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Evolution, current status and way forward for AOAN
Abstracts / Journal of the Neurological Sciences 357 (2015) e457–e512
relapse occurred in (60.7%), indicating a remitting–relapsing course of epilepsy. 10.1 % of the patients had remission which was followed by relapse and never regained terminal remission with a worsening course of epilepsy. The prognosis for patients with ˃ 6 seizures before starting treatment and bad response to the first AED is unfavorable. Conclusion: The prognosis of the majority of patients with newly diagnosed epilepsy is good and the clinical pattern of epilepsy during treatment is complex and dynamic. Predictors for failure of achievement of 2 years seizure remission were high pre-treatment seizure frequency (≥6) and bad response to first AED. doi:10.1016/j.jns.2015.09.261
1688 WFN15-1871 Regional Pan-Arab Symposium Movement disorders S. Bohlega. Neurosciences, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia Parkinson Disease in the Arab World There are scares reports originating from the Middle East regarding the epidemiology and genetic data of various movement disorders among Arabs. The incidence of PD reported from Libya, Saudi Arabia, Tunisia, Egypt and Palestinians in Israel are remarkably lower than other parts of the world. As most of the Arab population is young which may explain the low incidence and prevalence which ranges from 27 to 43. The incidence of PD is reported at 4.5 per 100,000. Most of the responsible genes described in Arabs are inherited as autosomal recessive like Parkin and PINK1, ATP13A2, DJ-1, and PLA2G6. The G2019S LRRK2 mutation is more common in both familial (37-42%) and apparently sporadic PD (41%) in North African Arabs than in European and North Americans (2-3%). This frequency is the highest reported anywhere in the world so far. However, recent study from other Middle Eastern Countries did not show similar findings. Methodological issues and population age structures could partially explain the differences in incidence and prevalence studies among different Arabic countries. Additional epidemiological and genetic studies from the majority of Arabic countries are needed to enhance our understanding of PD. doi:10.1016/j.jns.2015.09.262
1689 WFN15-1866 Regional Pan-Arab Symposium Genetics of recessive ataxia C. Mhiri. Neurology, Habib Bourguiba Hospital, Sfax, Tunisia Recessive ataxia: Study of Tunisian series and literature review Autosomal recessive cerebellar ataxias (ARCA) are a group of little known and often neglected diseases. Cerebellar ataxia is the prominent sign (movement incoordination, unsteady gait…) and has a progressive and unremitting course (chronic). In our department we reviewed all cases of progressive ataxia occurring during childhood or adolescence with a pedigree suggestive of autosomal recessive mode of inheritance. We excluded acquired causes of progressive ataxia (tumor…). Using these criteria, we collected 107 cases belonging to 56 families (56 index cases and 51 secondary cases, 60 are male and 47 female). The mean age of onset was 11.2 + 6.8 years (range: 2.5 – 32). The prevalence of ARCA
e489
in our population is about 4 cases/100.000. Forty two patients had Friedreich ataxia (FA) phenotype. In this group, genetic study demonstrated that 25 cases are ataxia with vitamin E deficiency, 12 are FA, 3 are ataxia with ocular apraxia (AOA) type 2 and unknown genetic abnormality in two. 28 cases presented ataxia with telangiectasia (AT) and/or ocular apraxia. Genetic testing showed that 17 cases are AT, 8 AOA2, one AOA1 and no linkage to known loci in 2 case. 37 cases had spastic ataxia, 8 patient linked to ARSACS gene, 3 to SAX2, 6 to SPG11, 5 to SPG 46 and 15 patients are not linked to known genes. ARCA usually occurs during childhood or adolescence however the onset of autosomal dominant ataxias is late over the age of 30 years. Clinical picture permit to orientate genetic study. doi:10.1016/j.jns.2015.09.263
1690 WFN15-1696 Regional Asian-Oceanian Symposium Evolution, current status and way forward for AOAN M. Mehndirattaa, P. Mehndirattab, C. Tsaic, R. Kajid, N. Gulatie, M. Wasayf. aNeurology, Janakpuri Superspecialty Hospital, New Delhi, India; bNeurology, Vascular Neurology Fellow University of Virginia VA 22908, Charlottesville, USA; cNeurology, Chief of the Neurological Institute at Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan; dNeurology, Professor and Chairman Department of Neurology Institute of Health-BioscienceTokushima University, Kuramoto-cho, Japan; ePathology, Janakpuri Superspeciality Hospital, New Delhi, India; fNeurology, Aga Khan University, Karachi, Pakistan Evolution, Current Status and Way Forward for AsianOceanian Association of Neurology (AOAN) AOAN was established in 1961 with the primary aim of promotingneurological advancement via the exchange of ideas for development of educationprograms in Neurology and to encouragescientific research geared towards neurological diseases that are a majorhealth burden in the Asian-Oceanian countries. Over the years, AOCN has consistently brought togetherneurologists from the various member countries and has thus established itselfas an academic congress serving the needs of physicians in the Asian andOceanian realm. The membership of the association has grown over the years. Education and training of physicians inNeurology, is a top priority for AOAN. Developing standardized trainingprograms and courses for countries where there is an undersupply ofneurologists are top priorities. AOAN is extending financial and expertisesupport for CME in Afghanistan. We have plannedto use this model for other developing Asian countries especially Myanmar,Cambodia, and Laos etc. AOAN in collaboration with the WFN envisions holding CME programs in the countriesthat have limited resources with a longterm goal to uphold standardsof neurologic care provided in these areas like Central Asian countries. The challenges are many, but at the same time great opportunityexists for AOAN to implement strong and productive initiatives. Publicawareness and advocacy related to neurological diseases, development ofregional and local Neurology forums, and facilitation of training andmentorship efforts are important areas of work in the present Asiancontext. doi:10.1016/j.jns.2015.09.264
