Articles – Page 69

World Congress of Neurology Oct. 31-Nov. 5

Scenic Santiago, Chile, is host city for the Congress

By Renato Verdugo, MD

We are certain that the World Congress of Neurology will produce an impact. Chile and many countries in South America are at the edge of development. We are leaving behind health problems typical of underdevelopment although now we are facing the diseases related to aging. We are currently developing genetics, neuroradiology, rehabilitation and other techniques with the result being an in increase in the number of young neurologists and an expansion in their geographical distribution. Therefore, this is the right time to host the World Congress of Neurology in Chile, which will produce an impact within the country and in the entire Latin American region. It will not be just another congress, but it will really contribute to changing neurology worldwide, as the slogan of the Congress states.

As usual, the World Congress of Neurology will include the most recent advances in neurological sciences, with the participation of renowned neurologists from around the world. It will also include different social activities to enjoy the traditions of the host country, including its famous wine. It will be an opportunity to get to know an attractive country with a varied geography, which is also easy to reach. Santiago is in the Maipo Valley, with the Andes towards the east and the Pacific Ocean on the west, each just about an hour away. It is a city that embeds the essence of the country’s history with several interesting art, historical and cultural museums, full of restaurants and different neighborhoods with different styles according to the historical period in which they developed.

Santiago is one of the safest cities in Latin America and the main cultural and economic center of the country.

Close by is the port of Valparaiso, a UNESCO world heritage city with its narrow streets climbing up the hills of the coast where one of Pablo Neruda’s houses, “La Sebastiana,” is located. Adjacent to Valparaiso is Viña del Mar, a modern and dynamic touristic city. Flying just an hour north from Santiago you will find the driest desert in the world, and flying one hour south and you will reach a dense rain forest.

The country has developed a safe democratic environment and enjoys one of the most growing economies in the region. Chile is without a doubt one of the most interesting countries in Latin America. Come to the World Congress of Neurology. We will be pleased to show you around.

Dr. Verdugo is the Congress president.

World Congress of Neurology will Engage Key, New and Non-traditional Stakeholders Across the Globe

By Renato Verdugo

As the XXII World Congress of Neurology (WCN 2015) is just a few short months away, how can we not be excited about a scientific program that will usher in delegates from around the globe and will be led by some of the world’s leading industry experts? Chock-full of plenary sessions, teaching courses and workshops, a Tournament of the Minds, and regional and sponsored symposia, WCN will set the stage for networking opportunities, for learning and for important information sharing.

We are looking forward to receiving research papers from around the world in the coming months. In fact, we’ve had an overwhelming response with papers already received that focus on some of the latest developments in neurology, matched with uniquely innovative research in the field. As a result of the countless papers received to date, we have extended the abstract submission deadline to accommodate our colleagues from around the world. The new deadline for abstract submission is now May 7, 2015.

The major abstract submission topics include: epilepsy, movement disorders, stroke, neuro-critical care, dementia, MS and demyelinating diseases, neuromuscular disorders, headache, pain, neurorehabilitation and CNS infections. Take the opportunity to learn more about abstract submission topics and other congress information on the WCN website, www.wcn-neurology.com.

The months leading up to this influential event have raised the bar on the WCN’s objectives and its activities around the globe. Most important is the bringing together of the world’s scientific experts and true leaders in their fields to catalyze and advance neurology in the scientific community. To that end, the congress is an elite meeting platform for community leaders, scientists and policymakers to promote and enhance programmatic collaboration. It is here that they can effectively address regional, national and local responses to neurology around the world and overcome those obstacles that limit access to prevention, care and much-needed services. Lastly and perhaps, most importantly, is that WCN successfully engages key, new and non-traditional stakeholders across the globe, reaching out to future leaders and decision-makers. It is these men and women in our industry who will embrace the congress theme, “Changing Neurology Worldwide,” helping to make it a reality.

Santiago, Chile, is a prosperous, prominent and colorful stage for WCN 2015. There are numerous reasons to bring WCN to Santiago, Chile. Today, Chile is one of South America’s most stable and affluent nations. It leads other Latin American nations in human resource development, competitiveness, income per capita and globalization, and it reigns supreme as a country on the road to long-term peace and economic freedom. Chile also ranks high on a regional scale in sustainability and in democratic development. In May 2010, Chile became the first South American nation to join the Organization for Economic Co-operation and Development. Chile is a founding member of the United Nations, the Union of South American Nations and the Community of Latin American and Caribbean States. Since July 2013, Chile has been viewed by the World Bank as a “high-income economy,” and has been deemed a developed nation.

