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Special Issue on Tropical Neurology

By John D. England, MD

John D. England, MD

During the World Congress of Neurology in 2017 in Kyoto, Japan, Profs. Marco Medina, Chandrashekar Meshram, Raad Shakir, and I proposed to publish a special issue on tropical neurology in the Journal of the Neurological Sciences. The selection of topics and authors was coordinated with the Tropical and Geographical Specialty Group of the World Federation of Neurology (WFN).  Because of the high incidence and prevalence of neglected tropical diseases (NTD) that affect the nervous system, this project was given high priority by the journal’s editorial board.

Almost half of the world’s population (approximately 3.3 billion) resides in the tropics. Taken together, NTDs affect close to 1 billion people each year. At present, these diseases affect the majority of Latin America, Asia, and Africa. Due to global climate change, these diseases are predicted to affect an ever-increasing number of people. We hope this special issue will bring greater attention to these important and highly prevalent diseases.

Because the special issue is an online product, articles are added as they are accepted for publication. Currently, nine articles covering the topics of CNS fungal infections, onchocerciasis, ebola, chikungunya, leprosy, tuberculosis, brucellosis, COVID-19, and environmental neurology are published; others covering neurocysticercosis, dengue, and zika will follow.

The articles in the special issue are available by accessing:

https://www.sciencedirect.com/journal/journal-of-the-neurological-sciences/special-issue/10NG1VC7F2Z •

John D. England, MD, is editor-in-chief of the Journal of the Neurological Sciences, the official journal of the WFN.

 

 

 

 

Brain Health Initiative in India

By Drs. Chandrashekhar Meshram, JMK Murthy, Nirmal Surya and U. Meenakshisundaram.

The Tropical and Geographical Neurology Specialty Group of the WFN joined hands with the Indian Academy of Neurology (IAN) to celebrate the Brain Health initiative on Jan. 11, 2021, to raise awareness for the importance of brain health.

A public education and awareness activity in the form of a panel discussion was planned through virtual meeting. The theme of the session was brain health and what happens if brains are not healthy. Dr. Chandrashekhar Meshram, chief coordinator of the program, released the press note.

Dr. JMK Murthy, president of Indian Academy of Neurology and clinical director and chair of the Department of Neurology, CARE Hospitals Hyderabad, inaugurated the event.

Dr. Meshram, in his introductory remarks, emphasized the relevance of this initiative by the World Federation of Neurology. Dr. Sarosh Katrak, past president of IAN, explained the importance of the brain, explained its functions and discussed why brain health is the priority.

IAN Secretary Dr. U. Meenakshisundaram spoke about various brain diseases and when people should consult a neurologist. Dr. Subhash Kaul, past president of IAN, mentioned various risk factors for brain diseases and how a change in lifestyle is important for prevention of neurological disorders.

Marathon runner and neurologist Dr. Anuradha explained how regular physical exercises improve brain health. Dr. Meshram highlighted the misconceptions about diet and stressed the need to shift to a low carbohydrate diet. He said that wrong diet is responsible for the pandemic of metabolic syndrome all over the world.

Dr. Gagandeep Singh, past secretary of IAN, informed about the current status of COVID vaccine. Dr. Sudhir Kothari said that developing hobbies is a good idea to maintain brain health and suggested that there is no age bar to learning new things. Dr. Sudhir Shah explained the positive effects of meditation and yoga on brain health. Dr. Sumit Singh stressed the effects of air pollution on brain health and discussed the sources of air pollution.  Dr. Sudhir Bhave explained the need for sleep hygiene and the role of positive thinking.

The emphasis was on maintaining brain health and prevention of brain diseases.

Dr. Nirmal Surya, IAN president-elect, was the moderator, and he interacted with the panelists. Participants enjoyed the session and the opportunity to interact with the experts during the question-and-answer session. •

Selçuk University Hospital: One Year Later

By Ani-Osheku Ifeyinwa, Nigeria

Neurology Grand Rounds

In December 2019, I had the utmost privilege to spend four weeks at the neurology department of the Selçuk University in Konya, Turkey. It remains one of the most gratifying moments in my career as a young neurologist.

It has been over a year, yet the memories are ever so fresh. I clearly remember the feeling of excitement as I walked into the massive Selçuk University Hospital and made my way to the “nöroloji poliklinik” where I was greeted with so much warmth by the entire neurology staff. I met Prof. Şerefnur Öztürk, my supervisor, who provided me with the itinerary and a road map of what I was to expect in the coming weeks.

Indeed, it was a four-week period of intense learning in a relaxed and friendly environment. I had the privilege of exploring the world of the practice of neurology by the Turks under the able guidance and excellent mentorship of the neurology team of the Selçuk University Hospital.

Certificate presentation and the new year celebration.

Case after case, I witnessed the translational art of the pathological basis of neurologic diseases from therapeutic theorem to practical strategies using cut-edge technology and evidence-based medicine in the management of various neurologic conditions, including stroke, movement disorders, demyelinating disease (especially multiple sclerosis), neuromuscular diseases, and seizure disorders.

Prof. Öztürk shared with me priceless clinical pearls especially in the area of vascular neurology during the daily morning rounds in the neuro-intensive service as well as in the outpatient service. Her depth of knowledge combined with her wealth of experience has inspired me to push the limits of my career.

It was intriguing watching Prof. Gökhan Özdemir navigate stenosed and occluded vessels inserting stents and retrieving clots and ultimately achieving revascularization.

My experience with the neurophysiology laboratories left quite an impression on me that instinctively I knew I would pursue a fellowship in this area. I participated in carrying out and interpreting several EEGs, needle EMGs, and nerve conduction studies under the supervision of Profs. Gökhan Özdemir, Haluk Gümüş, and Dr. Hakan Ekmekci.

I learned the techniques of peripheral nerve blockade in the management of headaches and this service is one of the treatment modalities currently offered to patients with headache disorders in our neurology clinic. The ease of application coupled with the dramatic improvement has been a rewarding experience.

Lunch with neurology residents

I joined the neurosurgical team in the collaborative management of patients especially those with movement disorders, where I witnessed the usefulness of deep brain stimulation in advanced Parkinson’s disease.

One of the highlights of my stay was the opportunity to speak on “Nigeria, Its People, and Its Health Care System: A Focus on Neurological Diseases.” This lecture was delivered on Dec. 25,  2019, in the Dekanlik Donem 2 Amfisi, and I tagged it “A Christmas to Remember!”

The rich cultural heritage of the Turks makes the city a tourist’s delight. I savored the tastebud tantalizing Turkish foods and enjoyed the sceneries of some of the city’s famous sites, like the famous Mevlâna Museum and Alaaddin Cami.

Despite the numerous challenges the novel Covid-19 pandemic brought, redefining interactions in the health care sector along with restrictions in movements that put a hold on dreams for the physical quest in knowledge acquisition, I have continued to cascade the knowledge so acquired in my time in Selçuk in order to positively impact the lives of patients with neurological needs in Nigeria. I am currently working on various projects that include the transfer of skills acquired, especially relating to headache management and protocols for managing various neurology conditions.

Dr. Ani-Osheku Ifeyinwa giving a lecture

My profound gratitude to the WFN/TNS for this wonderful and innovative collaboration to give young neurologists like me the opportunity to experience the practice of neurology in an advanced society and a chance to improve our skills and broaden our horizons. Plenty of thanks to Mrs. Jade Levy and Mr. Burak for the seamless facilitation of my trip and stay in Konya. My deep appreciation to Selçuk University and  the dean of the College of Medicine for providing the enabling environment for my visit. To Prof. Şerefnur Öztürk, you inspire me in numerous ways to be the best version of myself. Finally, to the exceptional team at the Selçuk neurology department that showed me true friendship, generosity, and ensured I was well integrated, I say thank you!

I had the most amazing time in Konya and established alliances that I believe will go a long way. The lessons learned from my four weeks to Selçuk University will always be a reference point in my career development. •

Prospects for 2021

By William M. Carroll, president of the World Federation of Neurology

An Important Conjunction

William Carroll, MD

As this column goes to press in the first issue of World Neurology for 2021, it is surprising to see the energy and the activities the WFN will be involved in after such a trying 2020. I will enlarge on the role of the WFN in the COVID-19 pandemic, but first I wish to highlight two important events that occurred late last year and early this year.

The first was the adoption by the World Health Organization (WHO) of resolution WHA 73.10. As was communicated to all member societies in November and again in my column in December, this particular resolution was a landmark event. For the first time, neurological disorders were recognized by the WHO for what they are: a looming threat to individuals and societies, including both economic and personal burdens.

In common language, the WHO plans to develop an all-encompassing action plan to mitigate the effects of neurological disorders on brain health throughout life. This plan has become known as the Intersectoral Global Action Plan (IGAP) for epilepsy and similar neurological disorders.

Early in resolution WHA73.10, neurological disorders are described as “conditions of the central and peripheral nervous system that include epilepsy, headache disorders, neurodegenerative disorders, cerebrovascular diseases, including stroke, neuroinfectious/neuroimmunological disorders, neurodevelopmental disorders and traumatic brain and spinal cord injuries.” Subsequently, these disorders do occur as comorbidities of epilepsy and that many may benefit from similar public health measures to be developed for epilepsy.

Since this development, the WFN has been engaged with the International League Against Epilepsy, the International Bureau for Epilepsy, and the International Child Neurology Association in preparing the broader neurological fraternity, including members of the Global Neurology Alliance to be ready to contribute to the proposed plans if requested by the WHO.

The second important event has been the launch of the WFN Brain Health Initiative (BHI). The BHI arose through the perceived need to promote brain health more generally and more widely. This ambitious initiative is aimed at the global population and not just the WFN and its specialty constituents. Many members of the Global Neurology Alliance (GNA) have their own educational advocacy programs. Indeed, the WFN does this also through its biennial WCN and the annual disease specific World Brain Day (WBD), lately always partnered with a GNA member.

In this initial phase, the BHI will comprise five separate but sequential modules. The first two, titled “An Introduction to Brain Health” and “What Happens When Brains Are Not Healthy” were launched on Jan. 11 and the parallel webinar Feb. 17. The webinar also included contributions from each of the WFN regional organizations.

Modules 3 to 5 will follow soon with a launch webinar that will hopefully feature a wider collaboration from member societies.

The reason for highlighting the fortunate conjunction of these two crucial events is that there is an evolving momentum on the importance of brain health. Triggered in part by the Global Burden of Disease (GBD) study of 2016 showing neurological non-communicable disorders (nNCD) are the leading cause of disability and the second leading cause of death, a growing number of organizations and people are recognizing that brain health is not only a natural gift but that for some its attainment requires active, effortful participation as does the maintenance of optimum brain health.

It is hoped that along with improvement in health standards generally there will be increasing emphasis on the importance of brain health. People, societies, health care practitioners and governments need to advocate in concert for measures that reduce the risk of brain ill-health and injury.

