Good News at the End of 2020 the WHO Calls for Global Action Plan to Combat Epilepsy and Other Neurologic Disorders

Á VOL. 35 • NO.5 • DECEMBER 2020

THE OFFICIAL NEWSLETTER OF THE WORLD FEDERATION OF NEUROLOGY

PRESIDENT’S COLUMN Good News at the End of 2020 The WHO calls for global action plan to combat epilepsy and other neurologic disorders

BY WILLIAM CARROLL landmark event. Although the WFN has been closely involved s we reach the end of with neurological activities within, a very trying year with and related to, the WHO, the call A COVID-19 still rampant, for the development of global I have two pieces of good action plans to combat epilepsy news, in some respects, as and (importantly) neurological good as the imminent arrival disorders, is a first. It comes WILLIAM of the vaccines. CARROLL, MD courtesy of a sustained effort by The first is a momentous the ILAE (led recently by Prof. decision by the WHO and Sam Wiebe) and International the second is an important and rewarding Bureau for Epilepsy (IBE) to convince the Photo of WHA 73 from the WHO website. development for the WFN. Both point us WHO that epilepsy is a common disease, all in the same direction. causing considerable effect upon people, availability of anticonvulsant medication. the dilemma of epilepsy and those The decision by the World Health their neurological health, their cognitive It also occurred through the suffering from it, with a number of other Assembly (WHA) on Nov. 12, 2020, function, societal burden, and individual recognition of certain key member important neurological processes. The to adopt Resolution WHA73.10 is a stigmatization for want of the ready states that saw the synergies between see PRESIDENT’S COLUMN page 3

REPORT FROM A WSO-ESO TEACHING COURSE: NOV. 2, 2020 INSIDE ESSENTIAL BRAIN ANATOMY Palliative Care for Patients With Stroke & NEUROPATHOLOGY

BY WOLFGANG GRISOLD, CLAIRE J. PAGE 2 CREUTZFELDT, GILLIAN MEAD, AND FERGUS N. DOUBAL DEPARTMENT VISIT: uring the World Stroke Organization ST. OLAVS HOSPITAL, (WSO)-European Stroke Organization NORWAY D (ESO) Congress (https://eso-wso- PAGE 5 conference.org), a teaching course on palliative care issues in patients with stroke THIS DOCTOR CAN: was offered. There were four speakers: WOLFGANG CLAIRE J. GILLIAN FERGUS N. HIS JOURNEY Wolfgang Grisold (Austria), Claire J. GRISOLD CREUTZFELDT MEAD DOUBAL PAGE 6 Creutzfeldt (U.S.), Gillian Mead (U.K.), and FIRST WFN/AFAN Fergus N. Doubal (U.K.). They presented course showed, has many facets to be further work needs to be done for the long four lectures. discussed. trajectory of stroke survivors. E-LEARNING DAY PAGE 8 This initiative deserves merit, as despite Attention also needs to be given to much progress in palliative care in many Wolfgang Grisold (Austria) individuals with disturbed consciousness, E-COMMUNICATIONS aspects of neurology, there is considerable W. Grisold gave an outline on the present cognitive impairment, and speech disorders, COMMITTEE AND THE scope for improving palliative care in stroke. international guidelines on palliative care in who often can not actively participate in the APHASIA, DEMENTIA, AND Stroke is the most frequent neurological stroke. Guidelines are elaborate and define process of decision-making. disease globally and the leading cause of the need and the role. In addition, there From the conceptual and cultural point COGNITIVE DISORDERS disability adjusted life-years and deaths due is also a U.K. patient guide that is helpful. of view, it has to be acknowledged that SPECIALTY GROUP to neurological diseases. Therefore, such an Most of the guidelines are aimed at the the concept of palliative care is based on PAGE 9 initiative is important, and, as this teaching acute and subacute setting of stroke, and see PALLIATIVE STROKE page 6 2 WWW.WFNEUROLOGY.ORG • DECEMBER 2020

FROM THE EDITORS

BY STEVEN L. LEWIS, MD, EDITOR, Seidi from Sudan. AND WALTER STRUHAL, MD, CO-EDITOR In this issue’s History column, Prof. Peter Koehler provides us with additional e would like to welcome you insights into the background and interests to the December 2020 issue of the anatomist Sylvius, of aqueduct and W of World Neurology, the final lateral fissure fame. issue of this remarkable year. This issue In his column on WFN Committees

Editors-in-Chief begins with the exciting news from WFN and Specialty Groups, WFN Secretary- Steven L. Lewis (Editor) President William Carroll about the recent STEVEN L. WALTE R General Wolfgang Grisold updates us on Walter Struhal (Co-editor) decision by the World Health Assembly LEWIS, MD STRUHAL, MD the activities of the e-Communications WFN London Office on Nov. 12, 2020, to adopt Resolution Committee and the Aphasia, Dementia, Chester House Fulham Green 81-83 Fulham High St., London SW6 3JA WHA73.10, calling for a global action plan AFAN e-learning Day, which took place in and Cognitive Disorders Specialty Group United Kingdom to combat epilepsy and other neurologic October and was attended by hundreds of of the WFN. Tel.: +44 (0)20 3542 1657/1658 Fax: +44 (0)20 3 542 1301 disorders. neurologists worldwide. This issue also features a nicely [email protected] With regard to the WFN as a source Wolfgang Grisold, Claire J. Creutzfeldt, illustrated and thoughtful report from the

WFN OFFICERS of high-level global neurologic education, Gillian Mead, and Fergus N. Doubal recent participant in the WFN department President William Carroll (Australia) this issue features the article by Nobutaka provide their report on the recent teaching visit at St. Olav’s Hospital in Norway, First Vice President Ryuji Kaji (Japan) Secretary General Wolfgang Grisold (Austria) Arai, head of the Laboratory of course they organized for the World an opportunity created through the Treasurer Richard Stark (Australia) Neuropathology at Tokyo Metropolitan Stroke Organization and European Stroke generosity of and wonderful planning

ELECTED TRUSTEES Institute of Medical Science, whose Organization on palliative care for patients from the Norwegian Neurological Morris Freedman (Canada) website teaching neuroanatomic and with stroke, as an emerging and necessary Association. Alla Guekht (Russia) Steven L. Lewis (USA) neuropathologic concepts is available free development in the care of stroke patients. Finally, the issue concludes with a to all neurologists worldwide and available This issue also offers an inspiring heartfelt obituary of Dr. Juan Rafael CO-OPTED TRUSTEE Marianne de Visser (The Netherlands) as a link in the article and on the WFN article, reprinted with permission from the Santoni Mendoza, a father of Dominican website. Royal Society (https://www.rcplondon. neurology. REGIONAL DIRECTORS Maged Abdel Naseer (Pan-Arab) In addition, Prof. Riadh Gouider ac.uk/news/doctor-can-journey-bedwin- We wish you all a happy and healthy James C.Stevens (North America) provides an exciting update and the boy-eastern-sudan-professor-neurology) 2021 and look forward to your reports and Claudio Bassetti (Europe) Marco Tulio Medina (Latin America) successful statistics from the recent WFN/ describing the journey of Prof. Osheik suggestions for articles in the new year! • Beomseok Jeon (Asian-Oceania) Foad Abd-Allah (Pan-Africa)