We are extending an invitation to the upcoming World Congress of Neurology in Santiago, Chile, to share in the region’s developments and strengths in research. We are leaving behind the health problems of underdevelopment, and are facing the diseases of aging. We are developing innovative techniques in genetics, neuroradiology, rehabilitation and related disciplines. The result is an explosion in the number of young neurologists and an expansion in their geographical distribution. In this context, it is the right time to host the World Congress of Neurology in Chile. This important industry gathering will have an impact on the country and on in the entire Latin American region. It
will not be just another event. You and your colleagues will have a hand in contributing to the ever-changing neurology landscape.

Remember that Santiago is the nation’s capital and the largest city in terms of population and employment. It is the country’s pride and its center for political, economic, cultural and industrial activities and one of the most modern capital cities on the continent. It is a safe, vibrant
and cosmopolitan center with world-class venues, cuisine and renowned tourist attractions and sites.

If you want to reach key thought leaders, academic and industry researchers and clinicians or learn about the latest developments in neurology in Latin America and around the world, then this year’s World Congress of Neurology in Santiago, Chile, at the prominent CasaPiedra Event and Conference Center, is the place to be October 31 to November 5, 2015. We look forward to connecting with old friends, engaging young neurologists and professionals, and, together, taking the next steps in advancing neurology worldwide.

Announcing New Open Access Journal eNeurologicalSci

Bruce Ovbiagele, MD, MSc, MAS, FAAN

Elsevier is delighted to announce the launch of a new Open Access journal, eNeurologicalSci (eNS), on behalf of the World Federation of Neurology. eNeurologicalSci is a companion journal to the Journal of Neurological Sciences.

The journal is under the professional leadership of Bruce Ovbiagele, MD, MSc, MAS, FAAN.

eNeurologicalSci rapidly publishes high-quality articles across a broad research spectrum of neuroscience and neurology, with the potential for understanding mechanisms and informing management of diseases of the human nervous system. The journal especially serves as a venue for papers related to the mission of the World Federation of Neurology, and accepts contributions from basic neuroscience all the way through to community studies submitted by researchers from around the world. eNeurologicalSci also welcomes papers of major relevance to neurologic education and accommodates submissions from trainees in neurology (e.g. residents, fellows, post-doctorate scholars and medical students).

Types of manuscripts for consideration include original research papers, short communications, reviews, study protocols, editorials, perspective pieces, clinical pathologic conference summaries, unique neuroimaging photographs, society conference proceedings (full articles or abstracts), expert-consensus clinical practice guidelines, and letters to the editor. Examples of neurology-related fields of interest include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism.

Dear Colleagues,

These are exciting times in neurological research. Neurology is now well beyond being just a great specialty with a logical approach to a varied spectrum of interesting disorders. Compelling advances in the neurological sciences are taking place and even greater new discoveries lie ahead. eNS aspires to be at the forefront of exciting research initiatives in neurology and is poised to be a leading forum for the prompt and widespread dissemination of new knowledge as it accrues in this field. eNS

On top of publishing ingenious discoveries, eNS will take advantage of its primarily online milieu by facilitating enhanced use of audiovisual technology and social media tools, thereby enriching the experience of readers, broadening the exposure of articles, and providing opportunities to better engage with our published scientists.

I invite you to submit your best research to eNS so you can share your science in a very speedy and widely visible manner. If accepted for publication, authors are notified of the decision and requested to pay an Article Processing Fee. Following payment of this fee, the article is made universally available to all on www.sciencedirect.com and www.ens-journal.com.

I look forward to learning with and from all of you.

We are now inviting submissions for the journal. For the full Aims & Scope and to submit your papers online, please visit the journal homepage.

Peter Bakker
Executive Publisher, Neurology/Psychiatry
Elsevier

World Congress of Neurology 2015, Santiago, Offers Access to Collaboration and Cooperation

Donald H. Silberberg

As we begin to think about attending the forthcoming World Congress of Neurology in Santiago, Chile, it seems timely to consider how we might take advantage of the unique opportunity that this provides to advance our field. As WFN President Raad Shakir points out in his column in this issue of World Neurology, we neurologists everywhere attempt to address identical or very similar clinical problems, but in quite different environments. Some do so surrounded by colleagues and all of the support systems that are key to optimal care. Others of us walk alone, sometimes as the sole neurologist in a region with very few physicians. Because of differences in the local health care system, cultural and other environmental differences, the neurologist practicing in optimal circumstances thinks about epilepsy, Parkinson’s disease or stroke in quite a different way than her counterpart practicing in difficult circumstances or in conflict zone.

