eanpages
  • General interest
    • All Executive Page EAN News EAN Congress news Interviews
      Executive Page

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      EAN News

      EAN Contributes to Global Brain Health Agenda at UNGA78 with Leadership Presence

      September 28, 2023

      EAN News

      Earthquake in Morocco – EAN Statement

      September 11, 2023

      EAN News

      New EAN Coordinating Panel on Functional Neurological Disorders – Call for Applications

      September 7, 2023

      Executive Page

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      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: Management Group elections are coming – run for office and help shape our future!

      September 1, 2023

      Executive Page

      Executive Page: Thank you for making the EAN Congress 2023 a great success!

      July 24, 2023

      Executive Page

      Executive Page: Get ready for EAN 2023 in Budapest!

      June 1, 2023

      EAN News

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      EAN News

      EAN Contributes to Global Brain Health Agenda at UNGA78 with Leadership Presence

      September 28, 2023

      EAN News

      Earthquake in Morocco – EAN Statement

      September 11, 2023

      EAN News

      New EAN Coordinating Panel on Functional Neurological Disorders – Call for Applications

      September 7, 2023

      EAN Congress news

      African Academy of Neurology features in Special Studio Session at EAN 2023

      July 25, 2023

      EAN Congress news

      Find photos, facts, figures and reports in our EAN Congress Review

      July 24, 2023

      EAN Congress news

      Executive Page: Thank you for making the EAN Congress 2023 a great success!

      July 24, 2023

      EAN Congress news

      Special Session on Guidelines at the EAN Congress: Meet the new EAN Guidelines

      July 21, 2023

      Interviews

      Video Interview: Prof. Mary Reilly, Moritz Romberg lecturer at EAN 2023

      July 4, 2023

      Interviews

      Video Interview: Mark Hallett, C. Brown-Séquard lecturer at EAN 2023

      July 3, 2023

      Interviews

      Video Interview: Josep Dalmau, Camillo Golgi Lecturer at EAN 2023

      July 2, 2023

      Interviews

      Video Interview: Dementia & Cognitive Disorders Panel Co-Chairs

      September 8, 2022

  • Academic/Scientific
    • All Paper of the Month Neurology updates COVID-19 Eur J Neurol Scientific Corner
      Academic/Scientific

      Open Call: EMA seeks new data partners for DARWIN EU – deadline 31 October

      September 29, 2023

      EAN News

      New EAN Coordinating Panel on Functional Neurological Disorders – Call for Applications

      September 7, 2023

      EAN News

      European Journal of Neurology to be fully open access from January 1 2024

      September 7, 2023

      Paper of the Month

      Research Paper of the Month: Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA

      September 1, 2023

      Paper of the Month

      Research Paper of the Month: Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA

      September 1, 2023

      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 – September 2023

      September 1, 2023

      Paper of the Month

      Research Paper of the Month: Vorasidenib in IDH1- or IDH2-Mutant Low-Grade Glioma

      July 24, 2023

      Paper of the Month One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlight of the Month – July 2023

      July 24, 2023

      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

      COVID-19

      COVID-19 Research Round-Up: Literature reviews – April 2023

      April 26, 2023

      COVID-19

      COVID-19 Research Round-Up: Cross-Sectional Case Control Studies – April 2023

      April 26, 2023

      COVID-19

      COVID-19 Research Round-Up: Case Series/Case Reports – April 2023

      April 26, 2023

      COVID-19

      COVID-19 Research Round-Up: Literature reviews – March 2023

      March 16, 2023

      Eur J Neurol

      European Journal of Neurology to be fully open access from January 1 2024

      September 7, 2023

      Eur J Neurol

      Reasons to publish open access with European Journal of Neurology

      August 24, 2023

      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

      Scientific Corner

      New EAN Coordinating Panel on Functional Neurological Disorders – Call for Applications

      September 7, 2023

      Scientific Corner

      Special Session on Guidelines at the EAN Congress: Meet the new EAN Guidelines

      July 21, 2023

      Scientific Corner

      EAN Guideline Education and Cost-Conscious Healthcare (CoCoCare) kick-off workshop in Budapest 2023

      July 21, 2023

      Scientific Corner

      EAN Guidelines Workshop 2023: From questions to recommendations

      July 21, 2023

  • Educational
    • All eLearning Student Corner Resident and Research Fellows Fellowship reports Education corner
      Education corner Close up photo of a Black graduation cap and yellow tassel

      European Board Exam in Neurology – how to take it and how to help out

      September 20, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      eLearning