EDITOR OF THE JOURNAL OF THE NEUROLOGICAL SCIENCES John England (USA) Essential Brain Anatomy & Neuropathology (EBA&N)

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PRESIDENT’S COLUMN to be prepared for discussion at the partnership being bolstered by its such as the WFN, that will be similarly continued from page 1 WHA74 meeting in 2021. relationship with associated disease topic buoyed. To address these challenges in At the 144th Executive Board Meeting organizations of the Global Neurological the manner outlined in the WHA73.10 resulting WHA73.10 Resolution was in January/February 2019, the WFN Alliance, such as the World Stroke Resolution will also require the carried unanimously by members of the posted a statement asking the EB not to Organization, Alzheimer’s Disease development and implementation of plans 74th Executive Board and thence the 73rd defer consideration on further actions International, Parkinson’s Disease to overcome many barriers, which have World Health Assembly. In Clause (PP2) to address the global burden of epilepsy and Movement Disorders Society, the contributed to the inequities of access of WHA73, it is clear that the authors and and its health and social implications at International League Against Epilepsy, most keenly felt by less well-resourced the supporting member states recognized the country level. Again, in May 2019, we and Multiple Sclerosis International jurisdictions. The leadership of the a need to address all neurological joined with the ILAE and IBE to support Federation. WHO will be pivotal in maintaining the disorders. The clause specifically this initiative in a further Side Event, At the 146th Executive Board meeting momentum required. mentions epilepsy, headache disorders, urging member states to implement in February 2020, the WFN supported Finally, this most welcome event neurodevelopmental, neurodegenerative, a coordinated action against epilepsy the draft decision on the 2019 Global sits closely with the WFN Needs neuroinfectious/neuroimmunological, through the establishment of: Report “Epilepsy as a Public Health Registry. This registry was conceived cerebrovascular diseases including 1. national Health Care Plans for epilepsy Imperative” proposed by the Russian to provide a complementary balance stroke, and traumatic brain and spinal management to overcome inequalities Federation and co-sponsored by China to the data supplied by WHO member cord disorders. There is scarcely a single and inequities in health, social, and and Guyana. The WFN statement also states. Member states are by and large neurological disorder not encompassed by other related services requested the WHO director-general to national governments. The WFN this regulation. (See below.) 2. initiatives to promote public awareness expand the scope of the report EB146/12 Needs Registry is the product of WFN The regulation seeks to develop a of an education about epilepsy, to be presented at the 73rd WHA with an member societies, which are in turn comprehensive intersectoral approach and to reduce the misconceptions, additional consideration of “Synergies composed of neurologists and allied to addressing all neurological disorders stigmatization and discrimination in Addressing the Burden of Epilepsy neurological colleagues on whom people in line with the third pillar of the U.N. against people with epilepsy and Other Neurological Disorders” with neurological disease depend for Sustainable Development Goals. 3. actions to prevent causes of epilepsy and among other calls “to encourage prevention, diagnosis, and treatment. For the first time, neurological 4. greater investment in epilepsy research member states and related non-state The data collected by the Needs Registry disorders are being overtly recognized and increased research capacity. actors to contribute to discussions” on offers opportunities to advocate for for the threat they pose to all societies the “draft resolution on epilepsy and the redirection of resources as well as and health jurisdictions. We need The WFN also posted a statement other neurological disorders” based on additional resources where possible and to look no further than the most recent on the Prevention and Control of the report mentioned in paragraph 2 to do so collectively with member societies Global Burden of Disease Study, Non-Communicable Diseases (Agenda be presented for consideration by the 73rd and jurisdictions sharing common which demonstrated neurological item 11.8) highlighting the need to: WHA. challenges. non-communicable disorders to be the 1. elucidate treatments to prevent The leadership demonstrated by the Given the position of the WFN leading cause of disability and the second and/or modify stroke, migraine, WHO in the adoption of WHA73.10 and its relationship with the Global leading cause of death. To have the and Alzheimer’s Disease and other will be of inestimable benefit in the Neurology Alliance and the World WHO acknowledge the need for global dementias energization of all those faced with Health Organization, it is likely to be action plans to address this burden will 2. the disparity between high and low combating neurological disorders, able to contribute considerably to the provide enormous assistance to those at sociodemographic index nations particularly non-communicable attainment of useful outcomes in line risk of neurological disorders and those and the resultant unequal burden on neurological disorders and their with WHA73.10. In this regard, the attempting to combat them. resources devastating effect on individuals and WFN is planning to discuss in 2021 The WFN was proud to lend its 3. that the WFN was uniquely placed societies. For those so engaged to know with each of its regional organizations support to the ILAE and IBE at the as the only global neurological that the WHO, through its member states, ways in which these processes might be WHA71 (May 2018) “Side Event for organization with an almost identical will be encouraging, advocating, and advanced. Global Action on Epilepsy” and a matching regional and national reach. leading the intersectoral struggle will be I wish you your families and colleagues statement calling for a new report on the The statement pointed to the WFN’s heartened. a safe and joyous time through the festive implementation of Resolution WHA68.20 geographical advantage in advocacy There will be many non-state actors, season and a better New Year for all. •

