eanpages
  • General interest
    • All Executive Page Paper of the Month EAN News EAN Congress news COVID-19 Interviews
      EAN News

      New EAN Regional Teaching initiative – host an EAN session at your national society’s meeting

      March 30, 2023

      EAN News

      Sign up now for the European Brain Health Summit 2023 – live online on May 9!

      March 28, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Literature reviews – March 2023

      March 16, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Cross-Sectional Case Control Studies – March 2023

      March 16, 2023

      Executive Page Head and shoulders portrait photo of Irena Rektorova, in colourful dress

      Executive Page: Leadership, mentorship and many more EAN educational opportunities

      March 13, 2023

      Executive Page

      Executive Page: Key EAN events and new projects to strengthen neurology on many levels

      February 14, 2023

      Executive Page

      Executive Page: Submit, register, and join us for EAN 2023

      December 5, 2022

      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

      Executive Page: New guideline prioritisation process begins setting path for next two years

      November 1, 2022

      Paper of the Month One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – March 2023

      March 14, 2023

      Paper of the Month

      Research Paper of the Month: Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson’s Disease

      March 13, 2023

      Paper of the Month

      Research Paper of the Month: Headache attributed to SARS-CoV-2 infection, vaccination and the impact on primary headache disorders of the COVID-19 pandemic

      February 9, 2023

      Paper of the Month

      COVID-19 Paper of the Month: Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study

      February 9, 2023

      EAN News

      New EAN Regional Teaching initiative – host an EAN session at your national society’s meeting

      March 30, 2023

      EAN News

      Sign up now for the European Brain Health Summit 2023 – live online on May 9!

      March 28, 2023

      EAN News Mapy of the world made from pills of various sizes, shapes and colours

      EAN endorses MSIF and the WHO Collaborating Centre Bologna’s application to add MS treatments on WHO’s Essential Medicines List

      March 14, 2023

      EAN News Head and shoulders portrait photo of Irena Rektorova, in colourful dress

      Executive Page: Leadership, mentorship and many more EAN educational opportunities

      March 13, 2023

      EAN Congress news

      EAN 2023 Congress Quiz – your chance to win free registration!

      March 14, 2023

      EAN Congress news Photo of a sheet of paper, pencil and crumpled paper on a desk.

      Win a travel grant for a future EAN congress with our ‘Why Neurology?’ student essay competition!

      March 10, 2023

      EAN Congress news

      New ‘Start-Up Corner’ introduced for EAN 2023 industrial exhibition

      February 13, 2023

      EAN Congress news EAN 2023 congress logo top left; running stick figure centre with Register Now in large type; EAN 2023 hashtag, bottom right

      Register Now for EAN 2023 in Budapest, 1-4 July

      February 10, 2023

      COVID-19

      COVID-19 Research Round-Up: Literature reviews – March 2023

      March 16, 2023

      COVID-19

      COVID-19 Research Round-Up: Cross-Sectional Case Control Studies – March 2023

      March 16, 2023

      COVID-19

      COVID-19 Research Round-Up: Case Series/Case Reports – March 2023

      March 16, 2023

      COVID-19

      COVID-19 Research Round-Up: Meta-analyses/systematic reviews – March 2023

      March 16, 2023

      Interviews

      Video Interview: Dementia & Cognitive Disorders Panel Co-Chairs

      September 8, 2022

      Interviews

      Video Interview: Sleep-Wake Panel Co-Chair, Dr. Evelina Pajediene

      July 28, 2022

      Interviews

      Video: EAN supports World Brain Day

      July 19, 2022

      Interviews

      Video Interview: European Journal of Neurology Award winner, Dr. Jonathan Coutinho

      July 18, 2022

  • Academic/Scientific
    • All Breaking news Neurology updates Scientific committee reports Scientific panels reports Eur J Neurol Top 10 Articles Scientific Corner
      Academic/Scientific

      COVID-19 Research Round-Up: Literature reviews – March 2023

      March 16, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Cross-Sectional Case Control Studies – March 2023

      March 16, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Case Series/Case Reports – March 2023

      March 16, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Meta-analyses/systematic reviews – March 2023