relapse occurred in (60.7%), indicating a remitting–relapsing course of epilepsy. 10.1 % of the patients had remission which was followed by relapse and never regained terminal remission with a worsening course of epilepsy. The prognosis for patients with ˃ 6 seizures before starting treatment and bad response to the first AED is unfavorable. Conclusion: The prognosis of the majority of patients with newly diagnosed epilepsy is good and the clinical pattern of epilepsy during treatment is complex and dynamic. Predictors for failure of achievement of 2 years seizure remission were high pre-treatment seizure frequency (≥6) and bad response to first AED. doi:10.1016/j.jns.2015.09.261
1688 WFN15-1871 Regional Pan-Arab Symposium Movement disorders S. Bohlega. Neurosciences, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia Parkinson Disease in the Arab World There are scares reports originating from the Middle East regarding the epidemiology and genetic data of various movement disorders among Arabs. The incidence of PD reported from Libya, Saudi Arabia, Tunisia, Egypt and Palestinians in Israel are remarkably lower than other parts of the world. As most of the Arab population is young which may explain the low incidence and prevalence which ranges from 27 to 43. The incidence of PD is reported at 4.5 per 100,000. Most of the responsible genes described in Arabs are inherited as autosomal recessive like Parkin and PINK1, ATP13A2, DJ-1, and PLA2G6. The G2019S LRRK2 mutation is more common in both familial (37-42%) and apparently sporadic PD (41%) in North African Arabs than in European and North Americans (2-3%). This frequency is the highest reported anywhere in the world so far. However, recent study from other Middle Eastern Countries did not show similar findings. Methodological issues and population age structures could partially explain the differences in incidence and prevalence studies among different Arabic countries. Additional epidemiological and genetic studies from the majority of Arabic countries are needed to enhance our understanding of PD. doi:10.1016/j.jns.2015.09.262
1689 WFN15-1866 Regional Pan-Arab Symposium Genetics of recessive ataxia C. Mhiri. Neurology, Habib Bourguiba Hospital, Sfax, Tunisia Recessive ataxia: Study of Tunisian series and literature review Autosomal recessive cerebellar ataxias (ARCA) are a group of little known and often neglected diseases. Cerebellar ataxia is the prominent sign (movement incoordination, unsteady gait…) and has a progressive and unremitting course (chronic). In our department we reviewed all cases of progressive ataxia occurring during childhood or adolescence with a pedigree suggestive of autosomal recessive mode of inheritance. We excluded acquired causes of progressive ataxia (tumor…). Using these criteria, we collected 107 cases belonging to 56 families (56 index cases and 51 secondary cases, 60 are male and 47 female). The mean age of onset was 11.2 + 6.8 years (range: 2.5 – 32). The prevalence of ARCA
e489
in our population is about 4 cases/100.000. Forty two patients had Friedreich ataxia (FA) phenotype. In this group, genetic study demonstrated that 25 cases are ataxia with vitamin E deficiency, 12 are FA, 3 are ataxia with ocular apraxia (AOA) type 2 and unknown genetic abnormality in two. 28 cases presented ataxia with telangiectasia (AT) and/or ocular apraxia. Genetic testing showed that 17 cases are AT, 8 AOA2, one AOA1 and no linkage to known loci in 2 case. 37 cases had spastic ataxia, 8 patient linked to ARSACS gene, 3 to SAX2, 6 to SPG11, 5 to SPG 46 and 15 patients are not linked to known genes. ARCA usually occurs during childhood or adolescence however the onset of autosomal dominant ataxias is late over the age of 30 years. Clinical picture permit to orientate genetic study. doi:10.1016/j.jns.2015.09.263
1690 WFN15-1696 Regional Asian-Oceanian Symposium Evolution, current status and way forward for AOAN M. Mehndirattaa, P. Mehndirattab, C. Tsaic, R. Kajid, N. Gulatie, M. Wasayf. aNeurology, Janakpuri Superspecialty Hospital, New Delhi, India; bNeurology, Vascular Neurology Fellow University of Virginia VA 22908, Charlottesville, USA; cNeurology, Chief of the Neurological Institute at Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan; dNeurology, Professor and Chairman Department of Neurology Institute of Health-BioscienceTokushima University, Kuramoto-cho, Japan; ePathology, Janakpuri Superspeciality Hospital, New Delhi, India; fNeurology, Aga Khan University, Karachi, Pakistan Evolution, Current Status and Way Forward for AsianOceanian Association of Neurology (AOAN) AOAN was established in 1961 with the primary aim of promotingneurological advancement via the exchange of ideas for development of educationprograms in Neurology and to encouragescientific research geared towards neurological diseases that are a majorhealth burden in the Asian-Oceanian countries. Over the years, AOCN has consistently brought togetherneurologists from the various member countries and has thus established itselfas an academic congress serving the needs of physicians in the Asian andOceanian realm. The membership of the association has grown over the years. Education and training of physicians inNeurology, is a top priority for AOAN. Developing standardized trainingprograms and courses for countries where there is an undersupply ofneurologists are top priorities. AOAN is extending financial and expertisesupport for CME in Afghanistan. We have plannedto use this model for other developing Asian countries especially Myanmar,Cambodia, and Laos etc. AOAN in collaboration with the WFN envisions holding CME programs in the countriesthat have limited resources with a longterm goal to uphold standardsof neurologic care provided in these areas like Central Asian countries. The challenges are many, but at the same time great opportunityexists for AOAN to implement strong and productive initiatives. Publicawareness and advocacy related to neurological diseases, development ofregional and local Neurology forums, and facilitation of training andmentorship efforts are important areas of work in the present Asiancontext. doi:10.1016/j.jns.2015.09.264