THE 73rd WORLD HEALTH ASSEMBLY RESOLUTION WHA73.10 (PP1) Recognizing that epilepsy and of deaths due to neurological disorders Action Plan on Epilepsy and Other care and rehabilitation, including other neurological disorders are the has increased by 39%;3 Neurological Disorders referenced in treatment options with the potential to leading cause of disability-adjusted life (PP4) Acknowledging, as outlined paragraph 3.1; cure epilepsy and other neurological years and the second leading cause of in the WHO/ International League disorders; death worldwide, and that epilepsy Against Epilepsy/International Bureau (OP3) REQUESTS the Director- (OP3.2) To include in the and other neurological disorders for Epilepsy Global Report on Epilepsy General: Intersectoral Global Action Plan disproportionately impact people living (2019), that epilepsy is one of the (OP3.1) To develop, in consultation ambitious, but achievable, global in low- and middle-income countries;1 most common neurological disorders with Member States, and in full targets on reducing preventable cases (PP2) Noting that neurological globally affecting an estimated 50 collaboration with United Nations of, and avoidable deaths, resulting disorders are conditions of the central million people worldwide across all organizations and relevant non-State from epilepsy and other neurological and peripheral nervous system ages with increased rates in the young actors, a 10-year Intersectoral Global disorders, strengthening service that include epilepsy, headache and the old… Action Plan on Epilepsy and Other coverage and access to essential disorders, neurodegenerative (OP1) URGES Member States:1 Neurological Disorders in support medicines, improving surveillance disorders, cerebrovascular diseases (OP 1.1) To provide the appropriate of universal health coverage to and critical research and addressing including stroke, neuroinfectious/ support to WHO to develop the address the current significant gaps discrimination and stigma; neuroimmunological disorders, Intersectoral Global Action Plan on in promotion of physical and mental (OP3.3) To submit to the 150th neurodevelopmental disorders and Epilepsy and Other Neurological health, and prevention, early detection, Executive Board, a draft Intersectoral traumatic brain and spinal cord Disorders referenced in paragraph 3.1; care, treatment and rehabilitation, as Global Action Plan for consideration by injuries;2 well as social, economic, educational Member States, as well as to report on (PP3) Noting with concern that the (OP2) CALLS UPON all relevant and inclusion needs of persons and the progress achieved in implementing risk of premature death in people with stakeholders: families living with epilepsy and this resolution, with an intention to epilepsy is three times higher than in (OP2.1) To provide appropriate other neurological disorders, and the submit the plan to Member States for the general population and that, over support to WHO and partners to ongoing need for research to improve endorsement during the 75th World the past 30 years, the absolute number develop the Intersectoral Global prevention, early detection, treatment, Health Assembly. • 4 WWW.WFNEUROLOGY.ORG • DECEMBER 2020

HISTORY Sylvius and “The Quack” Masterpieces at a Leyden Home

BY PETER J. KOEHLER chemistry and anatomy in his leisure time, he returned to Leyden to become hen reading the name Sylvius, professor of medicine. He gave bedside most neurologists will think teaching in the nearby Caeciliahospital W of neuroanatomic structures and studied the pathological changes at like the aqueduct and the lateral fissure autopsy. of the hemispheres. Descendant from a Protestant family from northern Fissure of Sylvius France (the city of Cambrai that at He attracted many foreign students, the time was situated in the southern including Danish Niels Stensen (“Steno”; Netherlands), Franciscus dele Boë (1614- 1638-1688), who wrote that Sylvius’s 1672), also known as Sylvius, was born method of brain dissection was a Fissura Sylvii. in the German town of Hanau, east of combination of the ancient Galenic Frankfurt-am-Main. approach and the more recent method of He studied medicine in Sedan and Costanzo Varolio (1543-1575). Leyden, made a peregrination to southern The latter cut the brain from its base to German universities and defended a thesis above, thereby improving the visualization at the university of Basel, Switzerland of structures at the base, including the (1637). He graduated a second time the cranial nerves and the pons (Varolius). following year at Leyden university. Another pupil, Gabriel Ypelaer, defended He became famous for his anatomy a thesis under Sylvius’s supervision, in lessons, at the time including physiology. which he presented a description of the He demonstrated the circulation of the lateral fissure (1660). Sylvius published it blood as published by William Harvey three years later in his own Disputationem (1578-1657) a few decades previously (De medicarum decas. motu cordis, 1628). In 1774, the Swiss Albrecht von Haller “Many students, and certainly not the (1708-1777) emphasized that this was worst ones, attended his courses, so that probably the first description of the fissure. it seemed as if only he could understand Sylvius’s name became also associated with and explain anatomy.” Among his students the aqueduct, although many refer to the was Danish Thomas Bartholinus (1616- homonymous teacher of Andreas Vesalius Sylvius and his wife / “The music lesson” 1680), son of the famous anatomist Caspar (1514-1564), Paris anatomist Jacobus Sylvius by Frans van Mieris I (1672, oil on panel, 41x31 cm, courtesy Staatliche (1585-1629). Thomas’s notes of Sylvius’s (1478-1555). Kunstsammlungen Dresden - Gemäldegalerie course of the early 1640s was included Probably the structure had already been Alte Meister, Dresden, inv. no. 1743). in his father’s Institutiones anatomicae observed by others before Jacobus Sylvius, (1641 edition). Caspar Bartholinus wrote although there is discussion on whether including city official, merchants, and “we cannot pass by the very accurate they really saw the small canal. The Leyden like Sylvius, university professors. An anatomist D. Franciscus Sylvius; from his Sylvius, however, described the “canalis inventory of his house in 1673, half a year noble mind and ingenuity we take the vel aquae-ductus” between the converging after his death, shows that he had been the admirable new structure of the brain.” “roots of the spinal cord” and the corpora owner not only of a considerable library, Following a period of practicing quadrigemina below “our bridge” comprising hundreds of medical, chemical, general medical in Amsterdam (1641- (Disputationem (1663; chapter 21). and religious books, but also one of the Sylvius’s house in Leyden at Rapenburg 31. 1658), where he lived at the Keizersgracht With respect to physiology, Sylvius largest painting collections of the city. [canal], and during which he enjoyed rejected the classical qualities and humors, It seems that at the time he was a patron retaining the concept of animal spirits for contemporary painters, including Next to the painting with his second that were used in the brain and sent to the Experiens Sillemans (1611-1652/3; six wife, Van Mieris painted another portrait muscles through the nerves. He adhered paintings) and Simon Luttichuys (1610- of Sylvius (1665, see above, he inscribed the to a kind of chemical humoral pathology 1661; six) from Amsterdam, and Gerrit Dou age of the person 52, which should have that became known as iatrochemistry, in (11) and Frans van Mieris I (7) from Leiden. been 50 or 51). which effervescense, a vehement reaction Among the latter painter’s works, Sylvius Furthermore, Sylvius owned works by between acid and alkaline secretions occur, owned “The music lesson” with portraits Roelant Savery (1576-1639), Paulus Potter for instance, in the right ventricle of the of Sylvius and his second wife Magdalena (1625-1654), and Philips Wouwerman heart or the duodenum. L. Schletzer, whom he had married in (1619-1668), in particular animal scenes. 1666. During the plague of 1669, Sylvius Imagine living in such a kind of art gallery! Collecting Masterpieces became severely ill, but survived. However, A reconstruction of his home showed that Sylvius’s first wife, Anna de Ligne, whom his young wife (21 years old) died, even he had 22 paintings in his dining room he married in 1649, died the year before before Van Mieris finished the painting. It (including the five senses by Jan Miense he moved back to Leyden. Their two was hanging in Sylvius’s front room. For Molenaer), 34 in his large salon, 26 in a side children also died at a young age. Arriving Van Mieris, Sylvius was “zynen Mecenas” chamber, 16 in the upper back chamber, in Leyden, he bought a nice house at [his Maecenas]. Dutch writer and painter and 42 (including Van Dyck’s portrait of Rapenburg (on a canal) no. 31, not far from Arnold Houbraken (1660-1719) wrote: King Charles of England) in the master the university building. He had it converted “Professor Silvius, welke laatste dikwerf bedroom that was arranged as a kind of Sylvius by Frans van Mieris I (1665, oil on (for 10.500 guilders) into a distinguished verzogt, dat al wat hy maakte voor hem Kunstkammer. panel, 18,8x14,2 cm, New York, private home with dining room and salon. mogt wezen” [Professor Sylvius, the latter Apparently, he did not collect everything collection; see also The Leiden Collection Other houses at the Rapenburg were who often asked that all what he made from his surroundings, as is demonstrated FM-104). owned by upper-class Leiden citizens, might be for him] (Houbraken, 1721, p. 3). see SYLVIUS AND “THE QUACK” page 7 5 WWW.WFNEUROLOGY.ORG • DECEMBER 2020