      March 16, 2023

      Breaking news

      COVID-19 Breaking News: Meta-analyses/systematic reviews – November 2022

      November 8, 2022

      Breaking news

      COVID-19 Breaking News: Cross-Sectional Case Control Studies – November 2022

      November 8, 2022

      Breaking news

      COVID-19 Breaking News: Miscellaneous – November 2022

      November 7, 2022

      Breaking news

      COVID-19 Breaking News: Observational Studies – Prospective Longitudinal Cohort – November 2022

      November 7, 2022

      Neurology updates

      Performance of the 2017 and 2010 Revised McDonald Criteria in Predicting MS Diagnosis After a Clinically Isolated Syndrome – A MAGNIMS Study

      September 26, 2022

      Neurology updates

      Relapse-independent disability worsening plays a relevant role in every disease phase of MS

      September 26, 2022

      Neurology updates

      Epstein-Barr virus infection is a major risk factor for the development of multiple sclerosis

      September 26, 2022

      Neurology updates

      Glymphatic system impairment may contribute to multiple sclerosis pathology

      September 23, 2022

      Scientific committee reports

      Scientific Committee Snapshot: Didier Leys

      April 1, 2020

      Scientific committee reports

      Scientific Committee Snapshot: Rigmor Hojland

      February 26, 2020

      Scientific committee reports

      Scientific Committee Snapshot: Christian Enzinger

      December 1, 2019

      Scientific committee reports

      Scientific Committee Snapshot: Maurizio Leone

      November 1, 2019

      Scientific panels reports

      Highlights from the World Muscle Society annual meeting, chosen by the Scientific Panel on Muscle and NMJ Disorders

      November 2, 2022

      Scientific panels reports

      Coma and DOC Panel Update (May-June): news from the EAN Virtual Congress, personalized pain assessment, NIRS-EEG and machine learning to predict outcomes, prevalence of swallowing disorders and new multimodal predictive algorithms.

      August 11, 2020

      Scientific panels reports

      Statement of the EAN Sleep-Wake-Panel

      June 3, 2020

      Scientific panels reports

      Rare Neurological Diseases in the COVID-19 era: Suggestions for information to patients and caregivers

      May 13, 2020

      Eur J Neurol

      Video Interview: European Journal of Neurology Award winner, Dr. Jonathan Coutinho

      July 18, 2022

      Eur J Neurol

      EAN NeuroCOVID-19 Task Force position paper on COVID-19 vaccination hesitancy among people with chronic neurological disorders

      May 2, 2022

      Eur J Neurol

      European Journal of Neurology welcomes new associate editors

      December 13, 2021

      Eur J Neurol

      New European guideline and expert statements on the management of narcolepsy in adults and children

      June 30, 2021

      Top 10 Articles

      EAN is proud to announce the 2020 Virtual Master Classes Christmas Special

      November 13, 2020

      Top 10 Articles

      EUROPEAN JOURNAL OF NEUROLOGY – TOP 15 ARTICLES 2018

      February 1, 2019

      Top 10 Articles

      Interview with Prof. Patrick Cras – UEMS Section of Neurology (SN)

      February 3, 2018

      Top 10 Articles

      Interview with Mr. Bertrand Daval and Mrs. Nathalie Paulus

      February 3, 2018

      Scientific Corner graphic of a block staircase with text announcing the application deadline to the EAN's new Cost-Conscious Healthcare (CoCoCare) programme

      Training for the Future of European Guidelines: Cost-Conscious Healthcare 2023

      March 2, 2023

      Scientific Corner

      Join the EAN Guideline Workshop on 24 June!

      May 13, 2022

      Scientific Corner

      First EAN Science School proves a hit in Salzburg

      April 1, 2022

      Scientific Corner

      Invitation to the EAN-EBRAINS Joint Workshop on ‘The Future of Medical Data Sharing in Clinical Neurosciences’

      July 2, 2021

  • Educational
    • All eLearning Student Corner E-Brain Grand Rounds Resident and Research Fellows Fellowship reports Education corner
      EAN News

      New EAN Regional Teaching initiative – host an EAN session at your national society’s meeting

      March 30, 2023

      Resident and Research Fellows

      Report on the 3rd RRFS National Representative Network meeting in Berlin

      March 22, 2023

      Resident and Research Fellows

      Clinical Fellowship Reports 2022: Brno, Liège & Heeze

      March 21, 2023

      Resident and Research Fellows

      Clinical Fellowship Reports 2022: Grenoble, Prague & London

      March 17, 2023

      eLearning

      Keep your mind sharp with free content on Brain Health through the eanCampus!

