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WORLDNEUROLOGY

V i s i t t h e W F N w e b s i t e a t h t t p : / / w w w. w f n e u r o l o g y . o r g

V O L U M E 1 5 , N U M B E R 2 , J U N E 2 0 0 0

ALSO IN THIS ISSUE:

• President’s Column & Editorial• WFN Annual Report 1999

• Neurosciences in 2025• Prevention & Care of Epilepsy

• 1999 WFN Junior TravellingFellowships - Reports

• News• Book Reviews

• Meetings Calendar

FIRST-CLASS SCIENTIFIC PROGRAMME XVIITH WORLDCONGRESS OF NEUROLOGY, LONDON, 2001This programme will be of interest not onlyto neurologists but also to those who havean interest in neurological diseases suchas researchers, health care providers,pharmaceutical companies and last butby no means least, patients and patientsupport organisations. The Congress willbe built around main themes, which havealready been approved by the NationalDelegates of the WFN. The following pro-grammes will form the main themes:

STROKE (Monday)

Chaired by Professor Charles Warlowfrom Scotland, the programme will in-clude epidemiological, pathological andtreatment aspects of stroke n original andexciting feature will be a clinicopathologi-cal conference in which international ex-perts will pit their wits against a diagnostic

problem. Specific topics will include: 1)The worldwide burden of stroke; 2) Thepathology of acute ischaemic stroke; 3)The role of the neurologist in the manage-ment of subarachnoid haemorrhage; 4)Atrial fibrillation and stroke prevention; 5)The story of carotid surgery; 6) The storyof CADASIL.

DEMENTIA (Tuesday)

François Boller will chair a session on de-mentia, which will cover epidemiologicalto pathogenetic aspects. This symposiumwill include the inaugural MacdonaldCritchley Lecture to be given by ProfessorMartin Rossor from London on the earlydiagnosis of Alzheimer’s Disease. Specif-ic presentations will include. 1) Epidemiol-ogy (to include developing countries); 2)Molecular biology; 3) Genetics; 4) Non-

Alzheimer dementia; 5) Risk factors andclinical diagnosis; 6) Vascular dementia;7) Mild cognitive impairment; 8) Contro-versies in dementia – debate; 9) Copingwith dementia.

EPILEPSY (Wednesday)

The epidemiological aspects of epilepsywill be considered from a worldwide inter-national basis. There will be another clin-icopathological conference. Topics duringthis and the other themes will include pae-diatric issues so that the Congress will beof interest to paediatric as well as adultneurologists. Specific presentations willcover: 1) Epidemiology of epilepsy: a glo-bal problem; 2) The cellular biology of epi-leptogenesis; 3) Genetic aspects of epi-lepsy; 4) Anatomic brain imaging of epi-lepsy; 5) Status epilepticus; 6) Newtherapeutic developments; 7) Paediatricconsiderations; 8) Surgical interventions.

MULTIPLE SCLEROSIS (Thurs-day)

Chaired by Hartmut Wekerle from Germa-ny the programme will include epidemio-

cont. on page 4

The new ‘London Eye’ (seen from Westminster Bridge) affords tremendous views across the capitaland beyond. (© by Richard Lateano.)

WORLD

NEUROLOGY

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EDITOR-IN-CHIEFDr. Jagjit S. Chopra, # 532 Sector 33-B, Chan-digarh - 160 047, IndiaFax: +91-172-665532E-mail: [email protected]

EDITORIAL ADVISORY BOARDDr. Richard Godwin-Austen, World Federationof Neurology, 12 Chandos Street, London W1M9DE, UKDr. Robert B. Daroff, Case Western ReserveUniversity/University Hospitals of Cleveland,Department of Neurology Cleveland, 11100Euclid Avenue, OH 44106-5015, USADr. Jun Kimura,Park City Uji Byodoin 1203, 169Uji Myoraku, Uji Shi, Kyoto 611-0021, JapanDr. Theodore Munsat, Department of Neurol-ogy, New England Medical Center, Box 314, 750Washington Street, Boston, MA 02111, USADr. James F. Toole, Wake Forest University, Bap-tist Medical Center, Medical Center Boulevard,Winston-Salem, NC 27157, USA

REGIONAL VICE PRESIDENTS (by virtue of Presidency of Regional Congress)Dr. S.M. Al Deeb, Riyadh Armed Forces Hospi-tal, Department of Clinical Neuroscience, P.O.Box 7897, Riyadh 11159, Saudi ArabiaDr. Amado M San Luis, Rm. 1006, St. Luke’sMedical Center, E. Rodriguez Ave., QuezonCity, PhilippinesDr. Ndiaye, Centre Hospitalier Universitaire DeFann, Clinique Neurologique, BP 5035, Dakar,SenegalDr. Jes Olesen, Professor and Chairman,Department of Neurology, Glostrup Hospital,Nordre Ringvej, DK-2600 Glostrup, DenmarkDr. Gustavo Pradilla, Carrera 29 # 32-65, Edifi-cio San Diego Of. 201, Apartado Aereo 678,Bucaramanga, Colombia

ASSISTANT EDITOR Dr. I.M.S. Sawhney, Consultant Neurologist,Morriston Hospital, Swansea SA6 6NL, UK

WFN ADMINISTRATOR Keith Newton, World Federation of Neurology,12 Chandos Street, London W1M 9DE, UK

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CONTENTS

The Newslet ter o f the World Feder at ion of Neurology

Publishing Information

First-Class Scientific Programme XVIIth World Congress of Neurology, London, 2001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

President’s Column & Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

WFN Annual Reports: A Glance at Activities in 1999 . . . . . . . . . . 4Report of the First Vice President and Chairman of the Constitution and Bye-Laws Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Report from the Secretary-Treasurer General . . . . . . . . . . . . . . . . . . . . . . . 4Report of the Chairman of the Continuing Education Committee . . . . . . . . 5Report of the Chairman of the Research Committee . . . . . . . . . . . . . . . . . . 6Report of the Editor Journal of the Neurological Sciences . . . . . . . . . . . . . . 7Report of the Editor World Neurology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8WFN Neurosonology Research Group: a Report 9/97 – 12/99 . . . . . . . . . . 8Report of the International Symposium on Neurosonology and Stroke(INS’99) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Neurosciences in 2025 – A Peep into the Future . . . . . . . . . . . . . 9

Planning for Prevention and Care of Epilepsy . . . . . . . . . . . . . . 10

1999 WFN Junior Travelling Fellowships – Reports . . . . . . . . . . 11

News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Book Reviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Calendar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

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President’s Column 3

PRESIDENT’SCOLUMNThe more I travel to interact with World Fed-eration of Neurology Associations, the great-er becomes my conviction that neurology isstill in its formative years. In contrast to mostof the other major fields of medicine, ourspecialty began less than 150 years ago withsmall beginnings in Salpêtrière in Paris, theNational Hospital in London, and soonthereafter in the USA. In its nascent years,neurology went through a phase of correla-tion of clinical signs and symptoms with neu-roanatomy and neuropathology before spe-cific therapies were devised for the diseaseentities identified. This lasted so long thatsome opined that the few remaining neurolo-gists might be made irrelevant by remarka-ble advances in neurosurgery and psychia-try, which far surpassed medical manage-ment for neurological disorders. During thistime, because of the hard labors of a smallcadre, the light of neurology was preservedthrough these dark ages, later on to emergeas the most exciting specialty in the field ofmedicine. Within my time as a neurologist,we have learned how to visualize brain anat-omy and its vascular system non-invasively,to measure neural metabolism, to under-stand cellular machinery, and to intervenewith effective therapies and prophylaxis.

In the USA, the American Academy of Neu-rology, founded in 1948, became a focalpoint for a national and, later, internationalrenaissance in neurological education andresearch. When I joined the field in 1955,there were approximately 1,700 neurologistsin the USA; now there are more than 12,000

and 50,000 worldwide. In the 1950’s, few na-tions had neurologists; now nearly 90 na-tions do. Moreover, when I attend interna-tional meetings, I am struck by the ever-ex-panding knowledge regarding diseases ofthe nervous system, which make it increas-ingly more difficult, if not impossible, for oneto encompass the many facets of our cho-sen field. For example, when I became aneurologist, there was no group specializingin stroke. Now, the body of knowledge in thisone aspect of neurology is so great that therecent 25th Conference of the Stroke Coun-cil of the American Heart Association had at-tendance of about 2,500 and that of its paral-lel organization, the National Stroke Associa-tion of Mexico, Canada, and the US,exceeded the numbers of neurologists in theentire USA when I first became one.

However, as a group, we have been derelictin emphasizing this vascular neurology andin attracting young trainees to it. To illustratemy point, there is no specialty designationfor stroke within most neurological organiza-tions and even the World Health Organiza-tion uses the rubric, “Mental Health and So-cial Change,” to identify nervous system,neurology, stroke, and dementia. This mustbe corrected by emphasizing this increasingproblem of the aging population, particularlyvascular dementia and stroke, which arepredicted to become the fourth most com-mon disorder of human kind by the year2025. I believe that it is an obligation of neu-rologists to address these anticipated man-power needs by providing education to thepublic and to our co-workers in the healthprofessions. We must be aggressive in dis-tributing our knowledge because we havethe special training which is necessary to

have an impact on prevention, treatment,and rehabilitation of diseases of the nervoussystem. Further to illustrate my point thatneurology has extremely broad dimensions,in February 2000, I attended the III Interna-tional Symposium on Coma and Death heldin Havana, Cuba under the leadership of theCuban Neurological Association and Dr. Ca-lixto Machado. This very important interdisci-plinary meeting attracted neurologists, ethi-cists, religious leaders, and sociologistsfrom 22 nations, including a surprisinglylarge representation from the United States.

