Child Neurology Society

Hyatt Huntington Beach Resort & Spa

Huntington Beach, California

October 31 – November 3, 2012

2012

Forty First

ANNUAL MEETING

Where the next 40 years begins....

Learning Objectives of 2012 CNS Scientific Program

The CNS Scientific Program is designed

by and is primarily intended for child

neurologists and professionals in other

fields of study related to neurologic and

developmental disorders in children and

adolescents.

At the conclusion of this activity,

participants should be able to:

1. Incorporate recent advances in

neuroscience, neuro-diagnostics

and therapeutics in the practice

2. Create new and/or collaborative research

studies to enhance the management of

child neurology disorders

3. Select best treatment options based

on a multidisciplinary review of

neurological conditions

2012

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Where the next 40 years begins....

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of The Nationwide Children’s Hospital and the Child Neurology Society. The Nationwide Children’s Hospital is accredited by the ACCME to provide continuing medical education for physicians.

The Nationwide Children’s Hospital designates this educational activity for a maximum of 25.5 AMA PRA Category 1 creditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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7:30 AM – 4:30 PMSymPOSium i: Neurobiology of Disease in Children: Batten’s Disease

Organizer: Bernard L. Maria, MD, MBA Medical College of Georgia, Augusta, GA

Batten’s Disease Supported by the National Institutes of Health (NIH grant 5R13NS040925-09), the Child Neurology Society and Batten’s Disease Support and Research Association

7:30 AM – 7:40 AMOpening Comments

Bernard L. Maria, MD, MBA, Principal InvestigatorMedical College of Georgia, Augusta, Georgia

Story Landis, PhD, Director of NINDSBethesda, Maryland

Wednesday, October 31

2012

Forty First

ANNUAL MEETING

SESSIONS highlighted in blue are designated for CME credit

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Where the next 40 years begins....

7:40 AM – 9:45 AMSESSiON i: iNTRODuCTiON AND CLiNiCAL FEATuRES

Co-Director and Moderator: Jonathan Mink, MD, PhDUniversity of Rochester School of Medicine, Rochester, NY

7:40 AM – 8:05 AMNatural Histories and Classification of NCLs

Jonathan Mink, MD, PhD

8:05 AM – 8:30 AMGenetics of the NCLs

Katherine Sims, MDMassachusetts General Hospital, Boston, MA

8:30 AM – 8:55 AMNeurobehavioral Aspects of CLN3

Heather Adams, PhDUniversity of Rochester School of Medicine, Rochester, NY

8:55 AM – 9:20 AMNeuropathology of the NCLs

Jonathan Cooper, PhDKings College London, London, UK

9:20 AM – 9:40 AMQuestion and Answer Session

9:40 AM – 9:55 AMCoffee Break

SESSiON ii: mOLECuLAR mECHANiSmS

Co-Director and Moderator: David Pearce, PhD Sanford Children’s Health Center, Sioux Falls, SD

9:55 AM – 10:20 AMNeuroinflammation and microglial Activation in JNCL

Tammy Kielian, PhDUniversity of Nebraska Medical Center, Omaha, NE

10:20 AM – 10:45 AMCLN3: What does it do?

David Pearce, PhD

10:45 AM – 11:10 AMNeuronal Ceroid Lipofusin: marker or Cause of Disease?

David Palmer, PhDLincoln University, Lincoln, Canterbury, New Zealand

11:10 AM – 11:30 AMQuestion and Answer Session

11:30 AM – 1:00 PMLunch and Presentation by the Batten’s Disease Support and Research Association

ADDiTiONAL WEDNESDAy

mEETiNGS/SESSiONS

8:00 AM – 4:30 PMAssociation of Child Neurology

Nurses (See page 12)

2:00 PM – 5:00 PMProfessors of Child Neurology

6:00 PM – 8:00 PM

OPENiNG RECEPTiON Lighthouse Courtyard

8:00 PM – 10:00 PM

SiG meetings (including Movement Disorders)

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1:00 PM – 2:40 PMSESSiON iii: TRANSLATiONAL SCiENCE AND CLiNiCAL FRONTiERS

Co-Director and Moderator: Marc Patterson, MD Mayo Clinic, Rochester, MN

1:00 PM – 1:25 PM Gene Therapy and Enzyme Replacement

Beverly Davidson, PhDUniversity of Iowa, Iowa City, IA

1:25 PM – 1:50 PMCombinational Therapies

Mark Sands, PhDWashington University, St. Louis, MO

1:50 PM – 2:15 PMClinical Trials: Challenges and Opportunities

Erika Augustine, MDUniversity of Rochester School of Medicine, Rochester, NY

2:15 PM – 2:40 PMQuestion and Answer Session

2:40 PM – 3:00 PMCoffee Break

Wednesday, October 31 continued

2012

Forty First

ANNUAL MEETING

SESSIONS highlighted in blue are designated for CME credit

6

Where the next 40 years begins....