      March 13, 2023

      eLearning Illustration of two people holding an award between them and jumping in the air in a celebratory pose

      Learn with the eanCampus and win free EAN congress registration!

      January 12, 2023

      eLearning

      Kick off 2023 with highlights on the eanCampus

      January 10, 2023

      eLearning

      December Highlights on the eanCampus!

      December 5, 2022

      Student Corner Photo of a sheet of paper, pencil and crumpled paper on a desk.

      Win a travel grant for a future EAN congress with our ‘Why Neurology?’ student essay competition!

      March 10, 2023

      Student Corner Illustration of a vertical pencil point on a blue background, with a yellow light bulb above it

      Students’ Corner: What is it like to be a student on a neurology placement?

      March 10, 2023

      Student Corner

      Application for the Student Teaser Fellowship 2023 NOW OPEN

      February 1, 2023

      Student Corner Illustration of a vertical pencil point on a blue background, with a yellow light bulb above it

      Students’ Corner: What neurology taught me in 2022

      January 17, 2023

      E-Brain

      ebrain May update: new website and podcast series

      May 1, 2021

      E-Brain

      EBRA launches 3rd call for clusters

      May 1, 2020

      E-Brain

      News from ebrain

      February 28, 2020

      E-Brain

      ebrain to host the 2019 Neurology Formative Test Questions, from 15 April to 26 May

      April 1, 2019

      Grand Rounds

      eBrain: virtual case report from Belgium

      October 2, 2017

      Grand Rounds

      Free access to Ebrain for EAN members

      July 1, 2016

      Grand Rounds

      Ebrain granted Royal College of Physicians (UK) CPD/CME accreditation

      July 1, 2016

      Grand Rounds

      ebrain session of the month: neuromuscular junction

      February 1, 2016

      Resident and Research Fellows

      Report on the 3rd RRFS National Representative Network meeting in Berlin

      March 22, 2023

      Resident and Research Fellows

      Clinical Fellowship Reports 2022: Brno, Liège & Heeze

      March 21, 2023

      Resident and Research Fellows

      Clinical Fellowship Reports 2022: Grenoble, Prague & London

      March 17, 2023

      Resident and Research Fellows

      Research Fellowship Report 2021 – Pain Research Institute, University of Liverpool

      March 17, 2023

      Fellowship reports

      Clinical Fellowship Reports 2022: Brno, Liège & Heeze

      March 21, 2023

      Fellowship reports

      Clinical Fellowship Reports 2022: Grenoble, Prague & London

      March 17, 2023

      Fellowship reports

      Research Fellowship Report 2021 – Pain Research Institute, University of Liverpool

      March 17, 2023

      Fellowship reports

      Research Fellowship Report 2021 – Neurogenetics Laboratory at UCL, UK

      March 17, 2023

      Education corner

      New EAN Regional Teaching initiative – host an EAN session at your national society’s meeting

      March 30, 2023

      Education corner

      Clinical Fellowship Reports 2022: Brno, Liège & Heeze

      March 21, 2023

      Education corner

      Clinical Fellowship Reports 2022: Grenoble, Prague & London

      March 17, 2023

      Education corner

      Research Fellowship Report 2021 – Pain Research Institute, University of Liverpool

      March 17, 2023

  • Other News
    • All EAN Staff Grant opportunities News from EAN member societies EBC EFNA News in general Patients societies reports Surveys Forum
      Other News

      In Memoriam: Prof. Johan Aarli, former president of the World Federation of Neurology