Consideration of neuroethics is a growingnecessity for the aging population becausethe concept of brain death is changing andthere is an increasing demand for harvestingorgans. That is one of the reasons why theWFN has formed a Neuroethics Committeewith Dr. Franz Gerstenbrand as Chair. I waspleased that the conference was not onlyscientifically excellent but the ambiance wasvery cordial, despite political differences.This is another example of the fact that neu-rologists (and health care workers in gener-al) can conduct their scientific deliberationswithout being drawn into the political arena.

James F. Toole, MDPresident WFN

EDITORIAL

We are all looking forward to being in Lon-don in 2001 for a number of exciting events,the main attraction being the XVIIth WorldCongress of Neurology. Historically it will bethe first World Congress of the new millenni-um. A scientific programme befitting thisevent is planned and will attract a largenumber of delegates from all parts of theglobe. The local organizers of the Congresswill have to work hard to set the standard of ahigh-class Congress which will be a trend-setter for the congresses to follow in the newmillennium.

National delegates will also have the oppor-tunity during this congress to elect fromamongst a galaxy of nominees the leadersto form a formidable team to look after theaffairs of the World Federation of Neurology,the first elected team in the new millennium.The WFN President James F. Toole is rightlyperturbed about the current status of neurol-ogy as listed under Mental Health and SocialChange by the WHO. The WFN Manage-

ment Committee and all neurologists mustwork hard for recognition of Diseases of theNervous System as a distinct specialty.

This issue also carries the Annual Reports ofthe officials of the WFN for the year 1999.These provide a window on the running ofWFN and, indeed, could be considered atribute to the last millennium, which ofcourse ended on a marvellous note. The An-nual Report of the President was publishedin the March 2000 issue of WN.

Prof. K. Ganapathy, a neurosurgeon workingin a country where mythology is consideredscientific, predicts revolutionized changes inneurosciences by 2025. You may consider itas prophecy, fantasy or fiction; however,many neurologists worldwide will be in a po-sition to watch and see for themselves thetruth or otherwise of these predictions for2025.

We had initiated a discussion on Epilepsy inthese columns starting with the article on‘Epidemiology of Epilepsy’ in the March2000 issue by Prof. Allen Hauser. Dr. DonnaBergen, a seasoned neurologist, has given

her opinion on planning for the preventionand care of epilepsy. The discourse is inter-esting to read and worth considering forthose engaged in planning for care of epi-lepsy, especially in the developing countries.There are millions of epileptics in the worldwho suffer silently because very little atten-tion is paid to most aspects which DonnaBergen has highlighted. I thank her for thisinteresting manuscript.

I request readers to send their suggestionsand critical reviews of the deliberations pub-lished in World Neurology. We can only learnfrom our mistakes and I shall accept theirsuggestions with humility.

Jagjit S. Chopra, MDEditor-in-Chief, World Neurology


4 WFN ANNUAL REPORTS: A GLANCE AT ACTIVITIES IN 1999

logical and pathogenetic mechanismsleading onto a discussion of exciting ad-vances in treatment and a look forward tothe advances in prospect. Specific topicswill include: 1) Genetic epidemiology ofMS; 2) The pathology of MS; 3) Immunemechanisms on MS; 4) The pathophysiol-ogy of demyelination and remyelination;5) Leucodystrophies and other white mat-ter disorders; 6) Imaging the CNS in MS;7) The provision of services for MS; 8)

Symptomatic treatments and rehabilita-tion; 9) Disease modifying treatments: ef-fects and indications; 10) Disease modify-ing treatments: future prospects.

NEUROMUSCULAR DISEASE (Friday)

Frank Mastaglia from Australia will chairthe main theme on Neuromuscular Dis-ease, which will include discussion of thepathogenesis and management of Pe-ripheral Neuropathy in the morning and

Muscle Disease in the afternoon. Specificpresentations will include: 1) Environmen-tal factors; 2) Genetic factors; 3) Immunemechanisms; 4) Mechanisms and treat-ment of neuropathy; 5) Paediatric periph-eral neuropathy; 6) Painful neuropathy; 7)Treatment of inflammatory neuropathy; 8)Muscle disease; 9) Muscular dystrophy;10) Mitochondrial myopathy; 11) Treat-ment of inflammatory myopathy; 12) Pros-pects for gene therapy of muscular dys-trophy.

WFN ANNUAL REPORTS: A GLANCE AT ACTIVITIES IN 1999

Report of the First Vice President and Chairman of the Constitution and Bye-Laws Committee

Thanks to the efforts of the Committee, wewere able to update the Constitution andBye-Laws of the current, unincorporatedWFN and distribute them to Delegates.This laid the groundwork for developinggoverning instruments for WFN Inc., anew incorporated Federation registered inthe UK. The Management Committeeconcluded that we should revise theMemorandum and Articles of Associationof WFN Inc. themselves to tailor them tothe specific character of the WFN.

Our legal advisors prepared a preliminarydraft and a number of recommendationsalso stemmed from the long-range Strate-gic Planning Meeting held last June. In ad-dition, our solicitor considered all the over-riding requirements of the UK CompaniesAct and Charities Act. The plan was pre-sented to the Council of Delegates, whichre-affirmed the proposed incorporation.

Until transition to a fully incorporated bodyis finalized in 2001, there is no legal re-quirement to hold meetings of Delegatesannually. Nevertheless, it was thought de-sirable to introduce more frequent meet-ings than in the past, starting with a meet-ing during 2000. We asked our legal advi-sors to draft a document for initialconsideration by the Management Com-mittee in November. After some modifica-tion it was circulated among the Constitu-tion and Bye-Laws Committee. We intend-ed to distribute it to Delegates in earlyFebruary 2000. Each national society willdiscuss the matter in preparation for theCouncil meeting in May. The current unin-corporated WFN will then be dissolvedand its membership and assets trans-ferred to the WFN Inc.

The Memorandum and Articles containfew specific details on day to day opera-tions, to allow flexibility. Once the docu-ment is approved, we will develop a seriesof rules based on the current Constitution.It is a clear requirement of company law inthe UK that the ‘Trustees’ carry the re-sponsibility for running the organizationproperly. The ‘Members’ exercise demo-cratic control over their activities and holdthem to account for their actions or omis-sions. They do this primarily at the AnnualGeneral Meeting (AGM) which Trusteesattend but at which they cannot vote. Thisis a marked departure from previous prac-tice, where Officers have, by right, votedalongside Delegates as members ofCouncil. Nevertheless, it is an innovationthe Management Committee understandsand fully accepts.

I was involved in a number of other activi-ties, including Management Committeemeetings in Toronto and London, as wellas the Strategic Planning Meeting andCouncil of Delegates. I participated in theCentral American Congress of Neurologyin Honduras under the direction of Dr. Me-dina and his colleagues, who made a sur-prisingly quick comeback after the disas-ter caused by Hurricane Mitch. I also rep-resented the WFN at the 10th PanAmerican Congress of Neurology inCartagena, organized by Dr. Pradilla andhis associates despite the hardship creat-ed by the devastating earthquake and ex-aggerated concerns about safety. I at-tended the 54th Chile Congress of Neurol-ogy, Psychiatry and Neurosurgery inValdivia. Ted Munsat and I substituted forthe President at the Egyptian InternationalNeurology Conference in Cairo in Decem-ber.

In summary, this has been another busyand interesting year. I believe we are mak-ing steady progress in restructuring ourorganization, the better to serve the cause

of Neurology in the next Millennium.

Jun Kimura, MDFirst Vice PresidentChair, Constitution and Bye-Laws Com-mittee

Report from the Secretary-Treasurer General1999 has been a most important and ex-citing year for the World Federation ofNeurology and I have been fortunate tohave begun my term of office this year.With the establishment of Chandos Streetas the core of WFN activity it has beenpossible to move forward on severalfronts. We now have comprehensive pro-spective budgetary control: we have anoffice to co-ordinate and assist in the pub-lication of World Neurology: the office isthe distribution centre for educational ma-terial for the Education Committee: andthe Chandos Street office enables us tokeep in touch and help with congress or-ganisation both of World Congresses andRegional Congresses worldwide. It is nowdifficult to understand how the WFN man-aged without an office and secretariat.Keith Newton and Susan Bilger, our Ad-ministrator and Secretary, have worked ef-ficiently and conscientiously providing in-valuable support for the ManagementCommittee, Constitution and Bye-LawsCommittee, Executive Committee for

cont. from page 1:


WFN ANNUAL REPORTS: A GLANCE AT ACTIVITIES IN 1999 5

WCN 2001, Education Committee and forthe re-launch of World Neurology.

In June 1999 two major events for theWFN were (a) the three-day PlanningMeeting and (b) the meeting of the “Coun-cil of Delegates”. The Planning Meetingwas organised in such a way that the 47attendees were able to debate and finallyagree recommendations on a range of im-portant issues: i. A Mission Statement defining the pur-

pose and aims of the WFNii. Revision of the Constitution of the WFN

to establish our corporate status underUK Charity Law. This protects thefinancial and tax status of the WFN butof course carries important responsi-bilities for the Officers and Trustees ofthe WFN.

iii. Goals were defined for the ResearchStanding Committee, Education andPublic Relations

iv. Recommendations were drawn up forRegional and Sub-regional meetingsand World Congresses

But the importance of this meeting was tocreate a sense of purpose with identifiedaims for the WFN. And this sense of pur-pose carried through into the Council ofDelegates meeting on Sunday, 20th June1999. It was gratifying to note the enthusi-asm and support given to the WFN by theNational Delegates and the Chairmen ofthe various committees represented.

During 1999 income received totalled£286,000. Over a third came from Pfizer tofund the Neuro-urology Education pro-gramme negotiated by Dr. Munsat asChair of the Continuing Education Com-mittee. Annual dues from member socie-ties and Corporate Members contributed£76,500 (27%); investments produced£58,000 (20%); and income from publish-ing royalties came to £36,500 (13%).

