications of the Zika virus infection are the congenital Zika virus syndrome and Guillain-Barre syndrome. However, it was noted that other neurological complications, such as meningoencephalitis, myelitis, and sensory polyneuropathies, have also been reported.

Although the Zika virus does not appear to be spreading as aggressively as in previous years, the virus is still infecting large population segments in the affected regions. The WHO estimates that nearly 100 million people, and more than 1 million pregnant women in the Americas, could be infected, suggesting that tens of thousands of children may have the congenital Zika virus syndrome.

Pilot Programs

(From left) French Ambassador Dr. Pierre Christian, Dr. John England, Julio Raudales, and Marco Medina during the Zika meeting.

As more cases of the Zika virus infection emerge, there is a great need to strengthen health systems to enhance surveillance and to provide improved care and programs in the affected countries. The Honduran government, in association with the Institut Francais, PAHO, UNAH, UNICEF, the WHO, and the WFN, has stepped to the forefront of these efforts to institute pilot programs to help patients and families. Health care representatives from other Central American countries also are interested in joining these efforts.

The WHO help is central to the success of these efforts. Much work has already been done by the WHO to provide the information and tools that are necessary to provide a systems approach to fulfill these goals. A major part of the meeting in Honduras centered on discussions about the WHO Toolkit for the care and support of people affected by complications associated with the Zika virus.

The toolkit serves as a blueprint to enhance country and health care systems’ preparedness for Zika virus outbreaks and its complications. The WHO Toolkit consists of three manuals, each with several modules. There are separate manuals for public health planners and managers, health care professionals, and community workers. All participants agreed that the general principles outlined in the toolkit would help in developing comprehensive care and psychosocial support mechanisms for people affected by the Zika virus. There also was recognition and consensus that the toolkit would have to be adapted to fit the unique national and regional needs and context prior to formal implementation.

Participants pledged to plan future meetings and collaboration with health ministers and government officials from their respective countries and regions with the goal of instituting as many of the recommendations as possible. All participants recognize that governmental and health care system commitments and financial support are necessary to ensure the success of these efforts.

There also is hope that providing the resources and infrastructure for patients affected by the complications of the Zika virus will serve as a model for providing care and support of patients affected by other diseases in these countries and regions.

All of the participating organizations, including the WFN, pledged continuing support of these important goals in global health. Only by working together will there be success in these areas of public health. 

John D. England, MD, is the chair of the WFN Task Force on Zika. He also is editor-in-chief of the Journal of the Neurological Sciences.

A Report from the International Congress on Parkinson’s Disease and Movement Disorders

WFN Junior Traveling Fellowship Award Recipient

By Wael Ibrahim

Wael Ibrahim presented his poster, “ Epilepsy and Cranial Nerve Affection in a Patient With Wilson’s Disease and Intracranial Developmental Venous Anomaly,” at the 21st International Congress of Parkinson’s Disease and Movement Disorders meeting.

The 21st International Congress of Parkinson’s Disease and Movement Disorders was held June 4-8 in Vancouver, BC, Canada. The congress was organized by the International Parkinson and Movement Disorder Society. The purpose of the International Parkinson and Movement Disorder Society is promotion of research and education on Parkinson’s Disease and Movement Disorders, to improve the care for patients who have Parkinson’s Disease and other Movement Disorders, and to facilitate the dissemination of information regarding movement disorders.

Skills and teaching courses held during the congress were an excellent opportunity to share and exchange scientific ideas and improve our education and experience. It is always great to attend the lectures and discussions on ongoing research projects, hear lectures on the most interesting topics, and provide an opportunity for networking.

It was an honor to present the results of my case report as a poster presentation, “Epilepsy and Cranial Nerve Affection in a Patient With Wilson’s Disease and Intracranial Developmental Venous Anomaly: A Case Report.” To our pleasure, we received several interesting questions and remarks from colleagues and field experts about the study design and data interpretation.

Overall, attendance at the congress was successful and helpful for my future development as a clinician and researcher. Attendance at the Congress was kindly supported by the WFN. I want to express my gratitude and happiness for this great opportunity. Great thanks and best wishes to all members of WFN.

Wael Ibrahim is from the Kasralainy Faculty of Medicine at Cairo University in Egypt. www.kasralainy.edu.eg

A Report on a Visit to Sleep 2017 in Boston

WFN Junior Traveling Fellowship Award Recipient

By Oluwatosin Olorunmoteni

I am delighted to present my report on Sleep 2017. I had the privilege of attending this meeting through the sponsorship provided by the WFN as a recipient of a Junior Traveling Fellowship Award.

Oluwatosin Olorunmoteni at Sleep 2017 in Boston, Massachusetts.

Sleep 2017 was the 31st annual meeting of the Associated Professional Sleep Societies, LLC (APSS) comprising the Sleep Research Society (SRS) and the American Academy of Sleep Medicine. Although I developed interest in pediatric sleep medicine during the course of my training in pediatric neurology, I have not been able to take formal training in sleep medicine or attend a conference on sleep. I am exceedingly grateful to the WFN for making this dream come true.

Sleep 2017 was held June 3-7 at the Hynes Convention Center in Boston, Massachusetts. It was an educational and impactful experience for me.

On Saturday, June 3, I attended a half-day postgraduate course on EEG Essentials for the Sleep Practitioner. Following that, I had the privilege of participating in the SRS Leadership Workshop. The educational programs organized by SRS continued on Sunday, June 4, with the Trainee Symposia Series. These two trainee development programs by the SRS were my best sessions at the meeting as I had the privilege of meeting and learning from leaders in the field of sleep medicine. I also had opportunities of networking with colleagues.

