Wfn Elections June 2001 Our World Congress in London

THE NEWSLETTER OF THE WORLD FEDERATION OF NEUROLOGY

VOLUME 15, NUMBER 4, DECEMBER 2000 WFN ELECTIONS JUNE 2001

The Nominating Committee of the WFN has done a splendid job, after careful de- liberations, in making recommendations for the election of Trustees and Officers to form the future WFN leadership in June 2001 at the London meeting. They have produced a galaxy of names for various posts from the different geographi- cal areas of our globe. Their proposals are published on page 5. Both candidates for the post of President have presented their thoughts on the future direction of the WFN. Their statements are published on page 6. Dawn over Tower Bridge in London, the host city for the XVIIth World Congress of Neurology in 2001. (Copyright © 2000 Jeremy Woodhouse.) National Delegates, as representatives of the National Associations, will be entrust- OUR WORLD CONGRESS IN LONDON, ed with the most responsible task of cast- UK, JUNE 17–22, 2001 ing their votes in accordance with their As- sociation’s wishes. In this way, the entire There are now just 6 months before we neurology, each with a set of world class WFN membership is involved in the elec- welcome you to our lively, stimulating, speakers who will be joined by delegates tion process and all WFN members are and educational Congress. The full pro- giving platform presentations chosen from therefore requested to read this issue of gramme is available on the Internet submitted abstracts. World Neurology very carefully. at http://www.concorde-uk.com/wcn-2001 and contains the main themes and sym- There will also be an extensive educa- posia, along with an extensive educational tional programme with half-day teaching programme. We hope that you will attend sessions on the preceding Saturday and and submit abstracts (deadline November Sunday, as well as workshops and break- 15, 2000) because we wish the Congress fast and lunchtime sessions on topics to be of the highest scientific standard. such as neurological emergencies, useful neurological tips, and many others on The Scientific Committee intends that a (cont. on page 6) general neurologist attending the main topics on all five days would have been ALSO IN THIS ISSUE: updated in the most common neurological Jagjit S. Chopra, MD, conditions. The main themes are Multiple • President’s Column Editor-in-Chief, World Neurology Sclerosis, Epilepsy, Stroke, Neuromuscu- • WFN Election lar Diseases, and Dementia. These one- Recommendations The National Delegates have another, day programmes have been very carefully • Platform Programmes equally important job during the London planned to cover all aspects of each topic • Epilepsy & Surgery meeting – to select the country to host from aetiology through clinical presenta- • Inclusion Body Myositis the next World Congress in 2005, the pre- tion and management. In addition to the • Book Reviews mier scientific meeting of the WFN. The main themes, there are 30 or so half-day • Meetings Calendar (cont. on page 4) symposia covering most areas of clinical

Visit the WFN website at http://www.wfneurology.org 2 World Neurology

EDITOR-IN-CHIEF Dr. Jagjit S. Chopra, # 532 Sector 33-B, Chan- WORLD digarh - 160 047, India. Fax: +91-172-665532 E-mail: [email protected] EDITORIAL ADVISORY BOARD NEUROLOGY Dr. Richard Godwin-Austen, World Federation of Neurology, 12 Chandos Street, London W1G The Newsletter of the World Federation of Neurology 9DR, UK VOLUME 15, NUMBER 4, DECEMBER 2000 Dr. Robert B. Daroff, Case Western Reserve University/University Hospitals of Cleveland, Department of Neurology Cleveland, 11100 Eu- clid Avenue, OH 44106-5015, USA CONTENTS Dr. Jun Kimura, Park City Uji Byodoin 1203, 169 Uji Myoraku, Uji Shi, Kyoto 611-0021, Japan Dr. Theodore Munsat, Department of Neurol- ogy, New England Medical Center, Box 314, WFN Elections June 2001 ...... 1 750 Washington Street, Boston, MA 02111, USA Our World Congress in London, UK, June 17–22, 2001 . . . . . 1 Dr. James F. Toole, Wake Forest University, Baptist Medical Center, Medical Center Boule- President’s Column ...... 3 vard, Winston-Salem, NC 27157, USA REGIONAL VICE PRESIDENTS Recommendations for WFN Elections ...... 5 (by virtue of Presidency of Regional Congress) Dr. S.M. Al Deeb, Riyadh Armed Forces Hospi- Platform Programmes for Presidential Nominees ...... 6 tal, Department of Clinical Neuroscience, P.O. Box 7897, Riyadh 11159, Saudi Arabia Epilepsy Surgery ...... 7 Dr. Amado M San Luis, Rm. 1006, St. Luke’s Medical Center, E. Rodriguez Ave., Quezon Inclusion Body Myositis ...... 9 City, Philippines Dr. Ndiaye, Centre Hospitalier Universitaire De 2000 WFN Junior Travelling Fellowship - Report ...... 9 Fann, Clinique Neurologique, BP 5035, Dakar, WHO Meeting – a Report ...... 10 Senegal Dr. Jes Olesen, Professor and Chairman, De- Book Reviews ...... 11 partment of Neurology, Glostrup Hospital, Nor- dre Ringvej, DK-2600 Glostrup, Denmark Calendar ...... 13 Dr. Gustavo Pradilla, Carrera 29 # 32-65, Edi- ficio San Diego Of. 201, Apartado Aereo 678, Bucaramanga, Colombia ASSISTANT EDITOR Dr. I.M.S. Sawhney, Consultant Neurologist, Morriston Hospital, Swansea SA6 6NL, UK WFN ADMINISTRATOR Keith Newton, World Federation of Neurology, 12 Chandos Street, London W1G 9DR, UK COPYRIGHT © 2000 World Federation of Neurology. All rights reserved PUBLISHING STAFF Published by Elsevier Science BV, Amsterdam, the Netherlands. Publisher: Manuscripts accepted for publication become the copyright of the World Federation of Peter F. Bakker Neurology (WFN). Before publication a copyright form will be supplied by the Publisher, Marketing Manager: which must be completed by all authors. Joyce Hobbelink Design and Layout: using double spacing with margins of at least 3 World Neurology, ISSN 0899-9465, is published Helmut Hummelbrunner cm. Authors should submit material on compu- by Elsevier Science BV, Molenwerf 1, 1014 Operational Support: ter disk (Microsoft® Word or plain ASCII for- AG Amsterdam, the Netherlands; phone +31 Maureen Twaig, Annemieke van Es mat) whenever possible. Tables and figures (20) 485 3358, fax +31 (20) 485 3237; e-mail: ADVERTISING should be separated from the text and should [email protected] Please send inquiries about advertising in World clearly indicate the author’s name. Colour pho- REPRINTS Neurology to the Advertising Department, Else- tographs and illustrations are encouraged. Reprint requests and all correspondence re- vier Science Ltd., The Boulevard, Langford EDITORIAL STATEMENT garding the journal should be addressed to the Lane, Kidlington, Oxford OX5 1GB, UK. Phone: Although great care is taken to ensure accu- Editor. However, back issues of World Neurol- +44-1865-843258; Fax: +44-1865-843976; racy, the WFN and Elsevier Science BV cannot ogy can be obtained from the publisher. email: [email protected] be held liable for any errors or inaccuracies in CHANGE OF ADDRESS Publishing Information this publication. Opinions expressed are those of the authors. Elsevier Science BV, the Editor, Notice of change of address should be sent to: MANUSCRIPTS the WFN or the Grantor cannot be held respon- World Neurology, Editorial Secretariat, 12 Chan- The Editor is happy to receive unsolicited man- sible for the validity of clinical treatments, dos- dos Street, London W1G 9DR, UK. Fax: +44 uscripts or photographs for consideration, but age regimens or other medical statements 20 7323 4012; e-mail: [email protected] cannot accept responsibility for any loss or made. Any dosage referred to should be Printed by Key Dee Associates at Chandika damage to such material. Manuscripts should checked against the relevant data sheet for the Press Ltd,, 126 Industrial Area Phase 1, Chan- be submitted in English, typed on white paper product. digarh - 160002, India. PRESIDENT’S COLUMN 3 PRESIDENT’S However, money is but a means to for accomplishing our purpose than those our ends for better neurological care whose mission it is to destroy it by war. COLUMN and prevention for people with nervous Even though, for the thousands of years system disorders, clinical research, in- that we have considered ourselves to be WFN: Past, Present, and cluding methods for better prevention, “civilized,” we still persist in the savage Future treatment, and education of neurologists belief that we must occasionally settle and our colleagues in allied disciplines. In matters by killing one another. Is there an- In 1956, while I was a clerk at the Nation- order to do this, we have constructed a ything more inhuman than war itself? It is al Hospital in Queen Square, London, I global communication network, not only my belief that we must strengthen our ties was aware of the formation of the WFN by with hard copy through the Journal of the to the World Health Organization as the Ludo Van Bogaert and Macdonald Critch- Neurological Sciences with Editor Lisak first step toward unified action to influence ley but I did not become involved with and a newsletter edited by Jagjit Chopra the United Nations. our organization until 1981, when I was but also with a website with B. Todd Troost, A propos, I call your attention to the appointed Secretary-Treasurer General by which has the potential for rapid distribu- article by Sen and Bonita (Lancet then President Richard L. Masland. Since tion of information at a very low cost to 2000;356:577-582), who point out that the then, I have witnessed its enormous enormous numbers of neurologists who next public health challenge will be cere- growth, most recently including the forma- are unable to come to the regional and brovascular disorders, particularly stroke tion of a charitable foundation with which international meetings or to subscribe to and dementia, as we reduce the impact to foster clinical research and education. journals. of infectious diseases, such as poliomy- elitis and other communicable diseases of In 1981, our treasury contained $9,541 Concomitantly, our responsibilities have the nervous system. In another important from membership dues. Through the hard changed because we have globalized contribution, Volume 6, Supplement 2, of work of previous administrations, we have and developed a communication network, the European Journal of Neurology is de- accumulated a treasury that now nears a which makes the problems of one part of voted to the cost-effective value of neu- million pounds. This accrued both by in- the world apparent to all others, height- rological services, a subject which has creasing national dues and instituting a ening awareness and imparting a sense not been adequately addressed by any policy of sharing the risk and the benefits of obligation. With this knowledge, we are group. of World Congresses with the Host nation- developing a World Federation of Neurol- al organizations, initiating with the Con- ogy Research and Education Foundation, The office of the President of the World gress in New Delhi, India, continued with the purpose of which is to support pro- Federation of Neurology is evolving and the Canadian Congress in Vancouver, grams that have been recommended by there are a variety of new activities and re- Canada and, most recently, in Buenos peer reviewers to ameliorate these inequi- sponsibilities that I did not anticipate when Aires, Argentina. Each Host group con- ties. I was elected to the office, which has here- tributed a portion of Congress profits to tofore been somewhat honorary. For ex- the WFN and we have expectations that I have come to the conclusion that we, ample, in the first six months of this year, this will also occur with the about-to-take- in the health professions, who try to pre- I received 34 invitations to travel to impor- place London Congress. serve humanity, have far less possibility tant meetings, usually in far distant loca-