On the expenditure side, we were able toaward Travelling Fellowships, to youngneurologists from developing nations, of alittle over £10,000 funded by a generousdonation from Glaxo Wellcome the previ-ous year. A sum of £15,000.00 was invest-ed to establish a WFN Foundation in theUnited States, which will be the vehicle forfund-raising there. Total running costs forthe London Headquarters Office, inclusiveof rent, rates, utilities, staff salaries and acontribution to re-decoration, came to£89,000. The 1998 cost was £73,000 for10 months, the Office having opened atthe beginning of March that year. It is en-couraging to note that for the same 10-month period in 1999, expenditure wasonce again £73,000.

Management Committee expenses werealso contained at just under £14,000,thanks largely to the employment of inter-national telephone conference calls toconduct regular business in place of face-to-face meetings with all their associatedtravel and accommodation expenses.

Professional fees of some £20,000 reflect-ed not only the one-off, intensive legalwork required for finalizing the transition tocompany status but also insurance andauditing costs and the beneficial employ-ment of a professional facilitator at theStrategic Planning Meeting.

Although our financial situation is verytight, with careful budgeting and use ofour limited resources the WFN can looktowards the future with confidence.

.

Richard Godwin-Austen, MD, FRCPSecretary-Treasurer General

Report of the Chairman of the Continuing Education CommitteeThe last year of the millennium was a busyand hopefully productive one for the WFNEducation Committee, whose currentmembers are listed below. We have es-tablished effective e-mail communicationbetween all members of the Committeeand this has speeded the decision-mak-ing process significantly. We have beenencouraged by the results of the SopwellHouse long-range planning meetingwhich has placed education of develop-ing countries as a high priority and wehave directed our efforts with this goal inmind.

Because of the rapidly escalating amountof work, the Education Committee hasformed several sub-committees with spe-cific goals as follows:1. Neurology Training Programmes in

Developing Countries (Chair, AlbertoPortera-Sanchez, Spain)This sub-committee is charged withhelping to develop new training pro-

grammes in Neurology whenrequested by a developing country.The first such programme has beenestablished in Honduras under thedirection of Professor Marco Medina.Despite the tremendous disruptioncaused by Hurricane Mitch, five out-standing candidates from CentralAmerica began their training in Janu-ary 1999: Drs. Reyna Duron, HeickeHesse, Humberto Su, Lazaro Molinaand Hermann Calderon. A first yearreview of the programme will be con-ducted in March 2000. As this pro-gramme grows, it will undoubtedlylead to improved neurologic care forpatients not only in Honduras but all ofCentral America where the need is sogreat.

2. WFN Seminars in Neurology (Chair,Clare Fowler, UK)This series of educational courses isdesigned to provide CME experiencefor neurologists who practice in coun-tries with limited resources. It empha-sises low-technology diagnosis andcare but diagnosis and care which isnonetheless of the highest and mostcurrent calibre. The first course entitled“Neurology of the Bowel, Bladder andSexual Function” has been written by adistinguished international facultychaired by Professor Clare Fowler ofLondon and will be distributed to WFNmember societies without chargesometime this summer. Other coursesare being planned.

3. Zambia Project (Chair, Gretchen L.Birbeck, USA)The WFN has recently provided start-up funding for a unique projectheaded by Gretchen L. Birbeck, a Uni-versity of California at Los Angelesneurologist. Dr. Birbeck has had a per-sonal interest in the delivery of neuro-logic services to under-served Africanpatients, especially those in Zambiawhere there are no qualified neurolo-gists. She has begun preparing amanual of neurologic care for ClinicalOfficers, paramedics who currentlydeliver most of the neurologic care inthis country. This effort, which will takeplace in several stages, includes adetailed evaluation component. Dr.Birbeck’s work has already attractedothers with similar interests and thereis a distinct possibility that the pro-gram will eventually expand to coveran increasingly larger part of thisunder-served region.

4. The Neurology International Partner-ship Programme (NIPP) (Chair, DonaldSilberberg, USA)This innovative programme has cre-



ated links between academic centreswhich have a need for educationalmaterial and information, and thosecentres that are able to provide theseresources. Two hundred and twenty-five academic units in Australia, Can-ada, Europe, Israel, Japan, New Zea-land and the USA are now linked with227 departments and divisions inAfrica, Asia, Central and EasternEurope, the Caribbean, Mexico, Cen-tral and South America. Each Spon-soring Department is responsible forthe cost of any books or journalsacquired for their Partner and for thecost of shipping when necessary.

5. Neurology On-LineRecently, the American Academy ofNeurology has generously offered tomake its journal, Neurology, availableto academic institutions and medicallibraries in developing countries with-out charge. This provides an unprece-dented opportunity for neurologicsocieties with limited resources to gainaccess to neurology’s premier publi-cation.

6. The WFN CONTINUUM Study GroupProgramme (Chair, T. L Munsat, USA)The American Academy of Neurologyhas generously donated almost 2,000of its previously published CMEcourses entitled CONTINUUM to theWFN. CONTINUUM is an innovative,self-study, interactive CME pro-gramme that has been tested exten-sively and shown to be effective inimproving patient care. These courseswill be distributed to WFN memberneurologic societies which have dem-onstrated need on a first come, firstserved basis. Other than mailing, thereare no costs to the participating neuro-logic societies. In addition to receivingthe courses, participants will take partin discussion/study groups based onthe course material. Since thesecourses were prepared primarily forAmerican neurologists, some of thediscussion time will be spent address-ing how the scientific principles, whichare not region-specific, can be appliedto their own unique practices and ownregional health care systems. ThisWFN programme has been success-fully pilot tested in Sao Paulo, Brazil(Co-ordinator: Prof. Alain Gabbai).Courses are currently being preparedto be sent to neurologic societieswhich have indicated their interest inparticipating, including Russia, India,Tunisia, South Africa, Hungary, Egypt,Estonia, Czech Republic and Jordan.

7. CME Credits (Chair, Marco Medina,Honduras)This sub-committee has been chargedwith making recommendations to theManagement Committee and Councilof Delegates regarding the advisabilityof establishing a programme by whichCME credits and ultimately a certifi-cate of accomplishment could beawarded. A report from this sub-com-mittee is expected shortly.

8. Meetings Endorsements and Co-sponsorship (Chair, James Temlett,South Africa)During the past year the EducationCommittee has endorsed the followingmeetings: 5th Congress of the Euro-pean Society of Clinical Pharmacol-ogy; 10th Asian and OceanianCongress of Neurology; 10th Pan-American Congress of Neurology; 3rdInternational Symposium on Comaand Death; 3rd International Congressof Tropical Neurology; and the 4thWorld Stroke Congress. However, cur-rently the WFN has no specific rules orregulations regarding approval ofmeetings which are held by memberorganisations, Research Groups orother organisations. Professor Temlettis chairing a committee to address thisdeficiency and a report is expectedshortly.

During this first year of the new millenni-um, it is anticipated that few additionalprogrammes will be started. Rather theCommittee will focus on strengtheningand expanding existing programmes,several of which are just beginning andwill require close supervision.

Members, Continuing EducationCommittee:

Dr S M Al Deeb (Saudi Arabia); Prof A AKurdi (Jordan); Dr V Askanas (USA); Dr ABenomar (Morocco); Prof V Berginer(Israel); Prof P L A Bill (South Africa); Dr ACulebras (USA); Dr S Davis (Australia);Prof G Donnan (Australia); Prof E I Gusev(Russia); Prof A Guekht (Russia); ProfNdiaye (Senegal); Dr L Jimenez (PuertoRico); Dr Jin Soo Kim (South Korea); Dr AKoeppen (USA); Prof A Korczyn (Israel);Prof O Madkour (Egypt); Dr N Miladi (Tuni-sia); Dr P Monro (UK); Dr T J Murray (Can-ada); Prof J Olesen (Denmark); Prof Dr COzdemir (Turkey); Dr A Portera-Sanchez(Spain); Dr G Pradilla (Colombia); Dr G CRoman (USA); Dr A M San Luis (Philip-pines); Prof D H Silberberg (USA); Prof J A

Temlett (South Africa); Dr N H Wadia (In-dia)

Theodore L. Munsat, M.D.Chair, WFN Continuing EducationCommittee

Report of the Chairman of the Research CommitteeThis report has been approved by theCommittee membership. The last year ofthe millennium has been a meaningfuland busy one. The Research Committeecurrently consists of 29 active ResearchGroups (RG) as listed below and on ourwebsite (www.wfneurology.org)

Three RGs have been discontinued, onehaving achieved its mission (Neuroimmu-nology & Neurovirology) and two becauseof inactivity (Cerebrovascular Disease andNeuro-oncology). Two new ResearchGroups have been added: Occupationaland Environmental Neurotoxicology (R.Feldman, USA) and Clinical Neurophar-macology (A. Korczyn, Israel).

One of the major changes affecting theRG structure and activity has been thetransformation of the WFN into an officialCharity organization incorporated in theUnited Kingdom. This will be of great ben-efit to the way RGs function but at thesame time imposes significant new re-porting obligations to assure continuingmembership in the WFN. Each RG is nowrequired by Charity law to make a full an-nual report of its professional activities in-cluding detailed financial documentationin order to remain within the WFN. Thishas not been the practice in the past butis now a requirement for WFN affiliation.

The productive long-range planning re-treat at Sopwell House held last June, hadimportant ramifications regarding the fu-ture of the Research Committee. Whenthe WFN was originally organized therewas a divergence of views as to whetherits primary function should be research re-lated or involve other international neuro-


WFN ANNUAL REPORTS: A GLANCE AT ACTIVITIES IN 1999 7

logic activities such as education. Be-cause of this divergence of opinion, whichapparently at times was quite substantial,the Research Committee and its Re-search Groups was given significant ad-ministrative autonomy with its own stat-utes, its own mechanism of electing itsleadership and a permanent place on theManagement Committee. With the pas-sage of time it has become clear that thisadministrative autonomy is neither in thebest interests of the Research Committeenor the WFN itself, and the recommenda-tion was made at Sopwell House that theResearch Committee should be a stand-ing committee like any other WFN com-mittee. This view has received general ac-ceptance by the WFN leadership and willbe submitted to the Council of Delegatesas part of the new constitution currentlybeing framed.

