Commission on Asian and Oceanian Affairs

Aims

To develop, stimulate and coordinate the epileptology agenda in the Asian and Oceanian region.

Missions

• To advance and disseminate throughout the Asian & Oceanian region knowledge concerning the epilepsies;
• To improve education and training in the field of the epilepsies in Asia via the formation of the Asian Epilepsy Academy;
• To run the Asian Oceanian Epilepsy Congresses together with the International Director of Meetings (IDM) and IBE’s Regional Executive Committees;
• To facilitate clinically relevant epilepsy research in Asia;
• To serve as a link between ILAE, IBE, WHO, regional medical organizations to promote prevention, diagnosis, treatment, advocacy and care for all persons suffering from these disorders in the Asian and Oceanian region;
• To promote the activities of local chapters, encourage similar policies and administrative structures and facilitate their involvement within the global ILAE agenda;
• To review epilepsy services and the size of the treatment gap in each country and aim to improve the former and reduce the latter.

Commission Activities from 1st January 2007 through 31st May 2008

1.  Business Meetings

CAOA & ASEPA conducted joint business meetings.  There were 2 meetings conducted during this period. 

1. 10th July 2007, during the 27th International Epilepsy Congress (IEC) in Singapore
2. 15th May 2008, during the 7th Asian Oceanian Epilepsy Congress.

2.  Chapter Members

As of June 2008, there are 17 Chapters in the Asian and Oceanian region (including New Zealand Chapter but not including Vietnamese Chapter).  New Zealand Chapter was accepted into ILAE family during the 27th IEC in 2007.  Vietnam Association Against Epilepsy was formed in early 2008 and has provisionally been accepted as a new ILAE Chapter during the ILAE Executive Committee meeting in San Servolo in July 2008.

3.  Chapter Convention

The 2nd Biennial Chapter Convention of the Commission was held on Thursday, 15th May 2008, 11.30 am to 2.00 pm, at the Seaview Hall of the Xiamen International Conference and Exhibition Centre (XICEC), Xiamen, China.  National delegates from the 17 ILAE Chapters in this region participated in this Convention.  In addition, representatives from non-Chapter countries including Vietnam, Sri Lanka, Myanmar & Laos were invited and/or attended the Convention. 

The following items were covered: (1) Presentation by ILAE President Peter Wolf on development in other regions, development in education including distant education, centenary celebration in 2009 and South-South & North-South Network of Research Cooperation; (2) Update by Dr G Avanzini & CT Tan on the Global Campaign in the Asian and Oceanian region; (3) Briefing by N Moshe on the proposed ILAE’s Constitutional Amendment; (4) Presentation by M Brodie on financial support of ILAE; (5) Report by CAOA Chair on CAOA activities & plans; (6) Presentation by ASEPA Chair CT Tan on ASEPA development and activities, (7) Report by P Kwan on behalf of CAOA Research Task Force, and (8) Speech by candidates of ILAE Presidency Election.

4.  Organization of 7th AOEC

See Accomplishment 1.

5.  Selection of the Venue for the 8th & 9th AOEC

Members of the CAOA and the 2 IBE-Regional Executive Committees have jointly decided that the 8th AOEC will be held in Australia and the 9th AOEC in the Philippines.

With the strong support and enthusiasm of medical and non-medical professionals involved in the care of epilepsy patients, AOECs will remain as the major epilepsy congresses in this region.  These Congresses will continue to provide CME to practicing clinicians and to serve as a platform for young researchers to show case their research effort and exchange research ideas. 

6.  Research Taskforce

A Research Taskforce was formed under CAOA during 6th AOEC to explore the possibility of joint research.  The Taskforce is headed by Dr Patrick Kwan of Hong Kong and the Ex-Officio is Dr SH Lim, CAOA Chair.  The initial step the Taskforce took was to identify research priorities for the region.  Members of the Task Force were divided into different subgroups to focus on specific areas within the epileptology.  The attached is a list of names placed under the various subgroups based on expertise and/or indicated area of interests of all members. 

Members consist of representatives nominated by each Chapter of the region as indicated in the table below:    

The initial project the Taskforce took was to identify research priorities for the region.  The taskforce met for discussion in Singapore on 12th July 2007 during IEC, and further on 18th May 2008 during AOEC in Xiamen.  It is aimed that a unified document would be produced by end of 2008 or early 2009.

7.  Global Campaign Against Epilepsy (GCAE) Activity in Laos

There is progress in reducing the epilepsy treatment gap in Laos. The French Institute of Tropical Medicine in Vientiane, Laos has obtained the support from Sanofi to supply free drugs in Laos.  CAOA will assist in this project and aims to raise about US$30,000 yearly (US$15,000 from European Commission, US$5 each from Japan Epilepsy Society, Taiwan Epilepsy Societies and CAOA) tentatively for 3 years.  Other financial contributions to this project will come from organization such as Peter Wolf Foundation.