Participants of the International Workshop on Stroke Scales in Tokyo, Japan, 27–28 July 2000 (seated second from right Professor James F. Toole).

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org 4 PRESIDENT’S COLUMN tions. Of these, I could accept only 12. Be- cause the President has no financial allo- cation, each must be considered not only on its merit but on the time and personal expense involved. In addition to the cer- emonial activities, the scientific program requires presentation of material which is worthy and, in the field of medicine, “new information.” This has grown to a daunt- ing task and would require almost con- stant travel. Oftentimes it is very important for my wife to accompany me, which is always a pleasure but never underwritten by the host society. In my opinion, it is very important for both to be a presence at international meetings. With globalization and with the establishment of a permanent Secretariat in London, it becomes a requirement that the continuing presence of the leaders of the organization at meetings, to assess From left to right: Kelley N. Reavis, Svetlana A. Dambinova, James F. Toole, Sh.I. Bibileishvili, E. Bi- the impact of our organization and the bileishvili, Dee Dee Vernon, Galina A. Izykenova. needs of its constituents, is vital. Melbourne, Australia, in November 2000. from the far reaches of the globe. Recent- For example, I recently attended a meet- We, in the WFN, must take steps to resur- ly, it was a great pleasure to welcome ing of the International Stroke Society and rect and ensure our continuing presence Professor Sh.I. Bibileishvili, from Tbilisi, the Salzburg Conference Group on Cere- in the field of stroke and, in my forthcom- Georgia, and Drs. Svetlana Dambinova brovascular Disorders in Tokyo, Japan, ing role as the President of the Interna- and Galina Izykenova, from St. Peters- hosted by Professor Fumio Gotoh, Chair- tional Stroke Society, I look forward to cor- burg, Russia (see photograph above). man of the Research Group on Cerebrov- dial interaction with the World Federation ascular Disorders of the WFN (photograph of Neurology in attempting to consolidate James F. Toole, M.D. on previous page). In his tripartite role, our efforts in both of these organizations. President WFN Professor Gotoh has evolved and implemented a new stroke scale, which he will Finally, one of the greatest pleasures of present to the World Congress of Stroke in being the President is to receive visitors

WFN Elections – (cont. from page 1) though there are millions of epileptics who of some metabolite intermediates, co-fac- Secretary-Treasurer General of the WFN, require this procedure. tors and vitamins in mitochondrial dis- Dr. Richard Godwin-Austen, has summa- eases and recent advances on congeni- rized elsewhere in these columns all the As Editor of World Neurology, I was invit- tal myasthenic syndromes. That chronic key tasks that Delegates have to perform ed to participate in the Fifth Mediterranean polymyositis may in fact be inclusion body in June 2001. Society of Myology Congress held in Sep- myositis in its progressive form was the tember 2000 in Capri (Italy). Capri, a vil- disclosure made by Prof. Mastaglia from This brings us to the important invitation lage since Roman times, perched on a Australia. Prof. Doug Turnbull from the to all WFN members to come to London hill and surrounded by the blue Mediter- UK discussed the most recent molecular from WFN President, Dr. James F. Toole ranean, was an ideal venue for this state strategies: mainly to increase the relative and Secretary-General of the Congress, of the art congress on diseases of the amount of wild type over mutated mito- Professor Christopher Kennard. Please muscle. Attended by more than 300 del- chondrial DNA in diseases of muscle. Dr. make sure that you register for this Con- egates, the congress, organised by Prof. Nicholas Keep from London highlighted gress and also secure your hotel reser- Giovanni Nigro, was a resounding suc- the molecular chemico-physical charac- vation at the earliest, since June is the cess. It was preceded by a workshop on teristics of utrophin, a close homologue most attractive month for tourists to visit 'Strategic Approaches in Spinal Muscular of dystrophin and considered to possess London. Atrophy' organised by Dr. Ysbrand Poort- therapeutic implications. Prospects and man and was followed by a satellite sym- limitations of gene therapy in muscular The last of the four articles on Epilepsy, posium at Pisa on 'Perspectives in Mo- dystrophies, retroviral vectors for gene published in this issue, is 'Epilepsy Sur- lecular Therapy of Muscle Disease', or- therapy of Duchenne muscular dystro- gery' by Dr. Colin Binnie. Dr. Binnie has ganised by Prof. Gabriele Sicilliano. The phy, myoblast transfer and usefulness given a wonderful account of surgery in in- star attractions at the Congress and Sym- of satellite cells in regenerating muscle tractable epilepsy and his careful recom- posium were internationally renowned re- fibres were other important presentations mendations are worthy of serious consid- searchers on diseases of muscle. The mil- at these meetings. eration before deciding upon surgery on lennium lectures were delivered by Prof. an epileptic patient. It is a full team effort A.G. Engel and Prof. Salvatore DiMauro J.S. Chopra, MD, and should be undertaken only in centres from the USA. The latest information was Editor-in-Chief fully geared to perform such surgery, even given on the rationale of the usefulness

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org RECOMMENDATIONS FOR WFN ELECTIONS 5

