Byung-In Lee MD, Chair, CAOA ...................................................
Transcription
Byung-In Lee MD, Chair, CAOA ...................................................
November 2012 Byung-In Lee MD, Chair, CAOA.......................................................................................................................... 1 The 9th Asian Oceanian Epilepsy Congress in Manila, The Phillipines .................................................... 2 Memorial International Epilepsy Symposium one year after the East Japan Disaster .......................... 5 News from Australia.......................................................................................................................................... 9 Second Advanced International Course: Clinical Epileptology ................................................................ 11 Report on Indian Epilepsy Society -7th EEG Workshop 2012 ................................................................ 12 Activities of the Japan Epilepsy Society (2011 – 2012) ............................................................................. 14 Driving and Epilepsy in Japan....................................................................................................................... 15 News from Korean Epilepsy Society ........................................................................................................... 18 Sri Lanka League Against Epilepsy - 2012 ................................................................................................. 20 Stand Up For Epilepsy - Taiwan Epilepsy Sports Day ............................................................................. 21 News from Thailand........................................................................................................................................ 22 The EpiNet project .......................................................................................................................................... 23 AOEO CHAPTER LIST OF ILAE................................................................................................................ 24 Commission on Asian and Oceanian Affairs (CAOA)............................................................................... 26 The Asian and Oceanian Outstanding Achievement Epilepsy Award (AOEA) recognises and pays tribute to great leaders who have provided extraordinary contributions to Epilepsy Care. The Award is bestowed at each AOEC. The six Award winners for 2012 are, from the left, Liwen Wu (CHINA), Pongsakdi Visudhiphan (THAILAND), Kurupath Radhakrishnan (INDIA), Sunao Kaneko (JAPAN), Yushi Inoue (JAPAN) and Leonor Cabral-Lim (PHILIPPINES), with Byung-In-Lee, Josephine Casanova-Gutierrez and Robert Cole, Co-chairs of the Scientific Organizing Committee 9th AOEC. Issuer : CAOA information committee Publishing office : JSE 0 Dear Friends and Colleagues: I am very proud to introduce the publication of the first official Newsletter of the Commission on Asian and Oceanian Affairs (CAOA) of ILAE since its inception in 1996. The CAOA did not initially have a strong demand for its own newsletter because both the ILAE and IBE regularly provide excellent newsletters for members of the global epilepsy community. However, the importance of efficient regional communication, including a website and official newsletters, has become a increasing priority for the CAOA in order to promote closer communications, provide recognition of the great work of our members, and to facilitate more intimate interactions and collaborations amongst chapters. Professor Sunao Kaneko (Japan) and members of the Information Committee of CAOA successfully launched the CAOA-Website (http://www.caoa-epilepsy.org) in 2010, and have now made it possible to publish this first issue of CAOA-Newsletter. On behalf of the CAOA of ILAE, I express my deepest appreciation to Professor Kaneko and his colleagues for their outstanding contributions to the progress of our epilepsy communities. I also encourage all our members in the region to use this wonderful new resource to report and share our own experiences, opinions, and joint efforts in promoting education, patient care and research in our region. Although a newsletter is commonly used by numerous organizations for providing information to members, the CAOA-Newsletter reflects our commitment to pay more attention to, acknowledge and share experiences with our members in this region. The CAOA pursues our common missions and goals in harmony with the many and varied individual chapters and members of our region. The Asian and Oceanian Region has the largest land area, comprises almost two thirds of the whole world population and has rich diversity in peoples and cultures, with varied economic, social and political circumstances. These factors make our region the most dynamic and thriving region on earth. The great complexities and immense potentials of this this region provide us with many challenges. Our members and chapters are developing closer interactions based on mutual respect, community spirit and a commitment to help each other. More effective communications are essential to facilitate achieving our common goals of providing the optimal life opportunities and quality of care for people with epilepsy, and global leadership in epilepsy education and research. Our ILAE region has increased from six chapters in 1996 to 19 chapters in 2012, reflecting the most extraordinary and rapid evolution among all regional ILAE commissions. The ILAE is organized by individual chapters, with the CAOA aiming to harmonize and support development of all individual chapters and the whole region. This requires multidirectional communications, sharing of opinions, and consensus approaches among chapters, CAOA and ILAE. I expect the CAOA-Newsletter will help us to construct harmonized action plans crucial for our mutual progress and serve as a window measuring the standard of epilepsy care in our region. However, all chapters and every member in our region should actively participate in and contribute to the production of CAOA-newsletters, including the submission of opinions, reporting of experiences, sharing our views and recognizing our member’s contributions. Let us celebrate the publication of this first issue of CAOA-Newsletter and support its future development as a pivotal forum for sharing our ideas, hopes and achievements. Thanks Byung-In Lee, MD Chair, CAOA - 1 - The 9th Asian Oceanian Epilepsy Congress in SMX, ManilaA Meeting to Remember By Josephine Casanova-Gutierrez When Manila was announced as the host for the 9th AOEC during the Commission on Asian Oceanian Affairs (CAOA) meeting in Melbourne in 2010, there was a sense of uncertainty and discomfort. After all, a few months back, there was a badly publicized, fatal hostage-taking incident that involved Hong Kong tourists right across the grand Manila Hotel, a landmark in the heart of the city. This, however, did not discourage ILAE President Nico Moshe nor the Convention team headed by Richard Holmes as well as the Scientific Chairs, Byung-In Lee, Robert Cole and Josephine Gutierrez. From the very start, CAOA chair Byung-In Lee resolved we would have a great congress. Finally on March 22, 2012, the 9th AOEC in Manila opened to the cheerful percussions of a bamboo orchestra performed by young and graceful students in their native dress at the SMX, a spacious, state-of-the-art convention venue located in the big Mall of Asia complex by the bay. Everyone was ushered to their seats in the plenary hall and was mesmerized by the pageantry of the formal Opening Ceremony where officers of the ILAE, IBE, CAOA and PLAE paraded to the stage in