Epilepsy Pioneers including their Short Biography in Cyprus from Past to Present and Current Educational Programs in Cyprus

Savvas Symeon Papacostas

Comprehensive epilepsy centers begun sprouting around the world, mainly in academic settings, toward the latter part of the 20th century, a period during which I was engaged in my tertiary education and subsequent specialty training in neurology. My own journey toward Epileptology was by no means a straightforward one and neither was my decision to study medicine. I was born in Nicosia, Cyprus, an island in the Mediterranean region, where I received my early education having attended the Heleneion Elementary School and the Pancyprian Gymnasiun (High School). Following high school graduation in 1973, I had to serve an obligatory 2-year service in the military prior to continuing on with my education. As there were no universities in Cyprus at that time, people typically went to study in Greece or England and, to a lesser extent, other countries as well. Several universities have since been established. I did not follow that typical path but went instead to the United States to study biology and then to graduate school to obtain a Master's degree in Medical Anthropology. It was during that time when my interest in medicine and cross-cultural expressions of mental illness begun to develop. With that in mind, I decided to go into medicine, hoping to eventually specialize in psychiatry and pursue my academic interests further. So, I completed my medical education at Ohio University, followed by a residency in psychiatry at the University of Rochester in New York. It was during this time that I became interested in the neurophysiology of behavior and its anatomic substrates and the field of epilepsy appealed to me as it enabled me to combine my previous interests and training; therefore, I combined psychiatry and neurology and, subsequently, completed my fellowship in clinical neurophysiology and epileptology at Columbia University in New York.

As I was completing my fellowship in New York, the Cyprus Institute of Neurology & Genetics (CING) was established and its administration decided to follow through with developments elsewhere and organize a comprehensive epilepsy center. I applied for a position at the CING and thus became the first epilepsy specialist, who returned and set up an epilepsy clinic in Cyprus. I am still based at the CING where I currently have the position of Senior Consultant Neurologist and Head of the Epilepsy and Behavioral Neurology Clinic. I was fortunate to have managed to assemble a team of staff (see below) that helped me establish the Clinical Neurophysiology laboratory in 1994, and the long-term monitoring unit for epileptic seizures in 2002. Thereafter, we gradually expanded our activities to include not only services, but also research and education.

My team and I introduced surgical treatments for intractable epilepsy and participated, with intraoperative monitoring, in the first operations performed in Cyprus in 2004 and thereafter. The first Ethics Committee in Cyprus was also established following my recommendation to oversee research projects such as clinical trials involving humans.

With the establishment of the Cyprus School of Molecular Medicine, I was appointed Professor of Neuroscience where, in addition to teaching, my team supervises Doctoral and Masters' candidates' research in neurophysiology, behavioral neurology (dementia), the genetics of epilepsy, and in animal models of Alzheimer's disease.

In addition to academic activities, our clinic sees patients with intractable forms of epilepsy for evaluation and therapy which at times includes surgery. Moreover, due to my previous psychiatric training, I am also in charge of the behavioral neurology clinic of the CING where I see patients with dementing and other neurodegenerative disorders. We participate in local as well as international research on the epidemiology, consequences, and treatment of Alzheimer's disease.

In addition to my involvement at the CING, I am also an Honorary Professor of Neurology at the University of Nicosia Medical School. Previously, I have held a visiting associate professorship at the University of Cyprus in Nicosia and an adjunct associate professorship at the University of Rochester in New York. I have been active in epilepsy research including antiepileptic drug trials, the first one being a study on Lamotrigine as add-on therapy in children with treatment-resistant epilepsy in 1996, followed by studies on quality of life in epilepsy, and have established collaborations with several academic institutions in Cyprus and abroad for the evaluation and surgical cure of epilepsy.

