by Pietro Cortelli and Max Hilz
The ANS Scientist Panel of the EFNS was set up in 1994 and co-ordinated by Chris Mathias until 2000. Subsequent coordinators were Pietro Cortelli until 2006, David B. Vodusek until 2008 and currently Max Hilz.
The aim of the group is to draw the attention of the European neurological community to the importance of ANS diseases in determining patient disability. As the ANS controls the function of all visceral organs and the skin, any acute or chronic autonomic impairment gives rise to myriad cardiovascular symptoms (transient loss of consciousness, cardiac arrhythmias, supine arterial hypertension and orthostatic hypotension), impaired sweating disturbing thermoregulation, disorders of the gastro-intestinal tract (constipation, diarrhoea) and genito-urinary system (incontinence, erectile dysfunction). These complex symptoms pose a challenge to neurologists not specifically trained to recognize their neurological origin, forcing patients to consult different specialists in order to secure appropriate treatment. For this reason, the panel supports quality of service within European countries by providing management and treatment guidelines (Eur J Neurol. 2006;13:930-6) on orthostatic intolerance and transient loss of consciousness.
In 1998 the neurologists belonging to the ANS Scientist Panel of EFNS joined forces with internal medicine and cardiology colleagues to set up the European Federation of Autonomic Societies (EFAS), the umbrella society of all national autonomic societies in Europe. EFAS promptly became the multidisciplinary twin of the EFNS ANS Scientist Panel sharing the common aim of circulating the knowledge that many of our patients’ ANS disorders can be correctly diagnosed and treated in a neurological setting. To this end EFAS has organized 13 annual international meetings, two (2004 in Amsterdam and 2007 in Vienna) in collaboration with the American Autonomic Society, two in collaboration with the EFNS (2008 in Madrid and the upcoming meeting to be held in Stockholm next September), and one meeting in collaboration with the International Society for Autonomic Neuroscience (2009 in Sydney). These meetings offered research scientists an opportunity to present their findings and a forum for discussion on ANS topics. They also attracted many young neurologists embarking on a specialization in this field and who now constitute our most important asset for an ongoing alliance between EFNS and EFAS in the fight against ANS diseases.
In addition, EFAS has established training initiatives especially dedicated to young neurologists starting with a teaching course on ANS disorders 2009 in Brasov, in cooperation with EFNS and EAYNT (Clin Auton Res. 2009;19:130). EFAS decided to develop a structured training programme and set up the European school on ANS in 2010 for intensive exposure to clinical autonomic medicine. The aim of the school is to create a teaching forum to provide a better understanding of ANS dysfunction and to develop a clinical autonomic network among medical residents. The idea is to stimulate scientific and training initiatives until the recognition and treatment of ANS disorders becomes a standard part of the everyday work of every neurologist in Europe.
Convinced that the alliance between EFNS and EFAS is the key to improving the treatment of autonomic disorders affecting so many patients in the many neurological sub-specialties (movement disorders, multiple sclerosis and stroke being among the most common), it is our hope that these twin forces shall continue to work together with the future European Academy of Neurology.
Pietro Cortelli is President of EFAS and Professor of Neurology at the IRCCS Istituto delle Scienze Neurologiche di Bologna and Dipartimento di Scienze Neurologiche, Alma Mater Studiorum – Università di Bologna, Italy
Prof. Dr.Dr. Max J. Hilz is Chair of the EFNS Autonomic Nervous System Scientist Panel and Professor of Neurology at the Department of Neurology, University Erlangen-Nuremberg, Erlangen, Germany and at the Department of Medicine and Psychiatry New York University School of Medicine, New York, NY , USA