Indian Epilepsy School 2013 - EpilepsyIndia.org you that the Indian Epilepsy School 2013 will be...

22
Indian Epilepsy School 2013 Jointly organized by In dian Epilepsy Society (IES) Indian Academy of Neurology(IAN) Under the Aegis of ASIAN EPILEPSY ACADEMY(ASEPA) COMMISION OF ASIAN OCEANIC AFFAIRS (CAOA) International League Against Epilepsy Date : November 13 – 16, 2013 (Wednesday to Saturday) Venue : Hotel Claridges Surajkund, National Capital Region, Delhi India Theme: Enhancing Clinical acumen in epilepsy management

Transcript of Indian Epilepsy School 2013 - EpilepsyIndia.org you that the Indian Epilepsy School 2013 will be...

IndianEpilepsy School 2013

Jointly organized byIndian Epilepsy Society (IES)

Indian Academy of Neurology(IAN)

Under the Aegis of ASIAN EPILEPSY ACADEMY(ASEPA)

COMMISION OF ASIAN OCEANIC AFFAIRS (CAOA)

International League Against Epilepsy

Date : November 13 – 16, 2013(Wednesday to Saturday)

Venue : Hotel Claridges Surajkund,National Capital Region, Delhi ‐ India

Theme: Enhancing Clinical acumen in epilepsy management

Indian Epilepsy School 2013

Dear Friends,

A large number of international experts from United States of America, Europe, Asian Oceania/ Pacific Region has shown spontaneous interest to be faculty of both the events. Similarly, the national faculty has also shown very enthusiastic response for both the events. The neurology residents and young faculty shall be eligible to attend the workshop. This will help them to enhance their knowledge of epilepsy and related fields like EEG, MEG, Neuro imaging of epilepsy. Asian Epilepsy Academy EEG examination ASEPA Part I / II examination will also be organized on the sidelines of the workshop.

On behalf of Indian Epilepsy Society & Indian Academy of Neurology, we are very happy to inform you that the Indian Epilepsy School 2013 will be held in New Delhi, India from November 13th – 16th , 2013 (Wednesday thru Saturday) in hotel Claridges located on New Delhi‐Faridabad road (National Capital Region). The venue is approximately 25‐30 Kms from the International Airport T‐3 in a peaceful location. A pre‐conference workshop on EEG has been planned before the conference.

It will be our endeavor to provide an opportunity to the young faculty as well an effort will be made to avoid stereotypy. The scientific programme of the Epilepsy School & EEG workshop will provide a comprehensive coverage of topics including latest advances in the field of epileptology. The Epilepsy School will be completely residential and all the accommodation expenses of the faculty & delegates will be met by the organizers. We have also envisaged some social and relaxation activities

The registration will be limited to 50 delegates and we are happy to inform you that we have already started receiving the registration.

For Registration Forms : http://www.ilae.org/Visitors/Congress/congressinfo/IndianEpilepsySchool‐2013.pdf

Pre‐conference EEG WorkshopOrganized by Indian Epilepsy Society

November 12th – 13th 2013(Tuesday‐Wednesday)VENUE: Janakpuri Super Speciality HospitalGovt. of N C T of Delhi, C‐2/B, Janakpuri, New Delhi ‐ 110058

Course Organizer : Dr. Man Mohan MehndirattaCourse Director : Dr. Manjari Tripathi

Indian Epilepsy School 2013From November 13th –16th , 2013 (Wednesday thru Saturday)Organized by Indian Epilepsy Society& Indian Academy of Neurology

Course Organizers:Dr. Man Mohan Mehndiratta & Dr. Manjari Tripath

Venue for EEG 

Workshop

VENUE – The Claridges

Nestled in a forested neighborhood, making it the perfect place for repose, The Claridges, Surajkund, Delhi, NCR, is set amid sylvan surroundings overlooking the 10thcentury heritage Surajkund Lake Complex. The luxury business resort's tranquil ambience belies its proximity to the busy South Delhi residential and commercial centers. Stylish elegance reflected in its minimalistic décor and state‐of‐the‐art facilities combine with advanced environment friendly features to create a soothing and refined ambience

COST DETAILSAccommodation Deluxe Room

DistancesInternational Airport 25 Kms – 45 MinutesDomestic Airport 22 Kms– 45 MinutesCity Centre 20 Kms – 35 Minutes

Official Event Manager

Contact Us for any query & ReservationEmail : [email protected]