(cont. from p.1) To relax and meet friends, London offers a various neurological disorders during the wealth of cultural and culinary experienc- week. As an exciting innovation, we will es and in addition to the Opening Cere- have a neurological tournament and hope mony and reception at Earls Court, we will that many countries, or groups of coun- be organising a Gala evening in the heart tries, will wish to put forward teams to take of the city of London in the grounds of the part in it during the week. Honourable Artillery Company. This will be a reflection of the youthfulness of our spe- When you feel in need of a break from the cialty and a time to enjoy yourselves. Professor Christopher Kennard high powered clinical science, then you Secretary General, WCN 2001 will be less than a mile from some of the The Congress and London have a huge for the WCN Organizing Committee major museums in London such as the amount to offer and we very much hope Victoria and Albert, Natural History and that you will make every effort to join us. Science museums. London, of course, If you wish to register or receive further has a great deal more to offer, much of information, you can find us at the fol- which will be completely new to you. You lowing web site: www.concorde-uk.com/ will be able to see the restyled centre of wcn-2001 or contact the Congress Or- the British Museum, the new British Library ganisers: Concorde Services Limited, 42 and of course the truly spectacular new Canham Road, London W3 7SR, UK. Tate Modern recently opened in a huge Phone +44 (0)20 8743 3106; Fax: +44 converted power station by the Thames. (0)20 8743 1010; e-mail: wcn@concorde- Also enjoy the views of London from the uk.com. Professor James F. Toole, new London Eye. President, for the WFN

RECOMMENDATIONS FOR WFN ELECTIONS

The Nominating Committee of the World of individuals and organisations including Carroll, William Australia Federation of Neurology recommends to not only the national delegates and Eraksoy, Mefkure Turkey the membership through their representa- member societies of WFN but also com- Lana-Peixoto, Marco Brazil tives on the Council of Delegates those mittee members past and present, and Madkour, Obsis Egypt listed below as candidates for election as others familiar with the Federation’s work. Nitrini, Ricardo Brazil WFN trustees and officers in accordance A formal meeting of the Nominating Com- Sica, Roberto Argentina with the Federation’s Memorandum and mittee was held in London on Saturday, Silberberg, Donald USA Articles of Association. 10 June 2000 to review the many sugges- Wadia, Noshir India tions received and to draw up a shortlist The trustee post of Secretary-Treasurer for publication. General will not be contested in 2001. The Memorandum and Articles of Association It is open to anyone to make additional Officers – Regional Vice as drafted by the Federation’s legal ad- nominations for any post for further review visors and approved within the appropri- by the Nominating Committee by Presidents ate committees, including the Council of Delegates, provide for one year’s phasing • Securing the supporting signatures of European with regard to this post, to allow overlap five or more authorised delegates Aarli, Johan Norway Bogousslavsky, Julien Switzerland and continuity. The election for Secretary- • Submitting the name(s) of the Heiss, Wolf-Dieter Germany Treasurer General will therefore be held at individual(s) in question to the Secre- the Annual General Meeting in 2002. tary-Treasurer General, c/o the London Pan-American Secretariat office, at least thirty days Proposals were invited from a wide range Chaná C., Pedro Chile prior to the AGM (the date of which is Chouza, Carlos Uruguay 17 June 2001), specifying the post(s) for which they are a candidate. Pan-Arab NEW POSTCODE Al Deeb, Saleh M Saudi Arabia President Ibrahim, Mohamed Montasser Egypt LONDON OFFICE Kimura, Jun Japan Madkour, Obsis Egypt Paty, Donald Canada Changes have been introduced to Pan-African central London postcodes which First Vice President Fadli, Emad Egypt affect the address of the WFN Secre- Aarli, Johan Norway Fritz, Vivien South Africa tariat. The first part of the address re- Sica, Roberto Argentina Miladi, Najoua Tunisia mains the same – 12 Chandos Street, London – but there is now a new Elected Trustee (three code of W1G 9DR. Please use this in Asian-Oceanian all future correspondence sent to the vacancies) Kim, Jin-Soo South Korea London Office. Bogousslavsky, Julien Switzerland San Luis, Amado Philippines Caldas, A. Castro Portugal Wadia, Noshir India

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org 6 PLATFORM PROGRAMMES FOR PRESIDENTIAL NOMINEES PLATFORM PROGRAMMES FOR PRESIDENTIAL NOMINEES Jun Kimura, MD, regional neurological organizations which 2. Roots in Asia: Born in China of medical Kyoto, Japan work closely with the Federation. We missionary parents; my father’s China should seek to improve communication hospital is today a going concern. I It has been between member societies and encour- have been there twice and I am working my privilege age their continued participation. To im- to improve communication between and pleasure prove interaction, we must exploit the the West and that institution. to serve as means already available to us, namely, 3. Secretary General 1993 World the First Vice- Journal of the Neurological Sciences, Congress of Neurology in Vancouver: President of World Neurology, and the WFN web site, This WCN was a very successful one the WFN to facilitate the networking of information. and that experience provided me with during the I consider the role of Secretariat of para- a great deal of information concerning past three mount importance in the successful pur- the scientific and practice aspects of years. In the suit of our mission in this regard. the WFN. interim, the organization revised its Con- stitution, initiated major steps forward in Because these initiatives would take a 4. World Health Organization: Member of redefining its purpose and aim, and initi- great amount of work to prepare and the WHO Working Group on Multiple ated some of its priority programs under prosecute, we will need to generate an Sclerosis; being involved with both the the leadership of James F. Toole as Pres- outpouring of interest and energy from WFN and the WHO will bring contacts ident, Theodore Munsat as Chair of the member societies worldwide. In order to that will help in the realization of the Research Committee, and Richard God- achieve these objectives, we would also goals of the WFN. win-Austen as Secretary-Treasurer Gener- need to explore a number of options for 5. Canadian Representative to the WFN al. We are at a turning point not only in more active fund raising. In the United Council of Delegates for the last seven modernizing the structure, but also in reo- States, President Toole has founded the years. rienting our philosophy as an incorporat- World Neurology Foundation for this very ed charity organization for the cause of purpose. Following his lead, I would look If elected I will pledge to do the following neurology. I am proud to be nominated as into the possibility of forming a similar things: a candidate for the office of President of Foundation in Japan to attract charitable the Federation at this important juncture. donations in support of neurological re- 1. Increase the involvement of developing search and education worldwide. countries in the workings of the WFN. If elected president, I would like to move 2. Increase the cooperation of the WFN, forward on several initiatives. We must I would pursue these goals with increased the WHO, and non-government seek to achieve greater worldwide rec- vigor in order to achieve the Federation’s organizations, especially in the area ognition of our discipline, and make the overall purpose. I have learned a great of dissemination of information about prevention and treatment of neurological deal from other members of the Man- neurology, neurologists, and conditions the number one priority of gov- agement Committee whom I have worked neurological disease. ernmental medical policies. Specifically, very closely with over the years, including we should endeavor to encourage and the proper balance of assertion and com- 3. Work towards a method of information assist the education of young neurolo- promise. I firmly believe that it will take exchange in relationship to the following gists in developing countries. I would also a team effort to successfully run an in- issues: continue to promote the areas of the ternational organization, and I would not a) The impact of neurological disease nervous system, stroke and brain func- hesitate to ask for advice from those of on various populations for both health tion within the WHO framework. The WFN you more knowledgeable than I in this en- care professionals and the public should play a key role in coordinating deavor. It is my sincere hope that togeth- plans among the various local neuro- er we can further improve the value and b) The implementation of guidelines logical societies and non-governmental prestige of the WFN and achieve the mis- for the diagnosis and management groups who share the common interest sions and objectives of our newly incorpo- of common neurological problems in advancing neuroscience and its related rated Federation. applicable to both developed and fields. developing countries. Donald W. Paty, MD, 4. Work through the various standing While most national and regional groups Vancouver, BC, Canada committees and ad hoc committees of can address their own educational and re- the WFN to implement the policies of search needs with considerable sophisti- I will make an the WFN and work to raise the public cation, the WFN should not compete with effective Pres- awareness of the workings of the WFN such efforts. Rather, we should focus our ident of the and its members. attention on more global concerns and World Federa- advocate to implement programs of in- 5. Help to develop a preventative strategy tion of Neurolo- ternational consequence. The quadren- that can be implemented on a world- gy because of nial meetings of the World Congresses wide scale that will impact neurological the following: of Neurology serve as the most effective disease by better understanding of venue for presenting scientific achieve- 1. World-wide world patterns of epidemiology, ments and interacting with delegates of experience: Having lived as an adult genetics, and exposure to the varied backgrounds and perspectives. I in the USA, Malaysia, the UK, and environment. believe it is equally important to develop Canada.