      World Brain Day with the European Academy of Neurology

      July 21, 2023

      eLearning

      New eanCampus content especially for EAN 2023

      June 30, 2023

      eLearning

      eanCampus: An Award-Winning e-Learning Experience

      June 28, 2023

      eLearning

      One year of the eanCampus – An Interview with the e-Learning Editorial Board

      June 27, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

      Student Corner Illustration of a vertical pencil point on a blue background, with a yellow light bulb above it

      Student Corner: My EAN Congress experience

      September 5, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Rotterdam, London, & Paris

      August 22, 2023

      Student Corner

      Student Teaser Fellowship winners 2023

      June 28, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      Resident and Research Fellows

      Application deadline approaching for 2024 EAN Clinical Fellowships

      September 7, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      Fellowship reports

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

      Education corner Close up photo of a Black graduation cap and yellow tassel

      European Board Exam in Neurology – how to take it and how to help out

      September 20, 2023

      Education corner

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Education corner

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Education corner

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

  • Other News
    • All EAN Staff EBC News in general Surveys
      EAN Staff

      EAN Head Office Profiles: Kathrin & Sasha

      August 28, 2023

      General interest

      WHO’s Intersectoral Global Action Plan on epilepsy and other neurological disorders (IGAP) published in all six UN languages

      August 3, 2023

      EAN Staff Anja Sander receiving flowers at the end of EAN Congress 2023

      Celebrating 20 Years of Excellence: Anja Sander, EAN’s Executive Director!

      August 3, 2023

      EAN News

      WHO recognises the public health need for effective and affordable treatments for multiple sclerosis

      August 3, 2023

      EAN Staff

      EAN Head Office Profiles: Kathrin & Sasha

      August 28, 2023

      EAN Staff Anja Sander receiving flowers at the end of EAN Congress 2023

      Celebrating 20 Years of Excellence: Anja Sander, EAN’s Executive Director!

      August 3, 2023

      EAN Staff

      EAN Head Office Profiles: Dauren & Benita

      June 5, 2023

      EAN Staff

      EAN Head Office Profiles: Kristián & Anna

      May 2, 2023

      EBC

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      EBC

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 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

      News in general

      WHO’s Intersectoral Global Action Plan on epilepsy and other neurological disorders (IGAP) published in all six UN languages

      August 3, 2023

      News in general

      WHO recognises the public health need for effective and affordable treatments for multiple sclerosis

      August 3, 2023

      News in general

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      News in general

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      Surveys

      Neurorehabilitation Across Europe after Ischemic and Traumatic Brain Injuries: a survey to increase knowledge on brain-injury-specific neurorehabilitation

      July 14, 2023

      Surveys

      ILAE survey on genetic testing in the epilepsies

      July 14, 2023

      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

  • EAN
  • Congress 2023
  • EANpages
  • EAN Campus
  • Eur J Neurol
  • Virtual Congress

eanpages

  • General interest
    • All Executive Page EAN News EAN Congress news Interviews
      Executive Page

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      EAN News

      EAN Contributes to Global Brain Health Agenda at UNGA78 with Leadership Presence

      September 28, 2023

      EAN News

      Earthquake in Morocco – EAN Statement

      September 11, 2023

      EAN News

      New EAN Coordinating Panel on Functional Neurological Disorders – Call for Applications

      September 7, 2023

      Executive Page

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      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: Management Group elections are coming – run for office and help shape our future!

      September 1, 2023

      Executive Page

      Executive Page: Thank you for making the EAN Congress 2023 a great success!

      July 24, 2023

      Executive Page

      Executive Page: Get ready for EAN 2023 in Budapest!

      June 1, 2023

      EAN News

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      EAN News

      EAN Contributes to Global Brain Health Agenda at UNGA78 with Leadership Presence

      September 28, 2023

      EAN News

      Earthquake in Morocco – EAN Statement

      September 11, 2023

      EAN News

      New EAN Coordinating Panel on Functional Neurological Disorders – Call for Applications

      September 7, 2023

      EAN Congress news

      African Academy of Neurology features in Special Studio Session at EAN 2023

      July 25, 2023

      EAN Congress news

      Find photos, facts, figures and reports in our EAN Congress Review

      July 24, 2023

      EAN Congress news

      Executive Page: Thank you for making the EAN Congress 2023 a great success!