Brain Health Initiative and COVID-19

From the above, it is clear that the WFN will be focusing its virtual efforts on brain health including the Brain Health Initiative.

It is opportune to compare the preparations for this challenge with that which the world has had to undertake for the challenge of COVID-19. Although over a much shorter time frame, the world has begun to introduce a viable response to the pandemic. With the same energy and commitment, the world will meet the challenge of the increasing burden of neurological disorders.

Through 2020, the WFN has participated with two groups developing means to capture, measure, and treat any neurological state generated by the COVID-19 pandemic.

Both the WHO Global Forum on Neuro-COVID-19, headed by Tarun Dua (WHO Brain Health Unit) and the Neuro Covid-19 Coalition inaugurated by Andrea Winkler (University of Munich), have worked in parallel to assess the acute effects and the late effects of COVID-19 infection.

The development of the WHO Global COVID-19 Clinical Case Record Form (CRF) provides a uniform CRF that can be employed in the acute and importantly the post-infective stage of COVID-19 illness and will ensure as far as possible that the data collected from anywhere will be viable and informative. Thanks go to Richard Stark and Alla Guekht for their efforts on our behalf with these groups. It is envisaged that the WFN will continue to be associated with these two groups through 2021.

World Brain Day

Following on from the successful collaborations with the International Headache Society in 2019 and the International Parkinsons Disease and Movement Disorders Society through the peak of the pandemic in 2020, the WFN will likely partner with the Multiple Sclerosis International Federation in 2021.

The WFN decision on this topic was made only after careful consideration. Multiple sclerosis (MS) and other immune-mediated CNS inflammatory disorders have an important success story to disseminate, share a link with severe and often fatal COVID-19 disease, have caused concern among those with MS with regard to treatments and COVID-19 vaccination and highlight again the risk the pandemic poses to ongoing neurological management through the diversion of resources.

The success story for MS is that with the continuing development of effective therapies and the post-marketing observations, it has become evident that the accrual of disability from MS has been dramatically reduced and even more so if treatment is begun early. Furthermore, there are now therapies arriving that promise to slow the later, progressive phase of MS.

Communication

Thanks to the efforts of member societies and the London office staff of the WFN, we now have the ability to communicate rapidly and with high fidelity. Efforts now will be centered on maintaining this facility as is it clearly to the benefit of us all. Thanks also to those who maintain the WFN website, a never-ending task. The recent update of the homepage to accommodate the Brain Health Initiative is a case in point.

Needs Registry

Another crucial example of the benefits of reliable communications is the completion of the Needs Registry survey by some 115 of the 122 member societies. The data is now undergoing preliminary statistical evaluation, and it is hoped that this will be able to be shared with members soon. It is likely that the Needs Registry survey data will also be helpful for the IGAP.

World Congress of Neurology and Council of Delegates Meeting

Planning and organization of the 25th WCN will be a major effort through this year. Ryuji Kaji, chair of the WCN Congress Committee, reports on the progress of this WCN in this issue. At this time, it appears quite unlikely that this congress will be a wholly physical or face-to-face meeting. Kenes, the WFN professional conference organizer (PCO), has experience and expertise to hold a hybrid meeting or a totally virtual meeting, whatever eventuates. The WFN, the Society of Italian Neurologists and Kenes hope to hold off a final decision on the format of the WCN until April, some six months before the WCN. Given the uncertainties about the pandemic and the likelihood of a hybrid meeting, the trustees have determined to again conduct the scheduled elections electronically as was done successfully in 2020. In this regard, I draw your attention to the notice of elections and the call for nominations for those elections. •

From the editors

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

Steven L. Lewis, MD, Walter Struhal, MD

Welcome to the February 2021 issue of World Neurology. This issue begins with the news that Prof. Raad Shakir, immediate past president of the World Federation of Neurology (WFN), has been made a Commander of the British Empire (CBE) in the U.K. New Year Honors List, with a commentary on this remarkable honor provided by WFN President William M. Carroll.

Next. Dr. Carroll updates us on the many activities planned for the WFN in 2021, including plans with the World Health Organization (WHO) and the WFN regional organizations, the Brain Health Initiative (BHI) and COVID-19, the WFN Needs Registry, the World Congress of Neurology (WCN) and the upcoming Annual General Meeting (AGM) of Council of Delegates meeting COD meeting planned for WCN 2021.

With regard to the WCN, WFN Vice President Ryuji Kaji reminds all readers to submit abstracts to the WCN 2021 in Rome. Dr. Kaji also announces the creation of a new award for service to the WFN. In his column on the WFN Committees and Specialty Groups, WFN Secretary-General Wolfgang Grisold reports on the many activities of the WFN Tropical and Geographical Neurology Specialty Group and Standards & Evaluations Committee.

Drs. Chandrashekahr Meshram, JMK Murthy, Nirmal Surya, U Meenakshisundaram and Gagandeep Singh report on the many activities that recently occurred around National Brain Week in India, revolving around the theme of preventive aspects of the neurological diseases. Dr. Meshram also reports on the new monthly webinar series, “Inspiring People in Neurosciences,” with an exciting schedule of remarkable neurologists speaking about inspirational neurologists, a free educational series for which neurologists around the world and at all stages of their career should find of great interest.

In this issue’s WFN Training Center report, Drs. Olivier Kapto and Ratsitohara Santatra Razafindrasata, from Burkina Faso and Madagascar, respectively provide a nicely illustrated report of their successful year of specialty training at the WFN Training Center in Rabat, Morocco.