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org EPILEPSY SURGERY 7 EPILEPSY SURGERY of a discrete zone from which partial sei- tion of an ‘epileptogenic zone’. Satisfacto- zures arise (e.g. anterior temporal resec- ry outcome depends on removing tissue Introduction tion), 2) global resection or disconnec- that is both structurally and functionally tion of extensive dysfunctional tissue (e.g. abnormal. Resecting a focus of interictal Epilepsy surgery became available in a hemispherectomy, hemispherotomy), 3) discharges rarely relieves epilepsy if the few specialised centres in the early 1950s, division of pathways of seizure propaga- tissue is normal. Conversely, removal of a but has expanded world-wide only recent- tion (e.g. callosotomy), 4) activation of in- structural abnormality that is not associat- ly. At symposia in 1986 and 1991, Engel hibitory systems (e.g. by stimulation of ed with epileptiform activity is usually un- [1,2] reviewing the practices of major cen- the vagus nerve or of the subthalamic successful. tres found the operations in 5 years cov- nucleus), 5) transection of hyperexcitable ered by the second survey equalled the cortex into blocks too small to be capa- Various identifiable regions contribute to total in the previous four decades. ble of epileptogenesis (multiple subpial the determination of the epileptogenic The incidence of epilepsy is some transection). zone [6]. The ‘lesional zone’ is the area 50/100,000 and medication achieves con- of pathology underlying the epilepsy and trol in 70–80% [3]. Thus, the annual in- Convergence of usually detectable by neuroimaging. The cidence of intractable epilepsy is some ‘irritative zone’ is the region of interictal ep- 10/100,000. Between 1/8 and 1/4 of these Evidence from ileptiform activity demonstrable by scalp are surgical candidates, 1.25–2.5/100,000 Multidisciplinary EEG, and/or by intracranial recording. per annum [4]. Current provision, even This is usually more extensive than the in prosperous economies, falls short of Investigation ‘ictal onset zone’, where electrophysiolog- demand due largely to the complexity ical changes appear at seizure onset and of preoperative assessment, which re- The first of these approaches is that most which is rarely detectable without intrac- quires a multidisciplinary team, with exper- widely adopted and, together with subpi- ranial ictal recordings. A ‘hypofunctional- tise in neurological epileptology, neuro- al transection, depends on the identifica- zone’ may be manifest by neurological or surgery, neurophysiology, neuroimaging, neuropsychology, paediatric neurology, neuropathology, and neuropsychiatry. The COUNCIL OF DELEGATES MEETING pioneering developments of the 1940s 17 JUNE 2001 and 1950s were achieved by such teams. Attempts to emulate them without ade- The Council of Delegates Meeting on 17th June 2001 is the meeting where the quate resources led to ill-fated programs major decisions for the next four years will be made. At this meeting the Officers with poor results, and scepticism concern- and Trustees of the WFN 2002–2006 will be elected and the decision for the venue ing epilepsy surgery. The recent expan- of World Congress 2005 will be made. This is therefore a most important meeting sion of surgery resulted from the recog- and it is hoped that all eligible National Delegates will be present. nition of the importance of a multidiscipli- ELECTION OF TRUSTEES AND OFFICERS nary approach and advances in imaging. Equally, the perception that considerable At the start of the meeting, the Secretary-Treasurer General will make an announce- resources are required may discourage ment to clarify who is permitted to vote in the election of new Trustees and Officers: new programs, particularly in developing only Delegates of countries whose dues are fully paid up. He will read out a list of countries. their names mentioning any proxies they might hold. It may be helpful to emphasize that voting rights do not extend, for instance, to members of the Management Com- Minimum Standards mittee, unlike arrangements under the old Constitution & Bye-Laws. To address this problem, the International As provided for in the Memorandum & Articles of Association, no Delegate will be League Against Epilepsy commissioned allowed to cast more than two proxy votes. Notification of proxies will need to be a report on minimum standards for epi- received at the London Secretariat Office 3 working days before the meeting i.e. by lepsy surgery [5]. There was concern that the end of Tuesday, 12th June 2001. minimum standards would be regarded Voting will be in accordance with the recommendations of the Steering Committee: by cost-carriers as sufficient and funding a simple ballot with a requirement of 50% of the votes cast for an outright victory, would be refused for any resources above or else a second round contested by the top two candidates. the minimum, but a solution was found in the recognition that surgical candidates PRESENTATIONS BY COUNTRIES BIDDING TO HOST WCN 2005 comprise a varied case mix, requiring different resources. The Commission ad- At present, the following countries have entered the bidding: vised that surgical programs with limited Australia, Czech Republic, Egypt, Spain, Thailand, Tunisia. resources were acceptable, provided they undertook treatment only of those patients Countries will have 15 minutes to make their presentation. Video films and slides who did not require more complex preop- may be used and information regarding hotel accommodation, projected budget, erative assessment. congress venue, transportation and organizing committee must be presented. At the end of each presentation, 5 minutes will be allowed for questions to be put to Surgical Strategies the presenting country. A straight vote will then be taken and all Delegates present will vote. No proxies are allowed. The country receiving the largest number of votes Surgical treatment of epilepsy follows al- will be allocated the Congress in 2005. ternative strategies with differing require- ments for preoperative assessment: 1) lo- Richard Godwin-Austen calised resection or radiosurgical ablation Secretary-Treasurer General

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org 8 EPILEPSY SURGERY neuropsychological deficits, abnormalities the 1970s, patients were routinely treated evidence to determine the epileptogenic of ongoing EEG or ECoG activity, or hy- without ictal or invasive recording, even zone. pometabolism detected by PET or SPECT. in the absence of structural abnormality Clinical ictal events reflect disturbed func- demonstrable by the current radiological Conclusion tion in a particular region, the ‘symptoma- techniques, with results comparable to togenic zone’ which is not always close to those now obtained. To offer surgery only A key comment in the report of the Neuro- the onset zone. to those patients who do not require com- surgery Commission may also serve as a plex electrophysiological investigation is a summary of this brief over-view: The site and extent of the epileptogenic sensible approach to setting up and de- zone may be inferred from i) clinical ob- “… differing preoperative work-up and op- veloping an epilepsy surgery program. servation, history and examination (hypo- erative procedures may be appropriate functional and symptomatogenic zones. Concordant evidence of structural and for different patients. It is entirely accept- interictal EEG (irritative and hypofunction- functional abnormality is required. Where able that a new epilepsy surgery program al zones); ii) CT and structural MRI (le- the findings disagree, it is necessary either should be set up initially with limited facili- sional zone); iii) ictal video-EEG (indirect to explain the non-convergence or aban- ties, provided treatment is limited to those evidence of ictal onset zone, symptoma- don surgery. patients whose preoperative and opera- togenic zone) neuropsychological assess- tive needs can be met within the resourc- ment (hypofunctional zone); iv) carotid Sperling et al. [7] described a non-in- es available... Where such a limited serv- amytal test (hypofunctional zone-also evi- vasive protocol based either on conver- ice is to be provided, it is essential that the dence concerning possible cognitive defi- gent MRI, and interictal and ictal EEG lo- experience of the medical staff should be cits following proposed surgery); v) PET calisation, or on more rigorous EEG and of wider breadth and sufficient to ensure (hypofunctional zone); vi) ictal SPECT psychological criteria. On this basis, 50% that they are competent to distinguish pa- (ictal onset zone?), vii) sub-acute intrac- of patients underwent surgery, with good tients who can be treated with limited local ranial recording (irritative, hypofunctional outcome in 94% of tumoural and 74% resources from those who require more and ictal onset zones); viii) acute ECoG of non-tumoural cases. The patients who complex facilities”. (irritative and hypofunctional zones). failed these criteria were either withdrawn In short, as in most areas of practice, it is or underwent operation only after invasive The greatest variation between different pr- clinical expertise which is the best guaran- studies, with a lower success rate of 62%. tor of standards. eoperative assessment programmes lies It is clear that many patients do not need in their use of electrophysiology: conven- complex investigations, and those that do References tional EEG, long-term monitoring and in- are less likely to benefit. Engel J. Outcome with respect to epileptic sei- vasive intracranial recording. It is possible zures. In: Engel J. (Ed). Surgical Treatment to identify patients who may be success- The use of invasive neurophysiology has of the Epilepsies. Raven Press, New York. fully treated without ictal recording, from been changed by advances in neuroimag- 1987;pp 553-371. either intracranial or scalp electrodes but ing, but not as expected. Improved struc- Engel J, Van Ness PC, Rasmussen TB, Oje- ictal recording may be considered man- tural imaging, supported by PET has in- mann LM. Outcome with respect to epi- datory to exclude non-epileptic seizures. creased the number of patients who can leptic seizures. In: Engel J. (Ed). Surgical be prepared for temporal resections with- Treatment of the Epilepsies, Second Edi- Patients requiring minimal electrophysi- out invasive neurophysiology. However, tion. Raven Press, New York. 1993; pp ology generally exhibit a discrete lesion non-concordance of evidence from these 609-621. Elwes RDC, Johnson AL, Shorvon SD et al. The on imaging concordant with the seizure and other sources leads to identification prognosis for seizure control in newly di- pattern and interictal EEG. Indeed, until of patients with extra-temporal complex agnosed epilepsy. New Engl J Med, 1984; partial seizures, with a consequent need 311: 944-947. WFN Silk Ties for depth recording. Moreover, improved National Institutes of Health Consensus Con- imaging reveals previously undetectable, ference. Surgery of epilepsy. J Am Med and Scarves operable pathology, as cortical dysplasia, Assoc, 1990; 264:729-733. commonly extra-temporal. Binnie CD, Polkey CE. Report of Neurosurgery TIE Commission: Minimum standards for epi- Sterling £ 20.00 (U.S. $ 30.00) In our centre, invasive recording is used for lepsy surgery. Epilepsia, in press. SCARF (31 x 31 inches) assessment of almost all non-lesional ex- Luders H, Awad I. Conceptual considerations. Sterling £ 30.00 (U.S. $ 50.00) In: Luders H. (Ed) Epilepsy Surgery. Raven tra-temporal epilepsies, combined depth Press, New York, 1991; pp. 57-62. Orders with payment to: WFN Sec- and subdural recording mainly in mesio- Sperling MR, O’Connor MJ, Saykin AJ, Philips retariat, 12 Chandos Street, London basal frontal cases, subdural electrodes CA, Morrell MJ, Bridgemann PA, French JA, W1G 9DR, UK alone in extra-temporal epilepsies arising Gonatas N. Noninvasive protocol for ante- from the convexity. The use of depth re- rior temporal lobectomy. Neurology, 1992; cording has declined to below 10%, not 42:416-422. so much as a consequence of developments in imaging, but rather because of unfavourable experience of resecting well localised extratemporal foci in radiologi- cally negative subjects. This decline in invasive electrophysiology is offset by an increased demand for subdural recording to help locate seizure onset in patients Dr. Colin D. Binnie in whom MRI demonstrated extra-tempo- Institute of Epileptology ral lesions but failed to provide enough King’s College, London, UK