      July 24, 2023

      EAN Congress news

      Special Session on Guidelines at the EAN Congress: Meet the new EAN Guidelines

      July 21, 2023

      Interviews

      Video Interview: Prof. Mary Reilly, Moritz Romberg lecturer at EAN 2023

      July 4, 2023

      Interviews

      Video Interview: Mark Hallett, C. Brown-Séquard lecturer at EAN 2023

      July 3, 2023

      Interviews

      Video Interview: Josep Dalmau, Camillo Golgi Lecturer at EAN 2023

      July 2, 2023

      Interviews

      Video Interview: Dementia & Cognitive Disorders Panel Co-Chairs

      September 8, 2022

  • Academic/Scientific
    • All Paper of the Month Neurology updates COVID-19 Eur J Neurol Scientific Corner
      Academic/Scientific

      Open Call: EMA seeks new data partners for DARWIN EU – deadline 31 October

      September 29, 2023

      EAN News

      New EAN Coordinating Panel on Functional Neurological Disorders – Call for Applications

      September 7, 2023

      EAN News

      European Journal of Neurology to be fully open access from January 1 2024

      September 7, 2023

      Paper of the Month

      Research Paper of the Month: Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA

      September 1, 2023

      Paper of the Month

      Research Paper of the Month: Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA

      September 1, 2023

      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 – September 2023

      September 1, 2023

      Paper of the Month

      Research Paper of the Month: Vorasidenib in IDH1- or IDH2-Mutant Low-Grade Glioma

      July 24, 2023

      Paper of the Month One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlight of the Month – July 2023

      July 24, 2023

      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

      COVID-19

      COVID-19 Research Round-Up: Literature reviews – April 2023

      April 26, 2023

      COVID-19

      COVID-19 Research Round-Up: Cross-Sectional Case Control Studies – April 2023

      April 26, 2023

      COVID-19

      COVID-19 Research Round-Up: Case Series/Case Reports – April 2023

      April 26, 2023

      COVID-19

      COVID-19 Research Round-Up: Literature reviews – March 2023

      March 16, 2023

      Eur J Neurol

      European Journal of Neurology to be fully open access from January 1 2024

      September 7, 2023

      Eur J Neurol

      Reasons to publish open access with European Journal of Neurology

      August 24, 2023

      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

      Scientific Corner

      New EAN Coordinating Panel on Functional Neurological Disorders – Call for Applications

      September 7, 2023

      Scientific Corner

      Special Session on Guidelines at the EAN Congress: Meet the new EAN Guidelines

      July 21, 2023

      Scientific Corner

      EAN Guideline Education and Cost-Conscious Healthcare (CoCoCare) kick-off workshop in Budapest 2023

      July 21, 2023

      Scientific Corner

      EAN Guidelines Workshop 2023: From questions to recommendations

      July 21, 2023

  • Educational
    • All eLearning Student Corner Resident and Research Fellows Fellowship reports Education corner
      Education corner Close up photo of a Black graduation cap and yellow tassel

      European Board Exam in Neurology – how to take it and how to help out

      September 20, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      eLearning

      World Brain Day with the European Academy of Neurology

      July 21, 2023

      eLearning

      New eanCampus content especially for EAN 2023

      June 30, 2023

      eLearning

      eanCampus: An Award-Winning e-Learning Experience

      June 28, 2023

      eLearning

      One year of the eanCampus – An Interview with the e-Learning Editorial Board

      June 27, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

      Student Corner Illustration of a vertical pencil point on a blue background, with a yellow light bulb above it

      Student Corner: My EAN Congress experience

      September 5, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Rotterdam, London, & Paris

      August 22, 2023

      Student Corner

      Student Teaser Fellowship winners 2023

      June 28, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      Resident and Research Fellows

      Application deadline approaching for 2024 EAN Clinical Fellowships

      September 7, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      Fellowship reports

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

      Education corner Close up photo of a Black graduation cap and yellow tassel

      European Board Exam in Neurology – how to take it and how to help out

      September 20, 2023

      Education corner

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Education corner

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Education corner

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

  • Other News
    • All EAN Staff EBC News in general Surveys
      EAN Staff

      EAN Head Office Profiles: Kathrin & Sasha

      August 28, 2023

      General interest

      WHO’s Intersectoral Global Action Plan on epilepsy and other neurological disorders (IGAP) published in all six UN languages

      August 3, 2023

      EAN Staff Anja Sander receiving flowers at the end of EAN Congress 2023

      Celebrating 20 Years of Excellence: Anja Sander, EAN’s Executive Director!

      August 3, 2023

      EAN News

      WHO recognises the public health need for effective and affordable treatments for multiple sclerosis

      August 3, 2023

      EAN Staff

      EAN Head Office Profiles: Kathrin & Sasha

      August 28, 2023

      EAN Staff Anja Sander receiving flowers at the end of EAN Congress 2023

      Celebrating 20 Years of Excellence: Anja Sander, EAN’s Executive Director!

      August 3, 2023

      EAN Staff

      EAN Head Office Profiles: Dauren & Benita

      June 5, 2023

      EAN Staff

      EAN Head Office Profiles: Kristián & Anna

      May 2, 2023

      EBC

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      EBC

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 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

      News in general

      WHO’s Intersectoral Global Action Plan on epilepsy and other neurological disorders (IGAP) published in all six UN languages

      August 3, 2023

      News in general

      WHO recognises the public health need for effective and affordable treatments for multiple sclerosis

      August 3, 2023

      News in general

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      News in general

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      Surveys

      Neurorehabilitation Across Europe after Ischemic and Traumatic Brain Injuries: a survey to increase knowledge on brain-injury-specific neurorehabilitation

      July 14, 2023

      Surveys

      ILAE survey on genetic testing in the epilepsies

      July 14, 2023

      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

EAN NewsEAN Congress news

EAN/EFIC Controversies in pain research: migraine with brainstem aura and neuropathic pain

June 21, 2021

by Martin Rakusa

Part 1: Does migraine with Brainstem Aura exist?

Migraine with brainstem aura (MBA) is a rare subtype of migraine with aura. Its pathophysiological mechanisms are still not understood, and proposed clinical criteria may not be specific enough to diagnose patients correctly. Some studies even suggest that aura does not originate from the brainstem but from the cortex. Diagnostic criteria and even the existence of the MBA is still a matter of debate.

Professor Jes Olsen opened the discussion with his lecture ‘Migraine with brain stem aura does exist’. In 1961 Bickerstaff introduced the term MBA. Today we know that a spasm of the basilary artery does not cause it. In order to prove that MBA does exist, professor Olsen and this team first reviewed the literature to identify convincing cases of MBA. They found 79 cases in the literature fully described as MBA, and 44 of them fulfil the ICDH-3 criteria. In addition, they modify the current criteria in accordance that the MBA is a rare disorder.

Then they searched for patients from the Danish Headache Centre database and found 4 MBA cases out of 293 patients (1.37 %). In the end, they interviewed an extensive sample of people with migraine with aura. In total, 16.3 % of patients had MBA. However, after a face-to face expert interview, this number dropped to only 2.2 % of patients.

In conclusion, the MBA is very rare among patients with migraine with aura (up to 2 %) and even rarer in the general population (approximately 0.04 %). However, it does exist, and more specific criteria are needed in the future.    

His opponent was professor Anne Ducros. In her presentation, ‘Migraine with brain stem aura does  not exist’, she agreed with professor Olsen that patients with brainstem symptoms aura exist. However, she and her colleagues disagreed that symptoms originate from the brainstem. Instead, they presented the hypothesis that symptoms originate from cortical spreading depression. Vertigo is the most common symptom in the MBA and affects up to 63 % of patients. However, vertigo was also described as the aura in patients with epilepsy. E.g. it can originate from the parietal cortex. Up to half of the patients with MBA have diplopia. Also, diplopia may occur due to a lesion in the brainstem, but it may also be a dysfunction of the primary or secondary visual cortex. Another common symptom is ataxia, which was also described in patients with insular stroke. 

Dysarthria is described in 5 % to 63 % of patients with MBA. It may also appear after direct stimulation of precentral and postcentral gyri, parietal operculum and insula. Auditory symptoms such as tinnitus and hypacusis were also described in patients with epilepsy. Cortical dysfunction may also alter consciousness, which affects up to 25 % of patients with MBA.

Taken together, patients with the brainstem aura are real. However, their symptoms may originate from the cortex. This is also in accordance with the cortical spreading hypothesis.

Although her arguments seem firm, professor Olsen pointed to a few weak points. Patients have several different aura symptoms, which are too widespread to be explained with the cortical spreading depression. Neuroimaging has shown a decrease in blood flow in the territory of the basilary artery. In a few cases, a vertebra-basilar infarction was described as a complication of the MBA.  Last but not least, studies on rats have demonstrated spreading depression in the brainstem.

During the discussion, a question was raised from the audience about how to distinguish MBA from the TIA. Professor Ducros explained that if someone works in the hospital and sees the patient after the first attack, it is not possible to distinguish MBA from the TIA. However, if the patient had two or more attacks and fulfils the diagnostic criteria, this may be possible. Professor Olsen pointed to the temporal component of symptoms. E.g. several different symptoms in the MBA come gradually, one after another, while the symptoms in the TIA come all at the same time. Professor Bronstein added that a single symptom could be a warning sign, e.g. insular stroke, especially if it repeats. Another warning could be that symptoms occur in older people without a history of headaches. After a lively discussion, all agree that further studies and more specific criteria are needed.