A major function of an international meeting such as the World Congress of Neurology is to facilitate the sharing of knowledge, and to help develop ongoing working relationships that can lead to many advances for all. Although publications and electronic communications provide essential ways to communicate, an international meeting offers unparalleled access to one’s peers whose workplace and problems are far from home, but may be extremely informative.

Both information sharing and clinical and research collaboration become very real possibilities. Clinical collaboration today often takes the form of setting up periodic video conferences, supplementing important opportunities to visit one another. Research collaboration can lead the way to developing multilateral programs supported by universities, national agencies such as the National Institutes of Health (U.S.) or Canada’s Grand Challenges Program, and foundations such as the Bill and Melinda Gates Foundation. Many of us engaged in global neurology can think back to ways in which WFN congresses and other meetings introduced us to international problems, opportunities and colleagues—let’s put WCN Santiago to work for this purpose in November.

Neurology and Psychiatry in Babylon

Babylonians described epilepsy, stroke, psychoses, depression, anxiety

By Edward H. Reynolds

James Kinnier Wilson and Edward H. Reynolds.

In the last 25 years I have had the privilege of collaborating with James Kinnier Wilson (JKW) on Babylonian texts of neurological and psychiatric disorders. JKW is a Cambridge-based assyriologist and son of the distinguished neurologist, Samuel Alexander Kinnier Wilson (1878-1937) (see World Neurology, October 2014).

It was believed that studies of disorders of the nervous system began with Greco-Roman medicine, for example, epilepsy, “the sacred disease” (Hippocrates) or “melancholia,” now called depression. Our studies have now revealed remarkable Babylonian descriptions of common neuropsychiatric disorders a millennium earlier.

There were several Babylonian dynasties with their capital at Babylon on the River Euphrates. Best known is the Neo-Babylonian Dynasty (626-539 BC) associated with King Nebuchadnezzar II (604-562 BC) and the capture of Jerusalem (586 BC). But the neuropsychiatric sources we have studied nearly all derive from the Old Babylonian Dynasty of the first half of the second millennium BC, united under King Hammurabi (1792-1750 BC).

The Babylonians made important contributions to mathematics, astronomy, law and medicine conveyed in the cuneiform script, impressed into clay tablets with reeds, the earliest form of writing, which began in Mesopotamia in the late 4th millennium BC (see Figure 1, page 8). When Babylon was absorbed into the Persian Empire cuneiform writing was replaced by Aramaic and simpler alphabetic scripts and was only revived (translated) by European scholars in the 19th century AD.

A Babylonian cuneiform text on epilepsy. Obverse of BM47753 in the British Museum.

The Babylonians were remarkably acute and objective observers of medical disorders and human behavior. In texts located in museums in London, Paris, Berlin and Istanbul, we have studied surprisingly detailed accounts of what we recognize today as epilepsy (Figure 1), stroke, psychoses, obsessive-compulsive disorder (OCD), psychopathic behavior, depression and anxiety. For example, they described most of the common seizure types we know today, e.g., tonic clonic, absence, focal motor, etc., as well as auras, post-ictal phenomena, provocative factors (such as sleep or emotion) and even a comprehensive account of schizophrenia-like psychoses of epilepsy. Early attempts at prognosis included a recognition that numerous seizures in one day (i.e., status epilepticus) could lead to death.

The Babylonians recognized the unilateral nature of stroke involving limbs, face, speech and consciousness, and distinguished the facial weakness of stroke from the isolated facial paralysis we call Bell’s palsy. They did not, and perhaps could not, describe what we call transient ischemic attacks as they had no method of expressing small units of time such as seconds or minutes. The distinction between a transient ischemic event and some epileptic seizures would have been difficult, as it can be today.

The modern psychiatrist will recognize an accurate description of an agitated depression, with biological features including insomnia, anorexia, weakness, impaired concentration and memory. The obsessive behavior described by the Babylonians included such modern categories as contamination, orderliness of objects, aggression, sex and religion. Accounts of psychopathic behavior include the liar, the thief, the troublemaker, the sexual offender, the immature delinquent and social misfit, the violent and the murderer.