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org INCLUSION BODY MYOSITIS 9

Muscle biopsy remains the definitive diag- INCLUSION BODY MYOSITIS nostic investigation. The most appropri- Inclusion body myositis (IBM) is a distinc- ymyositis and dermatomyositis in which ate muscle to biopsy, provided that it is tive form of inflammatory myopathy and the muscle involvement is non-selective. not too severely affected clinically, is the an important cause of progressive muscle In the upper limbs the forearm flexor mus- vastus lateralis muscle. To observe the full wasting and weakness in later life. It is cles are usually affected earliest, in partic- spectrum of histopathological changes it the most common acquired myopathy ular the flexor digitorum profundus. As the is important to obtain tissue samples for in patients over the age of 50 years disease progresses the finger and wrist cryostat sectioning and for electron mi- and accounts for about 25% of patients extensors are also affected and weakness croscopy. At the light microscope level, with inflammatory myopathy referred to of more proximal upper limb and more the diagnostic changes are best seen in a neuromuscular clinic. Its prevalence distal lower limb muscles also develops. sections stained by the modified Gomori in the population is ~10/million rising to Asymmetric involvement on the two sides technique, or with haematoxylin and eosin ~35/million over the age of 50 years (Phil- is common. Atypical patterns of weak- and comprise: an interstitial and perivas- lips et al 2000). It is now recognised ness occur in some patients who may cular T cell (CD8+) infiltrate with invasion that most patients previously diagnosed have a proximal pattern of muscle involve- of muscle fibres by T cells and mac- as chronic polymyositis are suffering from ment in upper and lower limbs, or only rophages; HLA class 1 expression on IBM. Although most cases of IBM are spo- upper limb involvement, or a gluteal-ham- muscle fibres in areas with inflammatory radic, the condition may rarely be famil- string pattern of muscle involvement in the infiltrates; muscle fibre necrosis and re- ial. In contrast to IBM are a number of lower limbs (Mastaglia et al 2000). The generation; ‘rimmed’ vacuoles in non- other forms of hereditary inclusion body condition is usually slowly progressive, in necrotic muscle fibres and the presence of myopathy with a variable clinical phe- spite of treatment, leading to a severe cytoplasmic and intranuclear eosinophilic notype and similar pathological changes degree of physical incapacity with loss of inclusions although these may be incon- but without the inflammatory component independence and the ability to walk in spicuous; variable numbers of ‘ragged- (Askanas and Engel 1998). Inclusion body most cases (Oldfors and Lindberg 1999). red’ fibres which lack cytochrome oxi- myositis is not associated with malignan- dase activity (COX-negative fibres); and cy but may be associated with other au- Diagnosis atrophic muscle fibres which may contain toimmune or connective tissue diseases ‘rimmed’ vacuoles. Focal amyloid de- and may also occur in HIV-1 and HTLV-1 The diagnosis should initially by suspect- posits may be demonstrated in the vacu- infected patients. ed clinically on the basis of the pattern of olated muscle fibres with special stains. muscle involvement, but is often delayed Electron microscopy is necessary to dem- Clinical features (Phillips et al 2000). The serum creatine onstrate the 15-20 nm filamentous intra- kinase level may be normal or moderately nuclear and cytoplasmic inclusions, which Sporadic inclusion body myositis (s-IBM) elevated. The EMG findings may be con- are characteristic of the inclusion body is characterised by very slowly progressive fusing as there is often a combination of myopathies, and which have been shown muscular weakness and wasting, usually myopathic and neuropathic features, in- to be made up of paired-helical filaments commencing in the quadriceps femoris cluding long duration motor unit poten- containing phosphorylated tau as found in muscles in the lower limbs and in the fore- tials and spontaneous discharges. More- the brain in Alzheimer’s disease (Askanas arm muscles in the upper limbs. Often the over, nerve conduction studies may show and Engel 1998). patient does not present until the weak- evidence of a mild peripheral neuropathy ness of the quadriceps muscles has ad- in some cases. These findings have led Treatment vanced to a degree where the patient to the suggestion that there may be a starts to have falls. Dysphagia is a neurogenic component in s-IBM. How- The majority of patients with s-IBM fail common symptom, particularly later in the ever, quantitative EMG and macro-EMG to respond to treatment with conventional course of the disease. Careful examina- studies have not supported this conten- forms of immunotherapy such as corti- tion will demonstrate a selective pattern of tion. Muscle CT or MRI scanning may costeroids or immunosuppressive agents. muscle involvement in both the upper and be helpful diagnostically by demonstrat- However, in a minority of cases such lower limbs, contrasting with other forms ing the selective pattern of muscle involve- treatment may temporarily arrest the proof inflammatory myopathy such as pol- ment. gression of the disease. It is therefore our practice to offer patients a 3 to 6 month trial of treatment with prednisolone 2000 WFN JUNIOR TRAVELLING (~0.5-0.75 mg/kg/day, tapering to a low FELLOWSHIP - REPORT maintenance dose after a period of 3 to 6 weeks) combined with methotrexate (7.5 I would like to express my gratitude for (with co-authors) my poster “Smoking and to 10 mg once weekly) after taking into ac- the 2000 WFN Junior Travelling Fellowship other environmental factors for Parkin- count the patient’s age, general medical that enabled me to attend the 6th Inter- son’s disease in Lithuania”. The informa- condition and weighing up the risk of in- national Congress of Parkinson’s Disease tive and innovative pharmaceutical exhibi- ducing adverse drug effects. It is impor- and Movement Disorders, which was held tions were also of interest. It was a pleas- tant to monitor progress with quantitative in Barcelona on June 11–16, 2000. The ure to meet colleagues from other coun- assessment of muscle function in select- high level scientific program covered a tries to share opinions and knowledge. ed upper and lower limb muscle groups very broad spectrum of topics related to as well as functional assessments. If there I would like to thank the WFN for giving me Parkinson’s disease and other movement is improvement or stabilisation mainte- the opportunity to participate in this excel- disorders on both clinical and basic as- nance therapy is then continued with on- lent congress held in beautiful Barcelona. pects. The poster sessions were numer- going precautions to avoid steroid side ef- ous and of no less interest than the lec- Valmantas Budrys, MD, PhD fects. On the other hand, if muscle weak- tures. It was an opportunity to present Lithuania ness continues to progress or side effects