The history column by Peter J. Koehler provides his insights into the potential neurological origins of visions reported by a classic figure from the Middle Ages.

Finally, this issue also details the notice of elections for open positions in 2021 to be voted on at the AGM of the COD meeting at the WCN in October 2021.

Thanks to all readers for your interest in World Neurology. We look forward to continued submissions from neurologists and neurological societies worldwide to inform all neurologists about the remarkable variety of activities and opportunities available to enhance the field of neurology and our care of neurological patients around the globe. •

Submit Abstracts and Join Us at WCN 2021 in Rome

By Ryuji Kaji MD, WFN First Vice President

As the chair of the Congress Committee, I cordially invite you to join the 25th World Congress of Neurology (WCN) to be held Oct. 3-7, 2021, in Rome, Italy. Since the pandemic of COVID-19 will not completely fade out by then, we are most likely to have a hybrid-type congress, providing you the option of attending in person or virtually. The committee has decided that we will remain flexible until the end of March as to what extent the meeting can be held online.

The world is now suffering from COVID-19, which is comparable to Spanish flu or the influenza pandemic that occurred 100 years ago. At that time, peculiar neurological conditions were reported. These included encephalitis lethargica or von Economo’s encephalitis, which is now hypothesized as a sequela of the pandemic. Similarly, there are various neurological manifestations of COVID-19, such as anosmia, stroke, so-called “brain fog” and others. Despite the difficulties of having WCN 2019 at this time, it is a unique opportunity to discuss various consequences of the pandemic not only scientifically but also in terms of its impact on neurological education and patients’ care during the crisis to put our best pieces of knowledge together.

We will have the most updated sessions on COVID-19 and the nervous system, including a plenary session, so that we can share the strategies to fight against the virus. Also, we welcome abstract submissions on any advances in the other subspecialties of neurology. Our strengths include the worldwide links among membership societies and research groups, and we expect a number of breakthroughs in neurology to be presented at this meeting.

On behalf of our Italian colleagues, we welcome those who will be physically able to visit Rome and enjoy the most historic place in Europe: Inspired by the past to build the future of neurology. For those who are unable to come, you will also be able to present your paper online.

Please submit your abstracts now. The deadline is April 5, 2021. •

Standards & Evaluations Committee and the Tropical and Geographical Neurology Specialty Group

By Wolfgang Grisold

Wolfgang Grisold

In this issue, we want to introduce the World Federation of Neurology (WFN) Standards & Evaluations Committee, chaired by Prof. László Vécsei, and the specialty group on Tropical and Geographical Neurology, chaired by Dr. Chandrashekhar Meshram.

All WFN committees are listed on the WFN website, as well as the members of the committees and specialty groups. We are thankful, and acknowledge the work of the committee and the specialty group members. In these articles, we will just mention the chair as the representative for the group.

The WFN Standards & Evaluations Committee

This committee is chaired by Prof. László Vécsei from Szeged, Hungary. Prof. Vécsei is the head of Neuroscience Research Group in the Department of Neurology, Faculty of Medicine at the Albert Szent-Györgyi Clinical Center, University of Szeged, Hungary. Prof. Vécsei has much experience in working in neurological international societies and is presently the secretary-general of the Danub Group. (http://danubeneurology.eu). The committee has several experienced members who are actively involved in the review and decision process.

Prof. László Vécsei

Prof. László Vécsei

The important task of the WFN Standards & Evaluations Committee is to evaluate applications from international or national neurological congresses and any other scientific meetings in neurosciences in classical forms and as virtual meetings, for WFN accreditation that apply according to its guidelines as noted on the WFN application form, which can be reached on the WFN website: https://www.wfneurology.org/meetings-endorsement.

The task of this WFN activity is to keep and improve the standards of the neurological scientific meetings applying for WFN endorsement. This is done according to a structured guideline. Information on the required ethical issues and limitations with regard to relations with the pharmaceutical and other industries are to be found in the application form.

Once a completed application is received, it is reviewed by the committee, and applicants are notified of the decision within two weeks of their application.

A meeting endorsed by the WFN qualifies to use the WFN logo, it is announced on the WFN website and WFN newsletter and after the meeting, a brief summary can be published on the website or in World Neurology.

In addition to meetings, this committee reviews and accredits neurology related guidelines or books or other enduring material which requests WFN accreditation. Depending on its content, it may be reviewed together with the Education Committee, or with the aid of experts or the speciality groups.

The Tropical and Geographical Neurology Specialty Group

Dr. Chandrashekhar Meshram, MD, DM

Dr. Chandrashekhar Meshram, MD, DM

This Specialty Group is chaired by Dr. Chandrashekhar Meshram, MD, DM( PGI Chandigarh), India, who is supported by an active membership. He is a consultant neurologist and director of the Brain and Mind Institute in Nagpur, India, and past-president of the Indian Academy of Neurology (2013-14). Prof. Meshram has been active in many agendas for the WFN in the past years.

The specialty group on tropical neurology introduced a timely webinar series in 2020 (see below) on neurological infectious diseases, with an excellent scientific content, impeccable technical support, and has successfully sparked the interest on neuroinfections worldwide.