Room Type INR InclusionsSingle 10500 Room with all 

meals & taxesDouble  11500

Venue  for Epilepsy School

Organizing Committee for Indian Epilepsy School 2013 Patrons: Dr. K. Radhakrishanan Dr. Satish Chandra Dr. Sanjeev Thomas President Dr. Pravina U Shah Organizing Directors: Dr. Man Mohan Mehndiratta Dr. Manjari Tripathi Treasurer Dr. Manjari Tripathi Advisor: Dr. Satish Jain

INDIAN EPILEPSY SOCIETY EXECUTIVECOMMITTEE

Dr. Pravina U Shah –President

Dr. Satish Jain Past President

Dr.P.Satish Chandra Vice- President

Dr.Man Mohan Mehndiratta Secretary-General

Dr.Manjari Tripathi Treasurer

EC Members

Dr.Sarat Chandra

Dr.P.S.Kharbanda

Dr.V.V.Nadkarni

Dr.Sangeeta Rawat

Dr.K.P.Vinayan Bindu Menon

INDIAN ACADEMY OF NEUROLOGY EXECUTIVE COMMITTEE

Dr. Man Mohan Mehndiratta-President

Dr Ashok Panagariya

Dr. P.Satish Chandra

Past Presidents

Executive Committee Members IAN

Dr. Vinod Puri Dr. Apoorva Paurnik Dr. R. Lakshmi Narsimhan

Dr. VinayGoyal Dr. Gagandeep Singh Dr. Shyamal K. Das

Dr C.S Meshram President – Elect

Dr.Sanjeev V.Thomas Secretary

Pramod Kumar Pal Treasurer

Dr. Satish Khadilkar Editor

FACULTY: International: John Stern(UCLA-USA) Lim Shih-Hui (Singapore) Byung In- Lee (South Korea) MS Gopinath (Australia) National Pravina Shah V.V.Nadkarni Satish Chandra SanjibSinha Sangeeta Rawat Pratibha Singhi AshaLatha Radhakrishnan Chaturbhuj Rathore Sita Jayalakshmi Parampreet Kharbanda NandanYardi Jayanti Mani SridharanRamaratnam K.P.Vinayan BinduMenon Lakshmi Narsimhan Gagandeep Singh Local Satish Jain Man Mohan Mehndiratta Manjari Tripathi Madhuri Behari Meena Gupta Vinod Puri Kameshwar Prasad Satinder Aneja Padma Srivastava K.S.Anand Ajay Garg Chandra Shekar Bal Ashima Wadhawan S.P.Gorthi Kiran Bala Debashish Chowdhury Garima Shukla Achal Srivastava Rohit Bhatia Neera Chowdhury Samhita Panda Suman Kushwaha Bhupender Bajaj Mamta Bhushan Singh Atma Ram Bansal Atampreet Singh Deeti Vibha Suvasini Sharma Vinit Suri Manvir Bhatia

Scheduled Time for various scientific activities

EEG Workshop 12.11.2013 (Tuesday) 0800-2000 Hrs 13.11.2013 (Wednesday) 0800-1200 Hrs

13.11.2013 (Wednesday) ASEPA Exam 0900-1200 Hrs

Proceed by bus to Hotel Claridges, Surajkund Faridabad, Indian Epilepsy School Venue

Indian Epilepsy School 13.11.2013 (Wednesday) 1500-2000 Hrs

14.11.2013 (Thursday) 0800- 2000 Hrs

14.11.2013 (Thursday) ASEPA II Examination

0900- 1700 Hrs.

15.11.2013 (Friday) 0800- 2000 Hrs

16.11.2013 (Saturday) 0800- 1300Hrs

REQUEST TO FACULTY MEMBERS of Epilepsy School and EEG Workshop: o All the speakers are requested to preferably start their talk with a clinical

case presentation from their personal experience continue their talk and end the talk with another case so as to give it a bedside approach rather than pure bench side touch.

o After the talk the delegates should feel enriched with value addition to their clinical knowledge.

o It will be appreciated if speakers can include 1-2 MCQ quiz before and after the talk.

Learning objectives must be highlighted by each speaker

The speakers are requested to send the copies of relevant literature & PPTof their talks for distribution to the delegates and for DVD preparation for distribution.

Participants to submit cases for discussion by15.10.2013

• Wi-Fi shall be available in the venue and all presentations can be viewed on the mobile devices like I-Pad, I-Phone, Android devices and Laptops with Wi- fi accessibility.

