by the EMEA Chapter of the International Federation of Clinical Neurophysiology
The EMEA Chapter of the International Federation of Clinical Neurophysiology represents European, Middle Eastern and African specialists in clinical neurophysiology. The chapter organises a congress every two years in Europe, as well as advanced training courses. It also promotes and supports pre- and postgraduate education in clinical neurophysiology with scholarships and with a mentoring programme, and encourages scientific research.
To strengthen the collaboration between the EAN and EMEAC-IFCN, a Memorandum of Understanding (MoU) was signed in 2017. As part of the collaboration, joint scientific activities are organised during EAN congresses. In 2024, in Helsinki, an interesting clinical neurophysiology programme has been planned with several activities.
We will start on Saturday, 29 June, 08:30 – 10:00, in a HoC Room, with a Hands-on Course titled Neurophysiological tests for the assessment of movement disorders. In this Hands-on Course, the speakers will do a live demonstration of neurophysiological techniques useful for the differential diagnosis among parkinsonism, the distinction between tremor and myoclonus, the accelerometric determination of tremor frequency, the characterisation of dystonic features, the assessment of corticospinal and cortical excitability, and the recognition of functional movement disorders. Attendees will be able to practice the demonstrated techniques together with the speakers.
The second Hands-on Course, on Saturday, 29 June, 10:30 – 12:30: will include a short introductory theoretical part with three lectures on the basic principles of nerve conduction studies, with many clinical tips. The Hands-on Course will take place in three stations with the following training objectives: 1) nerve conduction studies of the hand (i.e. median entrapment and ulnar entrapment neuropathy); 2) nerve conduction studies of the forearm and upper limb; and 3) nerve conduction studies of the leg.
In the afternoon, Saturday, 29 June, 15:30 – 17:00, the physiological principles of the proper indications of botulinum toxin and the injection site and dose will be introduced. On the second day, Sunday, 30 June 09:30 – 10:30, the use of EMG and jitter analysis to differentiate weakness due to neurogenic disorders, myopathy and neuromuscular transmission disorders will be presented during a Hands-on Course.
https://ean-apps.m-anage.com/ean2024/en-GB/pag/session/90803In parallel, on Sunday, 30 Jun, 09:00 – 10:30, we offer a Focused Workshop in Room Helsinki, with the title Clinical neurophysiology: New developments in diagnostics and non-invasive therapy. Non-invasive brain stimulation techniques (NIBS) and other electrophysiological clinical methods offer useful insights into the functional integrity of the nervous system, mainly into the cortical and intracortical circuits. Recent developments in diagnostic techniques, such as multimodal evoked potentials, optical coherence tomography, and the combination of them with transcranial stimulation methods in the visual system have allowed for new understanding and diagnostic insight. Other more established techniques have developed too, such that evoked potentials can differentiate in vivo between demyelinating disorders, conduction block or axonal loss. There is also increasing evidence that threshold-tracking TMS is more sensitive, particularly in early diagnosis of amyotrophic lateral sclerosis. Beyond pharmacotherapy and behavioural/physical therapy, clinical neurophysiological techniques have moved into therapeutics. TMS techniques have established clinical utility in several neurological disorders, i.e. neurodegenerative and movement disorders, and chronic pain. Paired-pulse TMS paradigms may be performed either with conventional amplitude-based or threshold-tracking measurements. These developments will be addressed during the first part of the Focused Workshop. During the second part, low-intensity transcranial electrical brain stimulation (tES, either direct or alternating currents tDCS and tACS) as a promising treatment modality will be introduced, with the challenges and limitations arising from the method.
On the third day, Monday, 1 July, 08:30 – 10:00; during a Hands-on Course with the title Diagnostic and therapeutic transcranial magnetic stimulation and transcranial direct electrical stimulation, participants can learn the physiological principles of the non-invasive brain stimulation techniques, such as assessing central and peripheral motor conduction time from motor evoked potentials, determination of motor threshold, localisation of the optimal stimulation site and choosing stimulation parameters according to clinical indication.
On the last day, Tuesday, 2 July, 08:00 – 10:00, in Room Seville, a Hands-on Course will be given, with the title The role of EEG to guide diagnosis and treatment in different clinical scenarios. This Hands-on Course is free of charge and available on first-come-first-served basis on the day of the event. Organised in collaboration with the EAN Scientific Panel on Clinical Neurophysiology and the EMEA chapter of the IFCN, this HoC presents three scenarios where EEG is either crucial or highly valuable for plotting an optimal treatment strategy. Together, we will discuss three different clinical scenarios of varying complexity in which the general neurologist must try to identify a diagnosis, evaluate possible therapies, and formulate a prognosis: I) the framing of the patient after a first seizure; II) the diagnosis of a non-convulsive status epilepticus in a patient with altered mental status; and III) the role of interictal/ictal EEG abnormalities in the patients with dementia. This course is a pilot event for using an interactive web platform for EEG evaluation. Course participants will have access to the EEG from the patient cases for a limited time both before and after the course. This will allow participants not only to prepare for the cases beforehand, but also to return to them afterwards and see if their impression of the EEG has changed. Therefore, it is recommended that participants bring their own personal laptops, so they can also access the application during the course (https://epicurrents.io).
Overall, these joint EAN/EMEAC-IFCN initiatives covering different aspects of clinical neurophysiology will introduce you to the attractiveness of the field and improve your knowledge!