The WFN continues to be an important,and at times an essential, organization forthe successful activities of many RGs. De-tailed reports of some of the more activeGroups will appear periodically in WorldNeurology. In the case of some disci-plines, it is the only venue for an interna-tional organization and international infor-mation exchange. In some disciplines,particularly those which are large and dealwith the more common neurologic illness-es, the membership is better served by itsown separate organization. Epilepsy is anexample of this situation. It is clear that theResearch Groups do not do research perse. Rather they serve as forums for meet-ings and exchange of research related in-formation. In fact, at Sopwell House andafter, there has been considerable discus-sion about a change in name which wouldmore accurately reflect the true activitiesof the Groups. However, no name changeconsensus has been reached.

In the coming year I would predict thatmany of the Research Groups will morespecifically define their goals and in-crease their activity. The increasing availa-bility of internet communication is a majorasset to the work of the Groups and willundoubtedly result in new initiatives. Iwould expect that, as neurology continuesto sub-specialize, there will be a need forGroups which are interested in the inter-national aspects of their discipline andthat the WFN will continue to be an effec-tive and appropriate home.

Theodore L. Munsat, MDChair, WFN Research Committee

Research GroupRG contact and/or E-mail/faxChair (Ch) / Secretary (S)

Aphasia/Cognitive DisordersProf John [email protected]

Ataxia Dr S H [email protected]

Autonomic DisordersDr Horacio [email protected]

Cerebral Palsy PreventionDr Martin [email protected]

Cerebrospinal FluidProf Christian [email protected]

Clinical N-PharmacologyDr Amos [email protected]

DementiaDr Francois [email protected] P Antuono (Ch)

History of NeurosciencesDr C [email protected]

Huntington’s DiseaseDr David [email protected]

Intensive Care NeurologyProf Daniel [email protected] D W Krieger (S)

Migraine and HeadacheDr Keith [email protected]

Motor Neuron Diseases Dr Michael [email protected]

Multiple Sclerosis Prof Ian [email protected]

NeuroepidemiologyDr Milton [email protected]

NeurogeneticsDr Eva [email protected]

NeuroimagingProf Joseph C [email protected] Franz Gerstenbrand (S)

Neuromuscular DiseaseProf P K [email protected] L P Rowland (S)

Neuro-Ophthalmology & Neuro-otologyProf James [email protected] J A Sharpe (S)

NeuropathologyProf Stephan [email protected]

NeuroradiologyProf Jean [email protected]

Neuro-Rehabilitation & Restorative Neu-rologyDr Carolyn A [email protected] J Borg (Ch)

NeurosonologyDr Kurt [email protected] G M Von Reutern (Ch)

NeurotoxicologyProf Robert [email protected]

Organisation & DeliveryProf Bosko BaracTel: +385-1-4822297

PainDr Jorgen [email protected] R M Lawrence (S)

Palliative Care in NeurologyDr Raymond [email protected]

Parkinsonism and Allied DisordersDr Melvin [email protected]

Space/Underwater NeurologyProf Franz [email protected]

Tropical NeurologyDr Raad [email protected] S M Al Deeb (Ch)

Journal of the Neurological Sciences

Report from the Editor-in-Chief

The Editorial Board remained unchangedexcept for one minor change. Arnulf H.Koeppen will remain the Book Review Ed-itor, and the Editor-in-Chief will handle allother reviews. No format changes weremade to the journal. Eighteen issues fea-turing 263 articles, one supplement on theEighth International Symposium on Amyo-trophic Lateral Sclerosis/Motor NeuronDisease held in Scotland, and one specialissue on the Proceedings of the 9th Inter-national Symposium on Amyotrophic Lat-eral Sclerosis/Motor Neuron Disease heldin Germany were published. The reviewcycle has been shortened, resulting in anaccelerated acceptance/rejection rate. Ofthe 444 new submissions and the 193 car-ry overs from 1998, 244 manuscripts wereaccepted in 1999 compared to 177 last



year; 210 manuscripts were rejected in1999 compared to 180 in 1998. The distri-bution of manuscripts accepted by coun-try, however, parallels that of 1998. The topfive ranked countries were Japan (33%),USA (21%), Italy (9%), Germany (6%), andUK (5%). These five countries alone ac-counted for 183 or 75% of all manuscriptsaccepted in 1999. The USA almost dou-bled its rate of accepted manuscripts over1998. Geographically, rankings for ac-cepted manuscripts were as follows: Ja-pan had 82; Western Europe had 77; USAand Canada had 54; Asia (non-Japan)had 10; the Middle East had 6; Scandina-via had 6; South/Central America had 5;Australia had 2; and Africa and EasternEurope had 1 each. Clinical research stilldominates every issue. Editorial and re-view articles are being developed. Ad hocreviewers were acknowledged in June,volume 165.2 and again in September,volume 168.1.

Robert P. Lisak, MDEditor-in-Chief, JNS

World Neurology

Report of the Editor-in-Chief

World Neurology, the official Newsletter ofthe World Federation of Neurology, is pub-lished and mailed quarterly to over 22,000neurologists the world over in 84 coun-tries. It was published regularly till the lastissue of 1998, in December, by Cam-bridge Medical Publications based in theUK under the Editorship of Dr. Frank Clif-ford Rose who was also the Secretary-Treasurer General of WFN until Dec. 31,1998. The first three 1999 issues of WorldNeurology were suspended pending dis-cussion of its production in future in viewof the costs involved.

Dr. Robert Daroff, Chairman of the WFNPublications Committee, did a splendidjob by negotiating a contract on behalf ofWFN with Elsevier through Dr. TatjanaFischer-Driessen for future publication ofWorld Neurology by Elsevier from January2000 and the latter soliciting global adver-

tisements to defray the costs of publica-tion. Webmaster B. Todd Troost, in co-or-dination with Elsevier, has produced awebsite for World Neurology.

There was a change in the managementof World Neurology as well. The Publica-tions Committee at its June 1999 meetingselected Dr. Jagjit S. Chopra as the nextEditor-in-Chief of World Neurology and inorder to get more regional input, the Edi-torial Advisory Board included the Region-al Vice Presidents in addition to the offi-cials of WFN. The first issue of World Neu-rology under the new management wasVolume 14, Number 1, October 1999 is-sue which was mailed to the readers be-fore the turn of the Century. The Newslet-ter has been reformed and the settings ofOctober 1999 issue were made by Elsevi-er gratis and it was published and mailedat Chandigarh in India thereby utilising thestranded share of WFN funds held in theXIVth World Congress of Neurology (In-dia) Trust. The October 1999 issue carriedthe recommendations of WFN StrategicPlanning for the New Millennium in addi-tion to the WFN Annual Report for 1998and other WFN news.

Dr. Jagjit S. ChopraEditor-in-Chief, World Neurology

WFN Neurosonology Research Group: a Report 9/97 – 12/99

The membership has grown to 285 from36 countries (versus 237 in 1997). TheNSRG co-sponsored the Meeting of theAustrian Society of Neuroimaging, Salz-burg, November 1997 and the 3rd Meet-ing of the European Society of Neu-rosonology and Cerebral Hemodynamics,Glasgow, 25–27 May, 1998. The consen-sus paper “Brain Death” was distributedto all members. The NSRG is affiliated withthe Journal of Neuroimaging and sincespring of 1997 has had a presence on theInternet, at http://www.sime.com/nsrg/.The e-mail address is: [email protected] Newsletters are issued. The Re-search Group participated in the WFNStrategic Planning Conference, June 99,London and held its 8th meeting in Taipei,Taiwan, November 2nd – 6th, 1999. The311 participants from 29 countries pre-sented more than 150 invited lectures,oral presentations and posters, coveringall aspects of adult and pediatric Neu-rosonology.

FINANCIAL STATEMENT FOR 1999

Starting balance(January 1st, 1999): ATS 44,093.00(¤3,204.00)

Closing balance(December 31st 1999): ATS 46,360.10(¤3,369.00)

Dr. Kurt NiederkornSecretary, NSRG

Report of the International Symposium on Neurosonology and Stroke (INS’99)

The Symposium was organized by thePrasop Ratanakorn Foundation, the Neu-rological Society of Thailand on 8–9 No-vember 1999 at the Prasat NeurologicalInstitute, Bangkok. General Prem Tinsu-lanonda, President of the Privy Council,Statesman and Former Prime Minister ofThailand opened the Symposium. Re-marks were also given by ProfessorJames F. Toole, President of the WFN,Professor Athasit Vejjajiva, Regional Vice-President and Professor Prasop Ratana-korn. Scientific sessions included the lec-ture on Homocysteine and Stroke by Pro-fessor James F. Toole, lectures on neu-rosonology by Professor Charles H.Tegeler, President of the American Societyof Neuroimaging and Dr. Disya Ratanako-rn, Assistant Professor, Faculty of Medi-cine, Ramathibodi Hospital. There were200 participants including neurologists,neurosurgeons, vascular surgeons, radi-ologists and general practitioners.

Prof. Athasit VejjajivaBangkok, Thailand


NEUROSCIENCES IN 2025 – A PEEP INTO THE FUTURE 9

NEUROSCIENCES IN 2025 – A PEEP INTO THE FUTURE

How will our world be in 2025? For a start-er, the number of centenarians would betwenty times more. 15 to 20% of the pop-ulation of several countries will be octoge-narians. Today human sperms and ovacan be purchased through the Internet. Atleast 120,000 babies in the US alone haveso far been produced, not on a bed but ina petri dish. We have entered the era ofdesigner babies. The single largest contri-bution to unravelling the mysteries of thehuman nervous system will no doubt bethe Human Genome Project. Of the130,000 genes at least 30% direct thegrowth and development of the nervoussystem. The neuro-oncologist of the futurewill not be a knife-toting, aggressive skullbase surgeon, but a PhD in molecularneuro-oncology.

Discovery of the adult human neural stemcell will revolutionise treatment options.Stem cells can be injected stereotacticallyinto diseased areas, as a cellular replace-ment therapy. Manipulation of stem cellswill be the ultimate body repair kit. Organtransplantation may become redundant.Growing a new brain is certainly even be-yond the realms of science fiction. Grow-ing specific groups of cells in the brain isnot. The interventional neurologist will beinjecting highly specific capillary growthfactors into the thrombosed cerebralblood vessel to ensure angiogenesis andrevascularisation to reverse the deleteri-ous effects of stroke. The neurosurgeon of2025 may be the primary consultant in themanagement of insulin-dependent diabe-tes. This will involve transplantation of is-lets of Langerhans into a CSF reservoir.Can we replace our body? Most parts –yes. Nerves, blood vessels, bone and car-tilage, heart, liver, kidneys can be regener-ated from stem cells. Prosthetic limbs willbe directly wired to motor parts of thebrain. Genetically engineered tissue,grown in the lab, will be freely available.

It is now believed that neurotransmitterscan leak out of the synapse and head offon their travels to just about anywhere.Neurotransmitter receptors have beenfound far away from synapses. Is the braina wired super computer or a super phar-macy? Perhaps both! Complex cranioto-mies on the exteriorised primate foetushave been successfully performed. Betterand faster healing, besides quicker reor-ganisation in foetal brain cells, makes foe-tal neurosurgery an attractive proposition.Antenatal genetic diagnosis will be com-monplace. Foetal muscle biopsy will con-

firm myopathies leading to gene correc-tion. The Methuselah gene in the fruit flyincreases its life span by 35%. Will weidentify this in the human?

Telemedicine will electronically transportthe specialist to the patient irrespective ofwhere he is. Tomorrow’s cybersurgeon willcarry out advanced simulation routinelybefore executing any procedure. Electri-cal changes at the neuronal level will berecorded telemetrically. Eventually theirphysiological and even cognitive signifi-cance will be understood. The terrorist ofthe next decade will no longer have to bein prison. He will be on parole with an elec-tronic chip implanted in the amygdala.This chip will continuously monitor theelectrical activity. When even a thought ofan antisocial nature occurs, the change inelectrical activity will be detected and fur-ther propagation of the impulse to the ef-fector organ will be prevented. Advancedintraoperative functional imaging will ena-ble the surgeon to resect lesions from themost eloquent areas of the brain. Awakecraniotomies, with the neurologist in thetheatre evaluating the clinical effects ofstimulation, will be commonplace. Tomor-row’s neurosurgeon will be able to visual-ise the tumour through the intact skin,skull, dura and even through the cerebralcortex. He will be wearing special gogglesthrough which the MRI image of the lesionwill be superimposed three-dimensionallyas he looks through the skin over the skull.This will result in choosing the smallestopening. Frameless stereotaxy will even-tually replace frame-based stereotaxy.Craniotomies of the twentieth century willgradually fade into oblivion.

The computer in 2025 will have biologicalsignal sensors with in-built thought recog-nition software. A computer chip can nev-er reach the compactness of a neuron.Nerve cells grown in culture / proteinbased computers will replace the siliconchip. The body’s bioelectricity will beused. Minute discharges from muscles,nerves, brain will be amplified 10,000times and sent telemetrically from an elec-tronic cap worn on the head. The electron-ic mouse will have sensors which monitorpulse rate, temperature, sweating, muscletension and skin resistance. Voice imprintand visual images of the user will be ana-lysed in real time, to reveal the emotionalstate. A humanised digital voice in thecomputer will respond appropriately. Tac-tile sensation of an image on the screencan be felt just by pointing and clicking.

The pharmacy of 2025 will tailor-make adrug to suit your genetic profile, which isreadily available on your smart card. Thiscard will also contain your entire medicalhistory. The ultrasound taken when youwere in utero, your last coronary angi-ogram and the histology of your grand-mother’s breast cancer can be viewed in-stantaneously from this card with a voicecommand.

Ladies and gentlemen, where is all thisgoing to end? Will expert systems result inthe death of clinical neurology? Many wildanimals may be extinct in 2025. Whatabout the neurosurgeon of today? Well,he will certainly be an endangered spe-cies! Many of us are afraid of the futureand cling desperately to the present notrealising that we are already the past.Arthur C. Clarke once said, “Advancedtechnology will eventually be indistin-guishable from magic”. To face this mag-ic, what we require in the coming decadeis a mature head on young shoulders –not to get carried away by gadgets. Weshould never forget that we have theunique privilege of trouble-shooting andrepairing the greatest supercomputer ofall time, the human brain. Science withoutcompassion is blind; compassion withoutscience is lame. In our anxiety to enter thethird millennium let us never forget that weare healers first and technologists later.

Extracts from the lecture delivered by Prof.K. Ganapathy, Secretary General, AsianAustralasian Society of Neurological Sur-gery and Secretary, Neurological Societyof India at the 10th Asian and OceanianCongress of Neurology held in Manila,January 22–26, 2000.


10 Planning for Prevention and Care of Epilepsy

PLANNING FOR PREVENTION AND CARE OF EPILEPSYEpilepsy is one of the commonest chronicneurological diseases in all parts of theworld, with profound effects on employa-bility, social acceptance, self-esteem, andother aspects of quality of life. Designingeffective diagnosis and treatment strate-gies involves issues of pharmacologicalchoices and availability, and the effectivedistribution and use of costly technology.

The prevalence of epilepsy varies, de-pending upon population characteristicssuch as genetics, age distribution, socio-economic status, and endemic infections,making epidemiological surveys essentialfor planning purposes. Understanding thelocal causes of epilepsy is essential be-cause some causes of epilepsy are pre-ventable. For example, the relative risksposed by head trauma, neurocysticerco-sis, tuberculosis, meningitis, AIDS, malar-ia, and childhood lead poisoning varywidely from place to place; all are prevent-able causes of epilepsy. The severity ofepilepsy varies from a self-limited disordereasily controlled by medication to a disa-bling condition intractable to medicaltreatment. This clinical spectrum mostlogically lends itself to a stratified medicalsystem. The resources available to eachlevel of care, however, will depend uponthe economic strength and health carechoices of each country. The diagnosisand treatment of epilepsy generally falls tothe primary health care provider, whetherit be a medical assistant covering basicneeds in a remote rural area of a develop-ing country, or the primary care physicianin an industrialized one. Case-detectionmay not be straightforward, because epi-lepsy may be hidden by the patient orfamily where it is still considered a shame-ful or stigmatized condition.

At least 30% of those with epilepsy, how-ever, continue to have seizures or do nottolerate the first anti-epileptic drug (AED)tried, and many of them have no better re-sponse to the next one. A secondary levelof care is appropriate for such patients. Indeveloped countries this is usually a neu-rologist; in developing countries it may bea physician in a district hospital or clinic.Such a consultation allows the diagnosisto be confirmed, refined, or rejected, andshould include a broader expertise in theuse of AEDs, diagnostic resources, andsupport services. It can be argued thatwhere resources allow, most patients witha new diagnosis of epilepsy should havean initial consultation at this level, wherean exact diagnosis of the type of epilepsycan be made, the cause found if possible,genetic and psycho-social counseling

given, and initial and secondary treatmentplans sent back to the primary health careprovider. Help for patients who fail to ob-tain a satisfactory outcome at this levelmay benefit from the expertise of a tertiarycare center or center of excellence. Again,local conditions will define the servicesavailable, which ideally should include ateam of one or more epileptologists, spe-cialist nurses, neuropsychologists, andneurosurgeons. Clinical pharmacologists,health educators, and social workers mayalso be part of such centers. At this level,some patients will be found not to haveepilepsy, others will be improved by amore sophisticated use of standard or re-search AEDs, and some will have curativesurgery.

One of the most important activities of thespecialists at secondary and tertiary carecenters should be the continuing medicaleducation of practitioners down the line.Helping a single patient referred to a terti-ary care center is valuable, but educatingthe referring care-giver benefits many oth-er patients. And a better educated physi-cian is more likely to make cost-effectiveuse of diagnostic tests and therapies. Pa-tient education is crucial, to enlist cooper-ation in what is often years of drug-taking.Epilepsy is a good example of how lay ad-vocacy groups may be a crucial part ofhealth care planning, producing effectivepamphlets, posters, and other education-al materials often written by patients them-selves, at low cost. Specialists in tertiarycare are especially well placed to form oradvise these groups.

Technology

The most rational distribution of techno-logical aids may depend not only on theserelative levels of service, but with the goalsand the economic limits of the health caresystem. For example, although the elec-troencephalograph (EEG) has long beena part of the care of seizure disorders, it isrelatively insensitive as a diagnostic testfor many epilepsies, and when interpretedby the inexpert may also produce a dis-concerting number of false positive re-sults, particularly in children. Although of-ten used to refine an established diagno-sis of epilepsy or to characterize itsseverity, the cost-effectiveness of the rou-tine EEG in patients with readily control-led, cryptogenic epilepsy has not beenestablished. On the other hand, in sec-ondary or tertiary care centers confrontedby diagnostic dilemmas or evaluating pa-tients for surgery, the vital role of thestandard and ambulatory EEG is unques-

tionable. The production and reading ofan EEG requires specialized training, pa-per (for older equipment) is expensive,and technical maintenance may be aproblem in developing countries. The ap-plication of telemedicine to EEG solvesonly some of these problems. The tradi-tional use (and overuse) of the EEG in af-fluent medical settings may make it diffi-cult to avoid the reflex establishment ofEEG labs in places where scarce resourc-es might be more effectively devoted tobrain imagers (CT, MRI) with a high sensi-tivity not to the diagnosis of epilepsy, butto the treatable structural brain pathologywhich may cause it (e.g., neoplasms, ab-scesses, parasites).