      March 28, 2023

      EBC

      EBC & EFPIA launch RETHINKING Alzheimer’s disease White Paper

      March 22, 2023

      EBC

      Registration and call for abstracts launched for 2023 Brain Innovation Days

      March 21, 2023

      EAN Staff Chest-height portrait photo of a woman,

      Never say never – or my 8,752 days with neurologists

      March 20, 2023

      EAN Staff Chest-height portrait photo of a woman,

      Never say never – or my 8,752 days with neurologists

      March 20, 2023

      EAN Staff Composite image consisting of two chest-height portraits side-by-side

      EAN Head Office Profiles: Abigail & Bernadette

      March 15, 2023

      EAN Staff Composite image consisting of two chest-height portraits side-by-side

      EAN Head Office Profiles: Katina & Robertina

      February 2, 2023

      EAN Staff

      EAN Head Office Profiles: Magda & Mira

      December 29, 2022

      Grant opportunities

      1st EAN Science School, 26-29 March 2022: “Pathophysiology of disorders of the nervous system”

      June 18, 2021

      Grant opportunities

      European Commission: Innovation and novelty in medical devices and in vitro diagnostic devices; towards common concepts of innovation-related risk assessments

      November 1, 2019

      Grant opportunities

      GBS|CIDP Foundation International 2020 Research Grant Opportunity

      October 29, 2019

      Grant opportunities

      The Clinical Fellowship application deadline is approaching

      October 1, 2019

      News from EAN member societies Black image titled "In Memoriam" in remembrance of the neurologists lost in the earthquake on 6 February 2023.

      Earthquake in Türkiye and Syria: Statement from President of Turkish Neurological Society

      February 20, 2023

      News from EAN member societies

      14 June: Special publication celebrates 10 years of the European Working Group of People with Dementia

      August 2, 2022

      News from EAN member societies

      14 June: Alzheimer Europe hosts European Parliament Lunch Debate examining EU and WHO policies on neurological conditions

      August 2, 2022

      News from EAN member societies

      22 June: Alzheimer Europe invites applications for its new Anti-Stigma Award

      August 2, 2022

      EBC

      EBC & EFPIA launch RETHINKING Alzheimer’s disease White Paper

      March 22, 2023

      EBC

      Registration and call for abstracts launched for 2023 Brain Innovation Days

      March 21, 2023

      EBC

      Connecting brains for the future: Brain Innovation Days 2022

      November 23, 2022

      EBC

      Final programme available for Brain Innovation Days – Register now!

      September 22, 2022

      EFNA

      OneNeurology European Summit underlines urgent need to prioritise neurology and drive change

      December 31, 2021

      EFNA

      EFNA launch eLearning Platform for neurology advocates

      February 1, 2021

      EFNA

      ‘Me and My Brain’ – Art Competition winners announced!

      February 1, 2021

      EFNA

      Survey on the impact of COVID-19 on neurology service delivery

      November 1, 2020

      News in general

      Registration now open for the launch event of the RETHINKING Alzheimer’s disease White Paper

      December 24, 2022

      News in general

      EAN lecture at the International Neuro-Urology Society annual congress 2022

      May 25, 2022

      News in general

      EPA-EAN Joint Symposium: ‘Etiology and Treatment of the Long Covid-19 Syndrome’ and other highlights at the 30th European Congress of Psychiatry

      May 25, 2022

      News in general

      Organise an EAN-Day or EAN Regional Teaching Course in your Country!

      May 17, 2022

      Patients societies reports

      News from Alzheimer Europe

      March 2, 2020

      Patients societies reports

      News from the WHO

      January 9, 2020

      Patients societies reports

      News from EFIC and the European Pain Forum

      January 3, 2020

      Patients societies reports

      News from EFIC and the European Pain Forum

      January 2, 2020

      Surveys

      COVID-19 and neurology: a survey of previous and continued restrictions on clinical practice, professional education and neuroeconomics

      March 3, 2023

      Surveys

      Help EAN contribute towards the development of a European Pain Research strategy

      December 5, 2022

      Surveys

      Survey: management of covert brain infarction

      October 29, 2021

      Surveys

      Driving with an intracranial tumor

      July 13, 2020

      Forum

      Call for Applications: e-Learning Platform Editor-in-Chief

      August 4, 2020

      Forum

      Neurological News from Denmark VI – the land of the 2nd EAN congress 2016: Pain Research in Denmark from a neurological perspective

      April 1, 2016

      Forum

      Neurological News from Denmark V – the land of the 2nd EAN congress 2016: Clinical Dementia Research in Denmark

      March 1, 2016

      Forum

      Updated recommendations to minimise the risk of the rare brain infection PML with Tysabri – Comment to EMA recommendation

      March 1, 2016

  • EAN
  • Congress 2023
  • EANpages
  • EAN Campus
  • Eur J Neurol
  • Virtual Congress

eanpages

  • General interest
    • All Executive Page Paper of the Month EAN News EAN Congress news COVID-19 Interviews
      EAN News

      New EAN Regional Teaching initiative – host an EAN session at your national society’s meeting

      March 30, 2023

      EAN News

      Sign up now for the European Brain Health Summit 2023 – live online on May 9!

      March 28, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Literature reviews – March 2023

      March 16, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Cross-Sectional Case Control Studies – March 2023

      March 16, 2023

      Executive Page Head and shoulders portrait photo of Irena Rektorova, in colourful dress

      Executive Page: Leadership, mentorship and many more EAN educational opportunities

      March 13, 2023

      Executive Page

      Executive Page: Key EAN events and new projects to strengthen neurology on many levels

      February 14, 2023

      Executive Page

      Executive Page: Submit, register, and join us for EAN 2023

      December 5, 2022

      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

      Executive Page: New guideline prioritisation process begins setting path for next two years

      November 1, 2022

      Paper of the Month One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – March 2023

      March 14, 2023

      Paper of the Month

      Research Paper of the Month: Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson’s Disease

      March 13, 2023

      Paper of the Month

      Research Paper of the Month: Headache attributed to SARS-CoV-2 infection, vaccination and the impact on primary headache disorders of the COVID-19 pandemic

      February 9, 2023

      Paper of the Month

      COVID-19 Paper of the Month: Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study

      February 9, 2023

      EAN News

      New EAN Regional Teaching initiative – host an EAN session at your national society’s meeting

      March 30, 2023

      EAN News

      Sign up now for the European Brain Health Summit 2023 – live online on May 9!

      March 28, 2023

      EAN News Mapy of the world made from pills of various sizes, shapes and colours

      EAN endorses MSIF and the WHO Collaborating Centre Bologna’s application to add MS treatments on WHO’s Essential Medicines List

      March 14, 2023

      EAN News Head and shoulders portrait photo of Irena Rektorova, in colourful dress

      Executive Page: Leadership, mentorship and many more EAN educational opportunities

      March 13, 2023

      EAN Congress news

      EAN 2023 Congress Quiz – your chance to win free registration!

      March 14, 2023

      EAN Congress news Photo of a sheet of paper, pencil and crumpled paper on a desk.

      Win a travel grant for a future EAN congress with our ‘Why Neurology?’ student essay competition!

      March 10, 2023

      EAN Congress news

      New ‘Start-Up Corner’ introduced for EAN 2023 industrial exhibition

      February 13, 2023

      EAN Congress news EAN 2023 congress logo top left; running stick figure centre with Register Now in large type; EAN 2023 hashtag, bottom right

      Register Now for EAN 2023 in Budapest, 1-4 July

      February 10, 2023

      COVID-19

      COVID-19 Research Round-Up: Literature reviews – March 2023

      March 16, 2023

      COVID-19

      COVID-19 Research Round-Up: Cross-Sectional Case Control Studies – March 2023

      March 16, 2023

      COVID-19

      COVID-19 Research Round-Up: Case Series/Case Reports – March 2023

      March 16, 2023

      COVID-19

      COVID-19 Research Round-Up: Meta-analyses/systematic reviews – March 2023

      March 16, 2023

      Interviews

      Video Interview: Dementia & Cognitive Disorders Panel Co-Chairs

      September 8, 2022

      Interviews

      Video Interview: Sleep-Wake Panel Co-Chair, Dr. Evelina Pajediene

      July 28, 2022

      Interviews

      Video: EAN supports World Brain Day

      July 19, 2022

      Interviews

      Video Interview: European Journal of Neurology Award winner, Dr. Jonathan Coutinho

      July 18, 2022

  • Academic/Scientific
    • All Breaking news Neurology updates Scientific committee reports Scientific panels reports Eur J Neurol Top 10 Articles Scientific Corner
      Academic/Scientific