The Tropical Neurology Specialty Group is the oldest WFN research group established in 1961. The Specialty Group (formerly “Applied Research Group”) was formed with the mission to foster research collaboration in aspects of neurological disorders prevalent in the tropics and to disseminate knowledge at international and regional levels. The specialty group holds regular congresses (INTROPICON-https://worldneurologyonline.com/article/tropical-neurology-intropicon-2018/), and publishes a special issue on Tropical Neurology in the Journal of Neurological Sciences

Jointly with the Forum for Indian Neurology Education (FINE) and Indian Academy of Neurology, a neuroinfection webinar series was introduced and endorsed by the WFN.

These sessions usually consist of a main lecture and three case presentations.

In the first series, talks were given on neurocysticercosis, cerebral malaria, zika and other arbovirus infections, neurobrucelloisis, encephalitis, cryptococcal meningitis, fungal meningitis as well as the general approach to neurologic infections, among other topics.

During series 2, talks on 12 more topics were organized and given. A weblink allows continued viewing of these sessions: https://us02web.zoom.us/j/87248087732.

All of These Activities Are Free.

This timely webinar series in 2020 on infectious diseases was designed at the right time and helped to introduce new technologies, enabling the scientific community to communicate and interact during the harsh and still unpredictable times of COVID. •

Screenshot capture of the inaugural meeting of the 2020 FINE/WFN Neuroinfection Webinar series in 2020.

Screenshot capture of the inaugural meeting of the 2020 FINE/WFN Neuroinfection Webinar series in 2020.

Good News at the End of 2020

The WHO calls for global action plan to combat epilepsy and other neurologic disorders

By William Carroll

As we reach the end of a very trying year with COVID-19 still rampant, I have two pieces of good news, in some respects, as good as the imminent arrival of the vaccines.

The first is a momentous decision by the WHO and the second is an important and rewarding development for the WFN. Both point us all in the same direction.

William Carroll, MD

The decision by the World Health Assembly (WHA) on Nov. 12, 2020, to adopt Resolution WHA73.10 is a landmark event. Although the WFN has been closely involved with neurological activities within, and related to, the WHO, the call for the development of global action plans to combat epilepsy and (importantly) neurological disorders, is a first. It comes courtesy of a sustained effort by the ILAE (led recently by Prof. Sam Wiebe) and International Bureau for Epilepsy (IBE) to convince the WHO that epilepsy is a common disease, causing considerable effect upon people, their neurological health, their cognitive function, societal burden, and individual stigmatization for want of the ready availability of anticonvulsant medication.

William Carroll, MDIt also occurred through the recognition of certain key member states that saw the synergies between the dilemma of epilepsy and those suffering from it, with a number of other important neurological processes. The resulting WHA73.10 Resolution was carried unanimously by members of the 74th Executive Board and thence the 73rd World Health Assembly. In Clause (PP2) of WHA73, it is clear that the authors and the supporting member states recognized a need to address all neurological disorders. The clause specifically mentions epilepsy, headache disorders, neurodevelopmental, neurodegenerative, neuroinfectious/neuroimmunological, cerebrovascular diseases including stroke, and traumatic brain and spinal cord disorders. There is scarcely a single neurological disorder not encompassed by this regulation. (See below.)

The regulation seeks to develop a comprehensive intersectoral approach to addressing all neurological disorders in line with the third pillar of the U.N. Sustainable Development Goals.

For the first time, neurological disorders are being overtly recognized for the threat they pose to all societies and health jurisdictions. We need look no further than the most recent Global Burden of Disease Study, which demonstrated neurological non-communicable disorders to be the leading cause of disability and the second leading cause of death. To have the WHO acknowledge the need for global action plans to address this burden will provide enormous assistance to those at risk of neurological disorders and those attempting to combat them.

The WFN was proud to lend its support to the ILAE and IBE at the WHA71 (May 2018) “Side Event for Global Action on Epilepsy” and a statement calling for a new report on the implementation of Resolution WHA68.20 to be prepared for discussion at the WHA74 meeting in 2021.

Photo of WHA 73 from the WHO website.]

At the 144th Executive Board Meeting in January/February 2019, the WFN posted a statement asking the EB not to defer consideration on further actions to address the global burden of epilepsy and its health and social implications at the country level. Again, in May 2019, we joined with the ILAE and IBE to support this initiative in a further Side Event, urging member states to implement a coordinated action against epilepsy through the establishment of:

  1. national Health Care Plans for epilepsy management to overcome inequalities and inequities in health, social, and other related services
  2. initiatives to promote public awareness of an education about epilepsy, and to reduce the misconceptions, stigmatization and discrimination against people with epilepsy
  3. actions to prevent causes of epilepsy
  4. greater investment in epilepsy research and increased research capacity.

The WFN also posted a statement on the Prevention and Control of Non-Communicable Diseases (Agenda item 11.8) highlighting the need to:

  1. elucidate treatments to prevent and/or modify stroke, migraine, and Alzheimer’s Disease and other dementias
  2. the disparity between high and low sociodemographic index nations and the resultant unequal burden on resources
  3. that the WFN was uniquely placed as the only global neurological organization with an almost identical matching regional and national reach.

The statement pointed to the WFN’s geographical advantage in advocacy partnership being bolstered by its relationship with associated disease topic organizations of the Global Neurological Alliance, such as the World Stroke Organization, Alzheimer’s Disease International, Parkinson’s Disease and Movement Disorders Society, the International League Against Epilepsy, and Multiple Sclerosis International Federation.

At the 146th Executive Board meeting in February 2020, the WFN supported the draft decision on the 2019 Global Report “Epilepsy as a Public Health Imperative” proposed by the Russian Federation and co-sponsored by China and Guyana. The WFN statement also requested the WHO director-general to expand the scope of the report EB146/12 to be presented at the 73rd WHA with an additional consideration of “Synergies in Addressing the Burden of Epilepsy and Other Neurological Disorders” and among other calls “to encourage member states and related non-state actors to contribute to discussions” on the “draft resolution on epilepsy and other neurological disorders” based on the report mentioned in paragraph 2 to be presented for consideration by the 73rd WHA.

The leadership demonstrated by the WHO in the adoption of WHA73.10 will be of inestimable benefit in the energization of all those faced with combating neurological disorders, particularly non-communicable neurological disorders and their devastating effect on individuals and societies. For those so engaged to know that the WHO, through its member states, will be encouraging, advocating, and leading the intersectoral struggle will be heartened.

There will be many non-state actors, such as the WFN, that will be similarly buoyed. To address these challenges in the manner outlined in the WHA73.10 Resolution will also require the development and implementation of plans to overcome many barriers, which have contributed to the inequities of access most keenly felt by less well-resourced jurisdictions. The leadership of the WHO will be pivotal in maintaining the momentum required.

Finally, this most welcome event sits closely with the WFN Needs Registry. This registry was conceived to provide a complementary balance to the data supplied by WHO member states. Member states are by and large national governments. The WFN Needs Registry is the product of WFN member societies, which are in turn composed of neurologists and allied neurological colleagues on whom people with neurological disease depend for prevention, diagnosis, and treatment. The data collected by the Needs Registry offers opportunities to advocate for the redirection of resources as well as additional resources where possible and to do so collectively with member societies and jurisdictions sharing common challenges.

Given the position of the WFN and its relationship with the Global Neurology Alliance and the World Health Organization, it is likely to be able to contribute considerably to the attainment of useful outcomes in line with WHA73.10. In this regard, the WFN is planning to discuss in 2021 with each of its regional organizations ways in which these processes might be advanced.

I wish you your families and colleagues a safe and joyous time through the festive season and a better New Year for all. •

The 73rd World Health Assembly Resolution WHA73.10

(PP1) Recognizing that epilepsy and other neurological disorders are the leading cause of disability-adjusted life years and the second leading cause of death worldwide, and that epilepsy and other neurological disorders disproportionately impact people living in low- and middle-income countries;1

(PP2) Noting that neurological disorders are conditions of the central and peripheral nervous system that include epilepsy, headache disorders, neurodegenerative disorders, cerebrovascular diseases including stroke, neuroinfectious/neuroimmunological disorders, neurodevelopmental disorders and traumatic brain and spinal cord injuries;2

(PP3) Noting with concern that the risk of premature death in people with epilepsy is three times higher than in the general population and that, over the past 30 years, the absolute number of deaths due to neurological disorders has increased by 39%;3

(PP4) Acknowledging, as outlined in the WHO/ International League Against Epilepsy/International Bureau for Epilepsy Global Report on Epilepsy (2019), that epilepsy is one of the most common neurological disorders globally affecting an estimated 50 million people worldwide across all ages with increased rates in the young and the old…

(OP1) URGES Member States:1

(OP 1.1) To provide the appropriate support to WHO to develop the Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders referenced in paragraph 3.1;

(OP2) CALLS UPON all relevant stakeholders:

(OP2.1) To provide appropriate support to WHO and partners to develop the Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders referenced in paragraph 3.1;

(OP3) REQUESTS the Director-General:

(OP3.1) To develop, in consultation with Member States, and in full collaboration with United Nations organizations and relevant non-State actors, a 10-year Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders in support of universal health coverage to address the current significant gaps in promotion of physical and mental health, and prevention, early detection, care, treatment and rehabilitation, as well as social, economic, educational and inclusion needs of persons and families living with epilepsy and other neurological disorders, and the ongoing need for research to improve prevention, early detection, treatment, care and rehabilitation, including treatment options with the potential to cure epilepsy and other neurological disorders;

(OP3.2) To include in the Intersectoral Global Action Plan ambitious, but achievable, global targets on reducing preventable cases of, and avoidable deaths, resulting from epilepsy and other neurological disorders, strengthening service coverage and access to essential medicines, improving surveillance and critical research and addressing discrimination and stigma;

(OP3.3) To submit to the 150th Executive Board, a draft Intersectoral Global Action Plan for consideration by Member States, as well as to report on the progress achieved in implementing this resolution, with an intention to submit the plan to Member States for endorsement during the 75th World Health Assembly. •

WFN Committees and Specialty Groups

e-Communications Committee and the Aphasia, Dementia, and Cognitive Disorders Specialty Group

By Wolfgang Grisold

This column focusing on WFN committees and specialty groups has a dual purpose:

  • to inform and raise awareness on the important contribution of these groups for the functioning of the WFN
  • to raise interest among the readers for the work of the WFN, and perhaps find and recruit persons to work closer with the WFN, in the interest of neurology.

The work of the WFN depends on the contribution of many members worldwide. Several committees support the trustees in their work (https://wfneurology.org/committees) and also develop ideas and consult. A good example is the e-Communications Committee, chaired by Walter Struhal, which identifies and helps to integrate digital technologies into the WFN. The work of this committee is summarized by Dr. Struhal.

The WFN also has several Speciality Groups, which were previously known under ARGs (Applied Research Committee https://wfneurology.org/wfn-specialty-groups). Here, the work of the Specialty Group is introduced by Suvarna Alladi, a neurology professor from India.

The WFN e-Communications Committee has been created to facilitate the trend of remote learning, and e-learning’s purpose is enhanced by the present COVID crisis. The new and advanced digital techniques are now rapidly evolving and will also serve to improve teaching in remote areas of the world.