A bas-relief of a wounded lioness from the Palace of Ashurbanipal at Nineveh, in the British Museum.

The Babylonians had only a superficial knowledge of anatomy and no knowledge of brain or psychological function. Although they had no knowledge of the spinal cord, the Babylonians and the Assyrians clearly understood that an arrow in the center of the back led to paralyzed hind legs, another important clinical observation (figure 2). They had no systematic classifications of their own and would not have understood our modern diagnostic categories. Some neuropsychiatric disorders, e.g., stroke or facial palsy, had a physical basis requiring the attention of the physician or asà», using a plant and mineral-based pharmacology. Most disorders, such as epilepsy, psychoses and depression, were regarded as supernatural due to evil demons and spirits, or the anger of personal gods, and thus required the intervention of the priest or aÅ¡ipu. Other disorders, such as OCD, phobias and psychopathic behavior, were viewed as a mystery, yet to be resolved, revealing a surprisingly open-minded approach.

From the perspective of a modern neurologist or psychiatrist, these ancient descriptions of neuropsychiatric phenomenology suggest that the Babylonians were observing many of the common neurological and psychiatric disorders that we recognize today. There is nothing comparable in the ancient Egyptian medical writings and the Babylonians therefore were the first to describe the clinical foundations of modern neurology and psychiatry.

A major and intriguing omission from these entirely objective Babylonian descriptions of neuropsychiatric disorders is the absence of any account of subjective thoughts or feelings, such as obsessional thoughts or ruminations in OCD, or suicidal thoughts or sadness in depression. The latter subjective phenomena only became a relatively modern field of description and enquiry in the 17th and 18th centuries AD. This raises interesting questions about the possibly slow evolution of human self awareness, that is central to the concept of “mental illness,” which only became the province of a professional medical discipline, i.e., psychiatry, in the last 200 years.

References

Kinnier Wilson JV, Reynolds EH. Texts and documents. Translation and analysis of a cuneiform text forming part of a Babylonian treatise on epilepsy. Med Hist. 1990; 34:185-98.

Reynolds EH, Kinnier Wilson JV. Stroke in Babylonia. Arch Neurol. 2004; 61:597-601.

Reynolds EH, Kinnier Wilson JV. Neurology and Psychiatry in Babylon. Brain. 2014; 137: 2611-2619.

Edward H. Reynolds is former consultant neurologist to the Maudsley and King’s College Hospitals; former director of the Institute of Epileptology, King’s College, London and former president of the International League against Epilepsy.

Peter J. Koehler is the editor of this history column. He is neurologist at Atrium Medical Centre, Heerlen, The Netherlands. Visit his website at www.neurohistory.nl

Pediatric Neurology in Africa

Fellowship program builds skills for health practitioners

By Jo Wilmshurst, MD

Doctors trained in the management of child neurology conditions are lacking in Africa^1,2. Epilepsy is one of the major disease burdens in the continent and training in this area is even more scarce. EEG interpretation in children is very different to that for adults and grave errors can occur in patient management when misinterpretations occur.

The African Paediatric Fellowship Program (APFP) is a project developed by the Department of Paediatrics and Child Health at the Red Cross War Memorial Children’s Hospital, under the University of Cape Town in South Africa, to build skills capacity of health practitioners from Africa. The center is the largest dedicated children’s hospital in sub-Saharan Africa. Children are managed across primary to quaternary levels of care with the spectrum of diseases prevalent in Africa.

Figure 1. Some of the 2014 APFP fellows attending the end-of-year discussion group. Dr. Kija, child neurology trainee from Tanzania, is fourth from the left. Represented in the group are doctors training in areas from pediatric urology to pediatric rheumatology from areas in Africa inclusive of Uganda, Zambia, Kenya, Ghana, Zimbabwe and Malawi. The group remains as a cohesive support network and stay in contact after completion and following their return home.

The APFP formed collaborations with tertiary centers across Africa and has assisted their identification of strategic training requirements based on their countries’ key health care needs. Structured training occurs at the pediatric units through the University of Cape Town. More than 65 specialists have completed, or are completing in 2015, the training program in diverse pediatric areas, referred from 33 centers in 12 different African countries. There has been a 98 percent retention rate of trainees returning to work in their home country since 2008. The program is evolving with training arms supporting nursing and ancillary services. The trainee becomes the trainer in his or her home center, and a key opinion leader equipped to lobby for changes to health care policy (Figure 1).

The grant provided by the WFN to support neurology training in 2013 has enabled the focused training for six general pediatricians from different centers in Nigeria, and three further trainees from Zimbabwe, who manage large caseloads of children with neurodisabilities and epilepsy. The University of Cape Town rolled out in 2015 a post-graduate diploma in “basic electrophysiology interpretation and the management of children with epilepsy.” This requires one-on-one training with a focus on areas relevant to the African context. The aim of the post-graduate diploma is to establish safe practice and not to train accredited epileptologists. In Africa, most child health practitioners who manage children with neurologic disorders must address the comprehensive needs of the child inclusive of the other health issues, such as co-infections, nutritional deficits, and social challenges (Figures 2 a, b).

At the current time in most African settings, it is not viable to work as an epileptologist without addressing these other health care issues (Figures 3 a, b). However as a result of more cost-effective neurophysiology equipment, and through equipment donations, there are an increasing number of EEG machines that are potentially being operated and interpreted by health practitioners with no pediatric training. This training program was devised out of the needs that this situation created. The audit of the preliminary findings of a pilot study on the impact of the training course while it was being established is in press. The audit confirmed that access to a basic handbook improved EEG interpretation skills, but that the optimal outcomes were seen in those doctors who had additional one-on-one training.

a.) Children attending the neurology clinic at Red Cross War Memorial Children’s Hospital, enjoying a donation of new reading books. b.) One of the neurology patients occupied in puzzle play in the waiting area.

Between 2013 and 2014, three doctors from Nigeria, Tanzania and Ghana entered the APFP for formal training to become accredited child neurologists. Tanzania has no accredited child neurologists and Ghana has two. These trainees, in addition to completing the full post-graduate clinical master’s degree in child neurology, also are completing research in areas relevant to the context they work in. The doctor from Tanzania is heading a prospective study to review the effects on bone mineral density in children on antiepileptic drugs in the African setting. Vitamin D supplementation is not part of standard care of these patients and it is hoped that the findings from this study will lead to data to support lobbying for this intervention to be part of standard practice. The doctor from Ghana will complete a study assessing the neurobehavioral influences on children from antiretroviral therapy. The doctor from Nigeria has completed a large prospective study assessing the efficacy of attaining sleep EEGs in children using melatonin.

In the next training cycle it is hoped that there will be funding to support applicants from Sierra Leone, Zimbabwe, Uganda, Kenya, Sudan and Zambia.

The training curriculum, while in line with international templates, also accommodates approaches novel to Africa, such as the neurological care for children with tuberculous meningitis, HIV, malaria and neurocysticercosis. The perinatal complication rates remain high in Africa with significant numbers of neonates suffering hypoxic ischaemic encephalopathy. Other neuroinsults are seen from the effects of central nervous system infections and motor vehicle accidents. The training must accommodate these areas in depth as well. The returning trainee must often function in all areas from social welfare to rehabilitation, the training is adjusted for this.

a.) Mothers attending the Queen Elizabeth Hospital, Blantyre, in Malawi, taken during an APFP site visit in 2013. This is the main teaching hospital in the country, which has one pediatric neurologist for the total population. b.)
Child-care workshop for children with motor disabilities at the Child Rehabilitation Unit, Harare Hospital, Zimbabwe, taken during the APFP site visit to the referring units in the country in 2014.

Prevention and early intervention is one of the major aims for this project and all trainees in the program are facilitated in the knowledge gained during their training and assess its relevance to their home setting, how to introduce these skills to the optimal benefit to child health care and how these interventions can extend across all levels of health care—from primary to tertiary.

On the trainee’s return to their home center they maintain contact with their supervisor, and site visits are scheduled as needed to provide local input into service development and local training (Figure 3 a, b). Research collaborations also continue. These trainees are having a real impact in their home centers and are becoming voices in Africa lobbying to promote child health. One of the child neurology trainees who completed training in 2009 and returned to Kenya now sits on the national Kenyan pediatric body, assists selection of ongoing APFP trainees referred from the country, and is also on the Pediatric Commission for the International League Against Epilepsy. This trainee is part of a team developing its own subspecialty training program for East African doctors. This is viewed as a major future aim of the APFP. In order to grow and to fulfill the health care needs for the continent, more training sites are needed. It is important these remain within Africa with training relevant to the diseases of the region. There is much to learn from the approaches many innovative African centers undertake to cope with the challenges of scare resources.

