January 2017 – Page 2

From the Editors

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

Walter Struhal, MD

Steven L. Lewis, MD

We are very pleased to introduce the January/February 2017 issue of World Neurology, with a number of varied and quite interesting reports from around the globe.

Drs. Jorge G. Burneo, David A. Steven, and Miguel Arango describe the fruitful ongoing collaboration between Canada and Peru on a project to provide high-level epilepsy surgical care in Peru. Drs. Peter Spencer and Jacques Reis report on the International Meeting on Environment and Health that recently took place in Strasbourg. Dr. Gallo Diop reports on the recent exciting announcement of the process and promotion of seven neurologists within Africa to the rank of professor.

In this issue’s President’s Column, WFN President Raad Shakir notes that brain health is at the forefront of diseases leading to morbidity and mortality, highlighting the critical importance and role of neurologists in increasing the profile of neurology as a discipline around the globe. Dr. Bruno Giometto reports on the highlights of the recent successful XLVII Congress of the Italian Society of Neurology, and in a related report, Dr. Luigi Bertinato’s keynote lecture from the same Congress on the origins of public health and the history of plague control will be of great historical interest to our readers.

Drs. Sergey Lobzin and Natalie Zinserling report from the September 2016 Davidenkov Readings Conference in Saint Petersburg, Russia, and summarize the historical and modern aspects of Saint Petersburg Neurology. In his Editor-in-Chief’s Update from the Journal of the Neurological Sciences, the official journal of the WFN, John D. England, MD, announces the new Elsevier web-based editorial system to provide an improved and streamlined author and reviewer experience for the journal. In this issue’s history column, Dr. Peter Koehler informs us about the history of the discoveries and putative functions of “stones” in the brain.

Dr. Michael Ackerl reports on the latest developments of the European Board Examination in Neurology from the European Union of Medical Specialists from their last meeting in October 2016.

In what we also hope will be the model of many similar contributions from our readers for future issues, we know readers will appreciate seeing a “Photo of the Issue” that was provided by Dr. Shakir, showing Professor Jun Kimura giving a recent EMG workshop at the Lebanese society of Neurology in Beirut. Dr. Wolfgang Grisold, the Secretary-General of the WFN, and Dr. Alla Guekht briefly report on their international collaboration that resulted in a Russian translation of the American-European Atlas of Neuromuscular Diseases. Also in this issue is the official call for applications for the 2017 WFN Junior Traveling Fellowships.

We trust that you will enjoy the many and varied contributions from this issue about neurology around the globe, and we continue to encourage your suggestions and ongoing submissions on news of interest to neurologists worldwide.

Peru, Canada Collaborate on Epilepsy Project

By Jorge G. Burneo, MD, David A Steven, MD, MPH, and Miguel Arango, MD

First temporal lobectomy, with Dr. David Steven, a neurosurgeon, observing at the Instituto de Ciencias Neurologicas in 2012.

In 2008, a collaborative effort between Peru and Canada was born. The purpose of this collaboration was to establish epilepsy surgery centers in Peru. The catalyst for this endeavor was the North American Commission of the International League Against Epilepsy (ILAE) Partnership of Epilepsy Centers across the Americas (PECA) Program. This program funded initiatives to improve epilepsy care in Latin America through partnerships with North American epilepsy centers.

Our partnership with Peru has had the main objective of establishing epilepsy surgery programs in Peru. The epilepsy program at Western University in London, Canada, partnered initially with the Instituto de Ciencias Neurologicas (INCN), part of the Peruvian Ministry of Health, and subsequently with the Hospital Edgardo Rebagliati Marins (HERM), part of the Essalud system, both located in Lima.

The country of Peru has adequate neurological care in major cities, particularly in Lima. Peru has two major health systems: a public one, funded by the Ministry of Health, and the Social Security System (or Essalud), funded by major private employers. However, certain subspecialized care, such as epilepsy, is lacking. Despite access to most first-, second- and even third-generation antiepileptic drugs, epilepsy surgery was not previously available.

Dr. Miguel Arango, a neuro-anesthesiologist, with one of the Peruvian teams during an awake craniotomy in 2016.

The initial partnership with the INCN, which began in 2008, has allowed the establishment of a comprehensive epilepsy surgery program¹. Since 2012, when the first temporal lobectomy was performed, the team has completed 56 more epilepsy surgeries. The INCN has a single bed with video-EEG capabilities that has allowed the evaluation of more than 100 patients since opening in 2009.

The partnership began with an initial video-EEG workshop run by the team from Canada, and over the years, it has consisted of annual visits to deliver lectures through symposia and grand rounds, as well as discussion of cases in person and on-line. This also has been carried out with rotations of Peruvian colleagues in the Epilepsy Monitoring Unit in London, Canada. Furthermore, a fellowship in epilepsy surgery was undertaken in Mexico by Dr. Carlos M. Vazquez, and a fellowship in epileptology was undertaken in Brazil by Dr. Jose C. Delgado. The Canadian team also participated in different types of epilepsy surgeries, from the first temporal lobectomy in 2012, to the latest surgery in 2016, which involved an awake operation for mapping of language function prior to a dominant temporal lobectomy. The team used the Canadian model of presurgical assessment and molded it based on the Peruvian reality.

The Instituto de Ciencias Neurologicas team.

The partnership with HERM started in 2010 when Dr. Alicia Becerra, a neurosurgeon, came to London, Canada, to undertake an epilepsy surgery fellowship. This coincided with the visits of the neurologists Dr. Elliot Barreto and Dr. Mirla Villafuerte to our center as well. Despite the lack of initial support from their institution, they were able to perform three pre-surgical assessments that culminated in successful epilepsy surgeries before 2016. This year, however, their institution has been able to open its own single-bed epilepsy monitoring unit, and it has already been able to perform an awake surgery during a dominant temporal lobectomy.

Even though the initial funding came from PECA, subsequent funding came from Western University and private Canadian donations.

The collaborations have not ended. More trips to Peru and the future training of an anesthesiologist in neuro-anesthesia are planned for the near future.

It is finally our hope to use this model to establish epilepsy surgery centers in other parts of Peru and South America.

Reference

¹Burneo JG, Delgado JC, Steven DA, et al. A collaborative effort to establish a comprehensive epilepsy program in Peru. Epilepsy Behav 2013;26:96-9.

Jorge G. Burneo, MD, is an epileptologist; David A. Steven, MD, is an epilepsy surgeon; and Miguel Arango, MD, is a neuro-anesthesiologist, all at the Western University, London, Ontario, Canada.

American-European Atlas of Neuromuscular Diseases now Translated into Russian

By Wolfgang Grisold and Alla Guekht

A group of two U.S. neurologists (Eva Feldman and James Russell) and two European neurologists (Wolfgang Grisold and Wolfgang Löscher) co-wrote the second edition of the Atlas on Neuromuscular Disease, which was published by Springer in 2014.

Recently, further international collaboration has led to the publication of a Russian translation of the Atlas. The editors of the Russian version are Professor Alla Guekht and Professor Alexander Sanadze, from Moscow. The Russian version has been dedicated to the late Professor Boris Guekht, who was the leading Russian specialist in neuromuscular diseases.

The authors of the Atlas feel that this is a most useful and practical way for international cooperation, and sincerely thank Professor Guekht for her excellent initiative.