Moderators and Chairpersons are requested to maintain timelines

8th IES-ASEPA EEG workshop

EEG WORKSHOP VENUE: Janakpuri Superspeciality Hospital, C-2 B, Janakpuri, New Delhi-110058 (Near Bharti College) 12.11.2013 (Tuesday) 0730 Hrs Onwards Registration

0830- 0930Hrs Session I:

Interesting Case Presentation with impact of EEG on the Diagnosis

Convenor : Vinit Suri Chairs : Meena Gupta & John Stern

Each case presentation for 10 minutes and Two minutes Discussion

• Ashalatha Radhakrishnan

• Sita Jayalakshmi • Neera Chowdhury • Gagandeep Singh • Suvasini Sharma

Concluding remarks by Chairs 0930-1030 Hrs Session II:

Basics and Normal EEG Convenor : Bhupender Bajaj

Chairs : Madhuri Behari & Sanjay Singh

Each presentation for 20 minutes and Five minutes for Discussion • Clinically relevant Physics of EEG acquisition systems Sita Jayalakshmi • Polarity & mapping of potentials John Stern • Normal & abnormal waveform- Definitions Samhita Panda

Concluding remarks by Chairs 1030-1100 Hrs Coffee Break

1130-1330 Hrs Session III:

Evolution of EEG and Identifying Normal EEG Convenor: Rajesh Verma

Chairs: Lim Shih-Hui &Vinod Puri

Each presentation for 20 minutes and Five minutes for Discussion

• Effect of age on EEG MS Gopinath • Artifacts on EEG Vibhor Pardasani • Activation procedure Sangeeta Rawat • Normal EEG variants Ashalatha Radhakrishnan

Concluding remarks by Chairs 1320-1330 Hrs. Janakpuri Super Speciality Hospital-“Vision show case” 1331-1425 Hrs. Lunch

ASEPA EXAMINATION PART I 1500-1800 Hrs Resource Persons: Lim Shih Hui, Byung In-Lee, Man Mohan Mehndiratta 1430-1700 Hrs Session IV

Value of EEG in Epilepsies & Emergency Situations Convenor : C.S.Narayanan

Chairs : Kameshwar Prasad & Ashalatha Radhakrishnan

Each presentation for 25 minutes and Five minutes for Discussion

• EEG of Encephalopathies Sanjib Sinha • EEG of status epileptics Sanjay Singh • Seizure semiology in children-Generalized Suvasini Sharma • Seizure semiology in children-Focal Sita Jayalakshmi • Ictal Patterns Ashalata Radhakrishnan

Concluding remarks by Chairs Tea /Coffee continuous-Help yourself 1700-1800 Hrs Session V

Value of EEG in Epilepsies & Emergency Situations

Convenor : Deepti Vibha Chairs : Geeta Khwaja &Vasantha Padma

Each presentation for 25 minutes and Five minutes for Discussion

• Seizure semiology in adults-Temporal Manjari Tripathi • Extra temporal John Stern

Concluding remarks by Chairs 1800-2000Hrs Session VI Pediatric Age group Symposium Convenor: Mamta Bhushan Singh

Chairs: Satinder Aneja & Satish Jain 1800-1845Hrs

Case presentation by Suman Kushwaha, Sheffali Gulati &Vinod Puri 1845-1930 Hrs EEG in Catastrophic epilepsies in Childhood KP Vinayan 1930-2000 Hrs Cases presentation by K.P.Vinayan, Sita Jayalakshmi & Suvasini Sharma 2000-2130 Hrs Dinner Day I closes at 2130 Hrs.

EEG Workshop-Contd.

13.11.2013 (Wednesday)-Day 2 0730-0830Hrs Breakfast 0830-1000 Hrs Session VI

Convernor : Rohit Bhatia Chairs : Pratibha Singhi &K.S.Anand

EEG Quiz: Lim Shih-Hui, Sanjeev Thomas, Samhita Panda,

John Stern, Ashalatha Radhakrishnan, Manjari Tripathi, Sita Jayalakshmi, Vibhor Pardasani

1000-1130 HrsSession VII

Convenor : Achal Srivastava Chairs : P.U.Shah & Lakshmi Narsimhan

SPOT THE DIAGNOSIS: Videos and case presentation K.P.Vinayan, Manvir Bhatia,Vinay Goyal, Suvasini Sharma, Sheffali Gulati, Garima Shukla, Neera Chaudhary.

Delegates and speakers proceed for Epilepsy School – Claridges, Surajkund.

