Neurological Therapeutics -

1
Neurological Therapeutics - Diagnose and Adios
No More
Dr. Norman Delanty Consultant Neurologist Beaumont
Hospital, Dublin Neurology Update Meeting,
October 24, 2008
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The Role of the Doctor

• Providing explanation
• Reducing uncertainty
• Giving reassurance
• Improving quality of life
• Reducing suffering / pain
• Prolonging life

3
The Past

• Neurologists were seen as astute diagnosticians
• Great at chin-scratching
• Not much good at making a real difference to
  peoples lives
• Once diagnosis made, often no treatments to
  offer, and often no great need or point to
  continue to see patients on regular and frequent
  follow up

4
The Present

• Diagnostic capability improving, e.g.,
• Imaging
• Neurogenetics
• Video EEG monitoring
• Treatment modalities expanding
• Advances in classical pharmacology
• Biological therapies
• Non-pharmacological approaches

5
The Future

• Further understanding of neurobiology of disease
• Whole genome analysis of large number of patients
  with well phenotyped neurological conditions
• New biological pathways
• Pharmacogenomics
• New targeted biologicals

6
Resources

• Neurology remains the Cinderella of the medical
  specialties
• Particularly so in Ireland
• Little central planning for advances in
  therapeutics
• E.g., natalizumab
• No concept of investing to save in the Irish
  system

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PubMed

• Neurologocal therapeutics - 20,535
• Treatments for neurological disease - 257,024
• Treatments of Parkinsons disease - 7,789
• Antiepileptic drugs - 132,404
• Natalizumab - 345
• Lacosamide - 43

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Today

• Alzheimers disease - Colin Doherty
• Stroke - Mark McCarron
• Migraine - Peter Boers
• Anti-epileptic drugs - Kevin Murphy
• Multiple sclerosis - Joan Moroney
• Parkinsons disease - Tim Counihan
• Psychiatric disease in neurology - David Cotter
• Mitochondrial disease - Doug Turnbull