Executive Page

The year 2016 is beginning in many places with wonderful progress for neurology. But we should not forget that many of our colleges are working under the hardest imaginable conditions. The war in the middle east taking currently place in Syria, Iraq and neighboring regions is the most brutal and unhuman war which this region has ever suffered. I am writing about Syria but the situation is similar in the neighboring countries. The United Nations estimated at the beginning of 2015 that 220,000 people had been killed in Syria, but other monitoring groups put the death toll much higher. The people living in this region are constantly exposed to violence from all sides, the educational system suffers vita minima and regular jobs are a fiction for most people. Besides all direct military actions people suffer from unexpected explosions or killings for no reasons when walking on the road. Children and women are subject to violence through many and mostly unthinkable ways. Particularly young men fear of getting arrested at military barriers for recruitment and getting killed after a few days in front lines. There is a strong movement to Turkey or Lebanon and meanwhile to Europe. While Syria had 22 Million inhabitants in 2011 before the war currently almost 10 Mio of them are refugees abroad or have moved from the rural areas to the safer cities. The economic situation is also catastrophic as the inflation is grossly affecting all parts of the Society. While 1 US $ equaled 60 Syrian pounds (SP) in the past it equals now 250SP. Black market economy is increasing the suffering in particular of the poorer population. Physicians working in government services earned 400-600$ in the past but are now just between 50-75$ due to inflation and therefore also their families suffer.

The European Academy of Neurology was founded just 18 months ago and is becoming increasingly accepted as a hub for scientific knowledge and premier education (please see the EAN movie). This is reflected in the number of neurologists and trainees who join the EAN as members. To remind you: EAN has close to 25 000 associated members from 47 national European Member Societies, but accepts neurologists wanting to upgrade their membership as individual members.

Many political decisions within the health system are critical depending on the number of patients affected by a particular disease group and hence which discipline of medicine is responsible for the care of these patients. This applies for budgets for health care, number of beds for a particular disease group, overall budget for a discipline within a hospital, budgets for out- or inpatients care, but also percentage of research money which goes into particular fields of medical research. Also, the general public counts on these measures because mortality, morbidity and costs of disease are important to determine the importance of a disease group and usually, the higher the numbers the more important is the disease.

Neurology is a young and rapidly expanding field. This has many consequences - and ideas about a possible centrifugal development of neurological specialities are among them. Two major factors are facilitating the separation of sub-disciplines from neurology.

The First EAN congress took place in Berlin at the CityCube, June 20-23, 2015. 6400 participants from 106 countries were attending 8 Symposia, 25 Teaching courses, 23 Focused workshops, 5 Hands-on courses, 3 Interactive sessions, 5 Special Sessions and showed 1546 posters. Furthermore, 2 Scientific Satellite Symposia took place at the Charité, as well as 17 Industry Satellite Symposia. The feedback was overwhelmingly positive.

une 2015 is coming closer and the stage for the first congress will open on Saturday, the 20th. We expect more than 6000 participants from all over Europe and the world to come to the CityCube in Berlin, the brand new Berlin congress center, the venue of the congress.

Neurology is a rapidly developing field and many diseases have lost their poor or even fatal prognosis through scientific progress. Parkinson’s disease, multiple sclerosis, infections of the nervous system, epilepsies and many other diseases were barely untreatable only 50 years ago but can now be effectively treated and sometimes even cured. But all this progress needs to be brought to the patient. The providers who take care of this are the neurologists. Moreover, neurological disorders are among the most frequent diseases. This is increasingly recognised by the different European national health systems and luckily we have a constantly increasing number of neurologists in Europe. They are united in different national Societies and within the Academy at European level.

The wealth of scientific information is increasing and there are many ways to cope with this. Some of us are screening the most important journals for interesting papers as their way to keep up to date with the news in the field. Most of them give up after some time. Others restrict this to reading their specialty journals only or leave it to specific questions which they have to solve.

eatment of stroke has made tremendous progress during the past 3 decades. This is an excellent example how the introduction of new concepts and translational research has contributed to our field. The introduction of stroke units and thrombolysis with rtPa have been the main drivers of this outstanding development. But one patient group has always been left out of this huge progress. These were patients with large vessel occlusion, preferentially internal carotid, proximal media and combined media and anterior occlusions.

he number of patients with neurological diseases will rapidly increase in Europe during the next 50 years. For some of the neurological diseases even a doubling of the numbers of patients is expected. Therefore more neurologists are needed. One of the most important tasks of the EAN is to support all attempts to increase the attractiveness of neurology as a profession and to improve teaching for students, trainees and residents in our field.

Neurological diseases are seriously affecting life quality of the patients. Many of these diseases are followed by life-long disabilities or the patients even need care for the rest of their lives. Our daily work for the patients with neurological diseases transfers for politicians into costs for the Society and a recent analysis has found the annual costs for neurological diseases in Europe to be >300.000 Mio €¹, which is more than the annual budget of the German government.

The Lasker-DeBakey Clinical Medical Research Award is one of the most important medical awards and goes this year to Mahlong R. Delong, Atlanta, USA and Alim Benabid, Grenoble, France for the ‘development of deep brain stimulation of the subthalamic nucleus (STN-DBS), a surgical technique that reduces tremors and restores motor function in patients with advanced Parkinson's disease’.

The European Academy of Neurology has existed for 4 months now and many of the first steps are behind us. The latest step is that we can accept members now from the administrative side of the process. Therefore I will use my President’s Page today to explain why you should become a member. According to the bylaws of the Society we will have institutional and individual members.

The EAN is a young Society and our purpose is to promote ‘Excellence in Neurology in Europe’.  This task has many facets and one of them is to engage more people in the Society. This process is presently underway.

Neurology is an important discipline and is rapidly developing. Recent economic studies have identified that one third of the European population is affected by a brain disease and they need treatment by neurologists, neurosurgeons and psychiatrists. The costs for these diseases are getting astronomic.