Where available and affordable, CT andMRI scanning is routinely ordered by pri-mary care practitioners for adults withnew-onset epilepsy. Where resources arescarce, brain imaging at secondary carefacilities, and MRI scanning at tertiary carecenters, are essential guides to the care ofpatients with focal neurological signs ortreatment-refractory epilepsy.

Pharmacologic treatment of epilepsy

Like other chronic illnesses, epilepsy isbest treated by the same provider with along-term, consistent management plan.Medical records should be consistentlyavailable for each encounter. Almost allAEDs are produced in industrialized coun-tries. The price of AEDs ranges from lessthan $5 per month for phenobarbital, toseveral hundreds of dollars for some ofthe newer drugs. Prices for the same drugmay vary significantly from country tocountry. Because effective therapy can begiven in most cases with a few older, lessexpensive drugs with well-known side ef-fect profiles, simple treatment paradigmshave been shown to be effective and safewhen supervised by trained health careworkers in the setting of a neighborhoodclinic. Depending upon health care re-sources, the more expensive, newer AEDsmay be available or used only at the sec-ondary or tertiary level of care and exper-tise. Local circumstances may pose for-midable obstacles to appropriate AEDtreatment. Maintaining a constant supplyof individual AEDs can be physically oreconomically difficult, for example. Com-petition from traditional healers and alter-native medical treatments may be an is-sue, and may be one factor in why manypeople in some countries do not receiveconventional treatment. Devising ways torelate comfortably with such practices


1999 WFN JUNIOR TRAVELLING FELLOWSHIPS – REPORTS 11

may be a challenge to allopathic medicalworkers.

Careful planning for the care of peoplewith epilepsy is a health care strategywhich can be applied to other commonneurological conditions as a way to ration-alize delivery of neurological services.

ReferencesBaker GA, Nashef L, and van Hout BA. Current

issues in the management of epilepsy: theimpact of frequent seizures on cost of ill-ness, quality of life, and mortality. Epilep-sia, 38 (suppl. 1): S1–S8, 1997.

Beran RG and Pachlatko C. Final report of theILAE Commission on Economic Aspects ofEpilepsy, 1994-1997. Epilepsia, 38:1359–1362, 1997.

Bergen DC. The worldwide impact of newdrugs: development, distribution, and use.

Epilepsia, 38: 1050–1053, 1997.

World Health Organization Division of MentalHealth. Initiative of Support to People withEpilepsy. Geneva: WHO, 1990.

Donna C. Bergen, MDDepartment of Neurological SciencesRush Medical CollegeChicago, Illinois, USA

1999 WFN JUNIOR TRAVELLING FELLOWSHIPS – REPORTSI send my thanks to the WFN for the awardthat enabled me to attend the 9th WorldCongress on Pain held in Vienna, August22–29, 1999. I have attended many lec-tures, workshops and posters in such aprestigious event. The plenary sessionswere on subjects of great interest such aslectures about new advances in neuro-physiology and functions of the primarynociceptors, advances in neuropharma-cology on pain, the pain syndromes, theethical background of treatment and thepain patient. The workshops were de-signed to be as a dialogue or in the formof ‘Meet the Expert’. Many of the work-shops were useful and of value such asthat of back pain and visceral hyperalge-sia. The posters were numerous and of noless interest than the lectures. The ViennaInternational Centre, where the congresswas held, is near the Danube and of mod-ern architectural style. The exhibition wasalso of interest. Thanks again to the WFNawards and I’m looking forward to attend-ing the World Congress of Neurology thatwill be held in London in 2001.

Sherif Hamdy, MDEgypt

As a recipient of the Glaxo Junior Travel-ling Fellowship I had a remarkable oppor-tunity to attend the 4th Congress of theEFNS, which was held in Lisbon, Portugal,September 7-11, 1999. The scientific pro-gram of the Congress was very interestingand covered a broad spectrum of topicson both clinical and basic aspects of neu-rology. I would like to note high-quality sci-entific sessions and innovative exhibi-tions. It is difficult to single out any specificsession or presentation. Perhaps uninten-tionally biased I would like to mentionmemorable presentations by Dr. W.-D.Heiss, Dr. W. Hacke and Dr. M. Hennericion stroke mechanisms, diagnostics andmanagement, which are in the focus of myscientific interests. In general it was a re-

warding and unforgettable scientific andsocial experience.

Nina L. Tsakadze, MD, PhDGeorgia

I would like to express my gratitude to theJunior Travelling Fellowship that enabledme to attend the EFNS Congress, whichwas held in Lisbon in September this year.People were very friendly and at any timeready to help. The organisation, like socialevents and also the congress itself, wason the highest level. Concerning the con-gress programme, renowned speakerswere selected, who gave very good lec-tures on topics such as headache, Parkin-son’s disease, epilepsy, neuroradiology,etc. As a neurologist and intensivist, I hadalso expected some lectures on neurocrit-ical care, and more lectures on extremelydetrimental diseases, such as cerebro-vascular disease. At the end, I would liketo thank WFN for the opportunity to meetcolleagues from abroad and to exchangeknowledge, and last but not least to havethe opportunity to see the beautiful coun-try of Portugal.

Viktor Svigelj, Assistant ProfessorSlovenia

I wish to express my deepest gratitude tothe World Federation of Neurology forawarding me a Glaxo Wellcome JuniorTravelling Fellowship. It gave me a chanceto attend the XI International Congress ofEMG and Clinical Neurophysiology inPrague, Czech Republic, September 7-11, 1999. The scientific programme wasmost interesting and important for me asa young pediatric electromyographer. Iwas able to participate in some TopicalSeminars and Teaching Courses such as‘Pediatric EMG and Conducting Studies’which is my particular sphere of interest.The Congress gave me an excellent pos-sibility to meet many of my famous col-leagues from all over the world, and ob-tain first-hand information and knowledge

in medical science. I presented a poster‘Some Electroneurographic Data in Chil-dren of Diabetes Type I’ which I dare tosay aroused some interest among partici-pants. Here, I would like to emphasize theimportance of the above Fellowship formy country, since I was the only partici-pant at the Congress from Georgia.

David Chkhartishvili, MDGeorgia

I would like to thank the World Federationof Neurology for awarding me a JuniorTravelling Fellowship to attend the Euro-pean Charcot Foundation Symposium“Genes and Viruses in Multiple Sclerosis”,which was held in Venice in October 28-30, 1999. It was a great pleasure for me toattend this Symposium concerning themost controversial but challenging issuesin multiple sclerosis – its aetiopathogene-sis which, despite advances in research inthis area, remains still poorly understood.The Symposium opened with the 5th Eu-ropean Charcot Foundation Lecture byProfessor H. Wekerle entitled “Brain Im-munology and Pathogenesis of MultipleSclerosis”, followed by discussions of awide range of topics: genetic aspects ofMS; the HLA system and MS susceptibili-ty; genomic screening in MS; the relationbetween cytokine gene polymorphismsand disease susceptibility and progres-sion in MS; genetic control of susceptibili-ty to persistent infection; genetic suscep-tibility and epitope spreading in virus in-duced demyelination; infections and thecourse of disease in MS; the role of virus-es in inducing relapses; viral and bacterialspecificity of oligoclonal bands in MS; andthe relation between MS as a disease andviruses that are or may become neuro-tropic. There were also interesting discus-sions on the role of Hepatitis B and Influ-enza vaccination in MS; the difference be-tween infection, vaccination andimmunomodulation in MS; retroviral ele-ments associated with immuno- or neuro-toxic molecules production; the role of


12 Book reviews

Human Herpes virus 6 and Epstein-Barrvirus in MS; neuroinvasion by human res-piratory coronaviruses; and Chlamydiapneumoniae infection of the CNS in MS.Finally, the clinical trials of antiviral drugsin MS and in vitro data on the tropism ofHHV-6 for neural cell systems and the sen-sitivity of HHV-6 for antiviral compoundswere reviewed. Thank you for enabling meto be in Venice, and with hope for furtherco-operation.

Lodi Gogovska, MDMacedonia

The 4th Congress of the EFNS took placein Lisbon, the capital of Portugal, 7–11September 1999. The most difficult prob-lems facing modern neurology were re-flected in the Congress sessions. Dr. FClifford Rose presented some valuablematerial on the history of European neu-rology. Headache and migraine in Russia,which have been little explored, were ofparticular interest. The teaching course“Headache: Management of DifficultProblems” showed the different aspectsof these disorders and presented moderntreatments for everyday practice. The lackof objective assessment of the neurologi-cal status of patients provoked a numberof questions. The satellite symposia werewonderfully organised. They added toparticipants’ knowledge of new medi-cines. In the workshops and main topics,Parkinson’s disease, epilepsy and cere-brovascular diseases were all discussedas well as many other important themes.The excellent organisation of the postersessions allowed authors to present theirreports comprehensively and discusstheir ideas for further scientific researchwith each other and with chairmen. Thepresentation of the work from the St.Petersburg Neurologists Association andthe Neurosurgical Center of the hospitalwhere I am based aroused much interestand many questions. The printed materi-als received at the congress helped to il-lustrate the presentation. The 4th Con-gress will always remain in my memorybecause of its marvellous organisationand scientific importance.

Marina Koreshkina, MD, PhDRussia

NEWSSenior Management Changes at WHO

There have been management changesat the World Health Organization affecting

the representation of neurology at theagency. Dr. Derek Yach who has been Pro-gramme Manager for the WHO TobaccoFree Initiative becomes Executive Directorof a new ‘cluster’ combining the previous-ly separate areas of Non CommunicableDiseases (NCD) and Social Change andMental Health (HSC).

An epidemiologist from South Africa,where his interest in tobacco dates backto 1977, Dr Yach has been with WHOsince 1995 and has a long list of outstand-ing publications to his name. He workedfor the South African Medical ResearchCouncil in 1981 and again from 1985 to1995, initially as an epidemiologist andthen as a community-based researcher.