3:00 PM – 3:50 PMEXECuTiVE SummARy OF THE DAy

Jonathan Mink, MD, PhDUniversity of Rochester School of Medicine, Rochester, NY

David Pearce, PhDSanford Children’s Health Center, Sioux Falls, SD

3:50 PM – 4:25 PMSESSiON iV: FuTuRE DiRECTiONS PANEL DiSCuSSiON

Panelists:Danilo Tagle, PhD, Moderator NIH, Bethesda, MD

Marc Patterson, MDMayo Clinic, Rochester, MN

Robert Steiner, MD Oregon Health Science Center, Portland, OR

Gary Clark, MD Texas Children’s Hospital, Houston, TX

Anne Pariser, MDFDA, Silver Springs, MD

Beverly Davidson, PhDUniversity of Iowa, Iowa City, IA

4:25 PM – 4:30 PMClosing Comments and Thanks

Bernard L. Maria, MD, MBA

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7:00 AM – 8:15 AMCONTiNENTAL BREAKFAST AND SEmiNARS

BREAKFAST SEmiNAR 1: CHiLDHOOD ENCEPHALiTiS: NEuRORADiOGRAPHiC, ELECTRODiAGNOSTiC, AND LABORATORy CROSSROADS

Organizer: John Crawford, MD; UCSD, San Diego, CA

Speakers: Mark Nespeca, MD; UCSD, San Diego, CACarol Glaser, MD; UCSF, San Francisco, CA

BREAKFAST SEmiNAR 2: ETHiCAL iSSuES REGARDiNG FETAL mRi FOR NEuRODEVELOPmENTAL DiSORDERS AND GENETiC TESTiNG iN CHiLD NEuROLOGy PATiENTS

Organizer: Leon Epstein, MD; Children’s Memorial Hospital, Chicago, IL

Speakers: William Graf, MD; Yale University, New Haven, CTJennifer Kwon, MD; University of Rochester School of Medicine, Rochester, NYEdwin Trevathan, MD, MPH; St. Louis University, St. Louis, MOHoward Schub, MD; Atlanta, GA

BREAKFAST SEmiNAR 3: RECENT ADVANCES iN STuRGE-WEBER SyNDROmE PATHOPHySiOLOGy, DiAGNOSiS, AND TREATmENT

Organizer: Anne Comi, MD; Kennedy Krieger Institute, Baltimore, MD

Speakers: Joshua Ewen, MD; Kennedy Krieger Institute, Baltimore, MDCsaba Juhasz, MD, PhD; Wayne State University, Detroit, MI

8:45 AM – 9:00 AM CNS Lifetime Achievement AwardsM. Richard Koenigsberger, MD; Demarest, NJ Bhuwan Garg, MD; Indianapolis, IN (Posthoumous presentation)

Thursday, November 1

2012

Forty First

ANNUAL MEETING

SESSIONS highlighted in blue are designated for CME credit

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Where the next 40 years begins....

9:00 AM – 12:00 PM SymPOSium ii: PRESiDENTiAL SymPOSium: mECHANiSm BASED TREATmENTS iN NEuRODEVELOPmENTAL DiSORDERS

Organizer: Mustafa Sahin, MD, PhD Children’s Hospital of Boston, Boston, MA

Speakers: Tuberous Sclerosis Complex Mustafa Sahin, MD, PhD

Fragile X Syndrome Elizabeth Berry-Kravis, MD, PhD Rush University Medical Center, Chicago, IL Down Syndrome William Mobley, MD, PhD UCSD, San Diego, CA

Rett SyndromeMriganka Sur, PhD MIT, Cambridge, MA

AutismDaniel Geschwind, MD, PhD Geschwind Laboratory, UCLA, Los Angeles, CA

11:30 AM – 7:00 PMExhibits

12:00 PM – 12:30 PMCNS Business meeting

12:30 PM – 1:30 PM Arnold Gold Foundation for Humanism in medicine Luncheon

12:30 PM – 1:30 PMLunch, Exhibit & Poster Viewing

1:45 PM – 4:00 PMSymPOSium iii: RECENT PROGRESS AND CONTROVERSiES iN NEuROREHABiLiTATiON

