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Lisbon hosted the 4th EAN Congress, the largest European Neurology Congress ever held.

Comprised in the past by two societies, the European Neurology Society, with individual members, and the European Federation of Neurological Societies, a Federation of National Societies, were kept apart and organised two Neurology congresses in Europe simultaneously.

But José Ferro, former President of the European Neurology Society and current Director of the Neurology University Clinic and President of the School Board of the Faculty of Medicine, was responsible for merging these two European societies. At the time, one of the six members of the transition committee was able to harmoniously bring together the societies and turn them into one. Thus, the European Academy of Neurology (EAN) was born, the largest European Neurology Society.

Lisbon was not forgotten as a city that has been a home to so many brilliant minds and that is why the 4th EAN congress was held there last June, between the 16th and the 19th. Despite the advantage of being a cosmopolitan city with more and more air connections that shorten distances, all praise goes to the head of the local organising committee, the Chairman Joaquim Ferreira, Neurologist, Director of the Laboratory of Clinical Pharmacology and President of the Pedagogical Board of the Faculty of Medicine, who understood that in order to promote the city and a range of very good neurologists, he needed to face the challenge with no fear.



"The situation is very curious because I was in a meeting in Santiago de Compostela and on the other side of the table was Professor Günther Deuschl, the then President of the Academy, and I realised that they were having problems choosing where the 2018 congress would take place. At that point, there were some problems between the candidate countries as they were not agreeing on their responsibilities, so I thought there was a window of opportunity for Lisbon to apply. I sent an e-mail to the other side of the table and asked that they consider Lisbon as a candidate city to host this organisation. The Academy had to make decisions within a short deadline and after a week or two they came to Lisbon. At the time, Professor Victor Oliveira was the President of the Portuguese Neurology Society and was hugely generous and available to support this candidacy. We both served as hosts and visited the spaces in the city that were able to host the congress, which eventually happened. We immediately learned a lesson, which was that we only win a candidacy if we compete. This wasn't the only decisive factor, because the international credibility of the Portuguese neurological community also played a key role. If there wasn't a number of notable neurologists who, over the years, have gained credibility and have been recognised as leaders at the highest level of Neuroscience worldwide, none of this would have been possible".

Another advantage was the fact that the organising country was given the chance to choose Neurogenetics as the main theme of the congress. Although movement disorders, namely Parkinson's disease, are his preferred area of interest, Joaquim Ferreira praises the choice of a theme that honours the Portuguese School of Neurology. "There are certain neurological diseases, namely Machado-Joseph Disease and Familial Amyloid Polyneuropathy (FAP) (Paramyloidosis or Corino de Andrade's Disease), in which the national neurological community played a key role in terms of description and research. Prof. Corino de Andrade deserves a special mention as the man responsible for the initial descriptions of FAP, having also contributed to the study of the epidemiological, clinical and genetic components of the Machado-Joseph disease. Despite being different, they are both progressive diseases of genetic origin which cause difficulties with movement. Today, these diseases are still the preferred research topic in clinical research centres in the Universities of Lisbon, Coimbra, Porto and Minho".

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Invited for their scientific merit, the Portuguese professors who were present at the EAN Congress weren't random choices, as Joaquim Ferreira explained. "Of course I suggested some names, from various Medical Schools, based on their scientific merit and international recognition and not for geographical reasons. Naturally, with the Congress taking place in Lisbon, there ended up being a greater number of speakers from the University of Lisbon and the Neurology Service of the HSM; some of the most relevant guests were Professors José Ferro, Víctor Oliveira, Isabel Pavão Martins, Patrícia Canhão, Mamede de Carvalho, Miguel Coelho and Ana Verdelho. It's the same as saying that those in our faculty who are more scientifically active end up playing a more relevant role. One of the strengths of the Congress was the opening session in which Prof. Alexandre Quintanilha gave a remarkable lecture on the ethical implications of the progression of genetics.

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Other outstanding sessions were the highlights, which consisted of a selection of the best and most relevant lectures given during the Congress. The presentations by Prof. Isabel Pavão Martins, Prof. Patrícia Canhão and Prof. Mamede de Carvalho deserve mention. For the first time in the Lisbon Congress, there was a (Clinical Grand Rounds), session coordinated by Prof. Ferro with patient observations. This session went so well that it will be repeated in future congresses.

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José Ferro gave a lecture on Vascular Dementia, that is, the contribution of vascular injury to cognitive deterioration in the elderly, and organised a pioneering and very successful session with live patient observations. We listened to the Professor to understand the impact of this innovative presentation.

"I was a bit concerned that it might not go well, because it was the first time that it had been done. We has three patients, one with extrapyramidal disease, one with neuromuscular disease and the other with cerebrovascular disease. And I had a Portuguese intern from the service (Neurology at Santa Maria) with me. The idea was to present a single slide with the fundamental scheme of the patient's history, and then we would have a foreign expert chosen beforehand, who would ask the patient questions and observe them. All of this was projected on the screen and he was doing a live examination. As this happened, he was asking for tests: genetic tests, MRI, among others that the patient had already been subject to. At the end of the exam he had to reach a diagnosis".

The reaction of the patients to the public interaction was expected, because they had been chosen beforehand and given consent, "all these patients are chronically ill, one was followed by me, another by Dr. Miguel Coelho and another followed by Prof. Mamede Carvalho". To the question of whether public exposure of a clinical picture can intimidate the patient, being in front of an auditorium with about a thousand people, Professor José Ferro's answer was clear, "No, it may even be the opposite, the patient feels that gives them importance, and that they can talk about the problem, and that they are seen by another doctor, other than their doctor."

The session turned out to be a success, since the diagnoses traced corresponded to those that had already been mentioned by the original doctors. We should note that this session did not provide therapeutic solutions, so as not to create instability for patients.



In the words of Professor José Ferro, the key message was passed on and concerns "the invasion of complementary tests that are requested; when the patient is seen by an expert, a few questions and a neurological examination are enough to immediately reach a diagnosis, needing only two or three tests to confirm the initial thoughts".

This was the year when the event was attended by more people, about 6700; last year in Amsterdam, there were no more than 6000.

From the very positive balance that was made by the congress committee organiser, Joaquim Ferreira, he highlights the "opportunity that the young Portuguese neurological community had to show its quality, which makes us peers at the highest level, regardless of geographical boundaries".

The Congress will travel to Oslo in 2019, celebrating the 100th anniversary of the Norwegian Neurology Society and bringing together so many brilliant minds who study those who are suffering from neurological pathologies.

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These were the Neurology Professors that represented the Faculty so well:

Chairperson
Joaquim Ferreira

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Clinical Grand Rounds

Moderators: J. Ferro, M. Coelho

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J. Ferro

Vascular dementia

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J. Ferreira

Can people with PD drive?

Digital outcome assessment in Parkinson’s disease

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A. Verdelho

Neurogenetic avenues and new directions on risk factors in dementia?

To exercise prevention

Current treatment possibilities in dementia

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M. de Carvalho

Highlights Neuromuscular and neurophysiology

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P. Canhão

Highlights Stroke

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I. P Martins

Highlights Headache

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A. de Mendonça

Highlights Dementia and cognition

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M. Coelho

Highlights Movement disorders

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I. Conceição

Familial amyloid polyneuropathy: phenotype, genetics, treatment

Recent advances in therapy

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V. Oliveira

History of Neurology: lessons from Portuguese clinical neurosciences

From pioneers to interventional angiography

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Image credits: EAN Congress

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Joana Sousa

Editorial Team