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

      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 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 News

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

      March 13, 2023

      EAN News

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

      March 3, 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
      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

      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

      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

      Education corner

      Research Fellowship Report 2021 – Neurogenetics Laboratory at UCL, UK

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

      EAN Head Office Profiles: Abigail & Bernadette

      March 15, 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
      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

      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 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 News

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

      March 13, 2023

      EAN News

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

      March 3, 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

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Case Report: Reversible unresponsiveness and complex movement disorder in an 84-year-old lady with cerebral amyloid and hypertensive angiopathy

January 1, 2013

presented by Ricardo Ginestal et al.

An 84-year-old woman, with chronic renal insufficiency due to hypertension and a restrictive and obstructive chronic respiratory condition was admitted to our internal medicine ward with pneumonia and hypoxia. Before admission, her general practitioner (GP) treated her with levofloxacin 500mg bid for 10 days because of dyspnoea, cough and fever. She did not improve and her GP switched to Amoxicilin/Clavulanic Acid 500/125 tid. After 3 days with this treatment scheme she was admitted to our hospital with hypoxia (PaO2 58mmHg, O2 saturation 81%). A full dose regimen of intravenous Cefepime was chosen at admission to treat the pneumonia. Oxygen therapy was also administered.
On day two after admission, she started to be progressively unresponsive. On day 3, left upper limb coreic and ballistic movements, together with lower limb ballistic movements and generalized myoclonias appeared (Video EFNS Grand Rounds 01 2013). The CT scan (Figure 1) showed an extensive chronic microangiopathic angiopathy. The CSF exam did not disclose any sign of infection or haemorrhage. The EEG (Figure 2) demonstrated diffuse 2-3Hz triphasic acute waves. This finding was consistent with a diffuse encephalopathy but non-specific regarding the cause of the symptoms. No signs of epileptic activity were disclosed. The abnormal movements presented by the patient did not alter the EEG record. Due to the predominance of the myoclonias above all other abnormal movements and taking into consideration the renal insufficiency, we started treatment with intravenous valproic acid. We added enteral tiapride in order to control all movement disorders. We also recommended adjusting the antibiotic dose regimen to the glomerular filtration rate. On the 4th day after admission, an MRI scan was performed (Figures 3-7) showing an extensive and severe microangiopathic angiopathy. Several haemosiderin deposits related with old microbleedings were seen both in supratentorial and infratentorial locations. There were no signs of acute haemorrhage or ischaemia. After 4 days with the new antibiotic scheme and under valproic acid and tiapride, the patient started to improve. First, all abnormal movements disappeared. Then, the level of consciousness progressively returned to normal. She was discharged 27 days after admission with no signs of neurological impairment.

Laboratory results:
– At admission: serum Creatinine level was 2.0mg/dl (0.7-1.2) and the glomerular filtration rate of 25ml/min/1.73m2. PaO2 58mmHg, O2 saturation 81%.
– Four days after the introduction of the full dose regimen of Cefepime, serum Creatinine level was 2.5mg/dl (0.7-1.2), glomerular filtration rate of 19ml/min/1.73m2. PaO2 89mmHg, O2 saturation 96% (blood gas levels were normal since day two after admission).
– At discharge, serum Creatinine level was 1.5mg/dl (0.7-1.2) with a glomerular filtration rate of 35ml/min/1.73m2.

Comments by the authors:

Cerebral amyloid angiopathy (CAA), also known as congophilic angiopathy, is increasingly recognized as a cause of lobar intracerebral haemorrhage among individuals over the age of 50. The diagnosis is suspected when the haemorrhage is “lobar” and not in the typical distribution of hypertensive haemorrhages. The Boston Criteria for Diagnosis of Cerebral Amyloid Angiopathy-related haemorrhages classifies as “probable CAA” the event that presents with clinical data of a lobar haemorrhage and a Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) study demonstrating multiple haemorrhages restricted to lobar, cortical, or subcortical regions (cerebellar haemorrhage allowed) in individuals age ≥55 years old. Nevertheless, small haemorrhages can be seen on CT and MRI scans even in the absence of clinical symptoms.
Our patient, as shown in the CT and MRI figures, had both lobar and basal ganglia/ brainstem chronic haemorrhages. Taking into account her age and the clinical history of long-term hypertension, we could consider that she had imaging data fulfilling both cerebral amyloid and hypertensive angiopathy criteria.
The patient we present was admitted to our hospital with hypoxia (PaO2 58mmHg, O2 saturation 81%) and a glomerular filtration value of 25ml/min/1.73m2 (normal >60). A full dose regimen with intravenous cefepime was started. Oxygen therapy rapidly normalized blood gas levels but the renal function deteriorated until an adjustment of the antibiotic scheme to renal function was performed. The chronic vascular damage due to cerebral amyloid and hypertensive angiopathies remained unchanged during all admission time. No signs of acute haemorrhages or recent ischaemic strokes were detected by the imaging procedures. The CSF exam did not disclose signs of infection or bleeding inside the CNS. Therefore, other pathophysiological mechanisms, besides the chronic cerebrovascular disease, had to intervene in order to produce the drowsiness and abnormal movements beginning on day 2 after admission. We hypothesize that the responsible factors probably were a combination of fever and hypoxia due to the pneumonia on one hand and the non-corrected dose of cefepime to the glomerular filtration rate on the other.
Adjusting the cefepime regimen to the renal insufficiency led us to control the pneumonia not deteriorating the renal function.
Oxygen therapy normalized blood gas levels.
Intravenous valproic acid was used due to the predominant myoclonic movements. We preferred it to oral clonazepam because of the low level of consciousness.
Enteral tiapride was administered because there are reports of its utility in controlling movement disorders in cases of elderly patients with hypoxia. The benzamide derivative tiapride has a highly selective antagonistic effect on striatal adenylate cyclase-independent dopamine-2 receptors and the in vitro binding affinity is especially high for dopamine receptors which have been sensitized by pre-incubation with dopamine. The involvement of altered dopamine receptor sensitivity in several extrapyramidal dys- and hyperkinesia has been hypothesized. Clinical studies demonstrate its excellent efficacy in psychomotor agitation in geriatric patients and choreatic movement disorders. Tiapride is well tolerated in daily doses between 300 and 1200 mg. Adverse events are generally rare and mild.

A similar case was previously described by Mitsuoka and cols: A 75-year-old man with bilateral ballistic movements; He had suffered from pulmonary emphysema for about 35 years and was treated with oxygen therapy 3 years before. When he was 70 years old, involuntary movements appeared in bilateral limbs. His involuntary movements were ballistic, and gradually became worse. T2-weighted MRI after admission demonstrated high signal intensities in the bilateral pallidum, indicating multiple brain infarcts in the subcortical white matter. Laboratory studies revealed hypoxia. Medication with clonazepam and tiapride together with oxygen therapy normalized blood gas levels and improved his involuntary movements. But after discharge, he stopped oxygen therapy and involuntary movement became worse again, associated with hypoxia demonstrated by his blood gas analysis. These findings suggested that not only cerebrovascular disease but hypoxia might play an important role in the appearance and exacerbation of involuntary movements.
In this case Mitsuoka and cols, hypoxia appears to be the cause of the involuntary movements together with the chronic cerebrovascular disease in a 75-year-old man.

In our case, an 84-year-old woman with radiological signs of both chronic cerebral amyloid and hypertensive angiopathy, normalizing blood gas levels was not enough to control movement disorders. The worsening of the chronic renal insufficiency by the full dose regimen of cefepime seems to play a pathophysiological role in this clinical picture.

In conclusion, in the elderly patient who presents chronic cerebrovascular disease affecting basal ganglia and/or subcortical white matter, acute systemic disturbances such as hypoxia or renal insufficiency can initiate complex movement disorders. As the treatment with valproic acid, tiapride or other drugs is only symptomatic, metabolic and respiratory causes have to be detected and treated as soon as possible. If so, the prognosis seems to be excellent.

References:
Dose M, Lange HW. The benzamide tiapride: treatment of extrapyramidal motor and other clinical syndromes. Pharmacopsychiatry. 2000 Jan;33(1):19-27.
Mitsuoka T, Murata Y, Harada T, Ishizaki F, Nakamura S. An aged case of bilateral ballistic movement which was thought to be exacerbated by respiratory insufficiency. Nihon Ronen Igakkai Zasshi. 2000 Oct;37(10):823-7.

Ricardo C. Ginestal and his co-authors A. Herranz, P. Garcia-Ruiz, J. del Val, S. Bellido, M.A. Aranda, I. Navas, M.C. Alarcon-Morcillo, B. Gonzalez-Giraldez are working at the Neurology Department at Fundacion Jiménez Diaz Hospital in Madrid, Spain.

Case Report: Reversible unresponsiveness and complex movement disorder in an 84-year-old lady with cerebral amyloid and hypertensive angiopathy was last modified: December 18th, 2012 by Editor
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