|Congresses and Meetings|
|9th EFNS Congress, Athens, Greece, 17 - 20 September 2005|
Panagiota Davaki, Greece
Welcome Adress of the President
Welcome to the 9th Congress of the European Federation of Neurological Societies – the EFNS is proud and grateful to be in Athens, the cradle of European culture. For our annual congress we are grateful to have powerful allies in the effort to promote neuroscience and clinical neurology in the Hellenic Neurological society, our host, and the European Section of the Movement Disorder Society and we acknowledge the support of the World Federation of Neurology.
To have a medical congress in Greece is a privilege, an honour, but also an obligation and commitment:
Asklepios, the son of Apollo and Coronis, received his knowledge directly from the centaur Chiron, and he was moved to the stars as the deity of medicine after he was struck by Zeus with a thunderbolt when he tried to bring a human back to life. Of his 4 daughters Hygieia represents hygiene and Panakaia lets us hope for an all curing drug.
The impact of ancient Greece on neurology is reviewed in an excellent paper by Professor Clifford Rose (1994).
According to his studies, Alkmaion of Croton (500 - 450 BC) was the first to place sensation in the brain and claimed that there was a conduct to transmit the sensory impressions that external objects made on the eyes – and he concluded that the brain was the seat of the intellect, and thus was one of the first cephalocentric protagonists.
The other Greek medical authority I want to mention is Diogenes of Apollonia (499 – 428 BC) who gave the first description of the blood supply to the head: his diagram shows two great vessels on each side of the cervical spine passing through the neck to the brain.
Hippokrates of Kos (460 – 377 BC) is the father of European medicine and actually laid the foundations of medicine as a branch of science based on systemic observations and examinations. His – and the writings of his school – are included in the Corpus Hippokraticum, a collection of several books, where various diseases are clearly described. Also the Hippocratic oath is included in these writings. Out of the Corpus Hippocraticum the most important part for neurology in the treatise on the sacred disease where he clearly states that this is not divine or sacred, but a disease of natural causes.
In Aphorisms, Hippokrates was the first to state that headaches were not a visitation from the gods, but distinguished different types of headache and he was the first to describe several known features of migraine.
He was the first to report a case of otitic meningitis and a case of subarachnoid hemorrhage, and many other neurologic disorders.
Theophrastus (Tyrtamos) of Eresos (372 – 287 BC), a pupil of Aristoteles and actually the father of botany, wrote a book on Paralysis, caused by interruption of the flow of pneuma, but also the blood ceases to flow. The classical Greek period was transferred to Alexandria, where Herophilus of Chalkedon (330 – 260 BC) and Erasistratus of Joulos / Chios (325 – 250 BC) performed human dissections and were the founders of neuroanatomy and neurophysiology, and most important, considered the brain “the most noble part of the human body and the seat of intellect and senses”. These authors described the various parts of the brain, the spinal cord, the meninges, the lateral ventricles and the communication between the ventricles. They distinguished between sensoric and motoric nerves and between arteries and veins, and recognized the pump function of the heart. Erasistratos became also famous as he discovered the “illness of Antiochus”, the son of Seleucus, the King of Syria, who had fallen passionately in love with Stratonice, his young stepmother. Following the advice of Erasistratos, Seleucus gave his young wife to his son and made him his successor as king, and Antiochus was cured. This qualifies Erasistratos as the founder of psychosomatic medicine.
These themes of ancient Greek medicine are still up to date and are dealt with in the sessions of main topics of our Congress – and I expect that the sessions on Epilepsy, Headache, Infections will show the progress made since these times.
I would like to continue the thought initiated by Theophrastus (372 – 287 BC) who observed for the first time that “Paralysis” is caused by cessation of flow – a topic which is also represented in our program in the session on “Update on Carotid Artery Disease”.
The word “Apoplexia” meaning “Stroke” is already used in the Hippocratic corpus, and describes the acute occurrence of a paralysis of the whole body, of one side or one limb. In the old Greek literature the apoplexia is usually a disease leading to death, if the patients survive, they are severely disabled. As in our time, this disorder affects mainly people of advanced age, but also cases in young adults are reported. As the cause an accumulation of cold and viscous mucus or phlegma was postulated occluding the aorta. However, also risk factors were described including excessive food and wine consumption as well as lack of exercise. Of the therapeutic interventions recommended in the old literature venesection with the aim to balance the humors is still used in selected cases. Additionally, a large number of drugs were applied – and one is reminded on the large number of neuroprotective agents recommended for treatment of stroke – but without proven efficacy.
With the persisting and still pressing problem of cerebrovascular disease one wonders if there has been a significant progress. Still stroke is the third most frequent cause of death in Europe and the leading cause of disability. It is a matter of great concern that incidence and mortality show a large variation in different countries and regions in Europe (incidence: 388 / 100.000 /year and 312 / 100.000 / year in Novosibirsk compared to 124 / 100.000 / year and 61 / 100.000 / year in Friuli for men respective women in the age group 35 – 64 years; mortality: 200 – 300 / 100.000 / year in Eastern Europe compared to 28 / 100.000 / year in some Western countries).