formal procession and later gave their heartfelt greetings and messages to the international delegates. A highlight of the ceremony is the awarding of the CAOA’s Epilepsy Achievement awards as well the IBE’s Outstanding Persons with Epilepsy awards. The Commission on Asian and Oceanian Affairs under the leadership of Byung in Lee and John Dunne, paid tribute to six doctors from the Asian Oceanian region for their leadership and exceptional contributions to epilepsy care, education and research. This award is the highest honor given by this Commission and is given every two years. Awardees were Leonor Cabral-Lim (PHILIPPINES), Yushi Inoue (JAPAN), Sunao Kaneko (JAPAN), Kurupath Radhakrishnan (INDIA), Pongsakdi Visudhiphan (THAILAND) and Liwen Wu (CHINA). The IBE Outstanding Person with Epilepsy Awardees were Baldwin Kho (PHILIPPINES), Yashoda Wakankar (INDIA), Yung-Chich CHEN (TAIWAN), Fai Ming Hung (HONGKONG), Hongquan LI (CHINA), Martin Raffaele (AUSTRALIA) and Purevjav Tsogtsaikhan (MONGOLIA). - 2 - The Reception, which followed the Opening Ceremony, was conceptualized and coordinated by the officers of the Philippine League against Epilepsy (Chairs: Josephine Gutierrez, Marilyn Ortiz, Lourdes Ledesma) and hosted by the Philippine Department of Tourism. It was entitled "Pagdiriwang"- meaning “a celebration”. Indeed it was, for what followed after the Opening Ceremony wowed the over 1200 delegates who registered for the congress: as the doors to the Reception area opened to welcome the delegates, lively strumming of Filipino fiesta music filled the air. The stage blazed with lights and colors shouting “It’s more fun in the Philippines!” which is the Department of Tourism’s battle-cry for the year. The whole room was bedecked with colourful banners and grass huts all around, with small buffet tables laden with an endless variety of native culinary treats, delicately presented and prepared by the country’s premier catering company, Via Mare. Four giant paper mache effigies, called “higantes”, dressed in folk costumes roamed the hall, obliging excited delegates for a photograph. Native ice cream vendors pushing their brightly colored carts walked about, giving each giggling delegate guest a refreshing treat. A festive repertoire of dances, songs and music was performed by the famous Bayanihan Dance Troupe and Pangkat Kawayan. They regaled the international guests with the “Tinikling”, a skip-hop type of folk dance using bamboo sticks. Soon, they were able to coax even the shiest and most dignified looking delegate to kick their shoes and go for the bamboo. International delegates easily befriended locals in a joyful tangle in this very informally staged “village feast”. It was a night of fun, festivity and friendships. The Scientific Meetings in the next few days were attended by 1216 participants from 46 countries, with the biggest delegation coming from the host country, the Philippines (320), followed by India (174), China (97), Korea (78), Japan (77), Indonesia (70), Singapore (52), Taiwan (46), Vietnam (46) and Thailand (41). Of these, 152 attended the Epilepsy and Society meeting. - 3 - The delegates had a host of topics to choose from in the 4-day congress, ranging from epilepsy networks and seizure propagation, genetics, epilepsy and the developing brain, pharmacology and pharmacogenomics, psychiatric comorbidities, neuroimaging, epilepsy surgery, epilepsy and pregnancy, epilepsy and adolescence, epilepsy and autism, status epilepticus and video EEG sessions. These were delivered by 77 local and foreign speakers for the main scientific program and 23 local and foreign speakers for the Epilepsy & Society meeting. The Masakazu Seino Memorial lecture, “High Frequency Oscillations in Epilepsy” was given by Jean Gotman from Montreal. The Chairman’s Symposium highlighted the latest information on Epilepsy Networks and Seizure Propagation from animal models, imaging and surgical experiences. The ASEPA lecture on “Drug Resistant Epilepsy: Recognize it, Treat It” was a popular session and had standing room attendance. There were very pragmatic sessions on “The Need to advocate for Epilepsy Funding” and a workshop on the Global Campaign highlighting two model programs from the region and a talk on Evaluating Outcomes. Poster and platform presentations for researches in the region were also featured. There were over 200 researches submitted to the Scientific Committee for review, with most papers coming from Korea, India and China. (The proceedings of the 9th AOEC will be published as a supplement of Neurology Asia. This will also be available in an online version under open of the ILAE, CAOA website and Neurology Asia website. ) The "Epilepsy and Society Symposium" featured topics like the Burden of Epilepsy in the Asian Oceanian Region, psychiatric complications of epilepsy, epilepsy and pregnancy and empowerment of people with epilepsy. The strength of the IBE meeting was the robust attendance, the experts who lectured with enthusiasm and the touching testimonials of persons with epilepsy which were given after each session. The interactions were candid, with a lot of ribbing from friends within the IBE chapters. At the end of the congress, many participants felt it was one of the most memorable AOEC meetings. The Opening Ceremony and Reception set the mood and tone for what was going to be a warm, highly interactive and fun congress. Many observed the growing bonds between chapters, leaders and delegates in the region and the rising level of scientific interest in the congress. This is truly a success because the objectives for which the ILAE and CAOA organized these regional congresses– that of providing a venue for scientific growth and interaction between chapters in the region - have been met. The solid leadership of Solomon Moshe, Byung-In Lee and Richard Holmes, together with the generous contributions of all the members of the CAOA, IBE and the Philippine contingent guaranteed it would be an AOEC to remember. - 4 - Memorial International Epilepsy Symposium one year after the East Japan Disaster Date: 2012.3.19 mon 9:30~17:30 Venue: KKR Hotel Tokyo (Tokyo, Japan) Organized by Prof. Sunao Kaneko Japan Epilepsy Society, Japan Global Campaign against Epilepsy East Japan Disaster and Rescue Operation Hidetomo Kubota (Vice President of JEA) Dr. Hidetomo Kubota, Vice President of the Japanese Epilepsy Association (JEA) reported the disaster relief operations organized by the Japan Epilepsy Society (JES) and JEA after the Great East Japan Earthquake. Information services were provided immediately after the disaster. Upon JES’s urgent request, large quantities of AEDs were donated by pharmaceutical companies. After overcoming huge logistic problems, they managed to distribute medications to Iwate and Fukushima. Then medical teams were dispatched from Shizuoka Epilepsy Center and Nishi-niigata Epilepsy Center to the disaster areas. Some lessons were learnt from their operations. (1) Early information posted on the internet website was probably underused. Radios, mobile phones and social networks were the main information sources for many victims. (2) General medical teams lacked knowledge on epilepsy including medications. Learning from the experience, JES has started the following: (1) epilepsy care network, (2) epilepsy education for general physicians, (3) patient education, and (4) epilepsy disaster hotline. During the relief activities, what came across strongly was that not only patients, but some general physicians still thought that epilepsy is untreatable. This brings home the significance of advocacy in Global Campaign against Epilepsy that “epilepsy is treatable”. Report from European IBE (Driving