INDIAN EPILEPSY SCHOOL 13.11.2013 (Wednesday) Lunch 1300-1430 Hrs

1445-1500 Hrs Inauguration Chief Guest Dr. Pravina U Shah, President Indian Epilepsy Society Guests of Honor: Dr. Satish Jain & Lim Shih Hui 1500-1645 Hrs Session I Convenor : Y.S.Sirohi Chairs : Pravina U Shah & R.Sridharan TOPIC SPEAKER DURATION DISCUSSION

1 Definition of epilepsy incidence &

prevalence in adults & children P Satish Chandra,

1500 – 1520 10 minutes

2 Seizure type classification of epilepsies through video

Gagandeep Singh 1530 – 1550 10 minutes

3 Differential diagnosis of epilepsy- fits, faints & funny spells

- In children - In adults

KP Vinayan Sangeeta Ravat

1600-1620 1625 -1645

5 minutes 5 minutes

(Tea Break – 1650 to 1710 Hrs) 1710-1920 Session II Convenor: R.K.Garg Chairs : V.V. Nadakarni & Debashish Chowdhury

4 Pitfalls in seizure semiology

- In children

In adults

Chaturbhuj Rathore John Stern

1710- 1730 1740 – 1810

10 minutes 10 minutes

18 Approach to a person with new onset epilepsy

- In children - In adults

Pratibha Singhi Sanjay Singh

1820 – 1840 1850 – 1910

10 minutes 10 minutes

1930-2100 Hrs Sessions III

Convenor : Satish Jai Chairs : Padma Srivastava & S.P.Gorthi

1930-2100 Epilepsy Video Presentation Quiz by faculty: John Stern, MS Gopinath, Lim Shih-Hui, Byung In- Lee, Manvir Bhatia.

INDIAN EPILEPSY SCHOOL 14.11.2013 (Thursday) Part II ASEPA Exam Lim Shih Hui, Man Mohan Mehndiratta 0900-1700Hrs 0800-1030 Session IV Convenor : Atma Ram Bansal Chairs : Sanjeev Thomas & Sheffali Gulati

19 Benign epilepsy syndromes

- In childhood - In adults

MS Gopinath Meena Gupta

0800 - 0830 0840 - 0910

10 minutes 10 minutes

20 Neonatal epilepsies KP Vinayan 0920 - 0950 10 minutes

21 Epileptic encephalopathies NandanYardi 1000-1030 (Tea Break – 1040 to 1050 Hrs)

10 minutes

1050-1320 Hrs Session V Convenor : Atampreet Singh Chairs : Satish Jain, Chaturbhuj Rathore

22 Role of EEG in diagnosing epilepsy Lim ShuiHui 1050 – 1120 10 minutes

23 Role of VEEG P.S Kharbanda 1130 – 1200 10 minutes

24 Role of invasive EEG – strength & limitations

John Stern 1210 – 1240

10 minutes

25 Bedside EEG monitoring and Samhita Panda treatment decisions

(Lunch Time 1330 to 1400) 1400-1650 Hrs Session-VI Convenor- : KP Vinayan Chairs : John Stern & K.S.Anand

1250 - 1320

10 minutes

26 Treatment decisions - In febrile seizures - Pediatric new onset epilepsy - Adult new onset epilepsy - Young women with epilepsy - Elderly with epilepsy - Seizures in systemic disorders

Sheffali Gulati Rekha Mittal John Stern Sanjeev Thomas Atma Ram Bansal Atampreet

1400 – 1420 1430 – 1450 1500 – 1520 1530 – 1550 1600 – 1620 1630 – 1650

10 minutes 10 minutes 10 minutes 10 minutes 10 minutes 10 minutes

1710-1920 Hrs Session VII Convenor : Garima Shukla Chairs : Sanjay Singh & Kiran Bala 27 When to stop AED ?

- In children - In Adults - Following epilepsy surgery

Satinder Aneja Sanjib Sinha John Stern

1710 – 1730 1740 – 1800 1810 – 1830

10 minutes 10 minutes 10 minutes

28 1920-2100

Drug refractory epilepsy - Definitions & approach

Session VIII

Sanjay Singh 1850 – 1910 Convenor : Samhita Panda Chairs : Lim Shih Hui & P.S.Kharbanda

10 minutes

31 Role of genetics in epilepsy practical aspects

Satish Jain 1920 – 1940 10 minutes

32 Can AED’S aggravate seizures & drugs to be avoided in seizure

Atma Ram Bansal 1950 – 1910

10 minutes

33 Status epileptics management paradigms

Parampreet Kharbanda 2020 -2040 10 minutes

INDIAN EPILEPSY SCHOOL 15.11.2013 (Friday) 0800-1130 Hrs Session-IX Convenor : Sanjeev Thomas Chairs : Meena Gupta &Bindu Menon