Oluwatosin Olorunmoteni presented her abstract.

I presented my abstract on Monday, June 5. More than 1,200 abstracts were presented at Sleep 2017.

The abstract presentation afforded me the opportunity to meet specialists and colleagues in sleep medicine working on similar research areas. I also met a number of Nigerians in the diaspora. They suggested many ideas that can improve my future research. I also discussed the need for a sleep lab in my institution with many of them, and they offered useful suggestions on the way forward.

Sleep 2017 had many educational opportunities, which were highly beneficial especially for young professionals like me. There was never a dull moment as I attended sessions that included Invited Lectures, Conversation with Experts, Symposia, and Oral and Poster Presentations. I learned a lot from the pediatric sleep sessions, where discussions on actigraphy, pediatric narcolepsy, school start times, and parasomnias were discussed.

A major benefit of attending Sleep 2017 for me was the opportunity to visit the Boston Children’s Hospital where I saw the sleep lab. It further increased my quest to intensify efforts to get a functional sleep lab in my institution.

Despite the rainfalls, I was able to visit downtown Boston during the week. I also joined SRS trainees for a time out at the kickball game on Saturday.

I left Boston on Wednesday, June 7. I felt excited and fulfilled because Sleep 2017 was my best conference ever! I am grateful to the WFN for giving me this opportunity. 

Oluwatosin Olorunmoteni is from Obafemi Awolowo University in ILE-IFE, Nigeria.

Report of the Department Visit Program to Turkey

By Dr. Leonard Ngarka

From right to left: Prof. Recep Aygul, Prof. Serefnur Öztürk, Dr. Hakan Ekmekci, Dr. Leonard Ngarka, medical students, and Resident Dr. Azer Mammadli, during ward rounds.

I was delighted when I received the news of my selection for the WFN-Turkish department visit program in October 2016. It didn’t actually take place until Feb. 18, 2017, due to visa procedures. I am grateful to Prof. Alfred Njamnshi and Prof. Serefnur Öztürk, as well as Burak Tokdemir, who facilitated my visa acquisition.

I arrived at the University of Selcuk, University Faculty of Medicine in Konya, Turkey, on Feb. 17, and immediately settled into my accommodations. The next day, I was warmly received by the staff of the Neurology Department under the leadership of Prof. Öztürk, who presented the service. I was handed a detailed program for my stay there. Each working day ran from 9 a.m. to 5 p.m., with a break between noon and 1:30 p.m.

During the four weeks, I spent each day from 9 a.m. to noon seeing patients hospitalized in the department, including those in Neurointensive Care. For the first week, the period from 1:30 p.m. to 5 p.m. was spent in outpatient consultation with the different consultant neurologists, and we received 18-25 follow-up cases and six to eight new cases per day. This exposed me to the manipulation of recent drugs and protocols in the management of patients with neurological disorders.

Selcuk University Faculty of Medicine, Neurology Department team, including all staff in front of the Neurology Department (in-patient service).

The remainder of my afternoons were spent in clinical neurophysiology labs: EMG, EEG, and polysomnography labs for the second, third, and fourth weeks,  respectively. I carried out nerve conduction studies on patients who came during this period and did a good number of needle EMGs. All of these were conducted under the supervision of Prof. Recep Aygul and Dr. Hakan Ekmekci. My participation in the EEG sessions has improved my reading and interpretation of EEGs, especially video and sleep EEGs. During the last week of my stay, I had introductory lessons on evoked potentials and polysomnography, of which I did a few and assisted in their interpretation.

I participated in several staff meetings with other departments, including with neuroradiology and interventional radiology specialists to discuss cases of carotid artery stenosis; with endocrinologists, and ear, nose, and throat specialists to discuss the management of patients with sleep disorders; and with the department of psychiatry. There were other presentations in the department among residents and students, and I made a presentation on peripheral nerve disease and entrapment neuropathies.

My experience in Turkey was exceptional, and the memories will last long. It was an exposure to up-to-date science, to culture, and a challenge to pursue excellence. This visit has significantly impacted my clinical practice. I have adapted some of the protocols from Konya (Parkinson’s disease and other movement disorders) in patient care back here in Cameroon. I am presently assisting in doing EMGs in a hospital close to ours in order to continue the training and keep the skills I acquired.

Even though insufficient infrastructure, equipment, and drug availability remain a major setback in Africa, one thing stands: quality training is the bedrock for research and quality patient care and development on this continent. This visit has contributed to improving the quality of my training. 

I wish to express my heartfelt gratitude to the World Federation of Neurology, the Turkish Neurological Society, and the Neurology Department of Selcuk Medical Faculty for giving me this opportunity. I wish to thank Profs. Öztürk and Aygul, Dr. Ekmekci, and the neurology residents and staff of this department for making my stay memorable.

Candidate Nominees Announced

The WFN Nominating Committee announces the candidates for the following positions. The Council of Delegates will vote during the WFN elections at the upcoming World Congress of Neurology in Kyoto, Japan.

President

  • Professor William M. Carroll, Australia
  • Professor Wolfgang Grisold, Austria

Vice President

  • Professor Ryuji Kaji, Japan
  • Professor Renato J. Verdugo, Chile

Elected Trustee

  • Professor Riadh Gouider, Tunisia
  • Professor Man Mohan Mehndiratta, India
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