License, Epilepsy Day) Mike Glynn (President of IBE) Dr. Mile Glynn, President of Internal Bureau for Epilepsy (IBE) reported on the European IBE. Their activities include the newsletter Epi Focus and the Epilepsy Advocacy Europe (EAE) which is a joint task force of the ILAE and IBE. The European Epilepsy Day has been held in February since 2011. The theme for 2012 was “The Burden of Epilepsy”. In 2011, The European Parliament approved the Written Declaration on Epilepsy 0022-2011. This was reported in detail by Dr. Perucca in another presentation. The EU directive on driving (European Directive 209 / 112 EC) came into effect on 29 August 2009. The regulations provided for: (1) 1 year seizure-free period for Group 1 vehicles (cars, vans, motorbikes); (2) 10 years or more seizure-free period for Group 2 heavy goods vehicles (buses, lorries etc.); and (3) most EU countries had to amend their existing legislation to reflect these changes. Twenty-three of 27 EU member states have amended their laws in line with this Directive, but legal provisions are still not in place in some countries. - 5 - New Epilepsy Name in Korea Byung-In Lee (President of CAOA) Professor Byung-In Lee, President of CAOA, reported the status of epilepsy care and stigma in Korea from the historical perspective, and the process by which epilepsy is officially renamed to cerebro-electric disorder. In Korea, epilepsy was called Gan-zil (간질: 癎疾), a name that generates unpleasant feelings, leading to the concept of epilepsy being a “forbidden disease”. The public attitude toward epilepsy is still negative. Patients themselves are unwilling to disclose their illness and regard epilepsy as the worst chronic disease. Korea Epilepsy Association (KEA) proposed the project of epilepsy renaming in 2007, and formed the task force in 2008. In June 2009, “cerebro-electric disorder” (뇌전증, 脳電症) was chosen as the new name for epilepsy at the General Assembly of KES, and later approved by Korean Medical Association. The new name is appropriate because it is a neutral terminology, replaces the negative meanings of the old name, and appropriately reflects the scientific basis of epilepsy. Further campaign activities include official declaration in June 7, 2012, promotion at the 17th Annual Congress of KES, and general diffusion through mass media and internet are scheduled. A Strategic Plan of Action on Epilepsy -Epilepsy out of the shadowsCarlos Acevedo(Secretary General of IBE) Dr. Carlos Acevedo, Secretary General of IBE, reported the approval in Washington of a Strategic Plan on Epilepsy for the Americas on September 29, 2011. For the first time in the Pan American Hleath Organization (PAHO), epilepsy will constitute a priority in the national health plans of the governments for the next 10 years. This was the result of the success achieved by representatives of IBE-ILAE-WHO-PAHO. After the approval, workshops were held in various countries. The strategic plan officially began in January 2012. During 2012, Bolivia, Chile, Brazil, and North America are scheduled to lauch their strategic plans. The strategic plan has four areas: 1. Programs and legislation of care for people with epilepsy and protection of their human rights; 2. Health services network for the treatment of epilepsy stressing primary health care and drugs supply; 3. Education and raising public awareness; and 4. Reinforcing the information about epilepsy. Detailed objectives are given under each area. Monitoring, assessment and evaluation of the strategic plans will be in the form of progress reports every two years. The European Written Declaration on Epilepsy: Past, Present and Future Emilio Perucca(Treasurer of ILAE) Dr. Emilio Perucca, Treasurer of ILAE, reported on the approval of the European Written Declaration on Epilepsy. Gay Mitchell, a member of parliament (MEP), ILAE chapters, IBE Associations and many individuals worked to enlist the support of the European Parliament to pass a Written Declaration on Epilesy. On September 15, 2011, the Declaration was approved by an overwhelming majority of 459 MEPs. The Declaration recognizes the major medical and social burden associated with epilepsy; calls on the EU Commission and Council to encourage research and innovation, prioritise epilepsy as a major disease, encourage Member States to ensure equal rights for people with epilepsy, encourage effective health impact assessments; and calls on Member States to introduce appropriate legislation to protect the rights of all people with epilepsy. The EU Declaration has developed in parallel with major initiatives in other regions, such as the PAHO initiative and the US IOM Report. Communication and coordination among these initiatives will be useful. Similar developments in other regions are anticipated. - 6 - Forefront of Epilepsy Research Ⅰ Infantile Spasms: New Frontiers Solomon L. Moshe (President of ILAE) Dr. Solomon Moshé, President of ILAE, presented the new frontiers in the study of infantile spasms, one of the “catastrophic” epilepsies. Infantile spasms, or West syndrome, has several unique clinical features: onset between 3 and 12 months of age, highly specific EEG findings, developmental arrest or regression, evolution into other types of epilepsies, and multiple etiologies. Progress in understanding and treating infantile spasms has been limited by the lack of an appropriate animal model. Recently, however, several models have been developed, including the stress model, TTX model, Down model, and multiple hit model. Among them, the multiple hit model produced by sequential injection of doxorubicin, lipopolysaccharide and p-chlorophenylalanine into neonatal rats is promising. The model develops recurrent spasms associated with specific ictal EEG discharges, and shows seizure evolution, and autistic features and learning deficits. The model provides insight to understand the pathophysiology of infantile spasms and has proved useful in the investigation of medication responsiveness. These tools may be useful in future studies to identify etiology-specific differences in the pathogenesis and therapies of infantile spasms, which could improve outcome. Recent Developments in EEG and Functional Imaging Jean Gotman (ILAE Director of interactive Media) Dr. Jean Gotman, ILAE Director of Interactive Media, presented recent advances in EEG and functional imaging. EEG-functional MRI (fMRI) is based on the principle that epileptic discharges often result in a blood oxygen level dependent (BOLD) signal increase on fMRI. This method successfully identified responses in many types of epilepsies. EEG-fMRI offers a unique opportunity to study the origin and propagation of epileptic discharges in the whole brain, although it is limited by the necessity for epileptic discharges to take place during the study. High frequency oscillations were recorded with microelectrodes in the mesial temporal structures in rats and patients. Recent studies have shown that HFOs can be recorded in intracerebral EEG and appear most often in the region of seizure onset. They are better indicator of seizure onset zone than spikes. Unlike spikes, they fluctuate temporally like seizures, and may be a better indication of disease activity. HFOs appear to be useful to determine the resection area, and they seem to be recordable from the scalp. Epilepsy Network in Animal Models of Epilepsy Tatsuya Tanaka (The First Vice President of ILAE) Experimental models have expanded our understanding of the mechanisms underlying seizures and epilepsy. Professor Tatsuya Tanaka, First Vice-president of ILAE, presented the experimental aspects of epilepsy network and their clinical applications. Study of amygdalo-cortical evoked potential in amygdala