WFN DEPARTMENT VISIT REPORT St. Olavs Hospital, Norway

BY DR. ABDOUL BACHIR DJIBO HAMANI neurology, neurophysiology, and stroke. fantastic places in the city and learned to • All my supervisors and colleagues speak Norwegian (Takk=thank you). was honored to be accepted to do a who are too numerous to share our Since my return, I have performed department visit at the prestigious experiences. I spent an excellent stay in several blocks of the upper occipital I Norwegian University of Science and your company. nerve, and I have been able to set up Technology (NTNU) at the St.Olavs • The entire university hospital an electroencephalogram reading Hospital in the Department of Neurology administration. club for a better improvement of our in Trondheim in Norway. Planned from March 3-27, 2020, electroencephalogram laboratory. For this I would like to express my my program of visit of the neurology Our neurology department today has sincere thanks to: department at St. Olav’s Hospital adopted several therapeutic protocols • The World Federation of Neurology actually lasted from March 3 to July resulting from my stay in Norway. (WFN) for this wonderful opportunity 28, 2020, because of the coronavirus I am sure that this experience will to acquire this new experience in pandemic, which made my return trip to serve all of Africa in general and my With Prof. Christian Samsonsen, head of the care of people suffering from Africa impossible. country in particular. Thank you again. • the department of neurology at St. Olav’s neurological disease, especially to Jade During this stay, I had the Hospital. Levy, who was in charge of the visit opportunity to make daily visits to • The Norwegian Neurological patients in the neurology department Association’s president, Prof. Anne and also to participate in the outpatient Hege Aamodt consultation where I had the chance to • All the staff of the Department of strengthen my skills in the diagnosis Neurology and management of neurological • Prof. Christian Samsonsen, who was my pathologies, more specifically epilepsy. training supervisor. Prof. Samsonsen I also experienced a number of had confidence in me and supported neurodegenerative and autoimmune and encouraged me throughout the pathologies, such as multiple sclerosis, duration of my training. amyotrophic lateral sclerosis, and severe • Dr. Elisabeth Kvisvik and Dr. Thanh myasthenia gravis. Pierre Doan for having accepted me I also took part in botulinum toxin into this company and who have injections, upper occipital nerve block, facilitated my relations with other and the performance and interpretation colleagues in the departments of of electroencephalograms. I visited some 6 WWW.WFNEUROLOGY.ORG • DECEMBER 2020 This Doctor Can: A Journey From a Bedwin Boy in Eastern Sudan to a Professor of Neurology

BY PROF. OSHEIK AB’ASHA SEIDI, MB BS, no electricity, TV transmission, or I worked with many people stories and experiences of members of the MRCP (U.K.), ABIM, CCST (U.K.), FRCP paved roads. Soon, I was selected of extremely high caliber with African diaspora communities in Bristol and was born in a village called Aroma, after a tough competitive test to comprehensive knowledge Newcastle, this resource aimed to challenge named by the British for the nice smell join the Arab Board of Internal in medicine and many other young peoples’ perceptions of African I of its naturally growing wild roses, in Medicine residency program in sciences Sharing the teamwork countries and provide opportunities to the northeast African country Sudan. My Abha city, in the Asir Region of of my research committees, I question the way in which we see our world. parents could barely read or write, as they southwestern Saudi Arabia. published widely and participated The program was extraordinarily did not complete primary school. That was a 5-year residency in international neurology successful, and the teaching resource is My family was large and wanted all program. Luckily, in my second OSHEIK conferences as a speaker. The widely used. their kids to go to school. From the outset, year of the rotation, I managed AB’ASHA U.K. gave me what I was looking Over the past 10 years, I have moved SEIDI I was required to do many jobs as well as to pass the written and clinical for – opportunities to further back to Sudan and joined the Faculty of attend school. This included early morning parts of the MRCP (U.K.) and discover my personal strengths. Medicine at the University of Khartoum. shopping from the local market for fresh soon after obtained my ABiM (Arab Board During that time, I became aware of I progressed to professor of internal vegetables and meat, to the afternoon and of Internal Medicine) degree. I was then many misconceptions about Black people, medicine and neurology in 2014, and was a evening milking and feeding of our goats promoted to consultant physician at age 35, particularly those coming from Africa founding member for the African Academy and cows. an unusual thing in that setting. and more so from Sudan when the war in of Neurology (AFAN) and acted as the The educational system in my country My passion for neurology led me to Darfur was at its peak. I had many personal vice president for East Africa on the first of origin, Sudan, was strong and free. resign my job in Saudi Arabia and move to discussions with my colleagues and really felt steering committee (2015–2017). With the So, despite my family’s limited financial the U.K. in 1998, with my supportive wife that I must do something to clear the mist. solid support of many colleagues in Sudan, abilities, I was blessed by being able to make and three young kids. I started as a senior I moved to northeast England as a we managed to establish a PACES center in my way through primary, intermediate, house officer, but in a few months, I was training specialist registrar in neurology, Sudan in 2012, and I have supervised all the and high schools successfully, eventually promoted to clinical lecturer / registrar and in Newcastle upon Tyne, I met many MRCP (U.K.) examinations in Sudan from ending up in the Faculty of Medicine at the at Sheffield University Hospitals NHS Africans, including Dr. Peter Adegbie, an 2010 until now. University of Khartoum. Foundation Trust. inspiring and kind Christian priest originally I also actively participated in starting the The university was originally opened Still, my ambition was to excel in from Nigeria. He studied theology and Medical Training Initiative (MTI) and hosted in 1924 under the name “Lord Kitchener’s medical research as well as clinical skills, had similar feelings as mine regarding the the first trainee from Sudan when I was a School of Medicine” and was linked to so I kept an eye on suitable opportunities, need to clear the misconceptions about consultant in Sunderland, U.K., in 2007. I the University of London until 1956 when until I succeeded in getting a job as a clinical Black Africans. Together, with many other still help in the selection process of suitable Sudan became independent from British research associate at Guy’s, King’s College, African friends in the northeast of England, candidates from Sudan with leadership of colonization. I graduated with distinctions and St. Thomas’ School of Medicine in we participated in a major project called my colleague, Prof. Alaadin Hassan Ahmed, but soon realized that I would not be able 2000. There, I discovered new abilities in African Voices, led by Dr. Peter Adgebie and currently dean of the Faculty of Medicine at to support my family as the local economy myself as a researcher and combined basic funded by the European Union Fund. the University of Khartoum. was in complete disarray. I left for Yemen laboratory research with participation in We prepared and carried out a I hope my story will inspire many young while most of my colleagues expatriated to international randomized clinical trials on comprehensive program to shine a light Black people and other ambitious people of the Gulf countries. many drugs for multiple sclerosis. on African cultures and peaceful diversity. all colors and walks of life.• I managed to make some money in I learned a lot from my seniors at Training was for all ages, but mainly targeted Yemen, reasonably helped my family, got the department of neuroimmunology young people in the U.K. We also prepared This article is reprinted with permission from the married, and passed part 1 of the MRCP and was particularly influenced by Prof. a curriculum for children ages 5-9 years Royal College of Physicians. https://www.rcplondon. (U.K.). In the early 1990s, I moved to Saudi Richard Hughes and his impressive range with a simple approach to let them have ac.uk/news/doctor-can-journey-bedwin-boy- Arabia as a GP in a remote village that had of scientific styles and leadership abilities. true ideas about Africans. Through the eastern-sudan-professor-neurology

