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: Incoercible hiccups and vomiting as the main presenting symptom in a 14-year-old girl with NMO

December 1, 2012

by Sara Machado et al.

Introduction: Neuromyelitis optica (NMO) affects preferentially the optic nerve and spinal cord; and its serum marker, the antibody against AQP4, has improved the diagnosis. AQP4 is heavily expressed in area postrema, which explains clinical presentations such as incoercible vomiting. Nonetheless, it is also expressed in other organs such as kidneys and stomach and the reason why they are spared is not understood. With this clinical report we intend to highlight the potential pitfalls in the diagnosis of NMO, namely with atypical presentations such as vomiting.

Clinical Report: A previously healthy 14-year-old child presented to the A&E due to a subacute onset of vomiting and hiccups. A couple of days later she experienced weakness in the lower limbs with further progression to the upper limbs and urinary retention. On examination, the cranial nerves were spared (without RAPD), there was no Lhermitte’s sign; but a tetraparesis with a pyramidal pattern was found. Also, there was a sensory thoracic level, hyperreflexia and bilateral Babinski’s sign. The aetiological investigation disclosed: CSF with pleocytosis (240/uL) with predominance of polymorphonucleated cells, hyperproteinorraquia (113mg/dl) and oligoclonal bands in a mirror pattern. All the other CSF evaluations were unremarkable, including cultures and immune tests. All other CSF evaluations were unremarkable, including cultures and immune tests. Extensive lesion from the area postrema up to the conus medullaris, with preferential involvement of the grey matter (figures 1 and 2), positive anti-AQP4-IgG antibodies and also both haematuria and proteinuria was found. Methylprednisolone was promptly started but due to clinical deterioration, with necessity of invasive ventilation, cycles of IVIg, Plasma Exchange, cyclophosphamide, and rituximab were initiated. After approximately 6 months at the ICU, in spite of the aggressive treatment strategy, she deteriorated with bilateral optic neuritis, tetraplegia and finally fatal dysautonomia.

Comments from the authors:

NMO is a severe, demyelinating auto-immune disease of the central nervous system (CNS), with the sine qua non defining features of transverse myelitis and optic neuritis (1). Its distinct serum marker has been identified and it is an IgG auto-antibody against AQP4. NMO is usually described as a benign entity with a monophasic course but recent reports attest its relapsing and severe character, even in paediatric patients(2). The exact prevalence in children is not unknown.
The area postrema is an important target in this disease (3,4) leading to peculiar clinical presentations such as incoercible vomiting, which is an increasingly recognized symptom, often preceding optic neuritis and transverse myelitis(5).
There are findings supporting the diagnosis: Lesions involving more than three contiguous vertebral segments and CSF profile through pleocytosis with predominance of polymorphonuclear cells are very suggestive. One should take into account that seropositivity for other antibodies is a frequent finding and 50% of NMO patients are ANA+.(6) Hence, the presence of other antibodies must not exclude this diagnosis.
In conclusion, early diagnosis of this disease is critical as its acute episodes are usually devastating and may have a poor prognosis.(7) The NMO-IgG is a precious tool in the diagnosis of NMO and we believe that such antibody should be promptly requested in cases with spinal medulla lesions greater than three vertebral segments, even with unusual presentations. An early diagnosis may result in reduction of both morbidity and mortality.

References
1) Wingerchuck DM, Lennon VA, Lucchinettim CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica. Lancet Neurol 2007;6:805-815.
2) Huppke P, Blüthner M, Bauer O, et al. Neuromyelitis optica and NMO-IgG in European pediatric patients. Neurology 2010;75:1740.
3) Pittock SJ, Weinshenker BG, Lucchinetti CF, Wingerchuk DM, Corboy JR, Lennon VA. Neuromyelitis optica brain lesions localized at sites of high aquaporin 4 expression. Arch Neurol 2006;63:964 –968.
4) Rash JE, Davidson KG, Yasumura T, Furman CS. Freeze-fracture and immunogold analysis of aquaporin-4 (AQP4) square arrays, with models of AQP4 lattice assembly. Neuroscience 2004;129:915-34.
5) Popescu BFG, Lennon VA, Parisi JE, et al. Neuromyelitis optica unique area postrema lesions : Nausea, vomiting, and pathogenic implications. Neurology 2011;76;1229.
6) Pittock SJ, Lennon VA, Wingerchuck DM, Homburger HA, Lucchinetti CF, Weinshenker BG. The prevalence of non-organ specific autoantibodies and NMO-IgG in neuromyelitis optica (NMO) and related disorders. Neurology 2006; 66:A307.
7) Ghezzi A, Bergamashi R, Martinelli V, et al. Italian Devic’s Study Group (IDESG). Clinical characteristics, course and prognosis of relapsing Devic’s Neuromyelitis Optica. J Neurol 2004;251:47-52.

Sara Machado is working at the Department of Neurology, Hospital Professor Doutor Fernando Fonseca, EPE. Amadora, Portugal. Her co-authors are JP Vieira, R. Silva, P. Sousa and E. Calado from the Department of Paediatric Neurology, Hospital Pediátrico Dona Estefânia, Lisboa, Portugal; C. Conceição from the Department of Neuroradiology, Hospital Pediátrico Dona Estefânia. Lisboa, Portugal; M. Ramos from the Department of Paediatric Rheumatology, Hospital Pediátrico Dona Estefânia. Lisboa, Portugal; G. Queiroz and L. Ventura from the Paediatric Intensive Care Unit, Hospital Pediátrico Dona Estefânia. Lisboa, Portugal.

Comment by Kevin Rostasy

This is an unusual case of NMO with serum AQP4 IgG antibodies in a child because of the severe clinical presentation combined with a fatal outcome despite extensive medical treatment including immunosuppression with various drugs and intensive care monitoring. Usually the clinical presentation in the initial phase of the disease is characterized by episodes of unilateral or bilateral optic neuritis followed by transverse myelitis or vice versa. Presentation with hiccups and vomiting has been reported in adults but only rarely in children. Children often recover completely with adequate treatment such as intravenous methylprednisolone initially but require immune-modulation with drugs such as azathioprine or rituximab to prevent further attacks.
It appears that in particular children with NMO and serum AQP4 IgG antibodies have a more severe disease course and should be treated promptly with the above mentioned drugs.
Children with NMO and absent serum anti-AQP4 IgG antibodies seem to have a more benign course. In these children I recommend to repeat antibody testing of serum anti-AQP4 IgG antibodies in addition to serum anti-MOG IgG antibodies, both ideally with cell-based assays. Three studies (Mader et al., 2011; Kitley et al., 2012; Rostasy et al., in press) recently showed that in a subgroup of adults and children with definite NMO and absent AQP4 antibodies high titre of anti-MOG IgG antibodies can be found in serum.
Interestingly the clinical course of these patients is milder and treatment response to IVIG at monthly intervals is good (personal experience).
The child was treated with high dose steroids and IVIG in the acute phase but failed to respond clinically. Few reports are on record which describes adult patients with a severe manifestation of NMO who were treated successfully with cycles of plasmapheresis which might have been an option in this fulminant case of NMO.

Dr. Kevin Rostásy is Head of the Division of Neuropediatrics at the Children’s Hospital in Innsbruck, Austria. His special interest is paediatric neuroimmunology.

Case Report: Incoercible hiccups and vomiting as the main presenting symptom in a 14-year-old girl with NMO was last modified: November 26th, 2012 by Editor
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