The Republic of Lithuania is a state in northern-eastern Europe occupying 65.300 km2 area with Vilnius city as capital and a population of 2.979.000 inhabitants. Neighbors of Lithuania are Latvia, Belarus, Poland, and Russia. It is a parliamentary democracy, with a president, a government and the Seimas (Parliament) as the head of state. People of the Republic of Lithuania announced independence on 16 February 1918, restored later on 11 March 1990. Lithuania is a NATO member, and a member of European Union since 2004. National currency is the euro. Most Lithuanians belong to the Roman Catholic Church, but there are also Eastern Orthodox, Evangelical Lutheran, Reformed Church, Judaism, Islam and other religions. Ethnic Lithuanians make up 84.2% of population, with 6.6% Poles, 5.8% Russians, 1.2% Belorussians, and 2.2% of people of other nationalities. Average life expectancy in Lithuania is 73.7 years (female 79.1, male 68.1 years).
If you really want to know Lithuania, you must first begin to get to know its people. Most Lithuanians are very sincere, hospitable and helpful, long-lived people. If you are tired of civilization, you will have an excellent opportunity for retreat from its pressures. You only need to go away from the big cities and travel where your heart and mind can rest – to seemingly endless forests, lakes, scattered all over Lithuania, rivers that cross the country or the unforgettably beautiful Curonian Spit bathed by the Baltic Sea. If, on the contrary, you are a truly urban person, you will find lots of things to do in Lithuania’s big cities. There are numerous museums that have accumulated huge collections, national and private art galleries, the never-ending buzz of theatre and music halls, fascinating nightlife, a variety of entertainment options and sports events. Not to mention the national dishes and drinks, which must be tasted, if you would like to come home with new experiences.
Origins of neurology in Lithuania
Old Vilnius University
The Vilnius University (https://www.vu.lt/en/) was founded in the 1579 by the Jesuits in the multinational and multi-confessional city of Vilnius, in the Catholic Grand Duchy of Lithuania. It was one of the oldest and most respected universities in Central and Eastern Europe, modeled after the Jesuit College in Rome, and had only two faculties: Philosophy and Theology. The Faculty of Medicine was founded in 1781, and special attention was paid to the promotion of natural sciences in accordance with the ideals of the Age of Enlightenment. Even after the abolition of the Polish-Lithuanian Commonwealth and the final annexation of the Grand Duchy of Lithuania by the Russian Empire in 1795, the Vilnius University maintained the same rapid pace of intellectual life, continuing to stimulate the formulation of new ideas in the natural sciences.
Little can be stated about teaching courses about the nervous system and its diseases or about how systems of medicine were taught in Vilnius before the 19th century. What is known is that Jakob Marquart (1583 – 1658), a doctor of theology, introduced the basics of human anatomy to philosophy students during the 17th century using Andreas Vesalius’ (1514 – 1564) De humani corporis fabrica. Also, after the foundation of the Faculty of Medicine in 1781, Stephanus Bisius (1724 – 1790), a physician of Italian descent, began to lecture on anatomy and physiology, including not only osteology, splanchnology, angiology, and myology, but also what would become neurology, this being between 1781 and 1787. Bisius, in fact, might have been the first physician in Vilnius to publish an original study on nervous and mental diseases. This work was titled Responsum Stephani Bisii Philosophiae et Medicinae Doctoris ad Amicum Philosophum De Melancholia, Mania et Plica Polonica sciscitantem [A Reply of the Doctor of Philosophy and Medicine Stephanus Bisius to the Question from the Philosophical Society About Melancholia, Mania and Plica Polonica]. Additionally, as revealed in the curriculum of 1783-1784, Professor of Surgery Jacques Briôtet (1746 – 1819) lectured on external head wounds, concussions, subdural and intracerebral extravasations, and trepanation. Professor of Anatomy Joannes Andreas Loebenwein (1758 – 1820) lectured on the theory of sensibilitas [sensibility], and an Irish Professor of Therapy, John O‘Connor (1760 – 1801), lectured through the academic year of 1800-01 on the inflammatory diseases, including inflammations of cerebral membranes.
