| Chair & Contact Information:
Dr. Chong Tin Tan
Neurology Laboratory
University Hospital
50603 Kuala Lumpur
Malaysia
Phone: +6003 750 2585
Fax: +60037 557740
E-mail:
The business meeting of Commission on Asian and Oceanian Affairs
(CAOA) was held on September 11, 1999 in Park Hotel in Prague, Czech
Republic. The meeting was attended by Dr. Masakazu Seino (Chairman)
of Japan, Dr. M. C. Maheshwari (Secretary) of India, Dr. Yoshiaki
Mayanagi (1st Vice President of ILAE), of Japan, Dr. Kyoon Huh representing
Dr. Byung-In Lee of Korea, Dr. Christopher Rowe of Australia, Dr.
Chong Tin Tan of Malaysia, Dr. Shi-Hui Lim of Singapore, Dr. Jing-Jane
Tsai of Taiwan and Dr. Pongsakdi Visudhiphan of Thailand.
1. Comprehensive Epilepsy Care
A survey was conducted by the Commission members on the current
status of comprehensive epilepsy care in 9 countries in Asia and
Oceania. This was compared with the results of a questionnaire survey
conducted in 12 centers in the Western countries. The structured
questionnaire was complied by Dr. M. Pfaeffelin et al. and presented
at the 10th Behtel-Cleveland Symposium. The survey highlighted that
every center in Asia provides both out- and in-patient services
for both adults and children. The estimated number of out- patients
per year in most centers exceeds 5,000 while that of in-patients
per year is less than 100. The Cost of per out-patient per personal
contact per year is less than $200 USD while that per in-patient
per day is less than $200 USD. The mean number of personal contacts
with a given out-patient per year in this region is greater than
in the West. The estimated percentage of patients with difficult-to-treat
seizures, learning disabilities and difficulties in school education
is less in centers in the Asian countries than in the West. Diagnosis,
history taking, neurological assessment, and scalp EEG are carried
out at a level similar to the West, but assessment of activities
of daily living, neuro-psychological testing, social occupational
and school career assessment and QOL assessment are seldom conducted
in the Asian region. In addition, treatment does not include psycho-social
and rehabilitative aspects. Co-medical staff members are not included
in diagnosis and treatment. There are fewer teams and team meetings
to discuss patient problems. Assessment of comprehensive care does
not include; vocational training, training for everyday and social
competence, social work counseling and patient education programs.
A doctor’s letter of assessment is not regularly offered when patients
leave the center. It was emphasized that a multidisciplinary management
team consisting of not only medical but co-medical professionals
is mandatory to ensure comprehensive care for people with epilepsy.
2. Epilepsy Care in Respective Countries
The members were requested to comment on this survey and present their
views in their respective countries. Dr. Chong Tin Tan introduced
a teaching course of epilepsy for medical professionals in Malaysia.
So-called Nipa House encephalitis, a recent epidemic caused by a virus
in Malaysia, was one topic. Dr. Shi-Hui Lim mentioned a national neuroscience
program in Singapore that includes an epilepsy program for general
practitioners. Preparation of minimal requirements for epilepsy care
is under way. Dr. Visudhiphan commented on education programs televised
regularly to educate school- teachers and citizens in Thailand. The
Korean Society was founded in 1996 and has now about 400 members.
Recent trends of epilepsy surgery in Korea were explained by Dr. Kyoon
Huh. The law related to drivers’ licensing was amended in Korea to
permit those patients to drive who were seizure free for two years.
Dr. Jing-Jane Tsai reported an epidemiological survey initiated recently
by the Taiwan Society. Dr. Ch. Rowe referred to fellowship for medical
professionals and nurse practitioners provided by the Australian Society.
The Society in India has now about 150 members. Epilepsy Digest has
been published in India. Dr. Maheshwari mentioned that an anti-marriage
law for those with epilepsy still exists in India. Dr. Seino explained
a new system developed in Japan to qualify epilepsy specialists. This
system was requested to develop by the Japanese Epilepsy Association,
a non-medical organization. 3. Chapter Development
Dr. Maheshwari has made continuous efforts for developing ILAE chapters
in Nepal, Bangladesh, Sri Lanka and Pakistan. The Nepalese Chapter
inaugurated their Society on August 21, 1999 and had completed almost
all the formalities and had applied to Secretary General of the
ILAE. Sri Lanka is almost ready. Bangladesh, Pakistan, Vietnam and
Malaysia are in preparation of forming their own societies. Countries
having too few professionals are Laos, Myanmar and Cambodia. Korean
and Philippine Society were officially approved as ILAE Chapters
at the 1999 General Assembly. Dr. Seino explained the triangular
relationship of the Commission with the Advisory Council and Epilepsy
Academy in Europe and desired to establish a similar triangular
relationship in this region in the future. To accomplish this goal,
it is essential that more chapters are formed in Asia and Oceania.