Dr. Yasuhiro SuzukiCurrent Executive Director of the HSC cluster will become Executive Director of the Health Technology and Pharmaceuticals (HTP) cluster.

BOOK REVIEWS

A Short History of Neurology: The British Contribution 1660–1910

Ed: F Clifford RoseISBN: 0 7506 4165 7No. of Pages: 282Price: £25.00Publication Date: 1999Publisher: Butterworth Heinemann

This attractive volume, edited with his usu-al outstanding efficiency by Frank CliffordRose, former Secretary-Treasurer Generalof the WFN, contains 20 essays, eachwritten by an acknowledged internationalexpert and based upon the proceedingsof a Mansell Bequest Symposium held atthe Medical Society of London in 1998 asa part of the Society’s celebrations com-memorating the 225th anniversary of itsfoundation. As the editor points out in hispreface, this work does not purport topresent a definitive history of British neu-roscience but shows nevertheless that thehistory of neurology, in Britain as else-where, is an active and fruitful field of re-search, showing how a discipline devel-ops and how some discoveries of yester-year, either largely forgotten or sometimeseven ignored, can have a very modern fla-vour. A short review such as this cannotdo full justice to this book, which is one topossess, enjoy and savour.

John Walton (Lord Walton of Detchant), Oxford, UK

The Treatment of EpilepsyEditors: Simon Shorvon, Fritz Dre-

ifuss, David Fish and DavidThomas

ISBN: 632-03782-2No.of pages: 835Price: £115Publication date: 1999Publishers: Blackwell Science Ltd.

A hard-bound book with contributionsfrom eighty-four authors in a total of 63chapters. The book is divided into fourmain sections. Pathophysiology, develop-mental basis and classification of seizuresare discussed in section one which alsohighlights the economic cost and progno-sis of epilepsy. In section two the authorshave discussed the medical treatmentwhich in detail explains the mechanism ofaction of anti-epileptic drugs, the pharma-cokinetic principles of drug treatment, thetreatment of newly diagnosed patients,chronic active epilepsy, childhood epilep-sy, epilepsy in the elderly, status epilepti-cus, drug interactions and social aspects.The anti-epileptic drugs including thenewer drugs are discussed in sectionthree. Surgical treatment, its principles,surgery of mesial temporal epilepsy, samein paediatric epilepsy, hemispherectoncy,corpus callosum section and some moresurgical aspects are discussed in detail inthis section. The historical introductioncovering 28 pages is one of the highlightsof this book. This is an excellent additionfor personal and institutional collectionsand one of the few books which discussesmany aspects of epilepsy.

J.S. ChopraEditor-in-Chief

Neuroscience at a Glance

Ed: Roger A Barker, StephenBarasi and M J Neal

ISBN: 0-86542 869 7 No. of Pages: 128Price: £11.95Publication Date: 1999Publisher: Blackwell Science

Neuroscience at a glance, indeed, livesup to its title. The carefully selected chap-ters are presented in an easily assimilableformat. Each chapter begins with a clear,uncomplicated diagram impregnated withthe subject matter to follow, which unfoldsthe message in one to two pages at themost. The bold emphasis on the keywords in the text enables the discerningreader to further 'quicken the glance'. Thebrevity has in no way compromised theclarity. The basic neuro-anatomy and em-


Book reviews 13

bryology is dealt with concisely in chap-ters 1–4 and 10–16. The more complexmodern concepts of neuro-physiology –on ion channels, resting membrane andaction potential, the neuromuscular junc-tion and synapses – are presented in aneasily understood manner in chapters5–7. Parts 2,3,4 of the book deal in an ac-curate, concise and ‘applied’ manner onthe sensory, motor and autonomic, limbicand brainstem systems respectively. Part5 on neural plasticity and disorders of thenervous system is the icing on the cake.The book is very readable and the avidreader may indeed imbibe a significantquantum over a weekend at a seaside re-sort in the tropics or even a long haul in aplane or an alert transit stop.

J. B. PeirisSri Lanka

The Clinical Practice of Critical Care Neurology

Ed: Eelco F.M. WijdicksISBN: 0-316-94759-8No. of pages: 419Price: $115.00Publication Date: July 1997Publisher: Lippincott-Raven

Critical care is a relatively new sub-spe-cialty of neurology so that this mono-graph, written by the co-director of theNeurology-Neurosurgery Intensive CareUnit of the Mayo Clinic, should be grate-fully welcomed. The first part on GeneralPrinciples of Management is essentialreading. The second part on Equipmentand Technologies comprises two chap-ters on Monitoring Devices and Diagnos-tic Procedures.

Part III deals with Specific Disorders andincludes a chapter on Brain Death whilstPart IV covers the Management of Sys-temic Complications. Altogether this is amodel monograph and should be ready tohand for any specialist dealing with criticalcare neurology.

Therapeutic Potential of MelatoninEd: G J M Maestroni, A Conti, R

J ReiterISBN: 3-8055-6439-2No. of pages: 174Price: US$172.25Publication Date: 1997Publisher: Karger

This book is based on a symposium heldin Locarno in May 1996 as part of a meet-ing on Neuro-endocrino-immunology. Itreviews the scientific basis of the hor-mone's action but is short on its use in

clinical practice, probably because muchmore needs to be done on this aspect. Itthus subserves a narrow need but will beimportant for researchers in this field.

Molecular Neurobiology of Pain

Progress in Pain Research and Management, Volume 9

Ed: David BorsookISBN: 0-931092-19-1No. of pages: 369Price: US$76.00Publication Date: 1997Publisher: IASP Press

While pain research is a relatively youngdiscipline, it is rapidly growing and thereshould be few patients, even with chronicpain, who would not benefit from the in-creasing range of our anti-nociceptive ar-mentorina. This book covers the active re-search fields and is a must for anyonewho looks after patients with pain prob-lems.

Perspectives of Motor Behavior and its Neural Basis

Ed: M-C Hepp-ReymondISBN: 3-8055-6403-1No. of pages: 138Price: US $85.25Publication Date: 1997 Publisher: Karger

This volume is based on a symposiumheld in Fribourg, Switzerland, at the end of1994, and attended by specialists in thefield of motor control. Based on a large va-riety of experimental approaches to motorcontrol, it will appeal to all neurophysiolo-gists interested in this area. The first andfinal chapters are excellent historical re-views, the latter by Mario Wiesendanger,in whose honour the meeting was held.

Frontiers in Headache Research, Volume 7

Headache Pathogenesis, Monoamines, Neuropeptides, Purines, and Nitric Oxide

Ed: Jes Olesen, Lars EdvinssonISBN: 0-7817-1208-4No. of pages: 316Price: US $109.25Publication Date: 1997Publisher: Lippincott-Raven

This is Volume 7 in the well-known seriesFrontiers in Headache Research. It deals

with the messenger molecules involved inheadache and so is important for pharma-cological research.

Divided into 6 sections, the first deals withGeneral Aspects, the second with CranialBlood Vessels, the third with PainProcessing, the fourth specifically withAmines and Amino Acids, the fifth withNeuropeptides, and Section VI is on theInvolvement of Nitric Oxide.

This is a very useful summary of presentknowledge and will be essential readingfor those involved in headache research.

Childhood Epilepsies and Brain Development

Editor: A Nehling, J Motte, S LMoshé, P Plouin

ISBN: 0 86196 578 7 No. of pages: 311Price: £59 / US$103Publication Date: 1999 Publisher: John Libbey & Company Ltd

This book is based on a meeting held inApril 1997 in France, 5 years after a similarone in Houston in 1992. It focuses on de-velopmental abnormalities of the brain inrelationship to childhood epilepsy. Divid-ed into seven parts, the first deals withbrain development, the second with neu-ronal migration disorders, and the thirdwith such age-specific syndromes as Len-nox-Gastaut, infantile spasms, and theLandau-Kleffner syndrome. Part IV is onexperimental models, part V on the conse-quences of seizures and Part VI on theconsequences of treatment.

The final Part VII is a useful summary indi-cating future research.

Emergency Neurology

(Principles and Practice)

Editors: Sid M. Shah and Kevin M.Kelly

ISBN: 521-49688-8No. of Pages: 614Price: £95.00Publication Date: 1999Publisher: Cambridge University Press

The editors themselves have long experi-ence in emergency medicine and havebrought out explicitly the neurologicalproblems as presented in the emergencydepartment of any hospital. It is a multi-author book divided into seven parts con-taining 43 chapters. Neurological exami-nation relevant to emergency room is dis-cussed in chapter 1 and chapter 2 deals

cont. on p. 16


14 Advertisement

Special Book HighlightFisch & Spehlmann’s EEG Primer Basic Principles of Digital andAnalog EEG3rd revised and enlarged editionEdited by Bruce J. FischOrganized to serve as a resource forthose just beginning to learn EEG aswell as those who are already experi-enced, the third edition of Fisch & Spehlmann’s EEG Primer con-tains concise presentations of the fundamentals of EEG technol-ogy and interpretation as well as an up-to-date review of the latestdigital EEG technology and EEG clinical correlations.Unlike other EEG textbooks, the second half of the book isuniquely organized according to EEG findings rather than individ-ual disorders. This is the best practical approach to learning inter-pretation because it mirrors the actual practice of EEG – the EEGer is confronted by EEG patterns, not diagnosis.ISBN 0-444-82147-3, Hardbound, US$ 198ISBN 0-444-82148-1, Paperback, US$ 70To order and for more details, go to:http://www.elsevier.com/locate/fisch“The layout is clear and logical. The text is clear and well writ-ten…. The book can be recommended highly.” — Journal of Clinical Neurophysiology (on reviewing the 2nd edition)

