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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Grand Rounds

Case Report: Orthostatic intolerance after high impact trauma with bilateral carotid dissection

September 1, 2012

presented by Walter Struhal, Franz Gruber, Milan Vosko, Daniel Floery, Franz Fellner, Stephanie Hödl, Klaus Böck and Gerhard Ransmayr

Case presentation:
A 37-year-old woman was admitted to the emergency department with a Glasgow Coma Scale 13. She had suffered a high impact car accident during an overtaking manoeuvre. Besides moderate traumatic brain injury she presented polytrauma with several head contusions, bilateral lung contusion and pneumothorax.
Neurologic examination revealed a complete left sided oculomotor lesion. Besides that no focal neurological signs were present. She was sedated and intubated at the emergency department and transferred to the Neurological Intensive Care Unit (NICU). Admission MR-angiogram showed bilateral dissection of internal carotid artery ranging from bifurcation up to intracranial region (Figure1, Figure 2). Intravenous heparine was started. On day 3 after admission, control MRI diffusion weighted images showed multifocal lacunar infarctions frontoparietal bilateral, in the right ncl. caudatus and in the corpus callosum. (Figure 3)
During the first days at the NICU her blood pressure was stabilised at about 130mmHg systolic to prevent deterioration of her dissections. Regular adaptions of the catecholamine treatment were necessary to cope with her extensive blood pressure variations. Other than marked blood pressure variability, the further course at the NICU was unremarkable.
On day 13, after a short weaning period, she could be extubated. Heparine was changed to phenprocoumon and sertralin 50mg was started to treat reactive depression.
Early mobilisation started 3 days later. At this time blood pressure was stable without catecholamines but she showed tachycardic episodes at night. During mobilisation the patient experienced recurrent episodes of light headedness. 4 days after mobilisation the patient suffered a presyncope in sitting position.
During the next days, light headedness and palpitation during sitting and walking increased and the patient suffered extreme attacks of fatigue, being unable to walk longer distances in the patient ward.
Ewing battery – a standard test battery for autonomic testing including parasympathetic and sympathetic reflex stimuli – was performed in the autonomic lab 11 days after mobilisation started. Heart rate variability (HRV) was unremarkable with CV 4.22 and expiration/inspiration ratio 1.22; Valsalva ratio was normal with ratio 1.88 and normal phase IIb and IV. 70° head up tilt (HUT) showed a marked increase of heart rate from 80 to 147 beats per minute (Figure 4), initially without blood pressure drop. 5 minutes after HUT started, there was a rapid blood pressure drop to 39/19mmHg with decrease in heart rate resembling neurocardiogenic syncope. Postural orthostatic tachycardia was diagnosed. Baroreceptor sequences could not be detected using the sequence technique [1] during relaxed lying. At the same time MRI angiography showed progression of dissection on both sides with increasing length and calibre reduction.
After receiving the results on noradrenaline levels (271pg/ml supine, 897pg/ml tilted) the hyperadrenergic subtype of Postural orthostatic Tachycardia Syndrome (PoTS) was diagnosed and a treatment with propranolol 40mg in the morning was initiated. The patient felt well on the very day treatment was initiated. She could from that point follow physiotherapy without problems and had only slight light headedness and no palpitation also walking longer distances.
Two days after treatment initiation Ewing battery was repeated and was unremarkable. On HUT heart rate increased from 71 to 99, during which the patient kept being asymptomatic. Sequence technique showed no baroreceptor sequences.
We felt the patient should stay hospitalised due to the progression of her bilateral dissection. However being rid of the orthostatic symptoms, the patient thought to be well enough to leave the hospital against medical advice.
The patient was followed up for 8 months. Ewing battery in the 3rd month was unremarkable. At the 7th month routine control Ewing battery showed asymptomatic orthostatic hypotension. Propranolol treatment was stopped. Without propranolol Ewing battery was repeated in month 8 with unremarkable results; there were no signs of PoTS.

Comments by the authors:

PoTS is a common autonomic disorder with heterogeneous pathogenesis. It is defined as presence of symptoms of orthostatic intolerance associated with a heart rate increase of 30 bpm (or rate that exceeds 120 bpm) that occurs within the first 10 minutes of standing upright tilt [2].
For baroreflex failure there are several causes reported: accidental trauma, carotid endarterectomy or other therapeutical procedures for pathology in relevant anatomic areas (carotid body tumor resection, radiation of laryngopharyngeal cancer [3]), brain stem stroke as well as rare genetic disorders (Leigh’s Syndrome, Groll-Hirschowitz Syndrome, hypertension-bradydactyly syndrome). Several clinical manifestations of baroreflex failure have been described, mainly hypertensive crisis, volatile hypertension, malignant vagotonia and also orthostatic tachycardia [4].
Immobilization and prolonged bed rest is associated with cardiovascular changes. Decreased vagal control of the heart and reduced heart rate variability occurs starting two weeks of prolonged bed rest. Decreased spontaneous baroreflex slope is reported in studies from 4 to 42 days duration. Heart rate is increased; noradrenaline levels either stay unchanged or are reduced during long time bed rest. Orthostatic intolerance is reported even after short time bed rest [5].
Our patient – subsequent to traumatic bilateral carotid dissection – presented symptoms and signs of PoTS of the hyperadrenergic type during autonomic testing. We take two important mechanisms into consideration being responsible for her clinical presentation.
The patient most probably suffered bed rest syndrome initially because the patient was immobilized for over 16 days after her accident and also had tachycardic episodes during this time [6,7]. However HRV was not reduced in her case, which one would expect in bed rest syndrome and catecholamine levels were elevated.
PoTS of partial dysautonomic form is reported to start after trauma or surgery [8], however we felt this was not the case in our patient. At the intensive care, blood pressure variability was a major problem [9]. During autonomic testing, baroreflex sequences were reduced compared to 7 months later. High noradrenaline values drew a typical picture of the hyperadrenergic subtype.
There are two possible pathomechanisms of decreased baroreflex sequences in this patient. She suffered bilateral dissection which included the bifurcation with possible bilateral denervation of her baroreceptors. This is supported by her initial intermitted blood pressure changes as well as orthostatic tachycardia which are both described for cases of baroreceptor injury [10]. Bed rest syndrome might as second pathomechanism be in part responsible for her reduced baroreflex.
Medical treatment with beta blocker (propranolol) – described to be beneficial for patients with hyperadrenergic POTS [11] – permanently solved the patient subjective problems such as lightheadedness and tachycardia. Further autonomic testing also could confirm clinical changes by showing no pathological findings.
We assume that our patient was suffering transient PoTS of hyperadrenergic type due to baroreceptor dysfunction in association with long time immobilisation. Nevertheless the patient responded quite well to beta blocker therapy, which a study described to have no beneficial effects on bed-rest syndrome [12].
The patient remained symptom-free for over half a year; asymptomatic orthostatic hypotension was observed during follow up autonomic testing. After discontinuation of propranolol the patient showed no symptoms or signs of autonomic dysfunction.

