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Neuropsychiatric Aspects

Commission Members

ES Krishnamoorthy, Chair Frank Besag
Michael Kerr Kousuke Kanemoto
Tebartz van Elst Julian Troller
Andres Kanner Marco Mula
Bettina Schmitz Bertand de Toffol
Alan Ettinger  

The commission has started its activity with an intensivfour-day workshop in Chennai, India, (13 to 16 July 2007) which followed the Singapore ILAE Congress.

The workshop began with a detailed presentation of the work of the last commission and the unfinished agenda thereof. It was decided that clarification would be sought from the chair of the last commission about some minor items that remained apparently unfinished in the last commission report. This commission would facilitate the completion of these items. The principal unfinished item “Transcultural Perspectives Workshop” is being taken up in a substantive way.

The present commission’s agenda was discussed in detail and a clear plan fructified during the course of the deliberations.

Education

After a presentation by Verena Hézser-V Wehrs, it was decided to develop an interdisciplinary module of education for epilepsy and behaviour and to make this available freely through the ILAE/ EUREPA initiative. A module was piloted to an interdisciplinary audience in India and feedback sought as a day long exercise on the 15th of July. This inaugural module is available on video (DVD) and this will be made available to ILAE/ EUREPA.

The commission proposes to offer a revised module tailored to an interdisciplinary audience with more interaction components at a future ILAE congress and to seek feedback before finalization. It was resolved to approach EUREPA with an offer to organize a session in conjunction with the Berlin congress.

Clinical Practice Guideline Framework

Professor Michael Kerr led a Delphi consensus exercise in this regard. Key disorders requiring a framework of guidelines were discussed in this session and the top ten disorders identified. The plan is to develop a questionnaire for the next phase which will be circulated to a group of experts in “neuropsychiatry of epilepsy” asking for input into clinical practice guidelines. Subsequent to this, a modified framework of clinical practice guidelines will be presented in February 2008 in India to a larger international audience and feedback sought. The consensus developed will be presented as a position paper (commission report) and submitted to Epilepsia, and will evolve from these tiered efforts.

Development of a Unified Research Protocol

It was agreed that a unified protocol was an essential first step in developing an international research program. It was agreed to organize a dedicated three day workshop to develop a unified protocol using a Delphi consensus approach.

Development of a Health Policy Paradigm

The commission had a day long meeting on the 16th of July with the TS Srinivasan National Working Group on “Disabling Epilepsy.” As the concept was novel and clinical criteria for it had to be developed, the commission has adopted the concept for further detailed exploration as its health policy theme. Disabling Epilepsy will therefore be the theme of this commission’s next round table workshop.

Future Plan

  • Intensive five day workshop in February 2008 (venue in India to be decided)- 13 to 17 February 2008
    • Full commission is expected to attend; each commission member will bring with her/ him, one guest, who is a well regarded expert in “Epilepsy Neuropsychiatry.”
    • Six members of the ILAE Executive Committee are being invited to lead and mentor this program; the President of ILAE is being requested to make the nominations and subsequently invitations.
    • The First Vice President of the AES, Prof. Steven Schachter will be in Chennai on a visiting professorship and to deliver a public lecture; he will attend and take part in this meeting.

  • 13th February 2008: Interactive workshop on Transcultural Perspectives in the Neuropsychiatry of Epilepsy; unfinished agenda of the last commission. Professors Besag, Kanner and Tebartz van Elst will convene the same with the logistic assistance of the Chair.
    Output: Commission report (position paper) to be submitted to Epilepsia.

  • 14 February 2008: Delphi consensus exercise to finalise clinical practice guidelines – to be lead by Prof M Kerr together with Dr Julian Troller and Prof Alan Ettinger.
    Output:  Commission report (position paper) to be submitted to Epilepsia.

  • 15 and 16 February 2008: Consensus Conclave on Disabling Epilepsy with the participation of the TS Srinivasan National Working Group convened by Prof ES Krishnamoorthy. The aim of this meeting will be to discuss the different aspects that cause disability for the person with epilepsy and arrive at a consensus on:
    • The concept of disabling epilepsy and clinical criteria
    • The contribution of each identified disabling factor
    • The compilation of a checklist based on the International Classification of Functioning Disability and Health (ICF)
    • Peer review of original research data from participating Indian centres
    • Modification and validation as an international health policy paradigm with potential forapplication worldwide, perhaps through the Global Campaign of ILA
    Output: Full supplement to Epilepsia is envisaged

  • 17th February 2008: Intensive panel discussion with representatives of the treatment commission to arrive at a consensus on the role and benefits of psychological therapy for people with epilepsy. A member-representative of that commission Dr. Nandan Yardi attended the July meeting as advised by Prof. Wolf and is expected to co-ordinate the interaction with the Neuropsychiatry Commission (facilitated by the Chair) in February 2008.
    Output: Joint Commission report (position paper) to be submitted to Epilepsia.

  • The TS Srinivasan Centre for Clinical Neurosciences & Health Policy will sponsor the five day meeting including accommodation for the participants, airport transfers and full hospitality. ILAE funds are being sought to facilitate travel for the 30 or so participants.

Other Meetings

  • An educational symposium on Neuropsychiatry of Epilepsy organised in tandem with the European Congress in Berlin; Prof Tebartz van Elst has offered to put this together in Freiberg thus providing an opportunity for a commission meeting.
  • A closed door workshop on unified research protocol development in the end of 2008; a potential venue and host are being explored.

The commission thus anticipates the completion of its current agenda by the end of 2008. Output from this commission is expected to include:

  • One full journal supplement
  • Four commission reports
  • A complete interdisciplinary educational module (DVD and workbook) on Neuropsychiatric Aspects of Epilepsy for dissemination by ILAE/ EUREPA

ES Krishnamoorthy
Chair, Commission on
Neuropsychiatric Aspects

 

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