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Commission on Asian and Oceanian Affairs

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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