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org 10 WHO MEETING – A REPORT

WINNERS OF THE GLAXO WELLCOME JUNIOR TRAVELLING FELLOWSHIPS 2000 Dr. Kakhaber Akhvlediani Georgia 5th EFNS Congress, Copenhagen, October 14–18, 2000 Dr. Ravindra Kumar Garg India XVIIth World Congress of Neurology, London, June 17–22, 2001 Dr. Inta Macane Latvia XVIIth World Congress of Neurology, London, June 17–22, 2001 Dr. Valmantas Budrys Lithuania 6th International Congress of Parkinson’s Disease, Barcelona, June 11–15, 2000 Dr. Alberto Diaz Vasquez Peru 54th Meeting of the American Epilepsy Society, Los Angeles, December 1–6, 2000 Dr. Miriam Velez Rojas Peru 3rd Latin American Congress of Movement Disorders, Guadalajara, Mexico, March 22–24, 2001 Dr. Rosa Velasco Peru XVIIth World Congress of Neurology, London, June 17–22, 2001 Dr. Myles Connor South Africa XVIIth World Congress of Neurology, London, June 17–22, 2001 Dr. Udaya Ranawaka Sri Lanka 4th World Stroke Congress, Melbourne, November 25–29, 2000 Dr. Ibtissem Ben Hamouda Tunisia 125th Annual Congress of ANA, Boston, October 15–18, 2000 develop the treatment is discontinued. the muscle lesions, the lack of response thies. Askanas V, Serratrice G, Engel WK to corticosteroid and immunosuppressive (eds). Cambridge University Press 1998, There have been several short-term con- therapy remains a stumbling block and p177 trolled and uncontrolled trials of intrave- suggests that there may be some addi- Mastaglia FL. Treatment of autoimmune in- nous immunoglobulin therapy, some of tional ongoing process, perhaps geneti- flammatory myopathies. Current Opinion which have shown slight functional im- cally determined, which is responsible for in Neurology 2000;13:507–509 provement in some cases. However, it re- the vacuolofilamentous degeneration and Oldfors A, Lindberg C. Inclusion body my- mains unclear whether this form of treat- accumulation of amyloid and other pro- ositis. Current Opinion in Neurology ment has any influence on the natural his- teins in muscle fibres. Oxidative stress 1999;12:527–533 tory of the condition and longer-term trials and age-related accumulation of mtDNA Phillips BA, Zilko PJ, Mastaglia FL. Preva- are required (Mastaglia 2000). The use of mutations may also be contributory fac- lence of sporadic inclusion body myositis interferon beta 1a is currently being evalu- tors. The pathogenesis of s-IBM is likely in Western Australia. Muscle & Nerve ated in North American and British trials. to be multi-factorial and we have hypothe- 2000;23:970–972 Other empirical forms of treatment include sised that multiple genetic factors includ- carnitine, coenzyme Q10, vitamin E, the ing DR3, apolipoprotein (4, mtDNA vari- anabolic agent clenbuterol, and an iso- ants and other as yet undetermined fac- metric exercise programme. tors interact to confer susceptibility to the Pathogenesis disease (Garlepp et al 1998).

There are still a number of aspects of the References pathogenesis of s-IBM which remain un- Askanas V, Engel WK. Sporadic inclusion clear. Although there is considerable evi- body myositis and hereditary inclusion dence in favour of an autoimmune patho- body myopathies. Archives of Neurology genesis, such as the invasion of muscle 1998;55:915–920 fibres by auto-aggressive T-cells; the as- Garlepp MJ, Blechynden L, Tabarias H, Lawson Prof. F.L. Mastaglia, MD, FRACP, FRCP sociation with other autoimmune diseases C, Van Bockxmeer F, Mastaglia FL. Genet- Centre for Neuromuscular and and with HLA DR3/B8; and evidence for ic factors in sporadic inclusion body myosi- Neurological Disorders, restricted T cell receptor V gene usage in tis. In: Inclusion Body Myositis and Myopa- University of Western Australia

WHO MEETING – A REPORT

The 53rd session of the WHO Regional the Region, of the UN and other agen- the achievement of polio eradication and Committee for South-East Asia was held cies, and of non-governmental organiza- the elimination of leprosy in the very near in New Delhi from September 4–7, 2000. tions having official relations with WHO, future. She said that 12 countries in the The WFN was represented by Dr. J.S. as well as by observers. The Member world were carrying 90% of the global lep- Chopra. The chief guest at the meeting States of this Region are Bangladesh, rosy disease burden. She remarked that was the Director-General of the WHO, Dr. India, Indonesia, Myanmar, Sri Lanka, tobacco control has now almost become Gro Harlem Brundtland. Thailand, Nepal, Bhutan, Maldives, and a movement in some countries of the DPR Korea. region, with Thailand standing out as a This session was attended by represent- role model. HIV/AIDS in this region was atives of all the ten Member States of Dr. Brundtland mentioned in her address low but countries needed to guard against

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org BOOK REVIEWS 11 complacency in order to prevent the future spread of HIV and thereby avoid a devas- tating economic, social and human disas- ter. She mentioned that the regional structure of WHO facilitated the establishment of regional priorities, such as elimination of leishmaniasis and control of Japanese encephalitis, as well as focusing on regional aspects of global problems such as tuberculosis, food safety and safe water supply. She also said that the G8 nations agreed on specific targets to reduce the death toll from malaria, HIV/AIDS, TB and children’s diseases by 2010. The Director-General reassured the delegates that WHO will be working closely with Member States in an initiative to enhance the performance of Health System to apply the new WHO assessment framework at national as well as sub-national levels; to use this analysis as an aid to national policy formulation, and to work to- Dr. Gro Harlem Brundtland, Director General WHO (3rd from left) and Dr. C.P. Thakur, Union Minister gether to facilitate positive change. Four of Health and Family Welfare, Government of India (3rd from right). SEAR countries are already participating in this initiative. Dr. Jagjit S. Chopra (World Federation of ration with countries in the prevention of Neurology) stated that the mission of the neurological disorders. Dr. Brundtland visualized the rapid shift World Federation of Neurology (WFN) was of the burden of disease from infectious to improve human health globally through Dr. Chopra met the WHO Director sepa- to non-communicable diseases, which promoting the care of persons with disor- rately and emphasized to her the impor- would seriously challenge the health care ders of the nervous system, by fostering tance of diseases of the nervous system system in the near future and necessitate the best standards of neurological educa- which should be given a separate status hard decisions. Global tobacco control tion, and in promoting research. He high- in WHO and not be linked under the um- was a key priority area and WHO would lighted areas of WFN’s significant collabo- brella of Mental Health. She gave the im- also look at a vastly neglected area of ration with WHO as well as with national pression that although our demand has public health - mental health. Mental and regional bodies. He underscored the merit and is under consideration, it may health will be the focus of World Health importance of giving adequate attention take sometime before it can be accepted Day, the World Health Assembly and the to diseases of the whole nervous system, in toto. World Health Report in 2001. and urged WHO to enhance its collabo-