While training experience in overseas centers offers obvious gains in skills development, the local relevance of the training may be questionable and the risk of the “brain drain” is high. A number of overseas specialists have opted to spend time working, training and lecturing in African centers. This is a superb way to assist skills development in African centers. Building on these relationships with regular visits develops sustained skills where often none existed before.

References

Wilmshurst JM, Badoe E, Wammanda RD, Mallewa M, Kakooza-Mwesige A, Venter A, Newton CR. Child neurology services in Africa. J Child Neurol. 2011 Dec; 26(12):1555-63.
Wilmshurst JM, Cross JH, Newton C, Kakooza AM, Wammanda RD, Mallewa M, Samia P, Venter A, Hirtz D, Chugani H. Children With Epilepsy in Africa: Recommendations From the International Child Neurology Association/African Child Neurology Association Workshop. J Child Neurol. 2013; 28 633-644

Dr. Wilmshurst is the head of paediatric neurology, Red Cross War Memorial Children’s Hospital, University of Cape Town, South Africa, and the director of the APFP.

Neurology Fellowship: UC San Francisco/Yale University

55844195 A neurology fellowship is offered by the Memory and Aging Center at the University of California, San Francisco, and the Neurology Department at Yale University (position can be filled at either location) through the NeuroHIV Cure Consortium, which operates numerous neurological research studies in acute HIV infection and cure strategies in Thailand and Africa. The Consortium is a research collaboration directed by Victor Valcour, MD, PhD (UCSF), Serena Spudich, MD (Yale University), and Jintanat Ananworanich, MD, PhD (U.S. Military HIV Research Program).

The NIH-funded work gives a neurologist opportunities to conduct research. The fellow will provide at least six months of neurological expertise at research sites in Thailand, including neurological evaluation of subjects and lumbar punctures, while developing a personal research portfolio. The incumbent will be expected to actively participate in manuscript preparation and analyses for publication as lead author, and apply for awards and other funding to support continued involvement.

The Consortium leaders have extensive experience as career and research mentors and will provide guidance and assistance in data analysis and preparation of presentations and manuscripts, as well as in independent fellowship and grant applications. The position is for one year, with opportunities for extension. The fellowship may be combined with a neurobehavioral fellowship at UCSF.

For more information: www.inhcc.net/opportunities.html.

Eye Movement Disorders in Clinical Practice by Dr. Shirley H. Wray

Wray SH (2014) Eye Movement Disorders in Clinical Practice. New York NY: Oxford University Press.

By Steven L. Galetta, MD

Eye Movement Disorders in Clinical Practice is written by a legend in the field of neuro-ophthalmology, Dr. Shirley H. Wray. The book is a wonderful compendium of the common and challenging disorders of ocular motility. Chapters are organized topographically beginning with the cortical control of eye movements, followed by chapters on the eyelids, the extraocular muscles and nerves, disorders of horizontal and vertical gaze, dizziness, the cerebellum and ocular oscillations.

Each chapter begins with a generous discussion of the relevant anatomy and physiology of a particular area of the brain. The key anatomical points are then summarized in a box to distill the critical information that is about to be given clinical relevance in the remainder of the chapter. Chapters in this book take some of the most complicated neuroanatomy and make it come to life with beautiful figures, clear discussions and key references. After the anatomy and physiology are reviewed within each chapter, the reader is then taken to cases where the history and examination are dissected, with an emphasis on how signs and symptoms are localized and correlated. Each case has a great video attached to it. The videos are of outstanding quality and clearly demonstrate the ocular motility disturbance. In fact, many cases are the best examples that I ever seen of the eye movement disorder. One minor criticism would be that the videos often do not point out the exact findings as you are taken through the standard neuro-ophthalmological examination. Nonetheless, such findings are summarized in the text and the reader is provided ample guidance on what to look for.

From the video section, the reader is taken back to the text for further discussion of localization, differential diagnosis, testing and treatment of the problem, emphasizing the importance of neuro-ophthalmological signs in managing the patient. The learning experience is then supplemented by special explanatory notes; these break down the problem and often provide some historical context to the findings.

The beauty of this book is its redundancy; the reader is never left to struggle with a single description of the neuro-ophthalmological topic. This is a great feature for both the novice and the expert and makes each case even more memorable.