Organizer: Warren Lo, MD; The Nationwide Children’s Hospital, Columbus, OH

Speakers: Overview: Why and What are the New Promises in Neurorehabilitation? Warren Lo, MD

Recovery, Plasticity or Vulnerability? Contributions to Functional OutcomesVicki Anderson, PhD University of Melbourne, Melbourne, Australia

motor Therapies: What Works in Grown-ups, What Works in Kids, and for Whom? Anne Gordon, BAppSc, MSc, PhDEvelina Children’s Hospital, London, UK

Cognitive and Behavioral interventions for Children with CNS Disorders: What We Know (and What We Don’t)Keith Owen Yeats, PhDThe Nationwide Children’s Hospital, Columbus, OH

4:00 PM – 6:00 PMChild Neuro News Break: Poster Walkaround/Wine & Cheese Reception 6:00 PM – 7:00 PMExhibitor Appreciation ReceptionHuntington Ballroom, Mariner’s Ballroom and Salon AB

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7:00 AM – 8:15 AMCONTiNENTAL BREAKFAST AND SEmiNARS BREAKFAST SEmiNAR 4: NEuRONEXT: NETWORK FOR EXCELLENCE iN NEuROSCiENCE CLiNiCAL TRiALS

Organizer: Bradley Schlaggar, MD, PhD; Washington University School of Medicine, St. Louis, MO Speakers: Petra Kaufmann, MD, MSc; NIH, Bethesda, MD Elizabeth McNeil, MD, MSc; NIH, Bethesda, MD E. Steve Roach, MD; President, CNS; The Nationwide Children’s Hospital, Columbus, OH

BREAKFAST SEmiNAR 5: VACCiNES AND NEuROLOGiCAL ADVERSE EVENTS: THE myTH AND THE REALiTy

Organizer: Max Wiznitzer, MD; Rainbow Babies & Children’s Hospital, Cleveland, OH Speakers: Max Wiznitzer, MD James Sejvar, MD; Centers for Disease Control and Prevention, Atlanta, GA

BREAKFAST SEmiNAR 6: BEyOND ADEm & mS: ALTERNATiVE DiAGNOSES yOu SHOuLDN’T miSS DuRiNG A WORKuP FOR PEDiATRiC DEmyELiNATiNG DiSORDERS

Organizer: Keith Van Haren, MD; Stanford University School of Medicine, Stanford, CA Speakers: Anita L. Belman, MD; SUNY Stony Brook School of Medicine, Stony Brook, NY Teri L. Schreiner, MD, MPH; Children’s Hospital of Colorado, Denver, CO Keith Van Haren, MD

LEGiSLATiVE AFFAiRS SEmiNAR: ADVOCACy 101 FOR CHiLD NEuROLOGiSTS

Organizer: Bennett Lavenstein, MD; Chair, CNS Legislative Affairs Committee; Children’s National Medical Center, Washington, DC Speakers: Joe Gagen; Legislative Grassroots Trainer, Austin, TX

8:30 AM – 10:15 AMPLATFORm SESSiONS i & ii: TBA

10:45 AM – 10:55 AMArnold Gold Humanitarian Award: TBA

11:00 AM – 11:25 AMPHiLiP R. DODGE yOuNG iNVESTiGATOR AWARD LECTuRE: “Functional Annotations of the medulloblastoma Genome”

Yoon-Jae Cho, MD; Stanford University School of Medicine, Stanford, CA

11:30 AM – 12:15 PMBERNARD SACHS LECTuRE: “medulloblastoma: Progress and the Challenges that Lie Ahead”

Roger Packer, MD; Children’s National Medical Center, Washington, DC

9:00 AM - 2:30 PMExhibits

12:45 PM – 2:15 PMmODERATED POSTER SESSiON

Moderators: Bradley Schlaggar, MD, PhD Washington University, St. Louis, MO; Janet Soul, MD Children’s Hospital of Boston, Boston, MA

12:30 PM – 2:30 PMLunch & Poster/Exhibit Walkaround 2:30 PM – 4:45 PMSymPOSium iV:NOVEL THERAPiES FOR PEDiATRiC EPiLEPSy

