Commission on Asian and Oceanian Affairs

Aims

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

Missions of CAOA & ASEPA:

1. To advance and disseminate knowledge concerning the epilepsies throughout the Asian & Oceanian region;
2. To improve education and training in the field of the epilepsies in Asia via the formation of the Asian Epilepsy Academy;
3. To organize the Asian Oceanian Epilepsy Congresses together with the International Director of Meetings (IDM) and IBE’s Regional Executive Committees;
4. To facilitate clinically relevant epilepsy research in Asia;
5. 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;
6. To promote the activities of local chapters, encourage similar policies and administrative structures and facilitate their involvement within the global ILAE agenda;
7. 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: 

1.  Communication and Business Meetings

Communication amongst members of CAOA and ASEPA were mainly through e-mails and during teaching courses/workshps.  In addition, CAOA & ASEPA had joint business meetings at least once a year as shown below:

• 29th July 2006, in conjunction with the meeting of the IOC and SAC of the 6th Asian Oceanian Epilepsy Congress (AOEC) in Kuala Lumpur, Malaysia;
• 15th November 2006, during 6th AOEC in Kuala Lumpur, Malaysia;
• 10th July 2007, during the 27th International Epilepsy Congress (IEC) in Singapore;
• 15th May 2008, during the 7th AOEC in Xiamen, China;

The next business meeting will be held in on 29th June 2009, during 28th IEC in Budapest, Hungary.

2.  Chapter Conventions

Two Biennial Chapter Conventions were held during AOECs: (1) 16th November 2006, 11.30 am to 2.00 pm, during 6th AOEC at the Kuala Lumpur Convention Center, Kuala Lumpur, Malaysia, and (2) 15th May 2008, 11.30 am to 2.00 pm, during 7th AOEC at the Seaview Hall of the Xiamen International Conference and Exhibition Centre (XICEC), Xiamen, China.  National delegates from the ILAE Chapters in this region participated in these 2 Conventions.  In addition, representatives from non-Chapter countries including New Zealand (before joining ILAE), Vietnam (joining ILAE in 2009), Sri Lanka, Laos, Myanmar, and Brunei were invited and/or attended the Conventions. 

3.  Organization of 7th Asian Oceania Epilepsy Congress (AOEC)

The 7th AOEC was successfully held in Xiamen, China, from the 15th to the 18th of May 2008.  Most members of CAOA and ASEPA were members of International Organizing Committee (IOC) and Scientific Advisory Committee (SAC).  The Congress was attended by 1800+ delegates, the largest number of all AOECs.  If not because of the devastating earthquake in Sichuan, China, the attendance would have been higher.  The Congress also received the highest number of abstracts, and 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 in awarding bursaries for those who submitted an abstract as well as those who did not submit an abstract for the Congress.  The Inaugural Masakazu Seino Memorial Lecture, a Chinese Language Session, a pre-AOEC teaching course on Translational Research, 4 Tadokoro’s Awards, and a special session on “Renaming” the Chinese word for Epilepsy, were the highlights of the Congress.

4.  Research Taskforce

As part of the missions of CAOA, a Research Taskforce was formed during 6th AOEC to explore the feasibility of joint research.  Headed by Dr Patrick Kwan from Hong Kong, the Taskforce identified research priorities for the region.  Members of the Task Force were divided into different subgroups to focus on specific areas within the epileptology.  Table 3 shows the list of participants according to their specialties and interests.  Taskforce met for discussion in Singapore on 12th July 2007 during IEC, and presented their proposal for joint research on 18th May 2008 during AOEC in Xiamen.  It was aimed that a unified document would be produced by end of 2009.

Table 3: CAOA Research Taskforce

5.  Establishment & Delivery of Masakazu Seino Lecture

          Dr Masakazu Seino, a distinguished Epileptologist, Past Chairman of CAOA (1996-2001), Chairman of ASEPA (2003-2007), Founding Chairman of the Asian Oceanian Epilepsy Organization, 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. Chong-Tin Tan, ASEPA Chairman 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 established a biennial lectureship in the name of Dr Seino, to be delivered at each AOEC.  The inaugural “Masakazu Seino Memorial Lecture” was delivered by Dr Yuko Fukuyama during the 7th AOEC in Xiamen in 2008.  Dr Kazuichi Yagi also spoke on Dr Seino. The memorial lecture was sponsored by Dainipon-Sumitomo and Eisai.  

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 assisted in this project and will work with the European Commission, Japan Epilepsy Society, Taiwan Epilepsy Society and the Peter Wolf Foundation to support this project financially.

Accomplishments:

1.  Organizing and Conducting Teaching Courses and Workshops

Under the leadership of Dr Chong-Tin Tan, ASEPA planned, organized and/or conducted a number of teaching courses and workshops, either as standalone meetings with the local host, or as part of the national or regional medical conferences such as the Biennial Conventions of the ASEAN Neurological Association (ASNA) and AOECs.  These workshops and teaching courses covered the following topics: General Epileptology, EEG, AED Treatment, Epilepsy Syndrome, Neuro-imaging, Paediatric Epileptology, Epilepsy Surgery, Basic Sciences, and Psychosocial Issues.  A Winter School was initiated by the Melbourne group of Epileptologists.  Table 4 gives the details of these courses and workshops.

Table 4: Courses/Workshops Conducted and Coordinated by ASEPA and Sponsoring Organizations

2.  Awarding Fellowship

Every year, 2 Clinical Fellowships were awarded by CAOA-ASEPA.   In addition, ASEPA assisted in the award of two 6-month Fellowships of the Epilepsy Research Foundation of Japan and one 12-month Fellowship from Epilepsy Society of Australia.  Successful candidates from China, Bangladesh, India, Myanmar, Vietnam, Sri Lanka, and Indonesia underwent training in Shizuoka-Japan, Melbourne-Australia, Trivandrum-India, Singapore and Kuala Lumpur-Malaysia.

3,  Improving Standard of EEG Interpretation and Reporting

ASEPA together with the ASEAN Neurological Association (ASNA) launched an EEG certification examination in 2005, to establish and improve standard of training and professional practice of EEG in Asia.  To be certified as a qualified Electroencephalographer, candidates have to pass Part 1 and 2 of the Examination, both conducted in English.  Part 1 is a written examination testing the knowledge of EEG instrumentation, normal and abnormal EEGs.  Candidates have to answer 150 multiple choice questions in 3 hours.  Part 2 is an oral examination, testing the skills of routine EEG recording, reporting and interpretation, by a panel of examiners who are either diplomats of the American Board of Clinical Neurophysiology and/or have extensive experience in using routine and long-term EEG monitoring. 

Drs Shih-Hui Lim (Singapore), Andrew Bleasel (Australia) and Akio Ikeda (Japan) are the 3 Chief Examiners of this EEG Certification Examination.  Other examiners were from Australia (Simon Harvey, John Dunne, Ernie Somerville, Terrence O’Brien and Mark Cook), Malaysia (Chong-Tin Tan, Raymond Ali), Singapore (Andrew Pan, Einar Wilder-Smith, Nigel Tan and Derrick Chan), Japan (Inoue Yushi), Taiwan (Shang-Yeong Kwan), Germany (Alois Ebner), and USA (Prakash Kotagal).

90 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, Cha Am, Thailand 2007, and Kuala Lumpur, Malaysia 2009), AOECs (in Kuala Lumpur, Malaysia 2006 and Xiamen, China 2008) and the International Epilepsy Congress (Singapore 2007).  The passing rate was approximately 60%. 

21 candidates have taken the Part 2 Examination, conducted during AOECs (Kuala Lumpur, Malaysia 2006 and Xiamen, China 2008), IEC (Singapore 2007) and ASNA Convention (Kuala Lumpur 2009).  All passed the Part 2 Examination (one candidate after 2nd attempt) and have been certified as Electroencephalographer.  Of these, 5 were EEG technologists. 

4.  Publishing Proceedings of Scientific Conferences

The Proceeding of the 6th AOEC, which consisted of presentations of the plenary sessions, symposiums, and 40 selected abstracts from free papers, was published in 2007 as a supplement of Neurology Asia.  Another Proceeding on the “Current status of epilepsy surgery in Asia”, also published as supplement of Neurology Asia in 2007, was based on presentations at the workshop on epilepsy surgery in Shizuoka, Japan, 2006. The publication is sponsored by UCB Japan.  Both supplements can be accessed online in www.neurology-asia.org

Future Work:

Myanmar, N Korea, Laos, PNG, Fiji and Timor Leste are the countries in the Asian and Oceanian region with significant populations without a national epilepsy organization and/or an ILAE Chapter. This reflects slow development of epilepsy care in these countries.  Even in those countries with ILAE Chapters, varying degree of knowledge, research and/or treatment gaps still exist. 

CAOA-ASEPA is not likely to have any meaningful influence on the economy and political situations in this part of the world.  However, as a strong medical professional group, CAOA-ASEPA could improve the standard of practice of Epileptology in this region.  We will build upon the foundation laid by our predecessors and create new initiatives to further strengthen the training and education of healthcare providers.  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.  Members of the CAOA-ASEPA are now working closely with our IBE-Regional Executive Committees and the Epilepsy Society of Australia to organize the 8th AOEC which will be held in Melbourne Australia in October 2010.  The 9th AOEC is likely to be held in the Philippines and CAOA-ASEPA will continue to play a significant role in the organization.

Smooth leadership transition and well thought succession planning are extremely important for any professional organization to excel in a forever changing environment.  We are pleased that the next ILAE Executive Committee led by the current President-Elect Dr Solomon L. Moshé have began their hard work in preparing a smooth leadership transition, especially for the Asian Oceanian region.  We are most glad that Dr Byung-In Lee from Korea will be leading the next CAOA from 2009 to 2013.  Dr Lee is one of the Founders of the Asian Oceanian Epilepsy Organization and is an eminent epileptologist in this region.  With his leadership, passion and vision, we are certain that CAOA-ASEPA will reach a greater height.

Summary:

CAOA-ASEPA had a busy but fruitful 3+ year term.  With our part-time involvement but full-time dedication, we managed to maximize the usage of limited human and financial resources to improve the standard of epilepsy care in this region which has the largest population of people with epilepsy.  With the commitment and scarifies of previous and current members of CAOA-ASEPA and the strong support of ILAE and many epileptologists in this region, we are glad to have accomplished our 2 main missions, i.e. (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.

Shih-Hui LIM (Singapore)  
Chair