families and also the importance of fourth most common cause of sudden Care in Stroke. Stroke 2014; Volume 45, Issue PALLIATIVE CARE 6,1887-1916. communication. An important issue is what death after cardiac causes, pulmonary continued from page 1 https://www.stroke.org.uk/resources/national- the individual expectancy for patients with embolism, and infection. clinical-guideline-stroke-patient-version the patient autonomy, which is culturally severe stroke is, and if this would change at When stroke causes sudden death, perceived differently. different time points during their disease, as especially in younger patients, there is a Claire J. Creutzfeldt, et al. Symptomatic and survival often ensues with severe disability. preponderance of intracerebral hemorrhages Palliative Care for Stroke Survivors. J Gen Intern Med. 2012 Jul; 27(7): 853–860. Claire J. Creutzfeld (U.S.) Reference to the study of Kendall et al, compared to ischemic stroke. When stroke Marylin Kendall, et al. Outcomes, experiences The issue of integrating palliative care 2018, was made, which posed the question causes death within 24-48 hours, the rate and palliative care in major stroke: a multicentre, and serious illness communication into of outcomes, experiences, and palliative of intracerebral hemorrhage is higher, but mixed-method, longitudinal study. CMAJ. 2018 high quality stroke care was addressed care in stroke. as time progresses ischemic stroke become Mar 5;190(9):E238-E246. doi: 10.1503/ by C.J. Creutzfeldt. The different disease One result was that palliative care still more prevalent as a cause of death. cmaj.170604. trajectories were discussed and compared has the connotation of withdrawal, or When death is sudden (within days), this Frederik Nybye Ågesen, et al. Sudden unexpected with those of other illnesses often withholding, and “dual“ narratives should can be challenging for patients, families, and death caused by stroke: A nationwide study considered for palliative care, such as cancer. be avoided. The loss of the former self of health care professionals who often need to among children and young adults in Denmark Int J Stroke 2018 Apr;13(3):285-291. doi: Building a partnership with the patient the patient is an issue for the patient and for work together to make important yet time- 10.1177/1747493017724625. Epub 2017 Aug 1. and his or her family, communicating carers. Guiding through the moral maze in critical shared decisions quickly. During this transparently and discussing hope with discussions with the family is important for process, it is important to base decisions on Wolfgand Grisold is Secretary-General of the WFN.

both realism and compassion are key skills providing emotional support and dignity. the patient’s values and what they would Claire J. Creutzfeldt is associate professor of neurol-

for stroke providers. Dr. Creutzfeldt gave a consider to be an acceptable outcome with ogy at the University of Washington - Harborview

strong testimony of the need for palliative Fergus Doubal (U.K.) families acting as proxies should the patient Medical Center in Seattle, Washington. care in stroke with the goal of improving Sudden death is common following stroke not retain capacity to participate. Often Gillian Mead is chair of Stroke and Elderly Care communication, decision-making, quality and can be due to several causes: immediate death may not be considered the worst Medicine at the Center for Clinical Brain Sciences, of life, and quality of end of life for patients pressure effects from a large stroke causing outcome compared to survival in a highly University of Edinburgh. with stroke and their families. brain edema, concurrent severe disease, dependent state. Fergus Doubal is the Stroke Association Garfield often cardiac, infectious, and other medical Weston Foundation Clinical Senior Lecturer, Gillian Mead (U.K.) complications, and also due to treatment References for Further Reading: NHS Scotland Research Fellow at the Center for Holloway RG et al. Palliative and End-of-Life Gillian Mead emphasized the role of withdrawal. In young adults, stroke is the Clinical Brain Sciences, University of Edinburgh. 7 WWW.WFNEUROLOGY.ORG • DECEMBER 2020

