The evaluation of a patient with neurologic disease remains one of the most daunting and anxiety-provoking tasks in clinical medicine. From the perspective of physicians who are not trained in neurology, the performance and interpretation of the neurologic examination is shrouded in mystery. The angst associated with the study of neuroscience begins in medical school and continues throughout residency, and the term “neurophobia” was coined in 1994 to define this fear.1
Although physicians usually acknowledge that neurology is the most interesting medical specialty, they also consider it the most difficult, and it is the only medical subspecialty that requires its own residency training program after internship.2 Both in the inpatient and outpatient setting, the neurologist is totally relied upon to diagnose and treat disorders of the brain and nervous system, because non-neurologists feel uncomfortable managing neurologic disease. It is also the perception of patients that the treatment of their neurologic disease rendered by a neurologist is superior to that of other physicians.3 With the impending shortage of neurologists, in conjunction with the explosion of new therapy and diagnostic techniques for neurologic disorders, a crisis is looming that can only be assuaged by advancing the clinical skills and comfort level of the primary care physician with regard to diseases of the nervous system.4 Medical schools and medical residency programs are placing more emphasis on clinical neuroscience training.5
Over the next 2 years we will be presenting a series of neurologic topics intended to provide the primary care practitioner with a basic understanding of neurologic disorders and a pragmatic approach to their diagnose and treatment. Topics will include Concussion, Understanding and Interpreting the Neurologic Examination, Epilepsy, Dizziness, Autonomic Disorders, Spinal Cord Disease, Headache, Brain Tumors, Stroke, Infections of the Nervous System, Sleep Disorders, Parkinson Disease and Tremor, Peripheral Neuropathy, Myopathy, Motor Neuron Disease, Gait Disorders, Dementia, Multiple Sclerosis, and Neuroimaging.
Our goal is to present a current and comprehensive compilation of important neurology topics that will provide an easy source of reference for the practicing physician and forever vanquish “neurophobia.”
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-William J. Mullally, MD
This article originally appeared in the August 2017 issue of The American Journal of Medicine.