Some other of my interests focus on clinical neurophysiology with experience and research in the field of evoking and analyzing signals that result from the stimulation of sensory organs. My laboratory has developed new diagnostic methods for the evaluation of the functionality of the central nervous system such as mapping of the cortical representation of the vestibular nerve. Several articles and review papers have been published on the subject. Moreover, I performed research on dementia epidemiology, the psychosocial aspects of the disease, clinical trials for novel medications and currently conduct studies on animal models of Alzheimer's disease.[1] [2] [3] [4] [5] [6] [7] [8] [9]

I have been involved in teaching both through didactic lectures in various tertiary institutions and the School of Molecular Medicine, but also with clinical and bedside training of medical students and from the three medical schools recently established in Cyprus as well as postgraduate residents. In 2013, we hosted the Migrating Couse on Epileptology which is sponsored by the Commission of European Affairs of the International League Against Epilepsy (ILAE) and held in various European countries.

I was honored with inclusion on the list of Faculty 1000 of the ILAE and have been awarded the distinction of Fellow of the American Academy of Neurology for my local, regional, and international work. I actively participate in local, regional, and international scientific meetings. I am also a member of the American Epilepsy Society, the American Academy of Neurology, and the European Academy of Neurology serving on several committees. I was a founding member and served on the first board of the Cyprus Neurological Association and I have founded the Cyprus Epilepsy Society and served as its first President. My book Madness and leadership: From antiquity to the New Common Era was published in September 2015 ([Fig. 1]).

Fig. 1 Prof. Savvas Papacostas.

• References

• 1 Papathanasiou ES, Lemesiou A, Hadjiloizou S, Myrianthopoulou P, Pantzaris M, Papacostas SS. A new neurogenic vestibular evoked potential (N6) recorded with the use of air-conducted sound. Otol Neurotol 2010; 31 (03) 528-535
• 2 Papathanasiou ES, Pantzaris M, Myrianthopoulou P, Kkolou E, Papacostas SS. Brainstem lesions may be important in the development of epilepsy in multiple sclerosis patients: an evoked potential study. Clin Neurophysiol 2010; 121 (12) 2104-2110
• 3 Papacostas SS, Myrianthopoulou P, Dietis A, Papathanasiou ES. Induction of central-type sleep apnea by vagus nerve stimulation. Electromyogr Clin Neurophysiol 2007; 47 (01) 61-63
• 4 Papathanasiou ES, Papacostas SS, Charalambous M, Eracleous E, Thodi C, Pantzaris M. Vertigo and imbalance caused by a small lesion in the anterior insula. Electromyogr Clin Neurophysiol 2006; 46 (03) 185-192
• 5 Papathanasiou ES, Zamba-Papanicolaou E, Pantziaris M. , et al. Neurogenic vestibular evoked potentials using a tone pip auditory stimulus. Electromyogr Clin Neurophysiol 2004; 44 (03) 167-173
• 6 Papathanasiou E, Zamba-Papanicolaou E, Pantziaris M. , et al. Click evoked neurogenic vestibular potentials (NVESTEPs): a method of assessing the function of the vestibular system. Electromyogr Clin Neurophysiol 2003; 43 (07) 399-408
• 7 Papathanasiou E, Zamba E, Papacostas S. Normative values for high voltage electrical stimulation across the brachial plexus. Electromyogr Clin Neurophysiol 2002; 42 (03) 151-157
• 8 Papathanasiou ES, Zamba E, Papacostas SS. Radial nerve F-waves: normative values with surface recording from the extensor indicis muscle. Clin Neurophysiol 2001; 112 (01) 145-152
• 9 Papacostas SS, Myrianthopoulou P, Papathanasiou E. Epileptic seizures followed by nonepileptic manifestations: a video-EEG diagnosis. Electromyogr Clin Neurophysiol 2006; 46 (06) 323-327
• 10 Papageorgiou A, McCrorie P, Georgiades S, Perdikogianni M. Psychology for Psychologists (A Problem Based Approach to Undergraduate Psychology Teaching). Milton Keynes, UK: Palgrave MacMillan; 2015
• 11 Papacostas SS, Myrianthopoulou P, Georgiades S, Papathanasiou ES. Pharmacoresistant partial-onset epilepsy misdiagnosed as panic disorder: a case report. Psychiatriki 2014; 25 (03) 217-221