September 2016

From the Editors

Walter Struhal, MD

Steven L. Lewis, MD

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

We are pleased to introduce the September/October 2016 issue of World Neurology.

In this issue, Raad Shakir, MD, president of the World Federation of Neurology (WFN), provides us with his insights about the infrastructural investments, in addition to the training of more neurologists, required for providing optimal neurologic care worldwide.

Wolfgang Grisold, MD, and Steven L. Lewis, MD, report on the recent successful site visit to Dakar, Senegal, now becoming the third WFN Teaching Center on the African continent. Dr. Grisold then reports on two recent international educational activities, the Eighth Joint European Board Examination in Neurology in Copenhagen, as well as the 14th International Congress on Neuromuscular Disease in Toronto.

Jera Kruja, MD, reports on the activities from the Albanian Day of the Brain celebration. John D. England, MD, provides his editor-in-chief’s update from the Journal of the Neurological Sciences, the official journal of the WFN.

In this month’s history column, Catherine E. Storey, MBBS, FRACP, MSc, provides an illustrated summary of the development of the ophthalmoscope and its introduction to British neurologists. Serefnur Öztürk, MD, announces an exciting international essay contest for young neurologists sponsored by the Turkish Neurological Society.

In the book review column, Carrie Grouse, MD, reviews a multiple-expert authored book devoted to discussing and contextualizing landmark neurological papers. Vladimir Hachinski, MD, DSc, adds his heartfelt memories about the life of John N. Walton, MD.

Finally, Dr. Grisold provides a tribute to Keith Newton, who stepped down from his work at the WFN after 18 successful years as executive director and consultant administrator.

We sincerely hope you enjoy the contributions from this issue, and we look forward to seeing the delegates of the WFN at the upcoming Council of Delegates meeting occurring Sept. 12, 2016, coincident with the 12th European Congress on Epileptology in Prague.

As always, we encourage your outstanding submissions and helpful suggestions for the benefit of all World Neurology readers around the globe.

EBN, EAN Hold Joint European Board Examination in Neurology

By Wolfgang Grisold, MD

Faculty provide students with instructions for the written exam.

The European Union of Medical Specialists (UEMS), as the European representation of medical specialists, encourages the use of a European board examination in neurology. The exam aims to test knowledge, problem-solving, presentation abilities, and handling knowledge and aspects of ethics and public health. These European board examinations are developing well and are replacing national examinations in several disciplines and countries. The European Board of Neurology (EBN) held its Eighth European Board Examination jointly with the European Academy of Neurology (EAN) in Copenhagen, Denmark.

The UEMS/EBN/EAN board exam in neurology took place May 27, 2016, at the EAN Congress. Seventy-two candidates from several European and non-European countries participated. The exam comprised multiple-choice questions (MCQs) in open- and closed-book fashion and was followed by a presentation of a short essay on a neurology, public health, or ethics topic and a critical appraisal of a neurological topic (CAT). The language of the examination was English.

The board examination in neurology faculty gather for the UEMS/EBN/EAN board exam.

The faculty for the board examination in neurology gathers for the UEMS/EBN/EAN board exam.

Although the largest part of the examination was the MCQs (80 percent), the oral interviews for the short essays and CAT allowed more personal contact with the candidates.

The examiners took great care to listen, evaluate, and appraise the short essays and critical appraisals (right). These exam items were prepared in advance, and interesting topics relating to current problems, therapies, and procedures in neurology were discussed. Teaching materials, such as ebrain, EFNS/EAN guidelines, and textbooks were suggested for preparation.

The examiners and faculty were involved in the prior preparation of the presentations. As they were from many regions of Europe and North Africa, several authentic languages were represented, to help in addressing communication issues during the presentation.

The successful candidates and faculty join together for a final photo after the examination.

The number of participants is steadily increasing, and also the number of non-European candidates is rising, which makes the UEMS/EAN board examination an attractive examination.

The next UEMS/EAN board examination will be in June 2017 during the EAN meeting in Amsterdam. The date is not fixed, but visit the UEMS/EBN website for technical details and announcements.