30 Non epileptic paroxysmal Events

- Diagnosis & classification - Management

Manvir Bhatia Atampreet Singh

0800 - 0820 0830 - 0850

10 minutes 10 minutes

29 Morbidity & mortality in epilepsy - Bone & nutritional health - Psychiatric and cognitive - Social –marriage, diving,

stigma - Sleep - SUDEP

Bindu Menon AshimaWadhawan P.U Shah Kiran Bala Sanjiv Thomas

0900- 0920 0930 - 0950 1000- 1020 1030 - 1050 1100- 1120

10 minutes 10 minutes 10 minutes 10 minutes 10 minutes

1140-1320 Hrs Session-X Convenor- : Sita Jayalakshmi Chairpersons : Lakshmi Narsimhan & Chander Shekhar Bal 34 Epilepsy surgery

- In children& Adults - In Adults

P Sarat Chandra P Sarat Chandra

1140 -1215 1220 -1250

10 minutes 10 minutes

35 Cortical dysplasias Chitra Sarkar

(Lunch Time) (1320 to 1350 Hrs)

1300 - 1320 10 minutes

1350-1550 Session XI Convenor : Chaturbhuj Rathore Chairs- : Sarat Chandra &Atma Ram Bansal

36 Temporal lobe epilepsy

- Surgicaloutcomes Parampreet Kharbanda

1350 - 1410

10 minutes

37 Outomes in palliative surgery Chaturbhuj Rathore 1420 - 1440 10 minutes

38 Extra temporal epilepsy surgical outcomes

Jayanthi Mani 1450 - 1510 10 minutes

39 Role ECOG in epilepsy surgery

1550-1750 Session-XII

Manjari Tripathi 1520 - 1540 Convenor : Debashish Chowdhury Chairs : Sunil Puri & Daljit Singh

10 minutes

40 Role of imaging in epilepsy Ajay Garg 1550 -1620 10 minutes

41 Nuclear imaging in epilepsy Chandra Shekar Bal 1630-1700 10 minutes

42 Neuromodulation in drug refractory epilepsy

Sanjay Singh 1710 -1740 10 minutes

(Tea Break – 1750 to 1800 Hrs)

43 Know your AEDs – clinical aspects Laxmi Narasimhan 1800 -1820 10 minutes

44 When is polytherapy justified John Stern for my patient and Rational combinations 1800-2000 Hrs Session XIII Convenor : Man Mohan Mehndiratta Chairs : Meena Gupta, John Stern, & Lim Shih Hui Active participation by delegates same day proceedings

INDIAN EPILEPSY SCHOOL 16.11.2013 (Saturday) 0900-1200 Hrs Convenor: Sangeeta Rawat Chairs-Sanjay Singh &Jayanti Mani Video Presentation on specific syndromes Case Presentation by faculty members and participants

Jayanti Mani, SitaJayalakshmi, SangeetaRavat, Chaturbhuj, Atampreet, NandanYardi, Atma Ram Bansal, P.S.Kharbanda, Suvasini Sharma, Man Mohan Mehndiratta, Samhita Panda

1830 -1850 10 minutes

Meeting Closes

Title :_____________________________________________________________ Last Name :_____________________________________________________________

First Name :______________________________________________________________

Institution :_______________________________________________________________

IESMembershipno:_______________________________________________________________

(If not, please enroll for IES membership to attend EEG Workshop)

Mailing Address : ________________________________________________________________

Postal Code :__________________ City:__________________Country:_______________

E-mail (Mandatory) :______________________________________________________________

Cell no :___________________________________Fax:________________________

Date: __________________ (Signature)

Registration will be restricted to 75 delegates

EEG Workshop Registration Fee

Upto 15.08.2013 Rs 4000/- USD-150/- (For International Delegates)

16.08.2013 to 31.08.2013 Rs.5000/

No spot registration

Registration Fee for the EEG Workshop

• Demand Draft should be in drawn in favor of “Indian Epilepsy Society” payable at New Delhi

Please send your registration form to: Dr. ( Prof.) Man Mohan Mehndiratta, Indian Epilepsy Society, Professor& HOD Department of Neurology, 3rd Floor, Janakpuri Superspeciality Hospital,C-2/B Janakpuri, Delhi-110058 Email: [email protected]