Organizer: Mary Zupanc, MD; University of California Irvine, Irvine, CA Speakers: The Protean Nature of Epilepsy: Beyond SeizuresRod C. Scott, MD; Dartmouth-Hitchcock Medical Center, Durham, NH The Newly Described Pediatric Epilepsy Syndromes: From the Channelopathies to Autoimmune EpilepsySusan Koh, MD; Children’s Hospital of Colorado, Denver, CO Current State of the Art Therapeutic Approaches to Pediatric EpilepsyMary Zupanc, MD Re-engineering the Epileptic Developing Brain: Future Approaches to TherapyTallie Z. Baram, MD, PhD; University of California Irvine, Irvine, CA

4:45 PM – 6:00 PMJunior member Seminars

Organizer: Renee Shellhaas, MDUniversity of Michigan, Ann Arbor, MI

7:00 PM – 10:00 PMCNS ALumNi RECEPTiONMore food choices, more conversation partners than the sit-down banquets of yesteryear. Greet friends, old and new, with designated “islands” grouped by training programs.

Friday, November 2

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7:00 AM – 8:15 AMCONTiNENTAL BREAKFAST AND SEmiNARS

BREAKFAST SEmiNAR 7: PLASTiCiTy iN THE DEVELOPiNG BRAiN

Organizer: Doris Trauner, MD; UCSD, San Diego, CA Speakers: Doris Trauner, MD Harley Kornblum, MD, PhD; UCLA, Los Angeles, CA William Gaillard, MD; Children’s National Medical Center, Washington, DC Donna Ferriero, MD; UCSF, San Francisco, CA

BREAKFAST SEmiNAR 8: 2012 uPDATE FOR CPT, iCD-10-Cm, PQRS AND GuiDELiNES: SiT AT THE TABLE OR BE SERVED AS THE mEAL

Organizer: Bruce Cohen, MD, Chair, CNS Practice Committee; Children’s Hospital of Akron, Akron, OH Speakers: Jeffrey Buchhalter, MD, PhD; Phoenix Children’s Hospital, Phoenix, AZ Deborah Hirtz, MD; NINDS, Bethesda, MD

BREAKFAST SEmiNAR 9: DOPA-RESPONSiVE mOTOR DiSORDERS: TREATABLE CONDiTiONS THAT mAy mimiC CEREBRAL PALSy

Organizer: Jennifer Friedman, MD; UCSD, San Diego, CA Speakers: Terence D. Sanger, MD, PhD; Sanger Lab, UCLA, Los Angeles, CA Kathryn J. Swoboda, MD, FACMG; Primary Children’s Hospital, Salt Lake City, UT Andrew Zimmerman, MD; Massachusetts General Hospital, Boston, MA

9:00 AM – 9:45 AMHOWER AWARD LECTuRE: “The Power of Belief”

Ann Tilton, MD Children’s Hospital of Louisiana, New Orleans, LA

10:00 AM – 12:15 PMSymPOSium V: miTOCHONDRiA: SO mANy DiSEASES, SO LiTTLE CROSS-SECTiONAL AREA

Organizer: Nina Schor, MD, PhD; University of Rochester Medical School, Rochester, NY Speakers: Conventional mitochondrial Disease: New Approaches to Diagnosis and Classification Amy Goldstein, MD Children’s Hospital of Pittsburgh, Pittsburgh, PA

Conventional mitochondrial Disease: Not-so-conventional TreatmentSumit Parikh, MD; Cleveland Clinic Foundation, Cleveland, OH

unconventional Roles for mitochondria: They’re Not Just Little Fuel CellsGeorge Porter, MD, PhD; University of Rochester Medical School, Rochester, NY

From Neurodevelopmental Disorders to Neurodegenerative Disease: it’s All mitochondria!Nina Schor, MD, PhD

SESSIONS highlighted in blue are designated for CME credit

Saturday, November 3

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2012

ACNN Conference ProgramHyatt Huntington Beach Resort & Spa

Huntington Beach, California

October 31 – November 2, 2012

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7:00 PM – 9:00 PM ACNN Welcome Reception (Nurses only)

7:00 AM – 8:00 AM Registration and Continental Breakfast

8:00 AM – 8:15 AM Welcome and introduction

8:15 AM – 9:00 AM Janet Brucker Keynote Address: Accidental Leadership: A Result of intentional Engagement?