      COVID-19 Research Round-Up: Literature reviews – March 2023

      March 16, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Cross-Sectional Case Control Studies – March 2023

      March 16, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Case Series/Case Reports – March 2023

      March 16, 2023

      Academic/Scientific

      COVID-19 Research Round-Up: Meta-analyses/systematic reviews – March 2023

      March 16, 2023

      Breaking news

      COVID-19 Breaking News: Meta-analyses/systematic reviews – November 2022

      November 8, 2022

      Breaking news

      COVID-19 Breaking News: Cross-Sectional Case Control Studies – November 2022

      November 8, 2022

      Breaking news

      COVID-19 Breaking News: Miscellaneous – November 2022

      November 7, 2022

      Breaking news

      COVID-19 Breaking News: Observational Studies – Prospective Longitudinal Cohort – November 2022

      November 7, 2022

      Neurology updates

      Performance of the 2017 and 2010 Revised McDonald Criteria in Predicting MS Diagnosis After a Clinically Isolated Syndrome – A MAGNIMS Study

      September 26, 2022

      Neurology updates

      Relapse-independent disability worsening plays a relevant role in every disease phase of MS

      September 26, 2022

      Neurology updates

      Epstein-Barr virus infection is a major risk factor for the development of multiple sclerosis

      September 26, 2022

      Neurology updates

      Glymphatic system impairment may contribute to multiple sclerosis pathology

      September 23, 2022

      Scientific committee reports

      Scientific Committee Snapshot: Didier Leys

      April 1, 2020

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Case Report: Recurrent painful ophthalmoplegia: sometimes remains mysterious….

August 1, 2012

presented by Vanessa Levrat & Anastasia Zekeridou

We report a case of a 76-year-old woman with a recurrent painful left ophthalmoplegia of obscure origin, with two episodes in two years.
The patient complains of pain in the left orbital area that worsens when she moves her eyes. She has diplopia which is maximal on looking to the left. There is no diurnal fluctuation. There are no other symptoms.
She presented with similar symptoms two years previously. The cerebral MRI, left temporal artery biopsy and blood workup at the time were unremarkable apart from a hypercholesterolemia. The diagnosis at the time was of a microvascular sixth nerve palsy in a patient with high blood pressure and hypercholesterolemia. She recovered completely after two months.
Presently, on examination, she showed an incomplete ptosis on the left with mydriasis (1mm of difference) and incomplete abduction of her left eye with horizontal diplopia which is maximal on abduction of the left eye without other signs. There was no proptosis, or scleral injection and no orbital bruit.
A neuroanatomical diagnosis of a partial third and sixth nerve palsies on the left was made.
The patient reported no significant family history.
The diagnostic work-up was comprehensive:

  • There was no diabetes, no thyroid dysfunction or antibodies.
  • The CK levels were normal and hypercholesterolemia was adequately controlled with oral treatment.
  • The brain and orbital MRI and a thoraco- abdominal CT were normal.
  • Clinical neurophysiological tests (ENMG) and anti-acetylcholine receptor antibodies were normal.
  • The infectious and inflammatory blood screen (HIV, syphilis, tuberculosis, Lyme) were normal.
  • A lumbar puncture showed a protein of 560 mg/ml.

After excluding an infectious disorder, the patient received oral prednisone treatment, which relieved her pain only.

Our final diagnosis was that of a painful ophthalmoplegia of unknown origin.

Dr. Vanessa Levrat and Dr. Anastasia Zekeridou both work at the Department of clinical neuroscience, Neurology Service, chaired by Prof. R. Frackowiak, CHUV Lausanne, Switzerland

Comment by the authors

We think that in our patient a recurrent neuropathy of microvascular origin is probable, given the hypercholesterolemia and treated hypertension, and absence of other abnormalities.
On the other hand, an inflammatory disease such as a Tolosa Hunt syndrome cannot be excluded given that 7.9% of these patients have no MRI findings (1).
Both of these disorders can be recurrent.
We do not believe that the patient has a myopathy or a neuromuscular junction disorder (pain, normal ENMG study and CK levels, normal MRI) nor an ophthalmoplegic migraine given the age and the absence of antecedent headache (2).
As for the long-term management, we have decided to gradually decrease prednisone doses.
A recurrence of symptoms would be in favour of Tolosa Hunt syndrome…