kindled cats demonstrated de novo SEP from the amygdala to motor cortex, indicating the limbic seizure propagation pathway. Practical application of this model includes seizure control action of anti-epileptic drugs on limbic seizures. Studies of focal and secondary generalized seizures induced by microinjection of kannic acid in cats and rats elucidated different modes of seizure propagation from the cortical focus: to surrounding cortex; to corpus callosum and then contralateral cortex, or to basal ganglia, thalamus and mesencephalic reticular formation. These findings have important clinical significance. We know that focal onset seizures may propagate to adjacent and remote area not only via cortico-cortical pathways but also through arcuate and/or fasciculus pathways, and subcortical structure connections. Therefore in epilepsy surgery, focus resection should be carefully verified considering possible remote epileptogenic lesions visualized by propagation pathways via anatomical and/or seizure networks. - 7 - Can we find better medicines for epilepsy? Edward Bertram (Information Officer of ILAE) Currently, one-third of patients with epilepsy do not achieve seizure control with AED. Dr. Edward Bertram, Information Officer of ILAE, tackled the question of finding better medications for epilepsy. The major problems with treating epilepsy are the diverse causes of the disease as well as poor definition of the seizure onset site and the changes causing seizures. Altered pharmacology in epilepsy is another issue. For example, the pharmacology of GABA receptors is changed in epileptic brains, and expressions of sodium channel subtypes are altered in epilepsy. This may mean that drugs that are discovered and developed in normal brains may not be effective in the epileptic brain. Another issue is the multidrug resistant proteins that have been observed in clinical and animal models of epilepsy. Experimentally, these proteins have been associated with decreased response to medications. The way forward to find better drugs may be to find the universal target, to prevent resistance, to identify syndrome-specific drugs, and to deliver drugs directly to key structures. These solutions require a better understanding of the pathophysiology of epilepsy. Better interaction among the lab, clinic and industry is essential. Forefront of Epilepsy Research Ⅱ Early Epilepsy Surgery Samuel Wiebe (Secretary General of ILAE) Dr. Samuel Wiebe, Secretary General of ILAE presented the favorable outcome of early epilepsy surgery. When patients with epilepsy fail AEDs, the seizure-free rates decrease by 50% for every 1.5 AEDs that had failed. Thus if two AEDs fail, prognosis is poor. Uncontrolled seizures not only damage QOL but also increase risk of death 5-fold. On the other hand, a large volume of evidence has demonstrated that surgery is highly effective, controls seizures, improves QOL, and saves money. Moreover, these benefits are durable. Nevertheless, patients wait for 20 years from disease onset before they receive surgery. Given the dire effects of frequent and uncontrolled seizures, early surgery is highly beneficial. Early surgery is very effective, with number needed to treat (NNT) less than 2, and improves QOL, energy, seizure worry, and attention. However, in dominant TLE, surgery results in 40% decline in verbal memory. Realistic risk-benefit assessment is necessary, but seizure outcome is the most important determinant. The recommendation is to determine drug resistance quickly and offer surgery early. Pediatric Epilepsy Surgery: State of the Art Gary Mathern (Chair of ILAE Strategic Planning) Dr. Gary Mathern reported the forefront of pediatric epilepsy surgery. The neurobiology and plasticity of the developing brain guide clinical decisions in pediatric epilepsy surgery. In children, the purpose of surgery is to stop seizures early to prevent cognitive disabilities. Children with pharmacoresistant are at risk of developmental delay and premature death. On the other hand, pediatric epilepsy surgery reduces epileptic encephalopathy resulting in better development and improved intellectual outcome after TLE surgery. However, the numbers of children evaluated and receiving epilepsy surgery each year are much smaller than the expected figures (31% in a US study). All children with persistent generalized or partial seizures after failure of 2 to 3 AEDs or unacceptable side effects should be referred to an epilepsy surgery center. Children under age 2 should be referred urgently to prevent developmental delay and epileptic encephalopathy. Children with special conditions such as cortical dysplasia, tumors with seizures, tuberous sclerosis, Sturge-Weber, hemimegalencephaly, and Rasmussen encephalitis should also be evaluated. - 8 - News from Australia www.epilepsy-society.org.au The Epilepsy Society of Australia (ESA) has hosted a number of educational and scientific programmes this year, including: ESA Master Class 2012 Held at the University of NSW, Sydney, August 2012. It was very practical one-day symposium dealing with common clinical issues in epilepsy. International Child Neurology Congress - ICNC 2012 The ICNC was held in Brisbane, May 27 - June 1. This was the largest child neurology congress held in Australia. The scientific program was complemented by educational symposia on all aspects of child neurology. ESA 26th Annual Scientific Meeting 21 October-2 Nov. This was preceded by the 2-day ANZAN EEG Course. The ASM programme included symposia on: Translational Research, Advances in Localisation, Epilepsy Classification, Epileptogenesis and Neuropsychiatry. Keynote Speakers were Professor Kevin Staley, Harvard Medical School, and Professor Ennapadam Krishnamoorthy, Director of Neuropsychiatry Group, Institute of Neurological Sciences, VHS Hospital, Chennai, India. In February, 2013, the ESA and ANZAN will hold the EEG Course and the Epilepsy Course (formerly Master Class) together at the beginning of the year. The ESA Epilepsy Course is a one-day, case-based workshop focusing on the practical management of common and sometimes difficult problems in the care of paediatric and adult patients with epilepsy. The EEG course will follow on Saturday and Sunday February 23rd and 24th. We will have an excellent local faculty and an international visitor; Dr Greg Cascino, Director of the Epilepsy Program at the Mayo Clinic Rochester, USA. CAOA/ASEPA Members of the ESA have joined with many friends throughout our region to participate in ASEPA and other educational activities, including: - 9 - • The EEG course with the 13th Annual Conference of the Indian Epilepsy Association and the Indian Epilepsy Society in Cochin, Kerala. • ASEPA-ANZAN EEG Course 7-9th September 2012, Penang • 1st International Epilepsy Symposium, Mongolia 21-22nd September 2012 • ASEPA Epilepsy Syndrome Workshop, Guiyang, China, 13-14 July 2012 - 10 - Second Advanced International Course : Clinical Epileptology Encouraged by the success of the First International Advanced Clinical Epileptology Summer School last year, the Second International Advanced Clinical Epileptology Summer School was held in Mountain Qingcheng, Chengdu, China from August 13th to August 18th, 2012. This summer school, which was anticipated and encouraged by ILAE and CAOA, hosted and prepared by CAAE and West China Hospital, sponsored mainly by Xi’an-Janssen pharmaceutical company, was an important initiative for enhancing clinical epileptology in China. This summer school was clinically-oriented, targeted to specialists in epilepsy care and focused on comprehensive aspects of diagnosis, treatment and rehabilitation of children and adults with epilepsy. We were widely supported by international and domestic senior experts in epileptology. Seven international experts (Peter Wolf, Byung-In Lee, Jacqueline A. French, William H. Theodore, Josemir W. Sander, Hermann Stefan and Patrick Kwan) and five domestic experts (Weiping Liao, Yuping Wang, Jiong Qin, Guoming Luan and Dong Zhou) had joined us by giving lectures and hosting discussion with the students. About 50 young specialists in neurology, neurosurgery, neurophysiology and pediatric neurology, took part in this course from all over China, including one international student from Korea. The program of the course was arranged with 4 days of lectures on the clinically relevant aspects of epileptology and conducting interactive case discussions and tutorials on EEG, imaging and clinical pharmacology. The course enabled the participants to receive up-to-date information and expert opinions on the main topics of clinical epileptology, and helped them to improve their competence and practical skills in the diagnostic work-up and decision-making concerning the management of different aspects of pediatric and adult epileptology. Additionally, some practical activities, such as small group discussion, debate and sport meeting were incoprporated in the course. After the summer school, a survey of course participants found that almost every attendant was satisfied with the academic program, tutors, accommodation, facilities, course arrangements, activities and food. It was a meaningful and remarkable event in elevating the international academic influence of China in epilepsy. We gathered to provide help to people with epilepsy and for self-expression and knowing others. We are committed to holding this summer school for several years and believe that it is not only a training course but also the bridge to connect with global epilepsy development. China Association against Epilepsy West China Hospital, Sichuan University 2012.8 - 11 - Report on Indian Epilepsy Society-7th EEG Workshop 2012 Venue: Auditorium, G.B.Pant Hospital, New Delhi-110002 India August 11-12, 2012 (Saturday-Sunday) Indian Epilepsy Society -7th EEG Workshop was held at G. B. Pant Hospital, New Delhi from August 11th & 12th, 2012 (Saturday-Sunday) under the aegis of Indian Epilepsy Society Dr. Man Mohan Mehndiratta was the course organizer & Dr. Manjari Tripathi was the course Director for the Workshop. We planned to restrict the registration to maximum of 60 but because of enthusiastic response we had to accept more registration and the total number of registered delegates was 124. This time we further enhanced the participation of faculty from all over India and we invited 37 national and two International faculties for this workshop. Dr. Byung-In Lee, Chairman Commission of Asian Oceanian Epilepsy Affairs (CAOA) from Korea & Dr. Lim Shih-Hui Chairman Asian Epilepsy Academy (ASEPA) from Singapore. Due to unavoidable circumstances Dr. Lim Shih Hui was not able to attend this workshop. He delivered this talk through video-conferencing. All the presentations were converted into PDF format and written on DVD to save the costs of printing and xeroxing. This time we have provided Wi-Fi & LAN connection facility to the delegates to access the speaker’s PPT presentation & EEG on their laptops or tablets. Another milestone for the first time during EEG workshop was ASEPA-ASNA (ASEAN Neurological Association) joint EEG Certification examination (Part 1) for neurologist, neurology resident and EEG technologist. The purpose of the EEG Certification examination is to establish and improve standards of training and professional practice of EEG in Asia. Fifteen candidates were registered for this exam and thirteen candidates appeared. Dr. Man Mohan Mehndiratta Course Organizer Dr. Manjari Tripathi Course Director - 12 - - 13 - Activities of the Japan Epilepsy Society (2011 – 2012) The 2011 Annual Conference of the Japan Epilepsy Society (JES) saw a continued increase in participants, reaching 1200 for the first time. This demonstrates the degree of interest in epileptology for the whole country. 1. At the 29th International Epilepsy Congress that took place in Rome, Italy from August 28 to September 1, 2011, 68 papers from the JES were presented, with over 80 members participating in the Congress. The number of presentations, especially oral presentations, at international conferences is showing an annual increase. 2. The second joint symposium organized by JES and Japanese Society of Neurology (JSN) was held at the 52nd Annual Meeting of JSN. The necessity for multidisciplinary epilepsy care, especially for adult epilepsy, is gaining recognition. The issues of treatment for patients with childhood onset epilepsy who reach adulthood (awareness of the status of carry-over care) are being highlighted. 3. The number of JES members continues to increase. The membership reached 2264 on October 10, 2011, with an increase of 143 from the same time in 2010. As of October 10, 2012, the membership has further increased to 2389, with more pediatricians, neurosurgeons and neurologists joining JES membership. 4. Including the 51 epileptologists who passed the certification examination in 2012, a total of 448 clinical epileptologists certified by the JES are now practicing. With the need to address the increase in elderly onset epilepsy, the current number of specialists is totally inadequate. Further measures to increase the number of certified epileptologists have to be considered. 5. The 45th Annual Conference of the JES was held on October 6-7, 2011 in Niigata City under the leadership of the chair Dr. Shigeki Kameyama. Over 1200 participants attended the meeting, who actively discussed and shared views. The number of attendees exceeded 1200 for the first time in the history of the JES Annual Conference. The conference was witness to the continued increase in interest on epilepsy care in recent years. 6. The JES Sponsored Award continues to be active, with 9 young JES members awarded study tours to North America and other regions. The JES Scholarship also continues to accept young researchers in the Asian Oceanian region to study in Japan. 7. To prevent traffic accidents related to epileptic seizures, the Legislative Affairs Committee of JES is engaged in surveying and preventive activities in collaboration with the National Police Agency and other related bodies. 8. JES in collaboration with the Japan Medical Association is constructing an epilepsy care network that transcends the boundaries of medical disciplines and regions. During 12 months starting from April 2012, approximately 40 courses on epilepsy are to be held all over Japan. (reported by Masako Watanabe) Stand up for Epilepsy - 14 - Driving and Epilepsy in Japan In 2002, the Road Traffic Laws in Japan were amended, granting a driving license for private vehicles to persons with epilepsy who fulfill a given requirement. The requirement is an assessment conducted by a doctor that: (1) no seizures have occurred within the past 5 years, and seizures are not likely to occur in the future; (2) no seizures have occurred within the past 2 years, and seizures are not likely to occur within about X (replace X with a number from 1 to 5) years in the future; (3) only simple partial seizures with no consciousness or motor impairment have occurred during a follow-up period of one year, and the symptoms are not likely to worsen in the future; or (4) seizures have been confined to during sleep during a follow-up period of two years, and the symptoms are not likely to worsen in the future. In the cases of (1), (3) and (4), a medical certificate from the attending physician is required for the initial application of the driving license, but resubmission of the medical certificate is not required during license renewal every five years. In the case of (2), resubmission of the medical certificate is required after X years. During the year 2010, 3865 persons with epilepsy submitted a medical certificate from their attending physicians, and 92% were granted renewal or a new driving license. However, from 2010 to 2012, several tragic traffic accidents associated with persons with epilepsy occurred in Japan. According to newspaper reports, the following accidents involving casualties were presumably caused by epileptic seizures: 1. In December 2010, at Yokkaichi, Mie Prefecture, a car collided with three bicycles at a crossing, killing two persons and injuring one. The driver was found guilty and sentenced to prison at the first trial, for “serious negligence in driving a car without carefully consideration of the possibility of seizure occurrence”. 2. In April 2011, at Kanuma, Tochigi Prefecture, a crane vehicle crashed into a group of primary school children on their way to school, causing six deaths. The driver was found guilty and sentenced to prison at the first trial, for “defying common sense in driving a vehicle while being aware that seizure may occur”. 3. In April 2011, at Matsue, a minivan ran into two persons waiting at the traffic light, causing one death. The driver was found guilty and sentenced to prison at the first trial, with the comment that “the accident was predictable given his negligence to take medications”. 4. In May 2011, at Fukuyama, Hiroshima Prefecture, a car crashed into a group of primary school children on their way to school, causing mild or serious injuries in four persons. The driver was found guilty and sentenced to prison at the first trial, for “continuing to drive despite being prohibited by the doctor”. 5. In October 2011, at Aira, Kagoshima Prefecture, a truck collided with a minivan and involved several vehicles, causing one death and four injuries. The driver was found guilty and sentenced to prison at the first trial, for “serious negligence in driving without carefully consideration, while stopping hospital visits and medications”. 6. In April 2012, a tragic accident occurred at Gion, Kyoto Prefecture, in which a minivan lost control and struck 19 pedestrians, causing seven deaths. It was reported that the driver had epilepsy, but the relation between the accident and seizure is under investigation and not yet known. While there was great concern that the above reports may promote misunderstanding and prejudice against epilepsy, in actual fact the reaction from the general public has been mostly calm and rational. Especially, a bereaved family of the accident in Kanuma commented that, “For those persons who are sincerely receiving treatment, of course they should have the right to drive” and “I am concerned that this accident may spark prejudice against people with epilepsy”. Moreover, a bereaved family collecting signatures for prevention of such accidents made the following comment, “I do have concern in my mind that our activity may limit the range of activities of the people with epilepsy”. One can only express great respect for these rational comments coming from persons who are in such grief and distress for the sudden death of their children. Furthermore, it was reported that the presiding judge of the lower count in Utsunomiya said to the convicted driver, “This was not an accident caused by the fact - 15 - that you have epilepsy, but by your failure to confront the disease with sincerity and disregard of the danger of driving”. The judge also commented that, “There is a concern that this case may lead to epilepsy being viewed as a dangerous condition and bring adverse influence on the patients”. At present, urgent attention is given to consider measures for the prevention of such tragic accidents. It was also reported that the above accidents were caused by persons who obtained their driving licenses without going through the proper procedures. If these reports are true, then the offenders were disregarding the serious consequences when seizures occur during driving, and they were not fulfilling their social responsibilities. For the people with epilepsy, some need a driving license to be able to work. For others living in rural areas, sometimes there are no means of transport other than motor vehicle, and a driving license is a necessity in daily life. Some express that they have to hide their disease in order to be able to live. However, if seizures persist despite treatment, then they have to be prepared to come face to face with the disease and consider options; whether they can maintain their current lives, or whether they need to consider changing work and way of living. For a person with epilepsy to obtain a driving license, the attending physician has to state in the medical certificate that the patient fulfills a certain requirement. For physicians caring for epilepsy patients, ensuring traffic safety is one of the most important issues. Because it is difficult to predict the risk of seizure recurrence in the future, many physicians feel a burden in writing the medical certificate. However, fitness for driving varies individually; therefore the evaluation by the attending physician or epileptologist is important, and the judgment should be respected. In Japanese law, the license suspension period is set at six months. Therefore if seizures occur, the license will definitely be cancelled in six months, which is a very strict law. When persons with epilepsy apply for or renew a driving license, they have to declare their own health condition. The Public Safety Commission in Japan try to address the problem of people not obeying this rule by proposing a new law that impose criminal punishment on those persons who do not self-declare their conditions. However, strengthening punitive measures alone is unlikely to improve the situation of compliance. It would make more sense to all parties concerned if Japan will relax the criteria for granting driving license to a level that is practiced internationally, which would actually encourage people with epilepsy to fulfill their responsibilities to abide by the law and ultimately reduce traffic accidents. If evidence can be obtained which supports the notion that amendment of the current laws or enacting new laws is useful to prevent occurrence of traffic accidents involving casualties, then new laws have to be proposed. Masato Matuura Committee of Legislative and Medical Care Affairs Section of Biofunctional Informatics、Tokyo Medical and Dental University - 16 - The first nationwide epidemiology study of epilepsy in Korea Epidemiology Committee (Chair: Professor Jung, Ki-Young) of KES has successfully finished nationwide epidemiology study in Korea and submitted a report on June, 2012. In Korea, only few systematic nationwide epidemiological data for epilepsy exist despite the availability of all state-of-the-art medical technologies required for the diagnosis and treatment of epilepsy. Korea has a unique health insurance system, which is run by the government and encompasses the entire population and all medical facilities. Motivated by these facts, KES organized Epidemiology Committee in 2007 to conduct systematized nationwide epidemiologic study of epilepsy using the National Health Insurance database. The number of potential epileptic patients was estimated from NHI database (from 2005 to 2009) by the criteria of AEDs use and diagnostic codes of seizure and epilepsy. To validate diagnostic accuracy of reclaimed data of NHI, a nationwide hospital survey using structured case recording form was conducted. Finally, the number of potential patients was refined based on hospital