WFN e-Communications Committee

Walter Struhal, MD

The origins of this committee stem from the Website Committee. Dr. Struhal got involved in this committee in 2010 as one of the founders of the worldwide young neurologists’ group—International Working Group for Young Neurologists and Trainees. Since 2014, he is in charge of the website and initiated social media channels and the WFN online footage with the close help of Chiu Man, who for more than a decade acts as WFN`s webmaster. He is assisted by Surat Tanprawate, Tissa Wijeratne and Wolfgang Grisold.

This was the early core of the current online presentation of WFN as well the roots of the present e-Communication Committee. The website was completely renewed and redesigned into a “responsive” design that allowed reader to view the same content with equal quality on mobile devices as on computer screens.

While social media increased over the years to a tremendous audience with more than 11,000 friends on Facebook, reaching with our posts from the last 30 days alone >17,000 followers, in addition to >2,700 followers on LinkedIn and >4,800 followers on Twitter.

Social media became one of the strategic core activities within WFN’s online footage and one way of reaching out to neurologists worldwide.

Today, this committee headed by Dr. Struhal consists of members worldwide (below). And the committee is actively supported by Simona Milenkova, a social media expert working for Kenes.

The main objective is continuously informing our audience on important developments in neurology on the global scale, on news from WFN, and recently in employing our growing online presence in e-Learning. One of the first meetings was the joint WFN/AFAN e-learning Day (https://wfneurology.org/2020-09-18-wfn-afan), which was well received worldwide. The large amount of information reaching this committee provides a large and challenging workload.

Aphasia, Dementia, and Cognitive Disorders Specialty Group (ADCD SG)

The WFN Aphasia, Dementia and Cognitive Disorders Specialty Group (ADCD SG) is an international community of cognitive neurologists and allied specialists dedicated to promoting research and improving clinical practice in aphasia, dementia, and other cognitive disorders globally. The group has been actively pursuing this mission since 1966 through its biennial meetings and has grown to having members from Europe, the U.K., North and South America, Australia. West, South and East Asia join its community over the years

The mission of the ADCD SG aims to stimulate scientific discussion in the field of aphasia, dementia, and cognitive disorders and to translate research findings into better assessment, management, and treatment of patients through teaching courses, biennial meetings, and participation in the World Congress of Neurology as well as other meetings. It is multidisciplinary, welcomes members of different specialties, across cultures, and seeks to collaborate with other organizations, within and outside the WFN.

Suvarna Alladi

The chair of the ADCD SG is Suvarna Alladi, professor of neurology of the National Institute of Mental Health and Neurosciences in Bangalore, India. Her clinical and research group focuses on providing multidisciplinary care for persons with dementia, cross-cultural issues in cognitive neurology, developing cognitive tests in different Indian languages and literacy levels and risk factors. Organizing community support for dementia, she co-founded ARDSI (www.ardsihyd.org) and strengthened policy for dementia (www.stride-dementia.org).

The Executive Committee is composed of distinguished experts from across continents: Prof. Morris Freedman, Canada; Stefano Cappa, U.S./Italy; Lorraine Obler, U.S.; Manabu Ikeda, Japan; Eneida Mioshi, U.K.; Peter Nestor, Australia, Matt Lambon, U.K.; Thomas Bak, U.K.; and Facundo Manes, Argentina.

The biennial meetings and teaching courses are the most impactful of the group’s activities. The first biennial meeting of the Specialty Group (formerly Applied Research Group) was held in 1966. The biennial meetings have traveled from venues in Europe to South America, Cambridge U.K., Edinburgh, and then eastward to Istanbul, Hyderabad India, and Hong Kong. The 50th anniversary meeting returned in 2016 to Lake Como, followed by Portugal and the next meeting is planned to take place in Nara, Japan.

The meetings have a tradition of putting the emphasis on quality rather than quantity and to create a forum for discussion and a genuine exchange of ideas. The symposia are based on a wide range of topics, in the traditional clinical areas in aphasia and cognitive disorders, along with newer areas in cognitive science, biomarkers, and technology.

During the COVID-19 pandemic, an online sharing of knowledge and continued interaction is planned. The expert group has developed a rich clinical and research resource across multiple disciplines of cognitive neurology, cognitive psychology, psycholinguistics, speech, and language pathology among others. The SG also has a repository of cognitive-assessment tools in multiple languages, including English, Spanish, Italian, Indian languages, Chinese, and Japanese, among others.

The global expertise of the group has focused on developing joint recommendations for adaptation of diagnoses, assessments, and treatments of aphasia and cognitive disorders across the world. Through its Forum for Young Researchers (FYRE), the SG encourages and nurtures young talents globally. •

 

WFN e-Communications Committee
Chiu Man: Webmaster (WFN U.K.)
Daniel Gams Massi: Pan-Africa (Cameroon)
Laura Druce: WFN office (WFN U.K.)
Maria Benabdeljlil: Pan-Arab (Morocco)
Riadh Gouider: Pan-Africa (Tunisia)
Surat Tanprawate: Asia-Oceania (Thailand)
Tissa Wijeratne: Asia-Oceania (Australia)
Wolfgang Grisold: WFN Secretary General (WFN, U.K.)