SYLVIUS AND “THE QUACK” cap and the other a black beret, behind continued from page 4 that man are discussing the scene. A man, leaning on the windowsill of the opened by the fact that he did not have any of window above, and a woman behind him, the moralizing genre pieces by Jan Steen are also listening. A number of objects are (1626-1679) or landscapes of Jan van Goyen displayed on the table, including a small (1596-1656). bottle with a plug, a spatula – it may be pointing in an intended direction - and The Quack and (Brain)Stones a bowl with a triturator. A big knife is Since Jheronimus Bosch’s painting “Cutting hanging from the edge of the table. the stone,” similar scenes have been At the background to the left, we see depicted in paintings and engravings during a farmer’s house and a church (and some the 16th and 17th century (see World persons, one of whom is obeying nature’s Neurology 2017, January, pp. 6-7). Adriaen call near the tree) and to the right façades Brouwer’s (c.1605-1638) “Quacksalver,” of six houses in a row. Deception of the now possessed by the Kunsthalle in credulous peasants seems to be the main Karlsruhe), was hanging in Sylvius’s entry subject of this scene. room. Although it is not a representation If the viewer would still have doubts, of the actual procedure of “cutting the the painter added, on the upper right stone,” stones are depicted hanging on corner of the banner, some letters: “JAN pieces of red string on the quack’s banner, CERNAKEL.” This is a reference to “Der Quacksalber” [Quacksalver] by Adriaen Brouwer that once belonged to Sylvius. in a way that can observed in several other Bruegel’s “Witch of Mallegem,” where it (c. 1630, oil on panel, 45,2x61,8 cm, courtesy Staatliche Kunsthalle, Karsruhe, inv. no.1897). paintings. It would indicate examples of is spelled with a “k” instead of “c.” The stones that the quack had removed in the German world “Karnickel” has several past from the heads of other patients. Even meanings, including rascal or bellwether. attributing such a function to the pineal Brouwer’s “Quacksalver” would also fit a knife has been attached to the banner. gland. The town physician of Nijmegen, in this idea of admonition to temperance The place of action is a market The Pineal Gland and Brain Stones subsequently professor of medicine and and several of the themes, also used in the square, where a quack, who has relatively Although the artists of the paintings and anatomy in Utrecht (1649), IJsbrand van literary arts of the period, including self- short legs, with long hair, a beard, and engravings that directly or indirectly refer Diemerbroeck (1609-1674), published a knowledge and “insight in the deceptive moustache, is standing on a partly sawed to “cutting the stone” had moralistic or new edition of his Anatome Corporis essence of the world.” It would be off or buried barrel. He is wearing a red satirical intentions, rather than showing Humane (1679; first edition 1672), in which recognizable in Sylvius’s inaugural address, hat with feathers, a yellow coat with blue actual practices, it is funny to see that he gave a description of the anatomy and when he became professor in Leyden stripes, and brown trousers. These clothes Sylvius at least owned one such painting. position of the pineal gland, mentioning (1658). The painting in Sylvius’s collection remind of the Italian comedy (commedia This is particularly interesting as he lived in “arena & calculi” [sand and calcification] gives evidence of his sense of humor as dell’arte), which was sometimes applied by a time, in which the pineal gland, by some, that occupied half the volume of the well as the perception of Van Mieris’s and painters. A dagger is attached to his belt. including René Descartes (1596-1650), gland, with a reference to Sylvius, who Brouwer’s work among the public. • He seems to be looking at the viewer. Henricus Regius (1598-1679), and Louis de indeed referred to the pineal gland in his In his left hand, he has a small pot and la Forge (1632-1666), was believed to be the Disputationes Medicarem IV (De Spirituum Further Reading: with the index finger of the right hand he organ in which the soul is localized. Animalium in Cerebro, Cerebelloque Baumann ED (1949). François dele Boe probably takes some ointment. Around The finding of calcifications, stones, in Confectione, per Nervous Distributione, Sylvius. Leiden, Brill the table in front of him, we see adult this organ led to several speculations. Some atque Usu Vario). He was much in doubt people, probably peasants listening and reasoned that these findings could never about its function. Beukers H (2000). The Sylvian Fissure. In: looking to the objects on the table. There be compatible with the idea of localization Koehler PJ, Bruyn GW, Pearce JMS (eds). are also some children. The one with the of the soul in the pineal gland. Others, “Know Thyself” Neurological Eponyms. New York, Oxford red beret with white feather and pink coat who had found such stones in persons This ancient Greek aphorism is one University Press, pp. 51-5. may be doing some mischief. The woman with behavioral disorders (including a of the Delphic maxims depicted on a in brown blouse and white bonnet behind woman who committed infanticide), column of the Temple of Apollo. Smith Houbraken A (1721/1976). De groote the table, laughing to the quack possibly believed rather that it proved that the cause (1999) believed that Sylvius’s painting schouburgh der Nederlantsche konstschil- took the plug from the bottle with the blue was in that organ. By its calcification, the collection “emphasized the importance of ders en schilderessen. Part III Amsterdam, fluid, or is she emptying a small pot? To the physiological flow of humors in that area self-knowledge and the effort to achieve Israël (see also http://www.dbnl.org/tekst/ right-hand side, a woman in pink coat with was believed to be prohibited (see World moderation in all things, like the numerous houb005groo01_01/colofon.php accessed white bonnet and apron, is sitting on a low Neurology 2017, January, pp. 6-7). fruit and flower still lifes in his collection, October 1st, 2020). bench. A man in front of her seems to be In these discussions, the name of which alluded to the ephemeral nature explaining what is happening; he is pointing Sylvius (and English physician/anatomist of human existence and the vanity of Smith PH (1999). Science and Taste: Painting, to the quack. Thomas Wharton [1614-1673]) was the things of the world, the message of Passions, and the New Philosophy in Seven- Two other persons, one with a red often found as opponents to the idea of neostoicism.” teenth-Century Leiden. Isis 90 :421-461.

https://wfneurology.org/ 8 WWW.WFNEUROLOGY.ORG • DECEMBER 2020

First WFN/AFAN e-Learning Day SCIENTIFIC PROGRAM REPORT BY RIADH GOUIDER The program was treated in four he World Federation of Neurology Scientific Sessions, with a parallel (WFN) and the African Academy session in French. T of Neurology presented their first • Session I: Stroke Burden and virtual one-day teaching course—the first Challenges in Africa WFN/AFAN e-Learning Day—which • Session II: Stroke Risk Factors and took place from 8:45 a.m. to 6 p.m. (BST), Subtypes Saturday, Oct. 10, 2020. • Session III: Stroke Imaging • Session VI: Stroke Management Collaborators (with parallel session in French) This educational event was held with the support of the European Academy of Conferences: 10 conferences Neurology (EAN), the American Academy were pre-recorded in advance of Neurology (AAN), and the World and broadcast Oct. 10 with two Stroke Organization (WSO). conferences by session.

