eanCast: Weekly Neurology

• Ep. 179: Language and communication impairment after coma

  Moderator: Alfonso Magliacano (Florence, Italy) Guest: Charlène Aubinet (Liege, Belgium) In this episode, Alfonso Magliacano is joined by Charlène Aubinet to examine how language and communication impairments shape the assessment and recovery of patients emerging from coma. They discuss the clinical distinctions between unresponsive wakefulness syndrome and the minimally conscious state, highlighting how aphasia and other comorbidities can obscure signs of awareness and lead to misdiagnosis. Dr. Aubinet outlines emerging tools, from eye-tracking assessments to EEG and fMRI markers, that help detect residual language processing even without behavioral responses. The conversation also explores how early linguistic abilities can serve as prognostic indicators, the practical challenges faced by speech therapists, and the evidence that some language processing may persist even in states of severely impaired consciousness, with important clinical and ethical implications.

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• Ep. 178: Interpreting emergency EEG in suspected non-convulsive status epilepticus

  Moderator: Justyna Paprocka (Katowice, Poland) Guests: Stephan Rüegg (Basel, Switzerland), Markus Leitinger (Salzburg, Austria) In this episode, Justyna Paprocka welcomes Stefan Rüegg and Markus Leitinger to examine how clinicians can approach emergency EEG in suspected non-convulsive status epilepticus (NCSE). They discuss NCSE epidemiology, the importance of continuous EEG, and the use of structured diagnostic frameworks including the Salzburg criteria and the 2HELPS2B score. The conversation highlights practical strategies such as IV anti-seizure medication trials, pitfalls in benzodiazepine use, and the complexities of distinguishing NCSE from encephalopathy. The experts also address EEG interpretation in post-anoxic patients and recommend foundational literature for early-career neurologists.

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• Ep. 177: Bridging Insights: Highlights from the EAN Pain and Headache Panels

  Moderator: Messud Ashina (Copenhagen, Denmark) Guests: Theodoros Mavridis (Dublin, Ireland), Oxana Grosu (Chișinău, Moldova) In this episode, Messud Ashina is joined by Theodoros Mavridis and Oxana Grosu to discuss the latest advances in pain and headache medicine, as highlighted in the EAN Pain and Headache Panels' Yearbook chapters. The conversation dives into recent breakthroughs in the pathophysiology of pain and headaches, as well as cutting-edge approaches to prevention and treatment. The experts explore how new research is influencing clinical practice, with a focus on the synergies between pain and headache management. They also examine emerging trends, potential future directions, and the impact of these developments on patient care.

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• Ep. 176: Embolic Stroke of Undetermined Source: Diagnostic Challenges and Therapeutic Options

  Moderator: Theodoros Mavridis (Dublin, Ireland) Guests: Diana Aguiar de Sousa (Lisbon, Portugal), Mira Katan (Basel, Switzerland) Embolic stroke of undetermined source (ESUS) continues to challenge clinicians as its definition and diagnostic approach evolve. In this episode, Theodoros Mavridis is joined by Diana Aguiar de Sousa and Mira Katan. They explore the epidemiological, clinical and mechanistic nuances of ESUS, discuss insights gained from major clinical trials, and examine current therapeutic strategies. The conversation also highlights advances in detecting covert embolic sources, the emerging relevance of atrial myopathy, the role of PFO closure, and the promise of biomarkers in shaping future patient care.

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• Ep. 175: Acute Ischemic Stroke: Evolving Guidelines and Clinical Decisions

  Theodoros Mavridis (Dublin, Ireland) Ana Catarina Fonseca (Lisbon, Portugal) In this episode, Theodoros Mavridis speaks with Ana Catarina Fonseca about the updated European guidelines for acute ischemic stroke. They discuss advances in reperfusion therapy, including extended time windows for thrombolysis using advanced imaging, broader eligibility criteria, and evidence supporting thrombectomy in patients with low ASPECTS scores, mild deficits, and posterior circulation strokes. The conversation also highlights the continued importance of stroke unit care and emerging pre-hospital technologies aimed at speeding diagnosis and improving outcomes.

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