The WFN was invited to observe, and, as WFN secretary general, I took the opportunity to observe and make this report.

Some of the CAT Topics (Examples)

NMDA Receptor Antibodies in CSF and Serum
rTMS for Refractory Focal Epilepsy
Cervical Trauma and MS
Rituximab for Optic Neuritis
Tetrabenazine for the Treatment of Chorea
Sphenopalatine Ganglion in Cluster Headache
Antiviral Therapy for GBS

Some of the Essay Topics (Examples)

Prolonged Ventilation in ALS
Malnutrition in India
Treatment Inequalities for MS in Europe
Vaccination Against Meningitis During Hajj in Saudi Arabia
Taking Presents From industry
Epilepsy and Driving
Dealing With Medical Errors
A Care Driver With Epilepsy Forbidding You to Make Known His Diagnosis

Dakar Named Third WFN Teaching Center in Africa

By Wolfgang Grisold, MD, Steven L. Lewis, MD, and Riadh Gouider, MD

The WFN delegation met with neurology faculty and residents during a site visit to Cheikh Anta Diop University in Dakar, Senegal, now the third WFN Teaching Center in Arica.

The WFN delegation met with neurology faculty and residents during a site visit to Cheikh Anta Diop University in Dakar, Senegal. This is the third WFN Teaching Center in Africa.

With the creation of several World Federation of Neurology (WFN) Teaching Centers, the WFN has increased the scope of its educational activities for training young neurologists worldwide.

In 2013, the University of Rabat, Morocco, was the first institution to be accredited, followed by the University of Cairo in 2015. Cheikh Anta Diop University, Dakar, Senegal, will be the third WFN training center in Africa. The rationale behind the application of Cheikh Anta Diop University is not only the need for an additional training center, but also the previous training experiences already accumulated by this institution. Outside of the African continent, the WFN also accredited training centers in Mexico in 2016.

Dr. Riadh Gouider gives a lecture to faculty and residents.

The neurology department at Cheikh Anta Diop University applied and was visited according to WFN procedures by Wolfgang Grisold, MD, Vienna, Austria, WFN secretary general; Steven Lewis, MD, Chicago, Illinois, United States, co-opted trustee and chair, WFN Education Committee; and Riadh Gouider, MD, La Manouba Tunisia, African Academy of Neurology and elected WFN trustee.

Prior to the visit, structured interviews were distributed to staff, teachers, and trainees. On site, the Visiting Committee interviewed randomly selected staff members and residents.

Dr. Gallo Diop makes a presentation for neurology residents.

The neurology department at Cheikh Anta Diop University has a resident teaching structure depending on the year of training. The four-year training includes one year in a different facility. First-year neurology residents predominantly are involved in inpatient services, and, at the later stages, they are involved in all outpatient and additional services. Night duties are under supervision, and a faculty member always can be reached. Daily visits of all inpatients occur. The department has a high number of educational events, including semiology, lectures, and case studies. Residents are encouraged to participate in meetings, give presentations, and participate in scientific projects. Internet is available to them.

Dr. Mansour Ndiaye (center), head of neurology, meets with Drs. Wolfgang Grisold (left) and Steven L. Lewis.

In terms of subspecialties, a one-year diploma of epilepsy can be pursued, and an additional diploma on neuromuscular diseases is being developed.

The visit to the department was carried out according to a predetermined checklist, which called for visiting inpatient departments. Visits to patient rooms also was granted. The team inspected several laboratories, including ultrasound, electrophysiology, and clinical laboratories. Other departments, including radiology, neurosurgery, pathology, and rehabilitation guarantee that multidisciplinary involvement will be achieved. Compared with other public hospitals seen during the visit to Dakar, the neurology department looked structured, and the interior seemed well organized.

Faculty and residents from Cheikh Anta Diop University observe a lecture.

The impressions of the site visitors were positive and confirmed a well functioning and busy department, devoted to patient care, training, and education. The staff comprises highly motivated colleagues who are keenly interested in teaching neurology and increasing the high level of patient care. The WFN is pleased to name the Cheikh Anta Diop University Dakar as the third WFN Teaching Center in Africa.