Outpatient Issues in Neurology

Derek Stitt, MD

Joseph E. Safdieh, MD, FAAN

The pace of evolution in the practice of clinical neurology continues to accelerate at a remarkable rate. New diagnostic methods and a large array of new therapeutic options have significantly improved the course of many neurologic illnesses. Much of modern-day neurology CME and teaching focuses on these new advances. However, before a patient is diagnosed with a neurologic condition in the first place, the neurologist must interpret the clinical presentation and utilize proper clinical reasoning. The day-to-day practice of clinical neurology is firmly grounded in the evaluation of patients with common neurologic symptoms. All neurologists should be comfortable with assessing these common symptoms, including knowing what key discriminating questions to ask during the medical interview and what specific features of the neurologic examination are important to look for. Neurologists should also recognize the role of appropriately ordered diagnostic testing.

In this issue of Seminars in Neurology, we go back to the basics of the office practice of day to day neurology. The issue is based on the approach to some of the most common symptoms (chief complaints) that patients report to the outpatient neurologist. We have called upon a talented and diverse group of neurologists to take us through the evaluation of these symptoms through their well-written and comprehensive articles. We asked them to address the key features of the medical interview, important findings on physical and neurologic examination, approach to diagnostic testing, and formation of a differential diagnosis. We also asked the authors to describe the initial approaches to treatment of the common disorders caused by these symptoms. The neurologic symptoms covered in this issue include cognitive impairment, sleep concerns, visual symptoms, dizziness, facial weakness, gait problems, headache, limb weakness, neuropathic pain, radiculopathy, and tremor.

We hope this issue is useful for both novice learners and veteran neurologists. Learning neurology through a symptom-based approach is particularly helpful for medical students and residents, but even the experienced neurologist will benefit from a refresher to approaching common symptoms, especially those they may be less likely to see in their subspecialty. Those readers who are educators may find these articles especially useful when precepting learners in the neurology clinic.

It has been a pleasure working on this important issue of Seminars in Neurology and we hope you enjoy reading it as much as we enjoyed putting it together.

Publication History

Article published online:
26 November 2021