It was a real pleasure to read this book. There were many moments when I could not put it down because it was fun to read such an organized and a logical approach to eyelid and ocular motility disorders. The chapters on the cortical control of eye movements and the cerebellum are true masterpieces; they take some of the most complicated anatomy and disorders of ocular motility and make them easy to understand. Another feature that makes this book so special is the simple way in which the examination is explained, and how symptoms are emphasized as a guiding factor in what the examiner should look for. I often found myself taking notes on the side, and trying to remember all the gems being offered.

Eye Movement Disorders in Clinical Practice is a keeper! I would recommend it to neurology and ophthalmology trainees and senior clinicians alike.

Dr. Galetta, is professor and chair of the Department of Neurology, New York University School of Medicine.

New Society Works to Improve Quality, Establish Standards

Guenther Deutschl

By David B. VoduÅ¡ek and Guenther Deutschl

The European Academy of Neurology (EAN) was founded on June 3, 2014, in Istanbul by joint efforts of the two parent societies at their (first and last) Joint Congress of European Neurology, the congress of the European Federation of Neurological Societies (EFNS) and the European Neurological Society (ENS)¹. (See also Grisold W, WFN Newsletter http://www.worldneurologyonline.com/article/ens-efns-ean/).

The society is established according to Austrian law, the main goal being to promote “excellence in neurology in Europe.” EAN is a new and vigorous society, which is taking over the good program, functions and initiatives from both parent societies along with the previous EFNS head office in the prestigious Museum District in Vienna, a fine centrally situated “Pentagon” of European neurology, assuring frictionless functioning of the diverse EAN organs.

The bulk of the new group of governing officers, the EAN Board, was elected in June by the hybrid Assembly of Delegates from 45 National European Societies (previously constituting EFNS) and 45 delegates from individual members (elected by the ENS in spring 2013). Prof. Günther Deuschl from Kiel, Germany was elected as president, and the other members of the EAN Board are:

Vice President: Prof Franz Fazekas, Graz, Austria
Secretary General: Prof Didier Leys, Lille, France
Treasurer: Prof Marianne de Visser, Amsterdam, The Netherlands
Chair Liaison Committee: Prof David B. VoduÅ¡ek, Ljubljana, Slovenia
Chair Scientific Committee: Prof Antonio Federico, Siena, Italy
Member at large: Prof Per Soelberg Sørensen, Copenhagen, Denmark

The Board has taken up the reins immediately, and after a call for applications, Dr. Hannah Cock from London, UK, was chosen as chair of the Education Committee, and Prof. Paul Boon from Gent, Belgium, as Chair of the Congress Programme committee. All committees were replenished with committee members by October 2014, with some members continuing from the previously active EFNS/ENS Committees of same name, and a strong representation of new names from all over Europe.

David B. Vodusek

Europe needs strong leadership in the field of neurology. A recent analysis has found the annual costs for neurological diseases in Europe to be greater than 300.000 Mio â‚¬², and this will increase in the years to come as in Europe the population above 65 years as a fraction of those below 65 years will rapidly increase from less than 25 percent in 2015 to more than 52 percent in 2060 ³. The threat of increasing the burden and the costs of disease is the stimulus for politicians to make plans to find solutions, and a chance for EAN to step in and help. The European Commission and the European Parliament have developed programs to support research and development, and over time the amount of money has been steadily increased. The term for the next program “Horizon 2020”⁴ has begun. The amount of money for Horizon 2020 is almost 80 billion â‚¬. Of this money 8 billion â‚¬ are reserved for health research. EAN is ready to help the 19,000-plus European neurologists to meet the challenges of the burden of neurological diseases and to increase their research efforts to fight them.

EAN is aware of the different national schools of neurology, which have also been exported in the last two centuries to many countries worldwide. These different cultures of practicing neurology will be respected and integrated in EAN. We consider such diversities of neurological cultures to be a strength of European neurology. On the other hand, we move forward together to improve quality of care within all countries, and also to establish minimal standards that can objectively be defined on the basis of sound scientific evidence. Thus, the member societies can use them to negotiate for appropriate financial resources in their respective countries.