BOOK REVIEWS qualified doctor to safely practise, rather clinic. A short chapter on neurorehabilita- than in the past when our students were tion is also a useful addition. I would sug- drowned in a torrent of factual knowledge, gest to all neurological teachers of medi- Lecture Notes on much of which was immediately dumped cal students that they recommend this as Neurology on passing finals. I found this little volume one of the best undergraduate texts cur- Editor: L. Ginsberg an excellent distillation of what medical rently available for core teaching. students need to know in our subject, writ- ISBN: 0 632 04827 1 Professor Christopher Kennard ten in a lucid and highly readable style. No. of pages: 208 London, UK The book is divided into two parts, the first Price: £14.95 section describing the neurological ap- Publication Date: 1999 Progress in Human Publisher: Blackwell Science, Oxford, proach including history taking, examina- UK tion and neurological investigation. In African Trypanosomia- the second section the common neuro- sis Sleeping Sickness The 7th edition of “Lecture Notes on Neu- logical diseases and symptoms are de- rology” comes in a completely new user- scribed. This edition moves away from the Editors: Michel Dumas, Bernard Bouteille, Alain Buguel friendly format, more than a decade since occasionally excessive lists of previous ISBN: 2-287-59655-0 the sixth edition, having been rewritten by editions, and includes helpful diagrams, No of pages: 344 Lionel Ginsberg. Much has happened in scans, just a few lists, the odd algorithm, Price: £86.00 or US$159.00 clinical neurology over the past decade and helpful key points ending each chap- Publication Date: 1999 not only in the diagnosis of neurological ter. There is also an extremely useful pair Publisher: Springer diseases and their management, but also of chapters on neurological emergencies in the way we teach it to medical students, and on neurology in general medical. The Sleeping disease, known since the 15th and these Notes are primarily aimed at latter will certainly enable students to ap- century as a disease of the African conti- them. We are in the age of teaching core preciate how wide the neurologist’s net nent south of the Sahara, became a high knowledge, sufficient to enable the newly is cast outside the neurological ward and priority on the international agenda only

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org 12 BOOK REVIEWS

on viruses, pathogenesis of virus infec- Animal Models of Parkinson’s Disease are Books for tions and the immune responses, which illustrated in six chapters in the second Developing they induce. I feel every reader should section and the third section of five chap- make the effort to familiarise themselves ters discusses Developments in Animal Countries with these fundamental concepts of neuro- Models of Huntington’s Disease. The re- virology. The section on acute and chronic maining two sections are devoted to Acute The London Office of the WFN Sec- neurological disease contains considera- Neurological Problems such as stroke, retariat keeps a stock of neurological ble information, which has been thought- head injury and innovative therapeutic text-books that have been received fully analysed and could be particularly agents. It is a useful book for those inter- for review in World Neurology and useful for the general clinical neurologist ested in animal models and their applica- can be forwarded to institutional/ whether from a developed country or tion for the mitigation of human sufferings departmental libraries in developing an economically developing country. The from some of the most intricate neuro-dis- countries. A list is available on appli- new chapter on human immunodeficien- orders. cation to the Administrator. If you are cy virus is particularly interesting. The last interested in any of the books and J.S. Chopra, section contains valuable information on Editor-in-Chief can either collect them when visiting prevention and treatment. I would highly London or pay for the mailing costs recommend this book for everyone con- Health, Law and Policy (postage can be expensive) please nected with the neurosciences and feel it let us know. will stand the test of time as well, as the A Survival Guide to previous edition did. Medicolegal Issues for after the European colonialisation due to Nadir E. Bharucha, Practitioners a major epidemic caused over a million Bombay, India Editor: Bryan A. Liang deaths in 10 years. At the start of the ISBN: 0-7506-7107-6 20th century the first drug was applied; Central Nervous System No. of pages: 309 at its end the disease still threatens to Price: US $39.95 spread across the intertropical continent. Diseases Publication Date: October 1999 This book comes to elucidate in detail Publisher: Butterworth-Heinemann the whole subject from animal experi- (Innovative Animal Models Chapter 1-5: Traditional Legal Medicine, ments and epidemiology to morphology, from Lab to Clinic) 6-9: Health Care Insurance Structure, molecular biology, antigenic variation, car- Editors: Dwaine F. Emerich, Reginald 10-14: Modern Delivery Considerations. bohydrate and polyamine metabolism of L. Dean, Paul R. Sanberg 15-16: End of Life Considerations. trypanosomes; from pathogenesis and ISBN: 0-89603-724-X immunology to clinical study, investiga- Pleasant to peruse. In Matters of Law, No. of Pages: 512 tions and management of the disease. The the structure of a Civil Lawsuit is ex- Price: US $145 thirty-five contributors in nineteen chap- plored; Malpractice is defined, differentiat- Publication Date: 1999 ters cover the topic of sleeping sickness ing it from Informed Consent as cause of Publisher: Humana Press giving current and scientific views focus- action. One learns that in court, contract- ing on a serious disease concerning a Appropriate animal models are neces- limiting liability is in disfavour, or that Prac- huge population of the world which does sary for understanding the pathophysiolo- tice Guidelines provide little protection! not happen to live in developed coun- gy of some of the neurological diseases of Confidentiality is revised in HIV status, tries. The book is informative and is rec- humans. Developing animal models is a with regard to disclosure to spouses. Es- ommended for medical libraries and for time-consuming task but can be reward- tablishment of Provider-Patient relation- those who are involved or interested in ing many times over, especially for ther- ship ends this part, explaining Tort if injury this disease. apeutic experimentation. This book illus- occurs to the patient on account of its sev- trates the direction of research work in the erance. Physicians are instructed how to P. Davaki, neurosciences. It is divided into five sec- plan Independent Contracts as Employee, Athens, Greece tions. The first section deals with Devel- to protect their Licensures, and to avoid opments in Aging and Alzheimer’s Dis- Fraud/Abuse. End of Life Advisory Direc- Viral Infections of the ease and is described in seven chapters. tives and Definition of Death end this sur- Nervous System GLAXO WELLCOME JUNIOR TRAVEL- 2nd Edition Editor: Richard Johnson LING FELLOWSHIPS - 2001 ISBN: 0 7817 1440 0 Glaxo Wellcome are again generously providing funding for up to 10 Junior Travel- No. of Pages: 527 ling Fellowships – each worth up to £1,000 – for young neurologists from devel- Price: $105.00 oping countries to attend WFN sponsored congresses in 2001. Applicants should Publication Date: 1998 hold a post not above that of Associate Professor and should not be over the age Publisher: Lippincott-Raven Publishers of 42 years. Applications (one clear copy of CV, a letter of recommendation from This is the long overdue second edition of Head of Department, a covering letter giving name and date of congress for which the standard textbook on viral infections of travel funds are sought and whether the applicant is presenting a paper or poster, the nervous system authored by Richard plus an estimate of expenses) must be sent to the WFN London Office to arrive by Johnson. It is divided into 4 sections - a 12 February 2001. general section, which contains chapters

