EAN 2022 Highlights
The 2022 Congress of the European Association of Neurology (EAN) in Vienna showcased the latest data in epilepsy, Alzheimer’s disease, multiple sclerosis and many other neurological conditions. Get all the latest updates, including:
- Differential diagnoses, drug resistance and surgery, and basic research in epilepsy
- Biobank data and biomarker analyses in risk, diagnostic and prognostic factors in Alzheimer’s disease
- Daily highlights of the most clinically relevant content from the congress
Day One Highlights – Getting evidence into practice in the management of epilepsies
By Leigh Findlay
The theme of the EAN Congress 2022, Getting Evidence into Practice, was also the topic of a symposium on epilepsy on Day 11.
Diagnosing epilepsy
The first speaker, Mar Carreño Martinez discussed the important first step in the management of epilepsies: correct diagnosis2. Timely and accurate diagnosis is vital for prognosis and guiding treatment – both correct diagnosis of the type of epilepsy and misdiagnosis of other seizure types as epilepsy have profound effects on a patient’s life.
Carreño Martinez noted that the two conditions most frequently misdiagnosed as epilepsy are psychogenic seizures and syncope. Other diagnoses are panic attacks, migraines, parasomnias and transient ischaemic attacks. She stressed the importance of comprehensive history taking, which is aided by evidence from reliable witnesses, especially if loss of consciousness occurs. Tongue biting can help distinguish epileptic seizures from syncope, while ictal eye closure is significantly more frequent in psychogenic seizures.
She noted that, in about 40% of cases, the first reported seizure was preceded by other unnoticed or unreported events, which must be identified. EEG is the cornerstone of differentiating epileptic seizures from those of other origin and is especially useful within the first 24 hours after the first seizure, when the specificity of EEG abnormalities is 94%.
A first seizure is preceded by unnoticed or unreported events in around 40% of cases
Medical treatment for epilepsy
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Day Three Highlights – Focus on dementia
By Leigh Findlay
Day 3 of the EAN Congress 2022, Getting Evidence into Practice, included a special session in cooperation with the European Psychiatric Association22. Leaders in the field gave their take on diagnosis, prevention and novel treatment options in Alzheimer’s disease and all-cause dementia.
Diagnosis of Alzheimer’s disease: towards personalised risk profiles
Professor Bruno Dubois discussed the importance of the definition, natural history and diagnostic criteria of preclinical Alzheimer’s disease (AD)23. He noted that the current definition of AD is clinico-biological and stressed that changes in disease biomarkers can precede clinical symptoms by many years. Moreover, and most importantly, while all cases of clinical AD show amyloid and tau deposition, many individuals positive for amyloid and tau biomarkers do not go on to develop the disease. Emerging research on the role of compensatory brain mechanisms and brain resilience in protecting against disease progression further complicates the picture.
Future development of personalised risk profiles that incorporate biomarker status, personal risk and preventive factors will allow us to classify the risk of asymptomatic people with positive biomarkers progressing to clinical AD as absolute (only carriers of autosomal dominant mutations for AD), high or low. The International Working Group currently recommends that asymptomatic individuals should not have AD biomarkers measured in a clinical setting24.
Can we prevent dementia?
Professor Alina Solomon discussed prevention of dementia25. She highlighted the 2020 report of the Lancet Commission that estimated a prevention/delay potential of about 40% by modifying 12 risk factors throughout the life cycle26. She echoed Professor Dubois in recommending individualised risk assessments and a tailored preventive approach simultaneously targeting multiple risk factors. She also noted prevention potential is highest in low-income countries.
Alzheimer’s disease risk is difficult to assess and should be individualised to each patient
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In the video clips below, listen to Professor Ley Sander’s take on the key discussions at the EAN 2022 Congress on the current and future management of epilepsy.
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Developed by EPG Health for Medthority. This content has been developed independently of the sponsor Novartis Pharma AG, who have had no editorial input into the content. EPG Health received unrestricted educational funding from the sponsor in order to help provide its healthcare professional members with access to the highest quality medical and scientific information, education and associated relevant content.