Pearls and Pitfalls, Part 1

 

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This issue of Seminars provides readers with experts' personal approaches to the diagnosis and management of various neurologic disorders. However, the one key element shared by all authors—and ourselves—is the patient's neurologic history, which remains one of the prime factors in achieving a precise diagnosis. In each chapter, our experts have included some features of the patient history that they use on a daily basis. It is worth reminding ourselves of the importance of history-taking, especially in an era of electronic medical records, time-pressured visits, and an overreliance on imaging and the laboratory.

William Osler's words still ring true, and emphasize the importance of taking a good history, perhaps even more so today than ever.

“Listen to your patient, he is telling you the diagnosis.”

Based on our own attempts to follow this advice, we further add that listening (rather than running through a checklist of questions) is also critically important in establishing rapport.

Obviously, it is impossible to comprehensively cover the myriad of neurologic disorders, both common and rare, so we have selected conditions where particular advancements have been made, including stroke, headache, and spinal cord and movement disorders. We are delighted that authorities in neurologic diagnosis and therapy from around the world provided their reviews, each with a unique and distinct individualized approach, and would like to sincerely thank them for their contributions. The reader is encouraged to learn from the “accumulated clinical wisdom” shared by our experts and can complement their contributions with more comprehensive articles and additional reading provided within each chapter's references. We believe, and sincerely hope, that readers of Seminars in Neurology will benefit from these reviews in their clinical practice.