Linda R. Littlejohns RN, MSN, FAAN 9:00 AM – 10:00 AM Case Studies: Neurogenetic and metabolic Disorders identified in a Neurology/Neurogenetics Collaborative Practice

Marian J Kolodgie MSN, CPNP

10:00 AM – 10:15 AM Break

10:15 AM – 10:45 AM Pediatric Neurology: The Role of Genetic Testing

Dona Clarin MSN, FNP

10:45 AM – 11:30 AM independent NP/PA Practice model as a method for improving New Patient Access within an Academic Pediatric Neurology Clinic

Scott Turner MSN, FNP 11:30 AM – 12:00 PM Awards and Annual Business meeting

12:00 PM – 1:00 PM Lunch

1:00 PM – 1:30 PM innovative Practice Award PresentationParenting with Parents: A Recipe for Success

Claire Chee RN, BS 1:30 PM – 2:30 PM “Handle with Care” Dealing with Dravet Syndrome

Deborah A. Gardner, RNC, BSN 2:30 PM – 2:45 PM Break 2:45 PM – 3:45 PM implementing Evidence Based Nursing Practice in Pediatric Neurology

Ruth Rosenblum DNP, RN, PNP-BC

3:45 PM – 4:15 PM Cyclic Vomiting Syndrome: Assessment, Diagnosis and management

Cynthia B. tenHoopen MS, RN, CPNP

4:15 PM – 4:30 PM Wrap up

12:00 PM – 12:45 PM LunchSpecial interest Groups Table Discussions

12:45 PM – 1:15 PM Epilepsy at a Glance – Health information Transfer

Melissa Reider-Demer DNP, CPNP

1:15 PM – 1:45 PM Current and Emergent uses of Botulinum Toxin for Pediatric Neurology Patients

Shuna Thomas APN, PNP-BC

4:30 PM 5k Run/walk fundraiser for ACNN/CNF Nursing Research Grant

12:00 PM – 1:00 PM Lunch

1:00 PM – 1:30 PM Diagnosing mLD: A Case Presentation

Cleo Park RN, MSN, CPNP

Note: The ACNN conference program is geared for nurses, but all CNS meeting registrants are welcome to attend any of the presentations. Nursing CE contact hours will be provided.

Tuesday, October 30

Wednesday, October 31

Thursday, November 1

Friday, November 2

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TRAVEL iNFORmATiONContact Partners in Travel at 612-338-0004 to take advantage of the many ways to save on meeting airfare by booking 60 days in advance (or more). The travel professionals at Partners in Travel will find the very best combination of price and schedule to suit your specific needs.

Partners in Travel, Ltd.12 S. 6th St., Suite 200Minneapolis, MN 55402Tel: 612-338-0004Fax: 612-338-2396

HOTEL ACCOmmODATiONSOn-line Booking for CNS Annual meeting now available.

The CNS has reserved a block of rooms in two hotels. Hyatt Huntington Beach Resort & Spa• All meetings are at the Hyatt. • Rates begin at $209/night. • Reservations can be made

on-line using the following link: https://resweb.passkey.com/Resweb.do?mode=welcome_ei_new&eventID=5272435

Shorebreak Hotel• Downtown Huntington Beach (2 miles

from the Hyatt). Restaurants, bars, shops.

• Rates begin at $199/night• Reservations can be made

on-line using the following link: www.shorebreakhotel.com/contact/

uPDATES & ON-LiNE REGiSTRATiONThe CNS Website will provide links with information regarding weather, tourist attractions, and scientific program updates. Log on at www.childneurologysociety.org to register. Hotel registration must be handled directly with the Hyatt or Shorebreak links provided on the CNS home page.

NOTE: THE WEDNESDAy NDC (Battens Disease) SymPOSium iS AVAiLABLE By ADVANCE REGiSTRATiON ONLy. • NDC registration ends Sept 20

or sooner (i.e., when all 300 seats available are taken)

To ensure adequate seating, printed handouts, food and beverage, etc., the following guidelines will apply: • No admission or printed syllabi will

be available to anyone not registering on or before September 20 for the Wednesday NDC Symposium,

• Additional $150 course fee is required for this symposium.

SPECiAL iNTEREST GROuP mEETiNGSPlan on attending one or more Special Interest Group Meeting(s). Consult the SIG work area on the CNS website for more information regarding times, dates, room assignments, and agendas.

Attendees are strongly encouraged to make hotel reservations AND

plane reservations early to ensure best options.

Travel, Lodging, Touring Information

2012

Forty First

ANNUAL MEETING

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Where the next 40 years begins....