REFERENCES:
1. S Colnaghi et al. ICHD-II Diagnostic Criteria for Tolosa-Hunt Syndrome in Idiopathic Inflammatory Syndromes of the Orbit and/or the Cavernous Sinus. Cephalalgia 2008 28: 577
2. L. La Mantia. Painful ophthalmoplegia: an unresolved clinical problem. Neurol Sci 2005 26:S79–S82

Comment by Silvia Colnaghi, Anna Pichiecchio, Maurizio Versino and Stefano Bastianello

This case report, by describing an interesting case of recurrent painful ophthamoplegia, demonstrates the difficulties embedded in the diagnosis of Tolosa Hunt Syndrome (THS) when the ICHD-II diagnostic criteria [1] (Table 1) are not fully satisfied.

In fact, the current THS diagnostic criteria are ambiguous regarding (i) the role of MRI (point B), and (ii) the dosage, schedule and expected effect of the steroid treatment (point D).

ICHD-II criteria are not mandatory about MRI methodology, but it is hard to reconcile the idea of THS as a possibly autoimmune, granulomatous disease with the possibility of a negative MRI as in this case report. Thereby, particularly in these cases, the MRI techniques should strictly adhere to the one proposed for evaluating the presence of granulomatous tissue in the cavernous sinus and/or the orbit, and a careful follow up should be mandatory both to confirm the THS diagnosis and to manage the steroid treatment [2]. More specifically, MRI should be performed with 3 mm thickness coronal and axial T1-SE and T2-TSE sequences and with T1 fat-suppressed weighted images after gadolinium administration at the level of the orbit and cavernous sinus.

Moreover, at least in cases with a negative MRI, the diagnostic work-up should also test, in addition to the full panel proposed by the authors, anti Gq1b antibodies to exclude a Miller-Fisher / Bickerstaff’ encephalitis [3].

Overall, since we do not have a biological marker for microvascular neuropathy (see point E), and the patient met the current THS diagnostic criteria, the diagnosis of THS could not be excluded, despite a recurrent microvascular cranial neuropathy was the most likely hypothesis.

1. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain.Cephalalgia 1988; 8 (Suppl. 7):1–96.1:
2. Colnaghi S, Versino M, Marchioni E, Pichiecchio A, Bastianello S, Cosi V, Nappi G. ICHD-II diagnostic criteria for Tolosa-Hunt syndrome in idiopathic inflammatory syndromes of the orbit and/or the cavernous sinus. Cephalalgia. 2008 Jun;28(6):577-84. Epub 2008 Mar 31. Review. PubMed PMID: 18384413.
3. Chiba A, Kusunoki S, Obata H, Machinami R, Kanazawa I. Serum anti-GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain-Barré syndrome: clinical and immunohistochemical studies. Neurology. 1993 Oct;43(10):1911-7. PubMed PMID: 8413947.

Table 1: ICHD-II diagnostic criteria for the Tolosa-Hunt syndrome
13.16 Tolosa–Hunt syndrome
Description:
Episodic orbital pain associated with paralysis of one or more of the third, fourth and/or sixth cranial nerves which
usually resolves spontaneously but tends to relapse and
remit.
Diagnostic criteria:
A. One or more episodes of unilateral orbital pain persisting for weeks if untreated
B. Paresis of one or more of the third, fourth and/or sixth cranial nerves and/or demonstration of granulomas by MRI or biopsy
C. Paresis coincides with the onset of pain or follows it within 2 weeks
D. Pain and paresis resolve within 72 h when treated adequately with corticosteroids
E. Other causes have been excluded by appropriate investigations

Dr. Silvia Colnaghi, Dr. Anna Pichiecchio, Dr. Maurizio Versino and Dr. Stefano Bastianello work at the  C.Mondino National Institute of Neurology Foundation, IRCCS Pavia at the University of Pavia, Italy.

Comment by Michele Viana and Peter Goadsby

The authors present an interesting case of recurrent painful ophthalmoplegia. We agree with the authors that there are few similar cases in the literature described as “mysterious” –meaning a clear nosological entity accounting for the symptomatology was not identified.