4. Third Regional Congress in 2000 in New Delhi
Dr. Maheshwari presented the status report of the 3rd AOEO and 2nd
AOBE Congress in the year 2000. All preparations, including scientific
programs, have been made. Profit sharing was discussed, keeping
in mind the prevailing economic situation in this region.
5. Epilepsy Workshops
The Epilepsy Workshop in Vietnam will be organized under the umbrella
of the CAOA and Pacific Rim Working Group (PRWG) in addition to
the Vietnamese Neurological Society on April 25 and 26, 2000 in
Hanoi attended by some 100 medical professionals in Vietnam. Dr.
Chong Tin Tan of Malaysia and Dr. Le Duc Hinh of Vietnam are responsible
for the local organization. The themes and lecturers are; Epidemiology
( CT Tan), Classification (Maheshwari), Febrile seizures (WL Lee),
Partial seizures (SH Lim), Differential diagnosis (SH Lim), Video
monitoring (M Chee), EEG workshop (P Wong), Neuroimaging (M Chee),
Medical treatment (SH Lim), Treatment in children (WL Lee), Temporal
lobe epilepsy (M Chee), Surgery (SH Lim), Psychiatric aspects (Y
Inoue), Psychological aspects (CW Lai), Epilepsy association organization
(MC Maheshewari), Comprehensive center (M Seino), and Panel discussion
(CW Lai). As seen in this program, the workshop is educational to
strengthen the infrastructure of epilepsy management in Vietnam,
rather than academic.
Exactly in the same context, the 2nd Epilepsy Workshop
will be organized in Bandung in Indonesia for three days in May
2001. The Workshop will be jointly organized by ILAE/CAOA, PRWG,
ASEAN Neurological Association and the Indonesian Epilepsy Society.
The first three groups will be responsible for the scientific content
and recruiting the overseas participants, while the Indonesian Society
will be responsible for the local organization.
6. The Fourth Regional Congress in 2002
There were two proposals for the 2002 Regional Meeting of AOEA and
AOBE.; one from Thailand and the other from Japan. Japan’s proposal
to host the regional meeting in the year 2002 was accepted. It will
be organized in conjunction with the annual meeting of the Japan
Epilepsy Society. Dr. Toshio Yamauchi will serve as the congress
president. Dr. Seino stated that the regional meeting will be held
in accordance with the ILAE guidelines. Dr. Seino noted there is
a specific budgetary regulation adopted in Japan that scientific
congresses can yield, at least theoretically, neither profit nor
deficit.
7. Sub-commissions
These Epilepsy Workshops are a task given to the Education Subcommission.
Dr. Chong Tin Tan of Kuala Lumpur, Malaysia is in charge of this
subcommission. In addition, CAOA has formed two more subcommissions;
Complementary Treatment and Chapter Development. The former, chaired
by Dr. Jing-Jane Tsai of Taiwan, has recruited members interested
in non-pharmacological management of epilepsy currently conducted
in this region. Questionnaires will be the source of information
for the time being. The latter, headed by MC Mahesheari, shoulders
an important mission to form new chapters. Such countries in the
South-east Asia as Vietnam, Cambodia, Laos, Myanmar, Bangladesh,
Pakistan and Nepal constitute an area where no signs for chapter
formation are so far perceived.
8. Fellowship
The CAOA is to provide funds for a limited number of fellowships
for residents/ tainees/non-medical persons who wish attend the 3rd
AOEO or 2nd AOEA Congresses to be held in New Delhi, November 11
to 13, 2000. The fellowship amount will cover only the
registration fee. All such persons should have submitted a paper/poster
for presentation at the Congress. Proof of being a resident/trainee
is required to be submitted with the registration form. This note
appears in the Final Announcement of the Congress.
Masakazu Seino
Chair
Annual Report 2000 Table of Contents
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