8.  The Establishment & Delivery of Masakazu Seino Lecture

It was with deepest sadness to receive the news that Dr Masakazu Seino, a distinguished Epileptologist, Past Chairman of CAOA (1996-2001), Chairman of ASEPA (2003-2007), Founding Chairman of the AOEO, and Past Vice President of ILAE, passed away on 7th April 2007.  On the day of his death, he was still communicating with one of the CAOA members on the future and financial support of ASEPA. 

Dr Seino’s family, together with his friends, colleagues and the Japan Epilepsy Society, held a memorial service at Hotel New Ohtani, Tokyo Japan on April 8, 2007.  Dr. Solomon Moshe, Secretary General of the ILAE, Dr. Shih-Hui Lim, Chairman, CAOA and Dr. Chon-Tin Tan, Vice President of the ILAE attended the service.

To perpetuate the memory of the Late Dr Masakazu Seino and to recognize his immense contributions to the field of Epileptology in the World, CAOA-ASEPA decided to establish a biennial lectureship in the name of Dr Seino.  The inaugural “Masakazu Seino Memorial Lecture” was delivered by Dr Yuko Fukuyama during the 7th AOEC in Xiamen.  Dr Kazuichi Yagi also spoke on Dr Seino. The memorial lecture is sponsored by Dainipon-Sumitomo and Eisai.  

Accomplishments

CAOA-ASEPA had a busy but fruitful period the last 18 months, maximizing the usage of limited human and financial resources.  With the commitment and scarifies of previous and current members of CAOA-ASEPA and the strong support of ILAE and other epileptologists in this region, we are moving closer to achieving our 2 main aims, (1) to advance and disseminate throughout the Asian & Oceanian region knowledge concerning the epilepsies, and (2) to improve education and training in the field of the epilepsies in Asia.

1.  Successful Organization of 7th AOEC

The 7th AOEC was successfully held in Xiamen, China, from the 15th to the 18th of May 2008.  The following are members of International Organizing Committee (IOC) and Scientific Advisory Committee (SAC), many of them are members of CAOA and ASEPA:

The Congress was attended by 1800+ delegates, the largest number of all AOECs.  It was felt that if not because of the devastating earthquake in Sichuan, China, the attendance would have been significantly higher.  The Congress also received the highest number of abstract, and it accepted 445.  There were 73 regional and 8 non-regional speakers.  Ms Kathryn Hodgson was the main person from the IDM office to provide all the important secretariat support. CAOA assisted IOC & SAC to award Bursaries for those who submitted an abstract as well as those who did not submit an abstract for the AOEC. 

The format for the Scientific Programme was altered slightly from the previous AOECs.  It followed that of the format for the International Epilepsy Congress, with a balance of medical, social and basic science topics.  The Scientific Programme included a Chairman’s Symposium (on stigma), 4 Main and 4 Post-Main Sessions (epilepsy surgery, pediatric epileptology, epilepsy & co-morbidities, and genetics), a Highlight Session, 8 Parallel Sessions, the Inaugural Masakazu Seino Memorial Lecture, 6 ASEPA Didactic Lectures, a Chinese Language Session, 5 Satellite Symposia and 15 Platform Sessions.  Basic science and translational research were emphasized at this AOEC, which included a pre-AOEC teaching course on Translational Research.  There were 4 Tadokoro’s Awards, given to the 2 best oral free paper presentations and 2 poster presentations.  In the one-day PWE programme, a special session on “Renaming” of Chinese word for Epilepsy was held.  There was very active discussion with participation of medical professionals from countries which used Chinese words. 

Below were some of the comments made by Dr Peter Wolf, President of ILAE, to members of CAOA and ASEPA: “My most pleasant encounter in Xiamen was with a young generation of future epileptologists from the region.  They are highly talented, eager to do research, and committed to contribute to reaching new horizons. It is fantastic that you could get such excellent young people interested in our field.  What can we together do more to keep them on board and give them optimal conditions to further develop their talent?  They need international contacts and exposure, occasions to meet both peers and seniors on an international level. They need more residential courses like the one conducted in San Servolo.  ASEPA could look into conducting similar courses in Asia. Networking for research is another approach. I had the impression that many groups are now working separately but could perhaps make more progress if they cooperated.   This should be of particular interest for the CAOA’s Research Task Force”.

2.  Conduct of Education and Training Activities by ASEPA

The ASEPA was formed in 2003, initially as the educational arm and now a sub-commission of CAOA.  Previously majorities of the Executive Committee members were also members of CAOA.  For the current Executive Committee of ASPEA 2007-2011, members are different from that of CAOA.  The purpose of this is to maximize the use of available human resources in this region to enhance the educational effort of CAOA.  The Committee also includes representatives from bigger countries such as Australia, China, and India.   