Organizing Committee Main Topic Quality Assurance Survey Invited Speakers: 10 speakers from The WFN/AFAN Day was organized The topic was “STROKE: a Treatable and The Quality Assurance Survey link all over the world presented lectures by Dr. Riadh Gouider, Dr. Wolfgang Preventable Disease.” was sent out to all the participants by and provided deep insight into the Grisold and Dr. Walter Struhal, under the the PCO. We received more than 200 latest developments in the field of direction of the e-Learning Committee Opening Ceremony answers to the survey made about the stroke and vascular diseases. on behalf of the WFN and the Board The opening of the e-Learning Day was opinion of the participants about this Prof. Foad Abdallah (Egypt, AFAN) of Directors of the African Academy of jointly directed by Prof. William Carroll, event. Much appreciation of the quality Neurology (AFAN). WFN president, and Prof. Foad Abdallah, of the educational content and technical Prof. Rufus Akinyemi AFAN president. platform was shared by more than 90% (Nigeria, AFAN) Local Organizers of the participants. The Certificate of Dr. Nobuaki Yamamoto The e-Learning Day was locally organized Quizzes Attendance will be managed and sent out (Japan, WFN) by the Tunisian Society of Neurology There were five Quiz sessions, animated by Kimberly Coard Karlshoej from the Dr. Naeem Brey (ATN) and the Tunisian College of by Prof. Riadh Gouider and Dr. Saloua WFN Office. (South Africa, AFAN) Neurology and Neurosurgery (CNN). Mrabet. 151 attendees participated in the quizzes. The quizzes were operated by the Second WFN/AFAN e-Learning Day Prof. Bruce Campbell Professional Congress Organizer (PCO) Voting Platform “Mentimeter.” The Quiz After the success of the First e-Learning (Australia, WSO) The Professional Congress Organizer Winner was Dr. Ahshish Govind from Day, we propose to have a second Prof. Kurt Niederkorn company is: Meet-in-TV, Millesima Events. South Africa. e-Learning Day on Epilepsy. • (Austria, WFN) Prof. Pierre Fayad (Nebraska, AAN) PARTICIPATION REPORT Prof. Valeria Caso (Italy, EAN) Prof. Faouzi Bel Hassen The WFN/AFAN Day brought (Maroc, AFAN) – French Session together neurologists, residents in neurology and health care Prof. Yacoube Mapoure professionals from Africa and around (Cameroun, AFAN) – French Session the globe. Registration: There were 1,118 Moderators: 10 moderators registrations from 90 countries animated the discussions and the worldwide, 944 registrations from 37 interaction between the speakers and African countries. As shown in the the audience during sessions. statistics below, registrants were from: Prof. William Carroll (Australia) • Tunisia: 180 registrants • Ghana: 161 registrants Prof. Augustina Charway Felli • South Africa: 101 registrants (Ghana) • Nigeria: 85 registrants Prof. Lawrence Wong Ka Sing • Egypt: 83 registrants (Hong Kong) 994 physicians registered for Dr. Marie0me Soda Diop (Senegal): the e-Learning Day, with 63% of She couldn’t connect to the live them neurologists and residents in streaming. Dr. Imen Kacem neurology. moderated the conference instead. Prof. Marc Fisher (Boston) ATTENDANCE REPORT Dr. Sarah El-Sadig Misbah (Sudan) Among those who registered, Dr. Julien Razafimahefa 576 participants from 60 countries (Madagascar) followed the event, with 513 participants from 31 African countries. Prof. Athanase Millogo The participation rate reached (Burkina Faso) 51.1 % of the registration. Prof. Chokri Mhiri (Tunisia) : French About 520 physicians participated Session in the e-Learning Day with more than 350 neurologists and residents in Dr. Imen Kacem (Tunisia) neurology. 9 WWW.WFNEUROLOGY.ORG • DECEMBER 2020

WFN COMMITTEES AND SPECIALTY GROUPS e-Communications Committee and the Aphasia, Dementia, and Cognitive Disorders Specialty Group

BY WOLFGANG GRISOLD Working Group for Young Struhal consists of members worldwide Neurologists and Trainees. (below). And the committee is actively his column focusing on Since 2014, he is in charge supported by Simona Milenkova, a social WFN committees and of the website and initiated media expert working for Kenes. T specialty groups has a dual social media channels and the The main objective is continuously purpose: WFN online footage with the informing our audience on important • to inform and raise awareness close help of Chiu Man, who developments in neurology on the on the important contribution for more than a decade acts global scale, on news from WFN, and of these groups for the WOLFGANG as WFN`s webmaster. He is recently in employing our growing functioning of the WFN GRISOLD assisted by Surat Tanprawate, online presence in e-Learning. One • to raise interest among the Tissa Wijeratne and Wolfgang of the first meetings was the joint readers for the work of the Grisold. WFN/AFAN e-learning Day (h t t p s :// WFN, and perhaps find and recruit This was the early core of the current wfneurology.org/2020-09-18-wfn-afan), persons to work closer with the WFN, online presentation of WFN as well the which was well received worldwide. The

in the interest of neurology. roots of the present e-Communication large amount of information reaching Suvarna Alladi The work of the WFN depends on Committee. The website was this committee provides a large and the contribution of many members completely renewed and redesigned challenging workload. Freedman, Canada; Stefano Cappa, U.S./ worldwide. Several committees support into a “responsive” design that allowed Italy; Lorraine Obler, U.S.; Manabu the trustees in their work (h t t p s :// reader to view the same content with Aphasia, Dementia, and Cognitive Ikeda, Japan; Eneida Mioshi, U.K.; Peter wfneurology.org/committees) and equal quality on mobile devices as on Disorders Specialty Group Nestor, Australia, Matt Lambon, U.K.; also develop ideas and consult. A good computer screens. (ADCD SG) Thomas Bak, U.K.; and Facundo Manes, example is the e-Communications While social media increased over The WFN Aphasia, Dementia and Argentina. Committee, chaired by Walter Struhal, the years to a tremendous audience with Cognitive Disorders Specialty Group The biennial meetings and teaching which identifies and helps to integrate more than 11,000 friends on Facebook, (ADCD SG) is an international courses are the most impactful of the digital technologies into the WFN. The reaching with our posts from the last 30 community of cognitive neurologists group’s activities. The first biennial work of this committee is summarized days alone >17,000 followers, in addition and allied specialists dedicated to meeting of the Specialty Group by Dr. Struhal. to >2,700 followers on LinkedIn and promoting research and improving (formerly Applied Research Group) was The WFN also has several Speciality >4,800 followers on Twitter. clinical practice in aphasia, dementia, held in 1966. The biennial meetings Groups, which were previously Social media became one of the and other cognitive disorders globally. have traveled from venues in Europe known under ARGs (Applied Research strategic core activities within WFN’s The group has been actively pursuing to South America, Cambridge U.K., Committee https://wfneurology.org/ online footage and one way of reaching this mission since 1966 through its Edinburgh, and then eastward to wfn-specialty-groups). Here, the work out to neurologists worldwide. biennial meetings and has grown to Istanbul, Hyderabad India, and Hong of the Specialty Group is introduced by Today, this committee headed by Dr. having members from Europe, the U.K., Kong. The 50th anniversary meeting Suvarna Alladi, a neurology professor North and South America, Australia. returned in 2016 to Lake Como, from India. West, South and East Asia join its followed by Portugal and the next The WFN e-Communications community over the years meeting is planned to take place in Committee has been created to facilitate The mission of the ADCD SG aims Nara, Japan. the trend of remote learning, and to stimulate scientific discussion in The meetings have a tradition of e-learning’s purpose is enhanced by the field of aphasia, dementia, and putting the emphasis on quality rather the present COVID crisis. The new and cognitive disorders and to translate than quantity and to create a forum advanced digital techniques are now research findings into better assessment, for discussion and a genuine exchange rapidly evolving and will also serve to management, and treatment of patients of ideas. The symposia are based on a improve teaching in remote areas of the through teaching courses, biennial wide range of topics, in the traditional world. meetings, and participation in the clinical areas in aphasia and cognitive World Congress of Neurology as well disorders, along with newer areas in WFN e-Communications Committee as other meetings. It is multidisciplinary, cognitive science, biomarkers, and The origins of this committee stem from welcomes members of different technology. the Website Committee. Dr. Struhal got specialties, across cultures, and seeks to During the COVID-19 pandemic, involved in this committee in 2010 as one collaborate with other organizations, an online sharing of knowledge and of the founders of the worldwide young within and outside the WFN. continued interaction is planned. The neurologists’ group—International Walter Struhal, MD The chair of the ADCD SG is expert group has developed a rich clinical Suvarna Alladi, professor of neurology and research resource across multiple of the National Institute of Mental disciplines of cognitive neurology, WFN e-Communications Committee Health and Neurosciences in Bangalore, cognitive psychology, psycholinguistics, India. Her clinical and research group speech, and language pathology among Chiu Man Webmaster (WFN U.K.) focuses on providing multidisciplinary others. The SG also has a repository of Daniel Gams Massi Pan-Africa (Cameroon) care for persons with dementia, cross- cognitive-assessment tools in multiple cultural issues in cognitive neurology, languages, including English, Spanish, Laura Druce WFN office (WFN U.K.) developing cognitive tests in different Italian, Indian languages, Chinese, and Indian languages and literacy levels and Japanese, among others. Maria Benabdeljlil Pan-Arab (Morocco) risk factors. Organizing community The global expertise of the group Riadh Gouider Pan-Africa (Tunisia) support for dementia, she co-founded has focused on developing joint ARDSI (www.ardsihyd.org) recommendations for adaptation of Surat Tanprawate Asia-Oceania (Thailand) and strengthened policy for dementia diagnoses, assessments, and treatments (www.stride-dementia.org). of aphasia and cognitive disorders across Tissa Wijeratne Asia-Oceania (Australia) The Executive Committee is the world. Through its Forum for Young Wolfgang Grisold WFN Secretary General (WFN, U.K.) composed of distinguished experts Researchers (FYRE), the SG encourages from across continents: Prof. Morris and nurtures young talents globally. • 10 WWW.WFNEUROLOGY.ORG • DECEMBER 2020