It is EAN’s purpose to bring European neurologists together. Berlin 2015 will be our first congress, the program is ready and we believe it will aptly demonstrate the richness and quality of European neurology. Participants from all over the world are most welcome, of course! We will hold our EAN congress annually and all new developments in the field of science and healthcare development as relates to neurology will be covered during these congresses. From 2016 in Copenhagen on, each congress will be dedicated to a certain theme. The scientists of Europe and from all over the world will present new insights and we will recruit our best teachers to have the latest knowledge transferred into clinical practice in the teaching courses.

EAN is reinforcing ties to member societies and is paying much attention to increase individual membership, striving to involve neurologists as individual contributors to developing neurology. EAN has already established closer links to the European Association of Young Neurologists and Trainees (EAYNT), and will make sure that the future generations of neurologists feel represented within the society.

EAN is aware of the important cooperation with UEMS, the representative body of all European specialists at the level of European Union, and is cooperating with its Section of Neurology. The main aims of UEMS are harmonization of postgraduate education, ensuring quality control of education, and delivering care to patients all over Europe. One of the great past achievements of the cooperation between the professional body (Section of Neurology, UEMS) and the scientific society (at that time EFNS and ENS) has been the organization of the European board examination in neurology, which EAN will continue to support.

EAN has also kept the ties previously established by EFNS to the leading voice of neurological patients in Europe, the European Federation of Neurological (patients’) Associations (EFNA), and is already planning coordinated actions aimed at improving patient care across Europe.

Looking back at the short interval since the establishment of EAN much has already been achieved in the past months, thanks to the good preparatory efforts of the parent societies in the past and the ambitious team leading the European Academy of Neurology.

References:

Bassetti C L, R Hughes. The European Academy of neurology is founded: a fundamental step linking the glorious past with our future challenges. Eur J Neurol. 2014 Jun;21(6):809-813
Olesen J, Gustavsson A, Svensson M, Wittchen HU, Jonsson B. The economic cost of brain disorders in Europe. Eur J Neurol. 2012 Jan;19(1):155-62
http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/.
COUNCIL DECISION of 3 December 2013 establishing the specific programme implementing Horizon 2020 – the Framework Programme for Research and Innovation (2014-2020) and repealing Decisions 2006/971/EC.

Congress Offers Inspiration, Motivation for Beginning Neurologist

By Dr. Pamela Noella Correia

I am a young neurologist from India and have just finished my training. I have a keen interest in the field of cerebrovascular disease. It was possible for me to attend the World Stroke Congress in Istanbul in October 2014, due to the World Federation of Neurology Junior Travelling Fellowship. The conference was held at the Halic Congress Centre, very scenically located at the Beyoglu, “The Golden Horn.”

I presented my abstract “Correlation of prothrombotic markers with genetic markers of hypercoagulability in ischemic stroke” under the genetics subsection at the Congress. I also took teaching courses on acute stroke treatment and uncommon causes of stroke. The lectures on translational stroke research and global stroke policies offered a good retrospective. The session on challenges in acute stroke trials also addressed some very important issues that are relevant in the implementation of any trial.

Participation in the WSC presented a unique opportunity to discuss my research in stroke genetics with many delegates from different nationalities from around the world. Such conferences help us to perceive that the world community must stay united across frontiers in search of solutions to problems that we all have: implementation in acute stroke care and improving stroke awareness globally. At the cusp of the matter though, is to address the issues of timeliness of action, intervention and holistic treatment thereby paving the way toward a fuller life after stroke.

It was very encouraging to listen to the results of the MR CLEAN trial (Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands), which were announced on the last day of the congress, and gave new hope in the field of endovascular stroke treatment.

They say that education is never complete without traveling, and so I managed to squeeze in some time into my itinerary to soak up a fair glimpse of the city of Istanbul. The Minia Turk, which was located very close to the congress venue, is a nice park displaying many historical Turkish locations in a miniature form—with cryptic details to encapsulate the significance—so as to flip through a moment in this cradle of civilization. I could traverse the memory lanes of time past: of monuments like Hagia Sofiya and the magnificent Blue Mosque. In the evenings we savored a few delicious Turkish specialties in Taksim.

Overall it was an enthralling experience for me—getting an impetus at the right time in my career and providing me with a better world view of the field of stroke neurology.

As inhabitants of this planet we all have a shared responsibility in the welfare of our fellow beings; as medical professionals, in true Hippocratic traditions, we have a commitment to alleviate the rigors of suffering humanity anywhere and everywhere with our combined resources, knowledge and skills. In this sense I am very grateful to the World Federation of Neurology for their initiatives, graciousness and support.