New Journal – SLEEP MEDICINE2nd issue out now!!Sleep MedicineVolume 1, 4 issuesISSN 1389-945Editor-in-Chief: Sudhansu ChokrovertyTable of Contents - Vol. 1 No. 2(April 2000)EditorialE. Mignot (USA) - Perspectives in narcolepsy and hypocretin (or-exin) research - 87Original articlesC. Stevinson, E. Ernst (UK) - Valerian for insomnia: a systematicreview of randomized clinical trials - 91D. Shechter-Amir, J.A. Wade, H. Moldofsky (Canada) - Narcolep-sy and the ability to resist sleep - 101H. Moldofsky, R.J. Broughton, J.D. Hill (Canada) - A randomizedtrial of the long-term, continued efficacy and safety of modafinil innarcolepsy - 109S.L. Camhi, W.J. Morgan, N. Pernisco, S.F. Quan (USA) - Factorsaffecting sleep disturbances in children and adolescents - 117L.E. Krahn, B.F. Boeve, E.J. Olson, D.L. Herold, M.H. Silber (USA)- A standardized test for cataplexy - 125Case reportsH.P. Attarian, C.H. Schenck, M.W. Mahowald (USA) - PresumedREM sleep behavior disorder arising from cataplexy and wakefuldreaming - 131S. Nath Zallek, R.D. Chervin (USA) - Improvement in cluster head-ache after treatment for obstructive sleep apnea - 135B. Lam, C.F. Ryan (Canada) - Arnold-Chiari malformation pre-senting as sleep apnea syndrome - 139

Journal search and commentary6 articles reviewed by R.P. Allen (USA), M.H. Sanders (USA), D.Garcia-Borreguero (Spain) – 145/159Controversies in sleep medicineJ. Montplaisir, M. Michaud, R. Denesle, A. Gosselin (Canada) -Periodic leg movements are not more prevalent in insomnia or hy-persomnia but are specifically associated with sleep disorders in-volving a dopaminergic impairment – 161/163International calendar –169For more information, including Instructions to Authors, go to:http://www.elsevier.com/locate/sleep

Announcing a change of title ….

Autonomic Neuroscience:Basic & ClinicalThe Journal of the Autonomic Nervous Systemhas changed its name to Autonomic Neuro-science: Basic and Clinical to reflect currentdevelopments in the field, a changing empha-sis in Aims and Scope of the journal towards abetter balance between basic and clinical pa-pers, and the stronger ties with the Interna-tional Society for Autonomic Neuroscience.The new name, and accompanying new cov-er, will be implemented starting Volume 82.What will remain the same is the excellentquality of articles published in the journal, under the expert man-agement of Geoffrey Burnstock, Director of the Autonomic Neuro-science Institute in London, and six international Associate Edi-tors.For more information on Autonomic Neuroscience: Basic andClinical, please visit http://www.elsevier.com/locate/autneuThe International Society for Autonomic Neuroscience will hold itssecond conference in London, 17–21 July 2000. For informationon the congress, please visithttp://plexus.physiol.unimelb.edu.au/isan/isan.htm

Come and meet usElsevier Science will have a booth at the meet-ings listed below. Please visit our booth tobrowse the latest releases in our book pro-gram, see online demonstrations of our elec-tronic products and services, and to get freesample copies of our journals.6th International Congress of Parkinson’s Disease andMovement Disorders,11–16 June 2000, Barcelona, SpainAmerican Society for Sleep Disorders,17–22 June 2000, Las Vegas, NV, USAFederation of European Neuroscience Societies,24–28 June 2000, Brighton, UKWorld Alzheimer Congress 2000,9–18 July 2000, Washington DC, USAAutonomic Neuroscience Society,17–23 July 2000, London, UKEuropean Congress of Clinical Neurophysiology,27–30 August 2000, Lyon, FranceChild Neurology Society,25–28 October 2000, St. Louis, USASociety for Neuroscience,4–9 November 2000, New Orleans, LA, USA


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Fig. 2. Representative inages of cerebral blood flow (CBF), cerebral meta-bolic rate for glucose (CMRglc), and glucose extraction rate (GER) in a 38-year-old healthy man under resting conditions. Note the low level of GER inthe medial temporal lobe and cerebellum.


16 CALENDAR

with neuroradiology with an extensive cov-erage with illustrations. EEG, EMG,evoked potentials and lumber punctureare dealt with in part I. Part II containschapters on common neurological pres-entations. Specific neurological condi-tions such as CNS infections, cerebrovas-cular disease, movement disorders, neu-romuscular disorders, multiple sclerosisand some neurosurgically related condi-tions are discussed in part III. Part IV is onneurological trauma to brain, spinal cordand peripheral nerves. Part V deals withpediatric neurological emergencies andpart VI with such problems related topregnancy. Neurotoxicology and brain re-suscitation are discussed in the last part.This book is of great value to the neurolo-gists, primary care physicians and othersdealing with neurological emergenciesand will be a valuable addition to theEmergency Department Library.

J.S. Chopra Editor-in-Chief

Jasper's Basic Mechanisms of the Epilepsies Third Edition, Advances in Neurology Series Vol. 79Ed: A V Delgado-Escueta, W A

Wilson, R W Olson, R JPorter

ISBN: 0-7817-1438-9No. of Pages: 1,104Price: US $159.00Publication Date: 1999Publisher: Lippincott, Williams and

Wilkins

This updated volume of the ongoing Ad-vances in Neurology series is the third edi-tion of the classical review of epilepsy re-search that was first published by H HJasper, A A Ward and A Pope in 1969. Thispresent volume is the culmination of threescientific meetings between 1992 and1996, presenting the current state of sci-ence regarding epilepsy research. Thismulti-authored text presents an agendafor epilepsy research for the next decade,organized in five sections and covering1032 pages from 207 contributors. Eachof the sections begins with an editor's in-

troduction, which provides an overview ofthe field of biology covered in that particu-lar segment. Following an overview anddiscussion of the epidemiology of epilep-sy, in Section I, Section II reviews neuraldevelopment and genes associated withthe epilepsies; Section III: the idiopathicepilepsies; Section IV: symptomatic le-sional epilepsies; and Section V: frontiersin brain imaging and therapeutics. Thesection on symptomatic lesional epilep-sies is the most lengthy portion of the text,covering four areas regarding the electri-cal and biochemical properties of neuron-al and glial circuitry during the generation,synchronization, spread and clinical ex-pression of epileptogenic discharges.This is an important reference source thatwill be an important addition to the libraryfor the basic science researcher, postdoc-toral student as well as the clinician whocares for the epileptic patient. The editorsand authors should be commended forthe high standard of scholarship present-ed in this reference source.

Prof. Mark S. Scher, M.D.Cleveland, U.S.A

CALENDAR

2000

Neuropathology 2000: XIVth InternationalCongress of Neuropathology3–6 September 2000

Birmingham, UKContact: Concorde Services Ltd, 4B, 50Speirs Wharf, Port Dundas, Glasgow G49TB, Scotland.Tel: +44 141 331 0123Fax: +44 141 331 0234E-mail: [email protected]

Headache World 20003–7 September 2000

London, UKContact: Congress Secretariat, MediTech-media Ltd., 125 High Holborn, London,WC1V 6QA, UKTel: +44 171 404 7151Fax: +44 171 404 6946E-mail: [email protected]: http://www.headache2000.com

15th European Sleep Research SocietyCongress12–16 September 2000

Lütfi Kýrdar International Congress & Con-vention Centre, Istanbul, TurkeyContact: Prof. Hakan Kaynak, CongressSecretary, Cerrahpasa Medical School,Dept. of Neurology, Sleep Disorders Unit,Cerrahpasa, Istanbul, Turkey

Tel: +90-212-586 1596Fax: +90-212-632 9696E-mail: [email protected]: http://www.tsrs.org.tr

5th Congress of the European Federationof Neurological Societies14–18 October 2000

Bella Center, Copenhagen, DenmarkContact: EFNS Head Office, NeurologicalHospital Rosenhügel, Riedelgasse 5,A-1130 Vienna, AustriaTel: +43 1 880 00 270Fax: +43 1 889 25 81E-mail: [email protected]

125th Annual Meeting of the AmericanNeurological Association15–18 October 2000

Marriott Copley Plaza, Boston, Massachu-setts, USAContact: American Neurological Associa-tion, 5841 Cedar Lake Road, Suite #204,Minneapolis, MN 55416, USATel: +1 612 545 6284Fax: +1 612 545 6073E-mail: [email protected]

3rd Congress of Asian Oceanian EpilepsyOrganisation (AOEO)11–13 November 2000

New Delhi, IndiaContact: Satish Jain, MD, Secretary General,Department of Neurology, NeurosciencesCentre, All India Institute of Medical Sci-ences, New Delhi – 110 029, IndiaTel: 91-1-659 4210/656 9007

Fax: 91-11-652 1086/686 2663E-mail: [email protected]

Second Asia Pacific Symposium on NeuralRegeneration30 November – 2 December 2000

Xian, ChinaContact: Vera S. Yip, Ph.D, Dept. of Anat-omy, The University of Hong Kong, 5 Sas-soon Road, Hong Kong, P.R. ChinaFax: 852-2817-0857E-mail: [email protected]

2001

XVII World Congress of Neurology17–22 June 2001

London, UKVenue: Earls Court 2, Earls Court Olympia,Warwick Road, London SW5, UKContact: WCN 2001, Concorde ServicesLtd, 42 Canham Road, London W3 7SR, UKTel: +44 (0) 181 743 3106Fax: +44 (0) 181 743 1010e-mail: [email protected]://www.concorde-uk.com/wcn-2001

XIV International Congress on Parkinson'sDisease 28–31 July 2001

Finlandia Hall, Helsinki, FinlandContact: CongCreator CC Ltd,PO Box 762, FIN-00101 Helsinki, FinlandTel: +358 9 4542 190Fax: +358 9 4542 1930E-mail: [email protected]://www.congcreator.com/icpd-2001

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