That means that it must be the most important mission of our society to bring the modern concepts of prevention and management of neurological diseases to an equal level in all countries of Europe and to rural as well as urban areas. European neuroscientists and clinical neurologists have been leading in many aspects of basic research on the pathophysiology of the ischemic damage, e.g. the concept of the penumbra, on the introduction of neuroimaging modalities to recognize early ischemic changes in acute stroke, in the development and clinical application of therapeutic strategies based on the basic concepts, as e.g. thrombolysis and carotid endarterectomy. They were also involved in the multicentre trials leading to an efficient treatment of risk factors. It is now our task to spread the new concepts of treatment and prevention of stroke all over Europe. For the achievement of this mission we utilize the classical Greek idea of regular gatherings of representatives from all nations to worship and to compete in various arts and sciences or athletic disciplines – and the Congress of the EFNS follows this tradition to bring together neurologists and neuroscientists from all European as well as many non-European countries in an endeavour to promote knowledge and skill necessary for the management of patients with neurological disorders and for the advancement of neuroscience. To follow the spirit of classical “Greek games” there is also a peaceful competition of the best young scientists in the tournament for the “Uschi Tschabitscher Prize”. And most important, the classical idea of Greek conventions is to meet and make friends and to enjoy the company of many colleagues in the relaxed atmosphere of a wonderful city.
President of the EFNS
The President of the Hellenic Republic, Dr. Karolos Papoulias, and the President of the EFNS, Professor Wolf-Dieter Heiss, were sitting together just before Dr. Papoulias was giving his Welcoming Address.
Dr. Papoulias talked to Professor Heiss in perfect German. It turned out, that Dr. Papoulias left Greece during the time of the Junta, studied in Cologne where Wolf-Dieter Heiss was chair of the Neurological University Clinic.
Greetings from Athens
The 9th Congress of the European Federation of Neurological Societies was held in Athens from 17 to 20 September 2005 and it was hosted by the Hellenic Neurological Society. It was the first time that Athens, Greece had the opportunity of welcoming an EFNS Congress. The Hellenic Neurological Society, being one of the founding members of EFNS, and the Local Organising Committee wished to make this meeting a special scientific and cultural event. Our efforts together with the Congress Programme Committee chaired by Jacques De Reuck and of the Teaching Course Committee chaired by Johan Aarli, resulted to the sufficient number of 4500 participants, coming from 92 countries all over the world, who attended the Athens Congress and filled the halls of Megaron during the 4 days.
33 lectures were given in the "Main Topics", 95 communications in oral sessions and 75 in focused workshops; there were 1061 communications in the poster sessions, 11 teaching courses and 20 satellite symposia. We might probably emphasize the success of............., the quality of the poster presentations and the outstanding level of the 2 oral sessions of the Tournament of Young Neurologists, the winners of which received the Uschi Tschabitscher Prize for Young Neurologists; the success of the Special Sessions particularly of those devoted to "Neurology and Arts" and "History of Neurology", the last one followed by an Ancient Greek Medicine Tour with Neurological Hints" round the Hill of Acropolis and the Ancient Asclepeion, guided by Mrs Alexandra Christopoulou, archaeologist, Ph.D, London University.
The success of the scientific programme seemed obvious from the fact that the lecture theatres and rooms were full in spite the nice weather and the attractiveness of the city.
As far as the social events is concerned: the Opening Ceremony was attended by almost 2000 participants in the Grand Hall of Megaron Opera House. After the welcoming speeches of Panagiota Davaki, Chair of the Local Arrangements Committee, and Wolf-Dieter Heiss, President of the EFNS, we had the great honour to declare the opening of the 9th EFNS Congress, His Excellency, the President of the Hellenic Republic Dr. Karolos Papoulias, who remained with us listening to the concert given by the Camerata of the Friends of Megaron Residence Orchestra conducted by Alexandros Myrat. All participants stayed during the reception that followed the musical programme, which was given in the halls and verandas of Megaron.
The main social event took place in the open air ancient amphitheatre of the Odeion of Herodes Atticus. Five thousand people, participants and accompanying persons, enjoyed the performance of Zorba the Greek by the Greek National Opera, music by Mikis Theodorakis, with enthusiasm; a magic atmosphere was created since the full moon favoured us with its presence.
The general impression is that the Athens Congress was a successful EFNS congress scientifically as well as socially. On behalf of the Local Organising Committee, we wish to express our thanks to Lisa Müller and her team in Vienna, Prague and Florence - collaborators for the great job, and to the EFNS PCO Kenes, and the local PCO FREI, for the perfect organisation of the congress.
Last but not least, we warmly wish good luck to Glasgow, the congress city in 2006, and great success to the coming EFNS congresses.
Chair of the Local Organising Committee.