Registration Form for EEG Workshop 2013 Novermber 12-13, 2013 (Tuesday-Wednesday) Janakpuri Superspeciality Hospital, Janakpuri, Delhi-110058 (Near Bharti College) Registration will be on first-cum-first serve basis Preference will be given to the IES members

Title :_______________________________________________________________ Last Name :_______________________________________________________________ First Name :_______________________________________________________________ Institution :_______________________________________________________________ IES Membership no:_________________________________________________________ (If not, please enrolle for IES membership to attend epilepsy school) MailingAddress:_____________________________________________________________ Postal Code :__________________City:__________________Country:_______________ E-mail (Mandatory) :__________________________________________________________ Cell no :___________________________________Fax:________________________ Date: __________________ (Signature) Registration Fee for the Epilepsy School Demand Draft should be in drawn in favor of “Indian Epilepsy Society”payable at New Delhi The completed form should be posted to Dr. ( Prof.) Man Mohan Mehndiratta, Professor & HOD Neurology, Room Number, 3rd Floor, Department of Neurology, Janakpuri Superspeciality Hospital, C-2/B Janakpuri, Delhi-110058 *You are requested to send dully filled form by email. Please type in computer as it is world fromat. Indian Epilepsy School Registration Fee Upto 15.08.2013 Rs.7,500/-

USD-200/- (For International delegates)

Accommodation on twin sharing basis will be provided

16.08.2013 to 31.08.2013 Rs.8500/- No spot registration

IndIan EpIlEpsy socIEty EpIlEpsy school-2013 Novermber 13-16, 2013 (Wednesday thru Saturday) Hotel Claridges, Surajkund NCR Delhi Registration will be on first-cum-first serve basis Preference will be given to the IES members

REgIstRatIon FoRm

Title :____________________________________________________________________

Last Name:_______________________________________________________________

First Name:____________________________________________________________

Institution:_______________________________________________________________

IES Membership no:______________________________________________________ (If not, please enroll for IES membership to attend epilepsy school) Mailing Address:_________________________________________________________

Postal Code :_____________City:__________________Country:_______________

E-mail (Mandatory):______________________________________________________

Cell no :___________________________________Fax:________________________

Date: __________________

(Signature)

Registration Fee for the Epilepsy School

• Demand Draft should be in drawn in favor of “Indian Epilepsy Society”payable at New Delhi

The completed form should be posted to Dr. ( Prof.) Man Mohan Mehndiratta, Professor & HOD Neurology, Room Number, 3rd Floor, Department of Neurology, C-2/B Janakpuri Superspeciality Hospital, Janakpuri, Delhi-110058 *You are requested to send dully filled form by email. Please type in computer as it is world fromat. Indian Epilepsy School Registration Fee

Upto 31.08.2013 INR equivalent to USD 120 01.09.2013 to 31.10.2013 USD 200

No spot registration

IndIan EpIlEpsy socIEty asIan EpIlEpsy acadEmy asEpa EXamInatIon-paRt-I Novermber 13-2013 (Wednesday) Jankapuri Superspeciality Hospital, Jankapuri, Delhi-110058 (Near Bharti College) Registration will be on first-cum-first serve basis Preference will be given to the IES members REgIstRatIon FoRm

Title :______________________________________________________________

Last Name :_________________________________________________________

First Name :_________________________________________________________

Institution :__________________________________________________________

IES Membership No. :_____________________________________________________ (If not, please enroll for IES membership to attend epilepsy school) Mailing Address:_________________________________________________________________

Postal Code :__________________ City:_______________Country:_______________

E-mail (Mandatory):______________________________________________________

Cell no :___________________________________Fax:________________________

Date: __________________ (Signature)

Registration Fee for the Epilepsy School • Demand Draft should be in drawn in favor of “Indian Epilepsy Society”payable at New Delhi The completed form should be posted to Dr. ( Prof.) Man Mohan Mehndiratta, Professor & HOD Neurology, Room Number, 3rd Floor, Department of Neurology, Janakpuri Superspeciality Hospital, Janakpuri, Delhi-110058 *You are requested to send dully filled form by email. Please type in computer as it is world fromat.

Indian Epilepsy School Registration Fee Upto 31.08.2013 INR equivalent to USD 150

01.09.2013 to 31.10.2013 USD 200 No spot registration

IndIan EpIlEpsy socIEty asIan EpIlEpsy acadEmy asEpa EXamInatIon-paRt-II Novermber 14-2013 (Thursday) Registration will be on first-cum-first serve basis Preference will be given to the IES members REgIstRatIon FoRm