 

 

 

Becoming Acquainted With the Pandemic

By the time this edition of World Neurology is available, it will have been more than eight months since the world had to learn to deal with COVID-19. In that time, our lives and practices have changed dramatically. Social distancing, travel restrictions, and educational activities have forced us to adapt to what is effectively a new world. In some countries, the pandemic is flaring again, resulting in death, disability, and the consumption and diversion of resources. In others, populations are variably safer but still constrained.

William Carroll, MD

It is nevertheless heartening to see and experience the intent of many of our colleagues at local, national, and international levels collaborating to record quality data so as to better understand the short-, medium-, and long-term effects of COVID-19. Groups such as the European Academy of Neurology’s “EAN NEuro-covid ReGistrY (ENERGY),” the World Health Organization’s Neuro-COVID Global Forum, and the COVID-19 Neuro Research Coalition are all actively involved in developing platforms and directions to facilitate the capture of neurological involvement in the pandemic. In many countries, clinicians, public health workers, and hospital facilities are struggling to care for those affected. Within this activity, we are also witnessing a disturbing trend of disbelief and even outright opposition toward the need for change in social behavior. There is a niggling sense that beneath the surface, there is a latent feeling of every person for themselves.

It is essential in such environments that professional organizations, such as ours, remain united in our efforts to care for those with neurological diseases, record accurately those with COVID-19-related neurological illness, support colleagues in the battle with COVID-19, and maintain the training of our next generation of neurologists.

As I have mentioned before, the WFN was already moving to a more electronic-based medium for its educational and communication activities prior to COVID-19. There are now several changes underway within the WFN that will likely drive new and innovative programs. These may result in transformation of WFN operations and potentially persist after the pandemic has subsided.

In communication, the London office has completed the first step to improve its ability to reach all member societies and their individual neurologists. Almost all 122 member societies have contributed to the updating of their contact details, for which the trustees and office staff are most grateful. The second step will be to ensure that material disseminated to member societies is timely, meaningful, and reciprocal. In an era where physical meetings may never be the same again, this is an important and essential development. Examples of how this development has already proven beneficial are the recent Council of Delegates Annual General Meeting, the trustee election, and the promotion of three successful educational programs. In all of these, up-to-date information was communicated to all member societies and through many of them to their memberships.

For the first time in the history of the WFN, a virtual Annual General Meeting was held on Sept. 9. This was notable also for the large number of member society delegates, given that in a non-World Congress of Neurology year, as 2020 is, attendance numbers are typically on the low side. Business was conducted in the usual format and essential motions proposed and carried. Dr. Morris Freedman was declared the new elected trustee following a smooth electronic electoral process contested by six high quality candidates. The clarity, rapidity, and accuracy of the election were greatly appreciated by the office staff, who are usually tasked with such matters manually. While this format lacked the usual intense discussions and face-to-face canvasing, it allowed many more societies to participate without having to travel or to arrange proxies.

Improved communication with member societies has also aided the promotion and the production of educational activities. Two WFN specialty groups and a regional organization have illustrated this aspect effectively. First, the Neuromuscular Disorders Specialty Group, chaired by Prof. John England, partnered with the Spanish Neurological Society to hold a virtual International Congress on Neuromuscular Diseases (ICNMD) Sept. 11-14. Some 800 registrants from almost 50 countries attended the congress and will be looking forward to the next congress in July 2021 in Valencia. Second, the Tropical and Geographical Neurology Specialty Group has just begun the second series of its highly popular and successful, mainly fortnightly, Neuroinfection sessions. Chaired by Prof. Chandrashekhar Meshram and supported by the Indian Academy of Neurology, the topics have updated many common and not-so-common neurological infections. This series will continue through to Dec. 12. The most recent WFN-related educational event was the AFAN/WFN E-Learning Day held on Oct. 10 and run out of Tunis. Eight lectures in four sessions dealing with stroke, with particular emphasis on Africa, were delivered by experts from the African, the European, and the American Academies of Neurology and from the World Stroke Organization. It was a great example of collaborative effort. Altogether there were approximately 1,100 registrants from 80 countries. Thanks go to all involved in the execution of this event and especially to Prof. Riadh Gouider, who was tireless in his efforts to ensure a rewarding e-learning experience. These meetings were all promoted by the WFN through the usual media sources and by direct communication with member societies.

World Brain Day 2020 also exemplified the value of improved communication in promotional terms. The WFN was greatly benefited by the partner organization, the International Parkinson and Movement Disorder Society (IPMDS), both around the July 22 commencement and at the final press conference held during the IPMDS virtual Congress in September. This year, the promotions and activities related to World Brain Day reached more than 50 million people globally, just outdistancing the numbers from the 2019 WBD. Other key social media parameters generated exceptional numbers for WBD. The WBD Committee, chaired by Prof. Tissa Wijeratne, was extremely successful in generating local and regional activities on and around July 22. Many of these are shown on the WFN website: www.wfneurology.org/wbd.

The WBD Committee is already planning the 2021 program. The two promotional videos prepared earlier this year dealing with WFN activities and the upcoming 2021 World Congress of Neurology were shown during the inaugural AFAN/WFN E-Learning Day lunch and coffee breaks and will no doubt be employed through to the World Congress of Neurology. The Brain Health Initiative is close to presenting the first of a series of five videos aimed at the general population. We hope that it and its successors will promote improved awareness of the importance of brain health and the provision of quality neurological care.

While we all miss the pleasure of meeting and communicating face-to-face with our colleagues, the resumption of that personal interaction with the developments described above will significantly enhance the cohesion and success of the WFN. Meanwhile, I wish everyone a safe coexistence with the pandemic. •

Prof. William M. Carroll
President, World Federation of Neurology

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