Between the 8th-11th November 2018, I was fortunate enough to escape the dull, dark and dreary depths of the UK winter to join 59 other colleagues in training from across Europe and beyond to participate in the inaugural European Academy of Neurology (EAN) Autumn School in Loutraki, Greece hosted by the Hellenic Neurological Society.
This meeting, following in the established footsteps of the EAN Spring School, aimed to deliver a practical course incorporating didactic, lecture-based morning sessions with interactive, case-based afternoon sessions using suitable patients identified by the local clinician leads for the course. Each of the three full days were given a different theme – Episodic loss of consciousness, Gait dysfunction and Tremors respectively – and were provided by multiple consultant experts in each of these fields. Even more luckily for me given my limited foreign language skills, the whole course including the exit exam was to be delivered in English!
Although torrential rain greeted my arrival at Athens airport, the heavens were to clear for the rest of the course with mild late autumn sunshine and some fantastic sunsets framing the low-season Greek holiday resort of Loutraki. After a warm greeting on the opening night by Professor Hannah Cock (St George’s University, London) then head of the EAN Education Committee and representatives from the Hellenic Neurological Society and the EAN Education team, the lectures started bright and early the following morning. Professor Cock, Dr Anastasios Bonakis (University of Athens) and Dr Tim von Oertzen (Linz, Austria) provided a whistle-stop but comprehensive review to the vast topic of episodic loss of consciousness, covering the approach to differential diagnosis and utility of investigations and other psychiatric and psychological assessments. The practical sessions in the afternoon allowed clarification of points introduced earlier in the day by a broad collection of patient-videos and concurrent EEG recordings, each of the three following a one-hour round-robin format with short coffee breaks in-between to retain alertness. Particular focus was placed on narcolepsy, cataplexy, parasomnias and unusual seizure syndromes of the frontal and temporal lobes – areas I had previously had little exposure to during my fledgling clinical career. This was followed in the evening by entertainment in the form of a moonlit boat trip along the historic Corinth Canal and a traditional Greek dancing display and dinner at a local hotel restaurant. Despite protestations from those around me I refrained from exposing my new colleagues to my terrible dancing once the opportunity arose to ‘join in’ later in the evening!
The next day moved onto the topic of ‘Gait dysfunction’ and was provided by Professor Espen Dietrichs (University of Oslo), Professor Leonidas Stefanis (University of Athens) and Dr George Koutsis (University of Athens). These sessions again provided a broad overview to include approach to history and examination, investigation of gait apraxias and classification and investigation of cerebellar ataxias with Professor Dietrichs’ common gait disorder imitations and references to John Cleese particularly memorable. This was followed in the afternoon by further excellent video cases on normal pressure hydrocephalus and a local patient diagnosed with Freidreich’s ataxia who kindly tolerated numerous examinations over the course of the session with good grace. Evening entertainment took the form of a friendly and inclusive scientific dinner with highlights including additional fascinating case presentations from the faculty and an interesting interactive quiz by Professor Dietrich.
The final day was dedicated to ‘Tremors’ with Professor Carlo Colosimo (Terni, Italy), Professor Maria Stamelou (University of Athens) and Professor Joaquim Ferreira (University of Lisbon, Portugal) the illustrious faculty covering the topics of classification, investigation and treatment. Video sessions and another kind patient with Parkinson’s disease giving up her Sunday allowed the pertinent defining points raised in the morning to be immediately reinforced by clinical application with Professor Stamelou’s enthusiasm for her subject proving particularly infectious. The exit exam swiftly followed including a number of questions directly derived from lectures earlier in the course with the final evening farewell party lasting into the early hours of the morning.
It was with some sadness that I bade farewell to my European colleagues the next day – I have made a number of friends and look forward to catching up with them at future events. In a time of increasing uncertainty regarding the position of the UK within Europe I was delighted to be able to attend this excellent course with the costs for accommodation, board and materials covered via the EAN with delegates only funding the cost of travel to Athens. We discussed similar clinical challenges facing us despite many miles and technological degrees of separation between us. In the ancient land of myths and legends I hope it is not too fanciful to think that even if Brexit does succeed in driving a political wedge between us and our continental partners, such a well-run and valuable course will be available to attend for future interested UK trainees. Following its success, it has recently been announced that there will be at least another year commissioned for November 2019 again in Athens – it would appear that the birthplace of civilisation has more to offer intrepid minds willing to take up the challenge!