survey data, which gave rise to the prevalence of treated epilepsy (Figure). The study revealed that the crude prevalence rate of epilepsy was 3.52 / 1,000 person, and higher prevalence rate in men (4.0/1,000) than women (3.1/1,000) with epilepsy. It is also observed that both young children (less than 10 years) and elderly people more than 70 years were higher prevalence rate compared with other age groups (Figure). It seems that the overall characteristics of prevalence of epilepsy are comparable to those of other developed countries. Professor Kim (president of KES) emphasized that KES will continue to support conducting next phase of epidemiology such as incidence and burden of illness and so on. Figure. Age- and gender-specific prevalence of epilepsy. - 17 - News from KES Reported by Jung, Ki-Young MD (Korea University, Seoul, Korea) “뇌전증” [Noi-Jeon-Jeung], a new name for epilepsy in Korea A public declaration ceremony for the New Name of Epilepsy in Korea, 뇌전증 (Noi-Jeon-Jeung), was held in Deoksugung Palace on the 7th of June, 2012. The Korean word for epilepsy, 간질 (Gan-Zil, 癎疾), has both discriminatory and stigmatizing implications. Gan-Zil was substituted with Noi-Jeon-Jeung (= 腦電症 in Chinese character), which means Cerebroelectric Disorder, by the Joint Task Force of Korean Epilepsy Society (President: Professor HD Kim) and Korean Epilepsy Association (Chair: Professor K Huh) and Noi-Jeon-Jeung was approved in June, 2011, as the legal language replacing the old term, Gan-Zil. The new name, Noi-Jeon-Jeung or Cerebroelectric Disorder, has neutral position without associated stigma and it more closely reflects the scientific basis of epilepsy. Furthermore, it can be easily differentiated from words of resemblance (e.g., convulsion, fits, spasm, etc.). Many people including Dr. S Moshe (president of ILAE) and Mr. Glynn (president of IBE) congratulated the successful outcome of the Epilepsy Renaming in Korea and expressed their strong wish for its positive impacts on the social attitudes toward patients suffering from epilepsy in Korea. The 5th JES-KES joint symposium in conjunction with 17th Korean Epilepsy Congress KES has held 5th annual joint epilepsy symposium with JES on 7 June, 2012. JES-KES or KES-JES joint symposium is annually held, hosted by both societies alternatively since 2008. This year, the theme of symposium was “Basic and Translational Research in Epilepsy” and more than 50 people participated in the symposium. - 18 - - 19 - Sri Lanka League Against Epilepsy- 2012 The main project organized by the Sri Lankan League against Epilepsy was a massive Epilepsy Walk organized in the Jaffna peninsula. Jaffna is the main city in the Northern Province of Sri Lanka. Access to this province was possible only after the culmination of the 30- year long civil war in 2009. This is the first time ever of a similar walk carried out in this part of the country. This was organized by the League in conjunction with Consultant Neurologist at the Jaffna teaching hospital, the Governor Jaffna District, Mayor of Jaffna, Provincial Directors of Health Services and Director Education Services. The “Walk” led by the Mayor of Jaffna and the neurologists commenced in front of the Jaffna Teaching Hospital and winding its way through the Hospital Road, Vembadi Girls School, Clock Tower Road. It was joined by hundreds of senior citizens, school teachers and children, National Cadet Corps, members of the medical profession, public health officers, midwifes, nurses, general public and local artists. The walk ended at the famous Jaffna Public Library, once destroyed by fire during the war but subsequently reconstructed to its former majesty. This was followed by public lectures related to epilepsy with a view of better awareness and social acceptance towards those with epilepsy. Lastly, a dance drama was performed by students of a local girls’ school depicting misconceptions on epilepsy. This was an attractive display with take home messages+ to public through traditional performances by local artists. Dr. Jithangi Wanigasinghe Joint Secretary - 20 - Stand Up For Epilepsy- Taiwan Epilepsy Sports Day To support the “Stand Up For Epilepsy” project of ILAE and encourage people with epilepsy to do outdoor activities, Taiwan Epilepsy Society (TES) organized an exciting and innovative event “Taiwan Epilepsy Sports Day” on 12 May, 2012. Over 250 people with epilepsy, their families, and doctors in Taiwan took part in a running event with Taiwanese ultramarathon champion Kevin Lin in the square of National Chiang Kai-shek Memorial Hall, Taipei. The major aim was to encourage patient with epilepsy to actively participate in sport and physical activity, and emphasise the right of people with epilepsy to participate in physical exercise. TES specifically asked swimming pool operators to remove the regulation that “people with epilepsy are prohibited from entering the swimming pools”. A well-designed gift, “Seizure First Aids Tips” necklace, was presented to each patient. Wearing this necklace during exercise may provide urgent safety and supportive information if a seizure occurs. On that day, there was also an associated carnival, including “Mother’s Day card DIY area”, “Balloon and Dart” game….. The event ended with a renew enthusiasm to “stand up for epilepsy” together with a fresh understanding that people with epilepsy, like athletes themselves, can be inspired to achieve their goals and lead active lives. - 21 - News from Thailand Prof. Pongsakdi Visudhiphan receives CAOA’s Achievement awards from Prof. Byung-In Lee. ASEPA Workshop on epilepsy surgery will be held from July 27-29, 2013 in Bangkok. Topics Main Workshop Epilepsy surgery: Past, Present and Future Recruiting candidates for epilepsy surgery How long does it take to become an epilepsy surgery candidate Presurgical evaluation: Comprehensive review Values & Pitfalls of seizure semiology(adults and children) How to deal with AEDs during EMU Invasive recording and functional brain mapping Dealing with postoperative complications Time to stop AEDs after surgical success Case discussion: Controversy in epilepsy surgery Post Main Workshop 1-day workshop on functional brain mapping Local Host : THE EPILEPSY SOCIETY OF THAILAND 7th Floor Golden Jubilee Building, Soi Soonvijai, New Petchaburi Road, Huaykwang, Bangkok, 10320. THAILAND TEL : (662)716-5114 FAX : (662)716-6004 E-mail : episxbangkok@gmail.com Prof. Somchai Towanabut, president of Thai Epilepsy Society(TES), met Sunao Kaneko, president of Japan Epilepsy Society(JES) during AOEC,2012, at Manila, on March, 22, 2012. He accepted a generous donation from JES to support relief efforts after the devasating flooding in Thailand with deep thankfulness.Thiswas a good circle of generosity after thye Korean Epilepsy Society(KES) kindly donated to JES after East Japan earthquake, March, 2011. - 22 - The EpiNet project The EpiNet study group is pleased to announce that a new version of the EpiNet database was released at the beginning of September. There have been several significant improvements compared with the earlier version of the database. We want to expand the collaboration. If you are not already participating, we would love you to join in this multinational research project. The database has been set up to record information about ANY patient with epilepsy. Patients can be registered from anywhere in the world. The platform is designed to facilitate research, and at the same time to help with the clinical management of patients with epilepsy. A great deal of information can be recorded, but most of this is optional, and relatively few data fields are mandatory. You will see that there is a 'Minimum data-set' option. Users