Part 2: Is it possible to diagnose NP with neurophysiological testing?

Pain is a subjective symptom and for many years doctors and researchers have tried to demonstrate it objectively. Classical neurophysiological tools such as nerve conduction studies and electromyography may not assess small neurons responsible for transmitting painful and thermal stimuli. However, there may be some neurophysiological tools with which we may objectively assess the neuropathic pain.

Professor Luis J. Garcia-Larrea presented arguments that it is possible to diagnose neuropathic pain with neurophysiological testing. To begin with, he reminded the audience of a different level of evidence of neuropathic pain published in 2016 in Pain.

Neuropathic pain may be possible, probable and definite. One of the criteria for definite neuropathic pain is to confirm a lesion with diagnostic tests. Among the different types of tests are clinical neurophysiological methods, which provide objective indicators for abnormal transmission in the somatosensory system. Garcia-Larrea also presented several cases where lesions seen on neuroimages affected the somatosensory system. However, patients did not have pain. In his lecture, he pointed out that quantitative sensory testing is not an objective method. In the next few minutes, he presented different techniques to assess small fibre neuropathy or lesions in the dorsal columns,  spinothalamic tract or sensory cortex. One of the techniques is laser evoked potentials, which may detect a lesion in the somatosensory system despite normal neuroimages. Hyperalgesia and allodynia may be assessed with autonomic testing, e.g. pupillary reaction, heart rate or sympathetic skin response.

On the other hand, a normal result on neurophysiological tests may indicate that the patient is not suffering from neuropathic pain, even in the presence of the morphologic changes. This does not mean that the patient does not have pain, but the type of pain is not neuropathic. A primary limitation of the neurophysiological test in 2004 was the lack of diagnostic centres. However, since then, this has changed, and there are no more reasons not to use the neurophysiological approach more often, concluded professor Garcia-Larrea.

As his opponent, professor Jean-Pascal Lefaucheur presented contra arguments to diagnose neuropathic pain with neurophysiological testing. He also briefly touched on the diagnostic diagram and then presented several studies and case reports, where on the one hand, patients had visible lesions on the neuroimages and normal neurophysiological tests. On the other hand, they may be without pain and have positive results on neurophysiological testing. In addition, the density of intradermal small fibres correlates with the severity of neuropathy and not with the severity of neuropathic pain. Pathological results of laser evoked potentials may demonstrate impairment of the small fibres or spinothalamic tract, but they do not necessarily demonstrate neuropathic pain.

Moreover, altered results correlate only with the loss of function. Lesions to the small fibres produce thermoanalgesic loss, but this doesn’t correlate with pain. Neuropathic pain is a consequence of the hyperactivity of the remaining nerve fibres. In the end, he briefly touched on genetic testing and gain of function. Similar to previous tests, he concluded that they might demonstrate the lesion of the thermal or nociceptive pathways, but they do not demonstrate pain.

The first question during the discussion was a logical consequence of professor Lefaucheur’s lecture: “Should we change the diagnostic diagram for neuropathic pain if we may not diagnose it with clinical neurophysiological tests?” Professor Lefaucheur quickly answered”yes!” Immediately, professor Garcia-Larrea disagreed and explained that the current diagram results from ten years of work. We should also understand that neurophysiological tests should be used in patients who already have pain. Patients with pathological findings and without pain should not be considered. Professor Lefaucheur replied that there are also patients who have pain but negative results. At this point professor, Garcia-Larrea replied that those patients are extremely rare.

Another comment from the audience was that every test has its sensitivity and their role in diagnosing neuropathic pain is a supportive one. Some members of the audience were convinced that neurophysiological results might not demonstrate neuropathic pain in a single patient. At the same time they believe that neurophysiology is a powerful method for group comparisons. A colleague also noted some skin biopsy markers, e.g. GAP43 or peptidergic fibres, which may have a close association with pain in diabetic neuropathy. A helpful technique for the evaluation of sensory neuron excitability is threshold tracking. This could be relevant to attribute a personal risk for neuropathic pain.

As usual, there was not enough time to hear all the arguments for and against. We may hope that we will learn more on neuropathic pain in the future and provide more help to our patients. 

EAN/EFIC Controversies in pain research: migraine with brainstem aura and neuropathic pain was last modified: June 21st, 2021 by Simon Lee
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