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  1. Division of Neuroscience and Psychological Medicine, Imperial College School of Medicine, London, UK

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    The dramatic expansion of the clinically related neurological sciences over the past decade has inevitably demanded improved opportunities both for the dissemination of new original data and for postgraduate education—known to many as Continuous Medical Education (CME). This has led to a surfeit of meetings of scientific societies which cover a multitude of neurological subspecialties, and in addition there are many meetings sponsored by the pharmaceutical industry. Encouraged by medical publishers, this trend has spawned a variety of new journals which not only lend scientific respectability to these societies, but also help to deal with the dramatic annual increase in the number of scientific papers submitted to scientific journals worldwide.

    With the expansion of clinical neuroscience centres, neurologists are increasingly working together in packs, enabling individual neurologists to subspecialise, in addition to carrying out their general neurological duties. This, therefore, imposes a range of external CME requirements, which would normally include attendance at the annual meeting of the neurologist’s national neurological society, essential to catch up on the gossip as well as learn who are the rising stars and where new exciting work is being undertaken. Secondly, a neurologist might be expected to attend a major regional general neurological meeting every year or perhaps every other year, and thirdly an international meeting devoted to the individual neurologist’s subspecialty interest.

    In North America the annual meeting of the American Academy of Neurology (AAN) represents the largest general neurological meeting, full of excellent teaching courses, as well as numerous sessions for original platform or poster contributions. The annual meeting of the American Neurological Association (ANA), with its long proud history, is smaller both in content and attendance, but no less enjoyable. What of Europe—spoilt for choice or suffering from unnecessary duplication? This personal view stems from my attendance at many European neurology meetings over the past 10 years. First some background. The European Neurological Society (ENS) was founded 10 years ago by a group of pioneers determined to establish a forum for European neurologists to meet annually together to present their latest research, as well as to provide CME in the form of teaching courses. The ENS is run by elected persons with no specific national affiliations, and has as its main and sole mission the organisation of a high quality annual scientific meeting. Two years later the European Federation of Neurological Societies (EFNS), the European arm of the World Federation of Neurology (WFN), was formed with a council consisting of delegates nominated by the constituent national societies. In addition to organising an annual neurological meeting with similar topics for symposia and invited speakers to the ENS, the EFNS does have political aspirations, and through the efforts of the late Professor Amaducci and others, successfully lobbied the European Community to earmark greater research funding for neuroscience. In addition, it has developed scientific panels in over 20 neurological subspecialties, several of which have successfully served as a European focus for the development of collaborative research across national boundaries.

    By observing the steady increase in the number of delegates at each of these meetings it might be concluded that all is well and that European neurologists appreciate the choice. However, talking to many neurologists from around Europe reveals a strong wish for the two meetings to be amalgamated into one large, high quality prestigious annual European Congress. They simply do not wish to have this choice, but would rather attend a single meeting which would provide them with the best of European clinical neurological science.

    How then is it possible that both organisations are succeeding in the face of this expressed need for a single annual meeting? An unexpected influence contributing to this, is the international pharmaceutical industry. Between 70% and 80% of the delegates at both meetings are sponsored by the industry—to the extent that their registration, airfare, and accommodation are paid. Both organisations, therefore, depend heavily on their support.

    Although various attempts have been made to bring these two youthful organisations together for a unified annual meeting, a solution has not so far being found. The current two Presidents (Thomas Brandt for the ENS, and Jes Olesen for the EFNS) are both men of vision epitomising the very best in clinical neurological science, and it is to be hoped that these two ardent Europeans can lead their organisations toward an acceptable rapprochement. Surely the new millennium and the location of the World Congress of Neurology in London in 2001, the first time it will have been held in Europe for 16 years, are added reasons for European neurology to become a coherent unified force on the stage of world neurology.

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