References:
[1] Parati, Journal of Hypertension 2000, 18:7-19
[2] Grubb et al J Cardiovasc Electrophysiol, Vol. 17, pp108-112 Jan 2006
[3] Timmers et al. Ann. N.Y. Acad. Sci. 1018:515-519 (2004)
[4] Ketsch et al. Circulation 2002;105:2518-2523
[5] Pavy-Le Traon et al. Eur J Appl Physiol (2007) 101:143–194
[6] Dittmer et al. Can Fam Physican 1993 ;39 :1428-1437
[7] Chobanian et al. Circulation 1974;49;551-559
[8] Grubb, Circulation 2008: 2814
[9] Ketsch et al. Circulation 2002;105:2518-2523
[10] Ketsch et al. Circulation 2002;105:2518-2523
[11] Thieben et al. Mayo Clin Proc. March 2007;82(3):308-313
[12] Haruna et al. J Gravit Physiol. Vol 4, Issue 1 ; Jan 1997, S.69-71

Dr. Walter Struhal is working at the Autonomic Unit and Neurological Intensive Care Unit of the Department of Neurology at the General Hospital in Linz, Austria.
Dr. Franz Gruber is working at the Neurological Intensive Care Unit of the Department of Neurology at the General Hospital in Linz, Austria.
Dr. Milan Vosko is working at the Neurological Intensive Care Unit of the Department of Neurology at the General Hospital in Linz, Austria.
Dr. Daniel Floery is working at the Institute of Radiology  at the General Hospital in Linz, Austria.
Dr. Franz Fellner is Professor of Radiology and Head of the Institute of Radiology  at the General Hospital in Linz, Austria.
Dr. Stephanie Hödl is working at the Autonomic Unit of the Department of Neurology at the General Hospital in Linz, Austria.
Dr. Klaus Böck is working at the Autonomic Unit of the Department of Neurology at the General Hospital in Linz, Austria.
Dr. Gerhard Ransmayr is Professor of Neurology and Head of the Department of Neurology at the General Hospital in Linz, Austria.

Comment by Roland D. Thijs

A presentation on PoTS at an autonomic congress often results in vivid discussions. At the one hand a somatic approach is favoured: various cardiovascular autonomic causes ranging from ganglionic acetylcholine receptor antibodies to norepinephrine-transporter deficiency are listed and medications are advocated.[1] At the other hand it is argued that medicalisation should be avoided since PoTS may have behavioural causes such as inactivity or bed rest.[2] From this viewpoint, exercise training is the favoured approach. As always, the truth lies in the middle. PoTS is heterogeneous in presentation and mechanisms. Major mechanisms are denervation, hypovolemia, deconditioning, and hyperadrenergic state. This case report by Struhal et al. underscores the complexity and the heterogenity of PoTS. The patient developed her complaints after prolonged bed-rest following a severe neurotrauma causing a bilateral carotid dissection. Autonomic investigations indicated that PoTS but the findings could not be explained by decondition alone. The autonomic responses to head-up tilt also pointed towards a concomitant cause: baroreflex dysfunction with the carotid dissection as the most plausible cause. A pathophysiologically based regimen of management including both mobilisation and beta blocker treatment was installed. The interventions proved successful: the patient became symptom-free and the medication could be withdrawn. This case report thus perfectly illustrates the different viewpoints on PoTS and favours a holistic approach in patients with orthostatic intolerance.

References:
1. Mathias CJ, Low PA, Iodice V, Owens AP, Kirbis M, Grahame R. Postural tachycardia syndrome–current experience and concepts. Nat Rev Neurol. 2011 6;8(1):22-34.
2. Joyner MJ. Standing up for exercise: should deconditioning be medicalized? J Physiol. 2012;590(Pt 15):3413-4.

Roland D. Thijs is Neurologist at the Stichting Epilepsie Instllingen Nederlan (S.E.I.N.) in Heemstede, The Netherlands

Case Report: Orthostatic intolerance after high impact trauma with bilateral carotid dissection was last modified: August 29th, 2012 by Editor
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