2.1  Teaching Courses and Workshops

The following workshops and teaching courses were conducted under the auspices of ASEPA between January 2006 and May 2008:

The following workshops and teaching courses are being planned, to be held in 2008:

2.2  Fellowship

Four fellowships were awarded in 2006/7 by ASEPA.  In addition, ASEPA assisted in the award of two 6-months from Epilepsy Research Foundation of Japan and one 12-months fellowship from Epilepsy Society of Australia.  These 7 candidates were from China (2), Bangladesh (1), India (1), Vietnam (1), Sri Lanka (1), and Indonesia (1). They will undergo training in Shizuoka, Japan (3), Melbourne, Australia (1), Trivandrum, India (1), Singapore (1), and Kuala Lumpur, Malaysia (1).

The ASEPA has offered two fellowships for 2007/2008, from Bangladesh and Myanmar for further training in India and Malaysia. The ASEPA also helped to select 2 awards for Epilepsy Research Foundation of Japan and Japan Epilepsy Society, from China and Indonesia; and one for Epilepsy Society of Australia from India.

2.3  ASEPA-ASNA EEG Certification Examination

The ASEPA in cooperation with ASEAN Neurological Association (ASNA) has launched a certification examination on EEG in 2005. The purpose of the EEG Certification is to establish and improve standards of training and professional practice of Electroencephalography (EEG) in Asia. 

The examination format of the American Board of Clinical Neurophysiology was adopted but simplified so that the examination could certify those who have met the "minimal" standard for the practice of Routine EEG.  To be certified as a qualified Electroencephalographer, candidates have to pass both Part 1 and 2 of the Examination.  Part 1 is the Written Examination in multiple choice question format in English, testing the knowledge of EEG instrumentation, normal and abnormal EEGs.  Candidates have to answer 150 multiple choice questions in 3 hours.  Part 2 is the Oral Examination, testing the skills of routine EEG recording, reporting and interpretation.  The oral examination is also conducted in English, by a panel of Examiners who are either ABCN-certified EEGers and/or have extensive experience in using routine and long-term EEG monitoring.  Dr Akio Ikeda from Japan and Dr Andrew Bleasel from Australia have been instrumental in setting up and running this EEG Certification Examination. 

To date, 55 candidates from Hong Kong, Indonesia, India, Japan, Malaysia, Singapore, Thailand and Vietnam have taken the Part 1 Examination, conducted during ASNA Conventions (in Jakarta, Indonesia 2005 and Cha Am, Thailand 2007), Asian Oceanian Epilepsy Congresses (AOEC in Kuala Lumpur, Malaysia 2006 and Xiamen, China 2008) and the International Epilepsy Congress (Singapore 2007).  The passing rate was approximately 60%. 

Fifteen candidates have taken the Part 2 Examination, conducted during AOECs (Kuala Lumpur, Malaysia 2006 and Xiamen, China 2008) and IEC (Singapore 2007) and 14 have been certified as qualified Electroencephalographer (one candidate retook the part 2).  Of these, 3 were EEG technologists. 

Another two Part 1 Examinations will be conducted in 2008: (1) Hong Kong on 22nd November 2008, and (2) Kuala Lumpur, April 2009.  The next Part 2 Examination will also be conducted in Kuala Lumpur in April 2009

2.4 Publications 

The proceeding of the 6th AOEC, which consists of presentations of the plenary sessions, symposiums, and 40 selected abstracts from the free papers, has been published in 2007 as a supplement of Neurology Asia.

Another proceeding on the “Current status of epilepsy surgery in Asia” has also been published in 2007. This is based on presentations during the workshop on epilepsy surgery in Shizuoka, Japan, 2006. This volume is edited by Y Inoue and M Seino. It is also published as supplement of Neurology Asia. The publication is sponsored by UCB Japan. Both supplements can be accessed online in www.neurology-asia.org

 2.5  ASEPA Website

It is proposed that the ASEPA set up a website, to provide information on educational courses/workshops, fellowships and publications. The lecture-slides of various ASEPA workshops can also be made available in pdf format. The proposed address is:  www.asepa.epilepsy-academy.org, to be consistent with academies from other region.

Future Work

 As of June 2008, there are 17 Chapters in the Asian and Oceanian region.  Vietnam Chapter will officially be the 18th Chapter in this region, if accepted at the General Assembly during 28th IEC in 2009.  However many countries in Asian and Oceanian region are without a national epilepsy organization and/or an ILAE Chapter. This reflects slow development of epilepsy care in these countries which have diverse political and economical background.  Even in those countries with ILAE Chapters, varying degree of knowledge, research and/or treatment gaps still exist. 

The Commission will provide necessary assistance in forming an ILAE Chapter in Sri Lanka and other countries in this region.  CAOA-ASEPA will continue to do its part to minimize knowledge gaps by increasing its educational effort in as many cities / countries as we could.  It is also hope that the Research Taskforce could help to narrow the research gap, thereby indirectly improve patient care.  Cooperation and collaboration with IBE-RECs, regional offices of World Health Organization, and regional neurological organizations needs to be increased to further reduce treatment gap in this region.

Shih-Hui LIM
Chair