On-line Registration is available at www.childneurologysociety.org

Registration Form

SEND TO: Child Neurology Societyc/o RMI, 6598 Carlisle CurveShakopee, MN 55379

EARLy REGiSTRATiONOn or Before Sept. 20

LATE REGiSTRATiONSept. 21 – Oct. 28

ON-SiTE REGiSTRATiONOct. 28 – Nov. 3

Active member $495.00 $575.00 $625.00

Emeritus member $295.00 $375.00 $425.00

Junior member (To qualify for Future Leaders Scholarships enter code # sent by CNS National Office to a) Jr Member presenters, and b) Jr Member 3rd Year Residents)

$295.00 $375.00 $425.00

Resident/Trainee Non-CNS Member (Apply for CNS Jr Membership by September 1 and qualify for $100 savings)

$395.00 $495.00 $545.00

medical Student Contact CNS National Office for Future Leaders Scholarship code #

$0 $375.00 $425.00

ACNN (nurse) member $295.00 $375.00 $425.00

Nurse (non-ACNN member) $395.00 $495.00 $545.00

Non-CNS member $625.00 $725.00 $775.00

Guest Nametag/Reception Pass $75.00 Includes Wednesday, Thursday and Friday Evening Receptions (Note: Registrant nametag = 1 pass for Wednesday, Thursday & Friday Receptions. Additional passes for spouse and/or children may be purchased.)

Name ___________________________________________________________

Wednesday NDC Symposium $150.00

TOTAL ENCLOSED ________________________Please sign and accurately enter credit card information. Checks payable in US funds only to Child Neurology Society.

VISA, MasterCard or AMEX #____________________________________________________

Signature__________________________________________ Exp Date__________________

REGiSTRATiON FEE SCHEDuLERegistration Fee includes admission to all educational functions (one exception—Wednesday NDC Symposium: Additional $150.00 fee), Wednesday opening reception, continental breakfasts, coffee breaks, lunches, Friday reception and banquet, CME credit. Fixed fee—no partial/day fees available.

ADVANCE REGISTRATION REQUIRED | indicate which sessions you plan to attend.

CANCELLATiONS AND REFuNDS • Cancellations received in writing on or before

September 20 will receive full refund (less $75.00 administrative fee).

• The CNS assumes significant non-refundable financial/contractual obligations one month prior to meeting, for which reason no refunds of registration fees will be made after September 20.

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WEDNESDAy | OCTOBER 31 NDC Symposium: Batten’s Disease

($150 course fee and preregistration by Sept 20 required; max 300 registrants)

THuRSDAy | NOVEmBER 1Breakfast Seminars: Select ONE

Breakfast 1: Childhood Encephalitis

Breakfast 2: Ethics Breakfast 3: Sturge Weber

----------------- Symposium 2:

Presidential Symposium Symposium 3:

Neurorehabilitation

FRiDAy | NOVEmBER 2Breakfast Seminars: Select ONE

Breakfast 4: NeuroNEXT Breakfast 5: Vaccines Breakfast 6: Peds Demyelinating Disorders LAC Breakfast Seminar (non-CME):

Advocacy 101-----------------

Dodge Young Investigator Award Lecture Bernard Sachs Lecture Moderated Poster Session Symposium 4: Pediatric Epilepsy Junior Member Seminar

SATuRDAy | NOVEmBER 3Breakfast Seminars: Select ONE

Breakfast 7: Plasticity in Developing Brain Breakfast 8: CPT Update Breakfast 9: Motor Disorders

----------------- Hower Award Lecture Symposium 5: Mitochondria

Name ___________________________________________________________

Degree (for nametag: MD, PhD, RN, etc) ________________________________

Address _________________________________________________________

City_____________________________________ State ______ Zip __________

Country __________________________________________________________

Tel_______________________________ Fax ___________________________

E-mail (required to process) _________________________________________

SPECiAL REQuESTSDietary Needs/Requests ____________________________________________

Handicap Access __________________________________________________

Other ____________________________________________________________

QuESTiONS? Phone: 651-486-9447E-mail: registration@childneurologysociety.orgFax credit card payment to: 952-487-5059

REGiSTRATiON CONFiRmATiON • E-mail confirmation only

(include address) • Hotel registration and

confirmation must be handled independently with the meeting hotels.

1000 West County Road E, Suite 290

St. Paul, MN 55126

Tel: 651-486-9447

Fax: 952-487-5059

E-mail: registration@childneurologysociety.org

Web: www.childneurologysociety.org

Where the next 40 years begins....