This issue of Continuum provides an in-depth and systematic approach to the diagnosis and management of our patients who have disorders that predominate outside the nervous system but affect the nervous system. I am so pleased that Dr Joseph E. Safdieh, our Continuum associate editor and associate editor of self-assessment and CME, accepted my request to reprise his role as guest editor of this issue, and I extend my sincere thanks to him for inviting such an outstanding team of authors to contribute to this topic in the Continuum curriculum that is so crucial to the daily inpatient and outpatient practice of neurology.
This issue starts with the article by Dr Natalie R. Weathered, who reviews the many neurologic syndromes that can occur in the context of cardiac and pulmonary disorders. Next, Dr Halina White discusses the neurologic disorders that occur as a consequence of gastrointestinal disorders (including malabsorption of essential nutrients) and hepatic diseases. In the following article, Dr Pantelis P. Pavlakis provides the latest thinking regarding the interface of rheumatologic disorders and the peripheral or central nervous system.
Dr Mary Angela O’Neal then discusses the neurologic syndromes that can occur as a consequence of obstetric and gynecologic disorders, a topic that is not often included under the rubric of “systemic disease” but is so important for informed neurologic practice involving the care of women throughout their lives. Next, Dr Nuri Jacoby provides an extensive primer and reminder to neurologists about the many electrolyte disorders, their management, and how these perturbations can present as nervous system dysfunction. Dr Alexander E. Merkler then discusses the neurologic syndromes that can occur in patients with different forms of blood cell disorders, particularly dyscrasias affecting red blood cells and platelets. In the following article, Dr Matthew B. Maas reviews the neurologic dysfunction that can be seen in patients we often see in consultation in the medical intensive care unit who have critical systemic illness. Dr Siddharama Pawate then reviews the diagnosis of neurosarcoidosis, including the most recent diagnostic criteria and current approaches to the management of this “great mimic.”
The final three review articles in the issue revolve around the neurologic dysfunction that can occur in relation to medications and other exogenous substances. In the first of these articles, Dr Mary L. Vo provides an encyclopedic review of the adverse effects on the nervous system that can occur from many of the drugs commonly used for medical illness. Next, Dr Bianca D. Santomasso discusses the neurologic syndromes that can occur as a consequence of the numerous anticancer drugs used in modern oncologic practice, including a thorough review of the neurologic disorders now being seen in relation to treatment with immune checkpoint inhibitors and chimeric antigen receptor (CAR) T-cell therapy. In the final review article of the issue, Drs Derek Stitt and Neeraj Kumar discuss drugs and other agents of abuse and their potential to cause central and peripheral nervous system toxicity.
In the Practice Issues article, Drs Bruce H. Cohen and Neil A. Busis and Ms Luana Ciccarelli provide their state-of-the-art review of the coding changes regarding non–face-to-face Evaluation and Management care that have recently occurred related to the COVID-19 global health crisis. In a first for Continuum, this article has already been published online ahead of the print issue, given the timeliness and importance of this topic, and is open access on ContinuumJournal.com.
After reading the issue and taking the Postreading Self-Assessment and CME Test written by Drs Adam G. Kelly and Allison L. Weathers, you may earn up to 20 AMA PRA Category 1 CreditsTM toward self-assessment CME or, for Canadian participants, a maximum of 20 hours toward the Self-Assessment Program (Section 3) of the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. Additional credit can be obtained by listening to Continuum Audio interviews associated with this and other Continuum issues, available to all subscribers, and completing tests on the Continuum Audio web platform or mobile app. Continuum Audio is also accredited by the Royal College of Physicians and Surgeons of Canada.
I would like to offer my sincere appreciation to Dr Safdieh for his meticulous guest editorship of this issue in our curriculum, from his organization of a diverse, thorough, and systematic set of topics to inviting such expert authors and his attention to details in all steps of the process to bring this issue to our readers. We will all benefit from having this issue available to us as we provide care to the patients we see who have neurologic dysfunction occurring in the context of a systemic disease (whether the systemic disease has been previously recognized or not) or as a consequence of the treatment of such a disease.
Finally, from the Continuum staff and the Continuum Editorial Board, we wish you all the best of health and safety at this time.
—STEVEN L. LEWIS, MD, FAAN