By the early-19th century, Vilnius University was the largest in the Russian Empire, based on student numbers and university departments. It remained a center of scientific thought and political freedom until it was closed by Russian imperial authorities in 1832, following the suppression of a Polish and Lithuanian national uprising in 1831. It was during this era, which was marked by an increased interest in new biological theories and clinical medicine, that Dr. Joseph Frank (1771-1842), Professor of Special Therapy and Clinical Medicine, and Dr. Andrew Sniadecki (Jędrzej Śniadecki, Andrzej Śniadecki; 1768 – 1838), Professor of Natural Sciences, were engaged in lecturing at the University. For example, Gall‘s theory of organology with its primary method of cranioscopy became well known and was generally accepted in the beginning of the 19th century in Vilnius. Johannes Andreas Loebenwein, a Professor of Anatomy at Vilnius University, had a rich collection of skulls of suicide victims and dead criminals in his anatomical cabinet, and used them for teaching Gall’s cranioscopic doctrine to his students. Physician Stanisław Morawski (1802 – 1853), a graduate of the University, described his medical education in his memoirs in 1823, mentioning dozens of human skulls, white as ivory, with all the organs marked using the system of Gall.
What is even more important, Joseph Frank and his father, Professor Johann Peter Frank (1745 – 1821) founded the Vilnius Therapy Clinic in 1805, and the surgery Clinic was established three years later. Various nervous system diseases, including head traumas and brain “fungi,” were diagnosed and treated in the Vilnius Clinics. Dizziness, somnolence and stupor, stertorous breathing, headache and weakness of voluntary movements were evaluated, taking the side of hemiplegia as one of the most important signs. If the patient presented with serious head trauma which caused brain compression, but no external head injuries and signs of skull fractures were observed, then the side of limbs paralysis was evaluated and trepanation was performed contralaterally to paralysis, evacuating epidural or subdural hematomas. Even though the theory of cortical localization was very new and still controversial in the beginning of the 19th century in Europe, physicians from Vilnius Clinics used the doctrine for practical purposes, choosing the side of trepanation, when epidural or subdural hematomas were suspected.
Neurology in Kaunas
The Department of Nervous and Psychiatric Diseases was established in 1924 in University of Kaunas. In 1985 it was expanded to the Department of Nervous, Psychiatry Diseases and Neurosurgery. In 1991 the structure of all clinical Departments has been reorganized by unifying academic and clinical structures according to the separate specialties. The Department of Neurology now combines the academic staff of adult and pediatric neurology clinical units. Since 2006 the department has been headed by habil. prof. D. Rastenytė.
Neurology in Lithuania today
The Vilnius University Hospital Santaros Klinikos (VUHSK), established in Vilnius in 1974, is one of the major hospitals in Lithuania, encompassing the provision of medical care in almost all key areas (http://www.santa.lt/). The activities of the hospital include practical and scientific medicine, education of students and residents, continuing professional training of medical specialists, modern management based on modern information technology solutions is applied. In the VUHSK Centre of Neurology (head, prof. Gintaras Kaubrys) modern neurological diagnostic and treatment procedures are available, including electroencephalography and long term EEG video monitoring, polysomnography, electroneuromyography, evoked potential tests, extracranial and transcranial color duplex sonography, modern computerized investigations for cognitive impairment, CT, MRI, CTA and DSA, PET and SPECT, intravenous trombolysis and mechanical thrombectomy for acute stroke treatment, immunomodulating treatment for multiple sclerosis, plasma exchange, botulinum toxin injections for focal dystonias and muscle spasticity, vascular surgery and stenting. Intraoperative neurosurgical technologies are available in the operation theater: ultrasound, neuromonitoring, neuronavigation system, intraoperative blood flow visualization and measurement. In the in-patient and out-patient departments all neurological services and consultations are provided, diagnosing and treating adult cerebral and spinal vascular disorders, multiple sclerosis, epilepsy, sleep disorders, Parkinson’s disease and other movement disorders, Alzheimer’s disease and other dementias, inflammatory, degenerative, demyelinating, neuromuscular, peripheral nervous system diseases, headaches and back pain, vestibular, and other disorders of nervous system.
The Neurology Center is a practical training base of neurology for medical students of the Clinic of Neurosurgery and Neurosurgery (lead by prof. Dalius Jatužis) at the Vilnius University Medical Faculty. The Neurology Center takes part in a number of international projects, trials and registries: SITS-EAST (Safe Implementation of Treatments in Stroke – prospective international database of acute stroke patients treated with reperfusion treatment), EuroHYP-1 (European multicenter, randomized, phase III clinical trial of hypothermia for acute stroke). Along with the Vilnius Gediminas Technical University and the Vilnius University, the Neurology Center investigates the biomechanics of Parkinson’s disease and multiple sclerosis, impact of modified dance therapy on motor condition and quality of life in early Parkinson’s disease. Another research priority of the Center is cognitive neurology (National Science Program “Healthy Ageing”, research on synthesis regulation of proteins, associated with the development of Alzheimer’s disease in cooperation with the Vilnius University Institute of Biotechnology). In the field of epilepsy the Center participates in pan-European project E-pilepsy dedicated to improve awareness and accessibility of surgery for epilepsy across different countries, the Standardized Computer-based Organized Reporting of EEG (SCORE) project and International Multicenter European Register of Antileptic Drugs and Pregnancy (EURAP) (prof. Ruta Mameniskiene). Since 1996 the Neurology Center participates in international clinical trials of new drugs. More than 100 trials were conducted: trials of drugs, used in epilepsy, multiple sclerosis, Parkinson’s disease, migraine, and stroke were performed.
The Hospital of Lithuanian University of Health Sciences (LSMU) Kauno klinikos is the largest healthcare institution in Lithuania (http://www.kaunoklinikos.lt/kk/en-GB/). Established in 1940, the Hospital has grown into one of the most prominent hospitals in the country. It’s Neurology Department provides secondary and tertiary level health service for neurological and pediatric neurological patients from Lithuania and abroad. The yearly turnover is about 20,000 consultations for adult patients and 5,000 for pediatric patients. In-patient units are for adult neurology (68 beds) with yearly admission of about 2,400 patients and for pediatric neurology (28 beds) with yearly admission of about 1,400 patients. Two centers for rare disorders has been established in 2013: the Center of Phacomatosis and the Center of Pediatric Neuromuscular Diseases. Current research projects include application of transcranial ultrasound investigations for the diagnostics of neurodegenerative diseases, European registries of stroke, pain coping strategies following traffic accidents in Lithuania, research and development of innovative evidence based non-invasive brain diagnostic and monitoring solutions for neurological and TBI patients (Lithuanian – Swiss program), molecular mechanisms of pathogenesis of Alzheimer disease (MALPAMA), European register of tuberous sclerosis.
The first specialized national neurological scientific journal Neurologijos seminarai (Seminars in Neurology) (www.neuroseminarai.lt) was founded in 1997 (its first chief editor was former longtime president of Lithuanian association of neurologists prof. Valmantas Budrys (1958-2015), from 2015 – prof. Gintaras Kaubrys). Now it is an official journal of the Lithuanian Association of Neurology, the Lithuanian Association of Child Neurology and the Lithuanian Society of Neurosurgery. This journal is included in the international EBSCO and Index Copernicus databases.
Lithuanian association of neurologists (current president is prof. D. Jatužis) actively participates in the organization of educational activities, including very popular traditional Summer Schools of Neurology (since 2003), conferences and seminars. Specialists of the association also contribute to the recommendations, legal acts and laws that are being developed by the Ministry of Health.
Prepared by Dalius Jatuzis, President of the Lithuanian Association of Neurology
Find out more about our national neurological societies here.