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org CALENDAR 13 vival guide, which includes 20 legally dis- Practicing Neurology ble to neuroscientists, general practition- sected cases. Part II concerns matters ers, postgraduate and medical students. of private and public health insurance Editor: Rahman Pourmand ISBN: 0 7506 9970 1 Editor-in-Chief in the US. Overview of Traditional Indem- No. of Pages: 367 nity Insurance, compared with solutions in Price: £19.99 public insurance, such as Medicare, Med- Publication Date: June 1999 CALENDAR icaid, Managed Care and HMO, are well Publisher: Butterworth-Heinemann examined in this excellent book. Medical * = Meeting endorsed by the Continuing Edu- leaders in countries where Social Medi- “Practicing Neurology” is easily under- cation Committee of the WFN cine is contemplated should study it. standable for medical practitioners not specialized in this area. The book gives 2001 Dr. Juan R. Santoni, a concise, accurate and complete un- International Symposium on the West Syn- Santo Domingo (UASD), Dominican derstanding of a wide range of neuro- drome and Related Infantile Epileptic En- Republic logical diseases and emergencies. It is cephalopathies (ISWS) an extremely important tool for students 10–11 February 2001 The Yayoi Memorial Hall, Tokyo Women’s Advances in Neurology and practitioners who want to reinforce and clarify their theoretical and practical Medical University, Shinjuku-ku, Tokyo, knowledge in the area. The therapeutic Japan Volume 81 Plasticity in Contact: Dr. Yukio Fukuyama, MD, Secre- approach is updated and complete. It tariat, ISWS, C/o Child Neurology Institute, Epilepsy: Dynamic Aspects of also helps to make a better and more ac- Samban-cho TY Plaza, 5FI, 24 Samban- Brain Functions curate diagnosis that will be useful in de- cho, Chiyoda-ku, Tokyo, 102-0075, Japan ciding either to treat the patient or to send Tel: +81-3-3238-1580 Editors: Hermann Stefan, Frederick him/her to a specialist. Fax: +81-3-3238-1502 Andermann, Patrick Cahvuel, E-mail: [email protected] Dr. Juan Carlos Duran, Simon D. Shorvon Méditerranée III - Neuroepidemiology in La Paz, Bolivia ISBN: 0-7817-1446-X the Mediterranean area No. of Pages: 396 8–10 April 2001 Price: U.S.$149.00 Neurology in Clinical Palermo, Sicily Publication Date: 1999 Practice Contact: Professor Giovanni Savettieri Publisher: Lippincott, Williams & Organizing Secretariat: SERONO SYMPO- Wilkins Vol. I - Principles of Diagnosis SIA, Via Casilina, 125, 00176 Rome, Italy This volume is based on the symposium, and Management Tel: +39 06 70384 513 / 506 Fax: +39 06 70384 677 Plasticity and Epilepsy: Dynamic Aspects Vol. II - The Neurological E-mail: [email protected] of Brain Functions. The dynamic aspects of brain function, development and prop- Disorders * First International Conference on Alz- Ed.: Walter G. Bradley, Robert B. agation of epileptic process and function- heimer’s Disease and Related Disorders Daroff, Gerald M. Fenichel al changes related to brain maturation as 18–19 April 2001 and C. David Marsden Limassol, Cyprus well as epilepsy treatment are discussed ISBN: 0-7506-9973-6 Contact: Rob P. Friedland, Amir H. Soas, in 42 chapters contributed by more than No. of Pages: Vol. I & II 2296 (Index pages Department of Neurology, Case Western 100 experts. Based on animal models and additional) Reserve University, Cleveland, Ohio 44106, clinical research, it gives a comprehensive Price: £295 (cont. on p. 16) coverage to findings in signal processing, Publication Date: 2000 reorganization, maturation, neurochemis- Publisher: Butterworth-Heinemann try and neuropharmacology as related to Policy Statement The two volumes of the Third Edition of epilepsy and brain damage. The experts Although World Neurology is the only this hard bound “Neurology in Clinical from a wide variety of disciplines of epilep- medium to go to every neurologist in Practice” provides a bonanza for readers. tology, neurophysiology, neuropsycholo- the world (approximately 22,000 in The Editors are of international repute and gy, neuroimaging and neurosurgery have 84 countries), it is not possible to pub- contributions from 152 authors make it an joined hands to address the key issues licise every neurological meeting that exceptional book in neurology. The chap- related to plasticity, brain functions and takes place. The prime aim of the Cal- ters have been updated from the previous epilepsy. The important topics include endar is to notify those meetings that Edition with considerable new input. Its seizures and cerebral damage, epileptic are sponsored by the WFN (World, Internet companion www.nicp.com gives activity and cognitive impairment, febrile Continental and Regional Congress- readers a unique opportunity to gain convulsions and temporal lobe epilepsy es), its Research Groups and Corpo- access to the most comprehensive neu- as well as the mechanisms of plasticity rate Members of the Research Com- rological references in the world. Read- involved in progressive dynamic changes mittee. Notifications of meetings of ers can really benefit from substantive en- and “running down” phenomenon. I am National Societies are included only if hancements. The website offers sophis- sure that all those interested in epilepsy there is significant international con- ticated searching, links from references will find it stimulating. This excellent book tribution. If space allows, others directly to Medline abstracts, etc. Every deserves a place in the institutional librar- may advertise in the Calendar, in neurological problem is discussed in the ies as a reference book. which case a charge of £125 is 86 chapters of this most comprehensive made. Contact Mr. Keith Newton at book. The excellent flow of the book Dr I.M.S. Sawhney, the WFN Secretariat, 12 Chandos makes for enjoyable reading. With its Assistant Editor Street, London W1G 9DR, UK. E-mail: plethora of references, it is a must for [email protected] for further in- every institutional library to make availa formation.

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org 14 Advertisement

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Controversies in sleep medicine chologists, as well as for all scientists engaged in research in the cognitive R. Cartwright (USA) neurosciences. This second all-new edition is designed to update chap- Sleep-related violence: does the polysomnogram help establish the di- ters covering research domains where considerable developments have agnosis? occurred. In addition, there has been an in-depth reorganization of con- In memoriam tent areas that have spawned new approaches since the first edition. All B.A. Malow, R.D. Chervin (USA) the chapters included in this new edition will provide the most recent data Michael S. Aldrich and references for further exploration and research. International calendar To be published in November 2000: For more information, including Instructions to Authors, go to: Handbook of Neuropsychology, 2nd Edition, Volume 3 www.elsevier.com/locate/sleep Handbook of Neuropsychology, 2nd Edition, Volume 2 Handbook of Neuropsychology, 2nd Edition, Volume 1 Announcing Handbook of Neuropsychology, 2nd edition For more details, please go to: www.elsevier.com/locate/hnp

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(cont. from p. 13) Lisbon, Portugal 13–16 September 2001 Baden-Baden, Germany USA Contact: Dr. Victor Oliveira, Hospital St. Contact: AKM Congress Service GmbH, Phone: 1-216 368 1912 Maria, Department of Neurology, P-1699 Obere Schanzstraße 18, D-79576 Weil Fax: 1-216 368 1989 Lisbon, Portugal am Rhein, Germany E-mail: [email protected] Secretariat: EuroCongressos, R. Francisco Tel: +49 7621 98330 URL: http://www.raphael.com.cy/hotel.html Andrade, 4, P - 1700-198 Lisbon, Portugal Fax: +49 7621 78714 * Symposium on Neurobiology of Demen- Tel: +351 218 472 577 E-mail: [email protected] tia in Developing Countries: Animal Mod- Fax: +351 218 473 746 126th Annual Meeting of the American Neu- els, Epidemiology, Genetics and Clinical E-mail: [email protected] rological Association Perspectives XVII World Congress of Neurology 30 September – 3 October 2001 24–25 April 2001 17–22 June 2001 Hyatt Regency Hotel, Chicago, Illinois, USA UNEP Conference Site Girgiri, Nairobi, London, UK Contact: American Neurological Associ- Kenya Venue: Earls Court 2, Earls Court Olympia, ation, 5841 Cedar Lake Road, Suite Contacts: Professor R N Kalaria / Dr Warwick Road, London SW5, UK #204, Minneapolis, MN 55416, USA Piero Antuono Contact: WCN 2001, Concorde Services Tel: +1 612 545 6284 E-mails: [email protected] Ltd, 42 Canham Road, London W3 Fax: +1 612 545 6073 [email protected] 7SR, UK E-mail: [email protected] American Academy of Neurology Annual Tel: +44 (0) 20 8743 3106 European Charcot Foundation Symposium Meeting and Exhibition Fax: +44 (0) 20 8743 1010 on The Progressive Phase of MS; its Pa- 5–12 May 2001 E-mail: [email protected] Philadelphia Convention Center, PA, USA http://www.concorde-uk.com/wcn-2001 thology and Treatment Contact: Judy Larson, 2221 University (including the 7th European Charcot Founda- XIV International Congress on Parkinson’s Avenue, SE.S. 336, Minneapolis, MN tion Lecture by Prof. P. Soelberg Sørensen on Disease 55414, USA The role of IVIG in the Treatment of Secondary 28–31 July 2001 Tel: +1 612 623 8115 Progressive MS) Finlandia Hall, Helsinki, Finland Fax: +1 612 623 3504 18–21 October 2001 Contact: CongCreator CC Ltd, PO Box Venice, Italy 6th Meeting of the European Society of 762, FIN-00101 Helsinki, Finland Contact: European Charcot Foundation, Neurosonology and Cerebral Hemodynam- Tel: +358 9 4542 190 Heiweg 97, 6533 PA Nijmegen, the ics and 9th Meeting of WFN Neurosonol- Fax: +358 9 4542 1930 Netherlands ogy Research Group E-mail: [email protected] Tel.: +31-24-3561954 http://www.congcreator.com/icpd-2001 (preceding the 10th European Stroke Confer- Fax: +31-24-3540920 ence) 4th Congress of the European Paediatric E-mail: [email protected] 13–15 May 2001 Neurology Society

WORLD NEUROLOGY, Volume 15, Number 4, December 2000 Visit the WFN website at http://www.wfneurology.org