IN MEMORIUM Dr. Juan Rafael Santoni Mendoza (1935-2020)

BY PROF. ANNA ROBLES AND PROF. MARCO T. MEDINA was at Colegio Santo Tomás in Santo over 50 years. He was a pioneer of Domingo and was followed by the two neurophysiology and epileptology ndeniably a father of Dominican first years of high school at Hackley formation for our country. He was neurology, Dr. Juan Rafael Santoni School in Tarrytown, New York, where a founding member of the Sociedad U Mendoza was honest, teacher his undisputed leadership led him to be Dominicana de Cefaleas (SODOC) in 1999. by vocation, tirelessly hardworking, elected class president. He returned to the Dr. Santoni worked as a neurologist researcher. He was devoted to his Dominican Republic so as to finish high at different hospitals in Santo Domingo: followers, but first of all to his patients. school at the Escuela Normal de Varones Hospital Moscoso Puello, head of the He gave us everything we expected from a of Santo Domingo. neurological department (1966-1976); great teacher and a great man. In 1959-1961, he did his internal Instituto Nacional de la Diabetes (INDEN), Prof. Santoni Mendoza, affectionately medicine training internship at St. consulting neurologist (1979-1996); Hospital known as “Fao,” passed away Sept. 29, Vincent’s Hospital Dublin, Ireland. Robert Reid Cabral for Children, honorary Prof. Juan Santoni represents 2020, after a short but aggressive systemic He chose to specialize in neurology assesor and consultant neurologist since six decades of exquisite world-class gastrointestinal pathology. Until then, he and neurophysiology at the Institute 1970; Centro de Rehabilitación foundation neurological practice. He was diligent, had been active fulfilling his professional of Neurology, Queen Square London 55 years (1965), appointed in 1974 head of exacting, and persistent; born with the activities as well as his academic and (1961-1963), received his degree in clinical the EEG department. researcher’s inquisitive curiosity. He family responsibilities. neurology and electroencephalography He published approximately 120 papers released scientific papers at exemplary He was born in Santo Domingo, with Prof. William Cobb (who frequently covering the most diverse range of topics rhythm. And on he goes, remaining light, Dominican Republic, on March 7, 1935. invited H. Gastaut from Marseille). He on epilepsy and neurophysiology. He wrote fresh, efficient. As if the passing by of He went on to marry Monica Howard attended as invited neurologist and dozens of scientific articles and chapters for years renewed his energies, to carry on the Williams de Santoni and was a father neurophysiologist (1963-1965) at the neurology books with his elder son walk along his brilliant road of life. to four children: Marcos, Maria Luisa, Fundación Jiménez Díaz and Gran Hospital Dr. Carlos Santoni Williams as collaborator. It was a privilege to consult him and Alexius Eduardo, and Carlos Juan. He was de la Beneficencia in Madrid, neurosurgeon Prof. Santoni has been member of imitate his example. Fao Santoni was a a neurologist and former president of the Professor Sixto Obrador Alcalde. prestigious academies and neurological human miracle made neurologist, and SDNN (Dominican Society of Neurology Dr. Santoni performed an intense societies, national as well as international, was today, with honors, we say good-bye. and Neurophysiology). pedagogical work: professor of a national delegate to the World Federation Undoubtedly with the absence of Dr. Dr. Santoni studied Medicine at the neuroanatomy and neurology at the of Neurology representing our country with Santoni, the Dominican Republic and Universidad Central de Madrid in Spain, Universidad Nacional Pedro Henríquez dignity for many years; and was life founding Latin America have lost a great man and nowadays known as “La Complutense de Ureña (UNPHU) until 1986; professor of member of the Dominican Society of EEG professor of neurology, but the world of Madrid,” received a degree in medicine neurology for the Universidad Autónoma and Clinical Neurophysiology. neurosciences has also been affected. and surgery in 1959. He studied under de Santo Domingo (UASD), for more than He was founding member (1968) of the distinguished and illustrious Prof. José three decades until 2008. the Dominican Yachting Federation and Prof. Ana Robles, FAAN, is former WFN regional Casas, Cátedra de Patología General de la He belongs to the group of neurologists president from 1972 to 1977. He was a director of Latin America. Prof. Marco T. Medina, Facultad de Medicina de Madrid in 1953. who founded and integrated our society tango dancer and student of Prof. Doña FAAN, FEAN, Chevalier is WFN regional director for His primary school education in 1968, a distinguished member for Milkeya Melo. Latin America and PAFNS president.