Clinical Neuroscience

[The future in danger: a survey of the changes in the number of neurologists and a prognosis for 2010 in Hungary]

BERECZKI Dániel, CSIBA László, KOMOLY Sámuel, VÉCSEI László

JULY 20, 2010

Clinical Neuroscience - 2010;63(07-08)

[Lack of neurologists has become an obvious problem recently in Hungary, not only in small hospitals, but in major health care centers and also in university hospitals. With the current survey we set forth to estimate the number of board certified neurologists, and to evaluate the foreseeable changes in the next decade. In the beginning of 2010 there were 1310 physicians in Hungary with an official license to practice neurology. During 2009 neurological performance at least once during the year was claimed to the National Health Insurance Fund by 948 board certified neurologists. The number of those neurologists who are routinely involved in neurological patient care was estimated to be around 750. The lack of the young generation is characteristic for the age distribution of neurologists. In nine out of the 19 counties of Hungary the number of neurologists below the age of 35 is one or nil. In the ten-year period of 2000-2009 the annual mean number of new board certifications in neurology was 22. This number is much lower than that needed to replace those who get employed abroad and who leave the system for other reasons. The number of neurologists in the age range of 40-60 years will drop to 2/3 of the current number by 2020 even if emigration of neurologists will completely halt. If emigration will continue at the current rate and the number of those in neurological training will not increase considerably, then by 2020 only about 300 neurologists will have to cover neurological services throughout Hungary. As this number is insufficient for the task, and the tendency is clearly foreseeable, the health care government should urgently react to this situation to ensure an acceptable level of neurological services in the near future for the population of Hungary.]



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[Migraine is a very common disorder characterized by the combination of typical headache with associated autonomic symptoms and ranked by the WHO as number 19 among all diseases worldwide causing disability. Considerable progresses have been made in recent years to understand the pathophysiology of migraine, which has led to improved treatment options for the acute migraine attack as well as migraine prophylaxis. When headaches are frequent or particularly severe, prophylactic therapy should be considered, however preventive treatment is often insufficient to decrease migraine frequency substantially or is not well tolerated. The present paper summaries the possible drug treatment options which have the A level of evidence for effective preventive therapy of migraine. Summarises the evidences for the prophylactic migraine treatment, specially the role of the newly approved topiramate in the prophylaxis.]

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