get their own database of all the patients they enter, with all information provided back in a clinically useful, up to date summary. Investigators remain in control of the data on their own patients. We recommend that you enter information that you want recorded for clinical purposes, or for your own research. However, de-identified data is also entered into the global database so that the study group as a whole can follow large numbers of patients with quite specific types of epilepsy. We intend to set up cohort studies and registries to follow particular groups of patients, and to run simple, large, multicentre pragmatic trials. We have recently established a registry of first seizure patients, and we would like as many epileptologists from the Asia-Oceanian region to enrol all patients they see who have a first seizure. We will soon establish a related registry of patients commencing their first AED. We will then establish a registry for patients who are seizure free and therefore withdrawing from their AEDs. We are hoping to commence our first clinical trial in 2013; this will be a trial in previously untreated patients who will be randomised to receive either levetiracetam, lamotrigine or sodium valproate. We are hoping that there will be large numbers of investigators from the Asia Oceanian region who will enrol patients in this clinical trial. The plan is that the people who do the work will get the credit. The investigators who enter the most patients in any study will be invited to be authors on any paper related to that particular study. You are welcome to have a look at a demonstration of the database here:http://staging.adhb.epilepsy.predict.co.nz/login.cfm You can log in with the User-Name 'Epilepsy' and password 'seizure' (Note that the staging website is in the public domain, but the research database is secure and password protected.) If you want to read an introduction to the website, you can do so here:http://epinet.co.nz/index.cfm?PageID7 Information is entered into the database via a series of forms. Some of these have an iterative approach, so that multiple sets of data can be entered. This applies in particular to the investigations, seizure history and drug treatment. There is no limit to the number of times data can be entered on these forms. Please contact me, Dr Peter Bergin (pbergin@adhb.govt.nz) , if you would like to participate. Please give us feedback on how user-friendly you find this database. It is still not perfect, and we would like to be made aware of further improvements that you can identify. Peter Bergin, President of the New Zealand League against Epilepsy and Chairman of the EpiNet steering committee - 23 - AOEO CHAPTER LIST OF ILAE Australia Bangladesh China Hong Kong India Indonesia Japan Korea (South Korea) Malaysia Mongolia Dr Andrew Bleasel A/Prof Annie Bye Armin Mohamed Deepak Gill Prof. Dr. M.A. Mannan Dr. Muzharul Mannan Dr. Shaheen Akhter Li Shichuo Wu Jianzhong Wu Liwen Hong Zhen Li Duan Liao Weiping Luan Guoming Qin Jiong Zhang Hui Zheng Xiaoying Kwan Kwok-Leung Patrick Kwong Mario Chak Wai Lui Colin Dr. Pravina Shah Dr. M.M. Mehndiratta Manjari Tripathi Dr. Satish Jain DR. Dr. Kurnia Kusumastuti, Sp.S(K) dr. Diah Kurnia Mirawati, Sp.S Dr. Lina Soertidewi Prof. Sunao Kaneko Dr. Masako WATANABE Heung Dong Kim Hoon Chul Kang Joon Soo Lee Sang Ahm Lee Chun Kee Chung Raymond Azman ALI Sau Wei WONG Azmi ABDUL RASHID G Tsagaankhuu A Tovuudorj - 24 - ableasel@usyd.edu.au a.bye@unsw.edu.au arminm@icn.usyd.edu.au deepakg@chw.edu.au neurologyfoundation@yahoo.com parthobd@hotmail.com shaheendr@yahoo.com shichuoli@hotmail.com caepswjz@public.bta.net.cn wlw1946@yahoo.com.cn hongzhen@medmail.com.cn health2003@sina.com liao@gzneurosci.com luanguoming@yahoo.com.cn qinjiong@263.net health2003@sina.com xzheng@pku.edu.cn patrickkwan@cuhk.edu.hk chakwk@gmail.com colinlui@netvigator.com drpushah@yahoo.co.in indianepilepsysociety@gmail.com manjari.tripathi@gmail.com satjain55@hotmail.com kurnia.kusumastuti@yahoo.com diahkm@yahoo.com lsdnzk@yahoo.com sk@cc.hirosaki-u.ac.jp wata-ms@ncnp.go.jp hdkimmd@yuhs.ac hipo0207@yuhs.ac joonsl96@yuhs.ac salee@amc.seoul.kr chungc@snu.ac.kr raymond@ppukm.ukm.my swwong@ppukm.ukm.my azmi_rash@yahoo.com tsagaang@yahoo.com tovuudorj@yahoo.com Nepal New Zealand Pakistan Philippines Singapore Sri Lanka Taiwan Thailand Uzbekistan Vietnam Dr. Rabindra Shrestha Dr. Saroj Prasad Ojha Dr. Sudarshan Pradhan Dr. Manen P Gorkhaly Dr. Angel Magar Dr. Rima Rajbhandari Peter Bergin Lynette Sadlier Claire Spooner Elizabeth Walker Prof. Shaukat Ali Dr Zarine Mogal Dr. Farah Minhas Prof. Hasan Aziz Hazel Paragua MD, MBA, FPNA Jean Marie B. Ahorro, MD, FPNA Fe Abacar De Los Reyes, MD Bernadette Terencio Katerina Tanya P. Perez-Gosiengfiao, MD, FPNA Josephine Casanova-Gutierrez Glicerio Cecilio Alincastre Elma Marañon Marilyn Ortiz Maria Felicidad Soto Shih-Hui Lim John Thomas Hian-Tat Ong Andrew Pan Prof. Ranjanie Gamage Dr. M. T. M. Riffsy Dr. Sunethra Senanayake Dr. Jithangi Wanigasinghe Dr. P. D. Rathnayake Wu Tony Lim Siew-Na Yen Der-Jen Somchai Towanabut Chacrin NaBanchang Suwannee Pancharoen Yakutkhon N. Madjidova Gulnora S. Rakhimbaeva Ibadulla A. Kilichev Khurshidakhon A. Rasulova Diana B. Sattarova TRAN VIET NGHI LE QUANG CUONG TA THI VAN ANH - 25 - rabin154@hotmail.com ojhasp@yahoo.com drsudar@yahoo.com mpgorkhaly@gmail.com ang2el@gmail.com praveshrajbhandari@hotmail.com PBergin@adhb.govt.nz lynette.sadleir@otago.ac.nz CSpooner@adhb.govt.nz EWalker@adhb.govt.nz shaukat_neuro@yahoo.com zarine_mogal@yahoo.com minhasfarah@gmail.com hasanaziz60@hotmail.com hazelparagua@yahoo.com jeanmarie.ahorro@yahoo.com fdrnaga@gmail.com bbterencio@yahoo.com drgosh@yahoo.com jcasanovagutierrez@gmail.com cesalincastre@yahoo.com elmskymar@yahoo.com.ph malen_ortiz@yahoo.com fsoto@surfshop.net.ph lim.shih.hui@sgh.com.sg john.thomas@sgh.com.sg Hian_Tat_ONG@nuhs.edu.sg panneuro@singnet.com.sg ranjaniegamage@gmail.com mtmriff@yahoo.com sunethra_aes@yahoo.com jithwani@yahoo.com oshanif@yahoo.com tonywu@adm.cgmh.org.tw siewna.lim@gmail.com djyen@vghtpe.gov.tw s_towanabut@yahoo.com c_nabangchang@yahoo.com s_phancharoen@hotmail.com madjidova1@yandex.ru rakhimbaevags@mail.ru qlichev@mail.ru khurshidakhon@mail.ru diana26@mail.ru tranvietnghinimh@gmail.com lequangcuong@hotmail.com vananhluc@yahoo.com Commission on Asian and Oceanian Affairs (CAOA) 1. List of members & Office Bearers: As of November, 2011, CAOA represents 19 chapters in the Asian and Oceanian region, including Australia, Bangladesh, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Mongolia, Nepal, New Zealand, Pakistan, Philippines, Singapore, Sri Lanka (formally accepted in September 1st at the 29th IEC in Rome), Taiwan, Thailand, and Vietnam. Nomination and election of the CAOA 2009 - 2013 Office Bearers were carried out in the second quarter of 2009. New members of CAOA took office officially in July 2009 and then were joined by ex-officio members representing India (V Nadkarni), Chair of CAOA-Research Task Force(P K wan) and Chair of Regional Committee of GCAE (E Somerville). Table 1. Officers of CAOA( 2009-2013) Chairman Byung-In Lee (Korea) Secretary John W Dunne (Australia) Treasurer Jing-Jane Tsai (Taiwan) Information Officer Sunao Kaneko (Japan) Menbers Hasan Aziz(Pakistan) Shi Chou Li (China) Chong Tin Tan (Malaysia) Shih-Hui Lim (Singapore) Ex-Officio Tatsuya Tanaka (Japan,ILAE-First Vice President) Vrushali Nadkarni (India) Task Forces 1.Research Task Force Patrick K wan(Hong Kong) 2.Global Campaign Task Force Ernest Somerville(Australia) The Asian Epilepsy Academy (ASEPA) was formed in 2003, initially as the educational arm and now a sub-commission of CAOA. The composition of ASEPA is shown in Table 2. - 26 -