BRAIN CHALLENGE 2021: Less is more!

by Juliette Dufour

This is the return of the Brain Challenge after one year missing because of the COVID-19 pandemic! Hosted once again by Professor Marie Vidailhet, this year the level was really high.

Two teams faced each other with great courage: a local Team (4 doctors) and an international team (5 doctors). Of course, the audience also had their role and participated online by submitting their own answers for each question.

The local team from Austria: Julia Ferrari, Matthias Mauritz, Tobias Moser and Alice Reining-Festa

The international team with doctors who are currently in Austria: Andrei Apetroae, Vanessa Carvalho, Isabella Colonna, Anush Karamyan, Fabio Rossini

The session was divided in two rounds (round 1 – ‘Warm up’ and round 2 – ‘Battle of brains’) with 8 questions each and 4 categories in total: ‘Youngster’, ‘Be Precise’, ‘The unexpected’ and ‘Wrong bodies’.

The beginning was difficult for both teams, with a trick question of anatomy regarding the clinical aspects of nucleus abducens damage, no one marked points. But the international team took the lead quickly and brilliantly by finding the diagnosis of an extremely rare disease named Vogt-Kayanagi-Harada (association of ophthalmologic lesions with inflammation uveitis and sedative nodules, skin discoloration and hearing problems). The questions kept coming and the battle was closed with difficult cases: pilomoteur seizure with anti-amphiphysin antibodies revealed by goosebumps; sporadic fatal insomnia that started with parkinsonism; cerebral veinous thrombosis complicated with subarachnoid haemorrhage; date of invention of hammer reflex; and finally a PERM syndrome with anti-glycine antibodies revealed by stiff man person syndrome, myoclonus and hallucinations.

At the end of round 1, the international team was ahead with 700 points to 600 points for the local team.

But during the 2nd round a fierce battle took place and allowed the local team to achieve a spectacular comeback. For this round, the rules were changed: multiple choices were no longer proposed, the team that pressed the buzzer first got 20 seconds to give the diagnosis. This second half of the challenge was also extremely rich: first a case with temporal glioma but also HSV positive in CSF; a posterior cord syndrome due to consumption of laughing gas; a CLIPPERS syndrome with brainstem contrast enhancement; an atrophy of cerebellum due to Phenytoin; a case with IgLoN5 encephalitis revealed by sleep disorders; a severe case of tuberculosis meningoencephalitis in a child; a typical neurocysticercose with calcifications of the brain; and and ultimately a CSF hypotension.

Finally, the local team won with 2700 points to 2100 points for the international team.

Prof Vidailhet closed this session with a French quote from Coco Chanel: “Less is more”, referring to the fact that the team with the fewest members won.

Thanks to all the scientific panels for providing content and beautiful cases that illustrated once again how neurology can be diverse and special.

We are looking forward to the Brain challenge next year and hoping for the possibility of a face-to-face contest this time.

We also would like to thank all those who submitted cases for the EAN BrainChallenge 2021.

(in alphabetical order)

Efthalia Angelopoulou, Scientific Panel on Neuro-epidemiology

Peter Berlit, Scientific Panel on Neuropathies

Giulia Berzero, Scientific Panel on Neuro-oncology

Marina Boziki, Coordinating Panel on Rare neurological diseases

Nese Celebisoy, Scientific Panel on Neuro-ophthalmology

Yildiz Degirmenci, Scientific Panel Dementia and Cognitive Disorders, Movement disorders

Massimo Filippi, Scientific Panel on MS

Rita Formisano, Scientific Panel on Coma and chronic disorders of consciousness

Svetlana Hadjiu, Scientific Panel on Child Neurology

Anna Heidbreder, Scientific Panel on Sleep wake disorders

Sonja Hochmeister, Scientific Panel on Neuro-immunology

Eleonora Matteo, Scientific Panel on Stroke

Lisbeth Marner and Anne-Mette Hejl, Scientific Panel on Neuroimaging

Cristina Moglia + Andrea Calvo, Scientific Panel on ALS

Alessandra Morano, Scientific Panel on Epilepsy

Gyula Panczel, Zita Biro    

Viktoria Papp, RRFS, BrainChallenge Task force

Michael Strupp, Scientific Panel on Neuro-ophthalmology

Svetlana Tomic, Scientific Panel on Dementia

Andrea Truini, Scientific Panel on Pain

And the EAN BrainChallenge Task Force: