Controversial Neurology : debates on diagnosis, pathology and treatment options at CONy 2012

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Neurological conditions encompass a wide spectrum of disorders such as dementia, degenerative diseases, neuromuscular disease, epilepsy and migraine. Treatment  options for many neurological conditions can prove to be complex due to high variability between patients of the same disease. Additionally, diagnosis of many conditions, such as migraine  is still a topic of much debate, and as such, there is much interest within these fields of research. Ongoing debates amongst neurologists on these topics were discussed in Vienna (March 8th – 11th ) at the  6th annual Controversies in Neurology conference (CONy), chaired by the BMC Medicine editorial board member, Prof Amos D. Korcyzn of Tel Avi University, Israel. The conference encourages these differences in opinion to be openly discussed, with sessions designed to include both a ‘pro’ and ‘contra’ argument on a given topic.

Amongst the highlights of CONy 2012 was a particularly lively debate between Michel Ferrari and Messoud Ashina on whether or not Familial Hemiplegic Migraine (FHM), is a useful genetic model for common migraine despite the fact that common migraine is genetically heterogeneous. The controversial topic on the use of valproate for treatment of epilepsy in women of childbearing age was also vigorously debated between Alla Guekht and Gerhard Luef, since high doses, although well tolerated and efficacious against seizures, can cause congenital malformation.

Marinos C. Dalakas and Abhijit Chaudhuri discussed the main reasons behind the clinicians decision to use plasma exchange or IVIg in the treatment of various neuroimmune disorders;  while in the debate on dementia, the importance of amyloid vs tau pathology was debated at great length between Ezio Giacobini and Johannes Thome. The argument over whether research on the role of amyloids in Alzheimer’s disease (AD) has provided any useful targets for therapy seemed to divide the audience, as some felt that tau is a more promising target in AD therapy, and therefore more efforts into research should be focused in that area. In addition, the current developments and future uses  of  reliable prognostic and predictive biomarkers in AD was discussed between Peter Riederer and Panteleimon Giannakopoulos.

All sessions provided  an exciting forum for debate, with audience participation being very much encouraged. These controversies can shape the way in which research should be directed, and it is hoped that this conference will spark new ideas and collaborative efforts in this diverse, divisive and progressive field.