William Davis Gaillard, Chair
| Sampsa Vanhatolo, Secretary
| John S Duncan
|| Demetrius Velis
The charge of the Commission of Diagnostic Methods is: 1) To provide information based guides to clinical practice for currently used selected diagnostic methods, and 2) To provide an electronic educational resource to train and educate colleagues around the globe in the appropriate use of selected diagnostic methods.
The Commission on Diagnostic Methods serves to advise and support the ILAE in all matters concerning epilepsy diagnostics.
Commission activities from 1 January 2006 until 31 May 2007
The Diagnostic Commission and Subcommittees met in San Diego during the AES meeting to report on past accomplishments and to plan future activities.
Dr Chiron has lead the organization of the Imaging E-Education Module initiated during the San Diego Organizational Meeting.
Dr Gaillard has organized the working group for imaging guidelines in children with epilepsy.
Dr Velis has lead implementation of the e-education course in neurophysiology and has also labored to establish recommendations for use of portable EEG in decentralized epilepsy care of countries with limited resources.
A. The Neuroimaging Subcommission
The Neuroimaging Subcommission submitted its draft for guidelines in the evaluation of children with recently diagnosed epilepsy and is now working on guidelines for the evaluation of children with refractory epilepsy. The commission, through WD Gaillard has worked with the AAN Practice Epilepsy Commission (Practice parameter team) and have identified 1,500 papers with MRI, PET, SPECT now being reviewed for pediatric content. A session at the Singapore ILAE meeting will be dedicated to evidence based use of imaging in the evaluation of children with epilepsy.
The Neuroimaging Subcommission, led by Dr Chiron, has organized a E-education module and is planning on launching the module in July at the Singapore meeting. Sections and authors have been identified and materials are due in June 2007.
B. The Neurophysiology Subcommission
E-Education: The Sub-Commission on Neurophysiology has made substantial progress on clinical neurophysiology distance learning module which has been successfully launched. Materials will eventually be made available in English, Spanish, and French; Dr Velis recommends linguistic expertise in these languages for all distance module faculty.
Establishment of recommendations for use of portable EEG in decentralized epilepsy care in countries with limited resources. Early exploration of ambulatory EEG met limited if not disappointing response from many chapters; but encouraging opportunities appear to be present with West African colleagues and South Asian chapters. Efforts continue to build this program.
Recommendations for Future Work
The primary goal of the Diagnostic Commission and its sub-commissions for the upcoming year is the effective implementation and consolidation of the E-education initiative and completion of guidelines.
The Diagnostic Commission will begin to focus on emerging technologies for diagnosis and planning interventions in patients with epilepsy. The Commission plans focus on MEG, Optical Imaging, TMS, and new MRI imaging sequences (e.g. DTI). In particular the Neurophysiology Commission is weighing a commission report on MEG with an emphasis on evidence based review of uses and limitations of MEG for interictal spike localization and source imaging for language. The Diagnostic Commission will also consider mechanisms by which new and recent diagnostic technologies may be evaluated across multiple sites.
Commission and sub-commission meetings are planned for ILAE Singapore, AES Philadelphia, and upcoming European meetings in 2008.
William D. Gaillard
Chair, Commission on Diagnostic Methods