Some considerations and comments:

On the presentation of the case we note that it was not reported whether the patient had an MRA or other angiography. The presence of a bruit is an important sign suggesting potential vascular causes, especially during the first approach to the patient, while its absence is not conclusive. Moreover, investigations for autoimmune presentations, such as SLE, sarcoidosis or Wegener’s Syndrome, would seem useful. It would have been useful to know if Gadolinium was given for the MRI. This can be useful to verify the presence of an inflammatory cranial neuropathy or a Tolosa-Hunt Syndrome. It might have been useful if some aspects of the pain were clarified, notably i) the quality and intensity of the pain; ii) the time relation between the onset of the ophthalmoplegia and pain; iii) the dosage and the schedule of prednisone therapy; iv) the time and extend of relief after the prednisone.

On the diagnostic discussion, a recurrent inflammatory cranial neuropathy seems a good possibility, given that condition often remits and relapses. An MRI with Gadolinium should be performed and more complete data about the effect of the corticosteroid therapy should be provided to verify this hypothesis. We would like to highlight that inflammatory cranial neuropathy is also now considered as the basis of ophthalmoplegic migraine, besides being associated to other conditions. “Ophthalmoplegic migraine” in fact it is a misnomer in that it is probably not a variant of migraine, at least in Caucasians, but rather a recurrent cranial neuralgia – in the second edition of the International Classification of Headache Disorders Ophthalmoplegic migraine was in fact classified under “cranial neuralgias” group. It is not correct to state that if the patient had no headache the diagnosis of ophthalmoplegic migraine is untenable.

A Tolosa-Hunt Syndrome (THS), which could fit with the clinical picture, has to be considered as a secondary option as an MRI should detect the typical changes. Yet, also here, we would like to know if the MRI was performed adequately to detect THS changes (with 3 mm thickness coronal and axial T1—SE and T2-TSE sequences and with T1 fat-suppressed weighted images after Gadolinium administration at the level of the orbit and cavernous sinus). In the case that a properly performed MRI was negative, the possibility that this patient is affected by a THS a very low. Just a very small part of patients with THS reported in literature (7.9%) had negative brain MRI. Moreover we should consider that those data came from cases studied with lower-field MRI with respect to what we use nowadays. Than this few patients (3 out of 64 described in the review cited by the Authors) might have presented structural changes that were not detected.

The microvascular hypothesis is less probable for the recurrence of the condition, in a patient with only hypercholesterolemia (well controlled) and high blood pressure as vascular risk factor, with no diabetes, no other signs of vascular lesions (either in the central nervous system or within other organs). In this context autoimmune serological test should be performed to exclude autoimmune diseases that might eventually cause microangiopathy. Anyway, also in such case, it would be difficult that such condition had involved just the microcirculation of two cranial nerves without giving other signs/symptoms or laboratory/imaging findings.

In conclusion we suggest making the patient have the exams not already performed. The therapy will come subsequently. With the data in our possession, assuming the patient is affected by a recurrent inflammatory cranial neuropathy, the steroid therapy is the more correct one. It should be noted that in such conditions although the pain usually respond to that therapy within few days, the neurological signs would probably take longer time to ameliorate.

Michele Viana is working at the Headache Science Centre, IRCCS “C.Mondino National Neurological Institute” Foundation, Pavia, Italy.
Peter Goadsby is Professor of Neurology at the Department of Neurology – Headache Group at the University of California, San Francisco, USA and President of the International Headache Society.

 

 

Case Report: Recurrent painful ophthalmoplegia: sometimes remains mysterious…. was last modified: August 20th, 2012 by Editor
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2 comments

shakya Bhattacharjee November 1, 2012 at 2:50 pm

Thanks for the very interseting case.Did you exclude Migraine? Sometimes migraine can present with ophthalmoplegia( painful type) without other classical features.
Regards
Shakya Bhattacharjee

Log in to Reply
Anastasia Zekeridou January 21, 2013 at 5:20 pm

Thank you for this interesting comment. We considered migraine but we excluded it given the age of onset (typically in younger patients) and the abscence of relative history of migraine in this patient.

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