Executive Page

This is the first NEUROPENEWS page written jointly by the Presidents of the both EFNS and the ENS. It marks a further step in the ever closer collaboration of the two organisations which will smooth the transition to the European Academy of Neurology (EAN) next summer.

Every year the President provides a report to the Council of Delegates, our senior governing body, about the events of the previous year. This year the Council will meet at the World Congress of Neurology and I shall report as follows.

When I had just been appointed a consultant in 1975, a renal physician friend examined the contents of my smart new diagnostic bag: "ophthalmoscope, red pin, tuning forks, cotton wool, pins, orange sticks, tendon hammer, lots of things to find out what's wrong with people and nothing to get them better with!" Everyone laughed.

Do you shake hands with your patients? I think you should, usually. As a junior doctor I was impressed by the example of consultants who greeted their patients by shaking hands and adopted this as a life-long practice. I would not claim that shaking hands is diagnostically useful: the detection of extrapyramidal rigidity or myotonia is more likely to be made from special tests of tone than from the initial handshake.

The European Commission held two major events during May to celebrate the European Month of the Brain under the Presidency of the Republic of Ireland.

Neurologists need no persuasion that the brain is the most important organ in the body and neurology and its allied specialties, including psychiatry, the most important in medicine. Just occasionally we need to remind the world of these truths. We now have the opportunity to do just that because the European Commission has declared May as the official European Month of the Brain 2013.

The EFNS Management Committee meets twice a year, once at our Annual Congress, and once in early March in our Vienna Head Office. We have just held our March 2013 meeting and had a busy agenda. Some highlights:

This title stands not, regrettably, for the President’s present state of mind or place but for the brilliant acronym of a research project called Psychosocial fActors Relevant to brAin DISorders in Europe.

Last month I told you that the bill for brain disease in Europe is €800 billion. To reduce this burden, we need to buy better brain treatment. To make a real long-term difference, we need more research to understand, treat and prevent brain disease better. In the meantime, of course, European and national governments should support healthcare and societal policies which we already know will help, such as reducing smoking, alcohol consumption, obesity and road traffic accidents.

A massive study of the global burden of disease has been published in the most recent issue of the Lancet (Horton 2012). It reports the mortality, causes of death, years lived with disability and disability-adjusted life years for 291 conditions in 21 regions taking into account 67 risk factors. Between 1990 and 2010 the world population has risen from 3.7 to 6.9 billion people.

Sherlock Holmes lived round the corner from my home at the fictitious address of 221b Baker Street. His larger than life statue nurses his traditional pipe as he greets travellers emerging from Baker Street underground station. For him evidence might be as little as a trace of mud on the soles of a suspect’s shoes. For neurologists observation may be adequate evidence for a clinical diagnosis and observational evidence may even suffice for some treatments.

The derivation of the word Europe is uncertain. It may come from a Phoenician word meaning “the west” or another meaning “of a white or fair aspect”. It has nothing to do with the mythical maiden Europa who was abducted from Phoenicia (the region around modern Lebanon) by Jupiter disguised as a bull: she rode on his back to Crete where in due course she gave birth to Minos. Homer used the word Europe to define the area around Greece.

The 16th EFNS Congress in Stockholm from 8th to 11th September was terrific, the largest congress we have ever had with 5400 participants and a packed programme of main topic lectures, focussed workshops, oral presentations and poster sessions covering the whole spectrum of neurology. The programme was organised in collaboration with the Movement Disorder Society and by the European Federation of Autonomic Societies. Singling out individual items is invidious but the highlight of every congress is the EFNS clinical lecture, this year eloquently given by Professor Marie-Germaine Bousser from Paris on CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy). She told us about her first family with young onset stroke and migraine and cerebral white matter lesions.

I write this from London where we are hosting and enjoying a wonderful Olympics, an honour which fell to Stockholm exactly 100 years ago.

Conflicts of interest between doctors and the pharmaceutical industry are a recurring theme in medical journals and the media. There are two main concerns: