I would like to thank Dr Zollinger and the many content-expert authors of this issue who so successfully ensured that the unsung disorders (the Professors and Mary Anns of neurologic clinical syndromes) are now included in our curriculum and given the top billing they deserve.
From the theme song to
Gilligan’s Island, 1964:
The ship set ground on the shore of this Uncharted desert isle, With Gilligan,
The Skipper too, The Millionaire and his Wife, The Movie Star, And the rest, Here on Gilligan’s Isle.
From the theme song to
Gilligan’s Island, 1965:
The ship set ground on the shore of this Uncharted desert isle, With Gilligan, The Skipper too, The Millionaire and his Wife, The Movie Star, The Professor and Mary Ann, Here on Gilligan’s Isle.
This issue of Continuum has been in the making since the beginning of my now more than 3-year tour as Editor-in-Chief, when I recognized the need to address disorders that we commonly encounter but that don’t quite fit into the usual disease-category–based theme of a typical Continuum issue. Hence, the current potpourri-style set of topics you will find in this issue, built around the unifying theme of outpatient neurology that Continuum Associate Editor Dr Charles A. Zollinger so kindly agreed to take the helm of as guest editor. Although many primarily outpatient-based disorders and syndromes are covered throughout the Continuum curriculum (eg, headache, movement disorders, neuromuscular diseases), the objective of this issue was to ensure that no important clinical neurologic disorder is “cast away” from our curriculum.
The issue begins with the article by Dr William P. Cheshire Jr, who provides a clear and important framework to use when we see patients with syncope or presyncope, whether of neurally mediated, cardiac, or other origin. In his encyclopedic article on dizziness, Dr Terry D. Fife then reviews with depth and clarity the clinical syndromes, differential diagnosis, and management options for the many causes of dizziness we encounter.
Dr Giorgio Cruccu next discusses the most current nosology, pathophysiology, and treatment of trigeminal neuralgia. Dr Ronald DeVere then provides an overview of the disorders of taste and smell, which, although relatively uncommon presenting symptoms in some of our practices, are a group of disorders that we nonetheless may take ownership of in assessing and managing. In the next article, which formed the seed of the idea for this issue when I realized that Bell’s palsy could be otherwise “missed” entirely in the topic-based Continuum curriculum, Dr Stephen G. Reich discusses the diagnosis, differential diagnosis, and management of this common syndrome.
Drs Jinny O. Tavee and Kerry H. Levin provide an evidence-based approach to the diagnosis and management of low back pain, with an emphasis on neurologic (radicular) causes of pain. Drs Lisa D. Hobson-Webb and Vern C. Juel then delineate the anatomy, diagnosis, and management of the many common entrapment neuropathies we encounter, which represent another set of disorders that we all need expertise in and yet have not been previously covered as a group in Continuum. Staying in the peripheral nervous system, Dr Lindsay A. Zilliox tackles the current management considerations regarding neuropathic pain. In the final review article of the issue, Dr Jalesh N. Panicker provides his neurourologic expertise to assist us in our evaluation and management of the urogenital symptoms that affect so many of our patients with neurologic disease.
In the Ethical and Medicolegal Issues section, Ms Rachel V. Rose and Dr Joseph S. Kass use an example from a neurology practice to illustrate how to mitigate cybersecurity risks.
In the Practice Issues article, Dr Anindita Deb discusses practical considerations in addressing physician burnout, a timely article that references the important ongoing American Academy of Neurology initiative and investigations into the causes and potential cures of this critical problem. In the Coding article (accessed online and on the Continuum apps), Dr Allison L. Weathers discusses the use of the electronic health record for coding in outpatient neurology, delineating how conscientious design can enhance its usefulness, while also informing us of important caveats that clinicians need to be aware of.
As with every issue of Continuum, several opportunities exist for CME. After reading the issue and taking the Postreading Self-Assessment and CME Test written by Drs D. Joanne Lynn and Joseph E. Safdieh, you may earn up to 12 AMA PRA Category 1 CreditsTM toward self-assessment and CME. The Patient Management Problem, written by Dr Safdieh, describes the case of a 40-year-old man who presents for an outpatient evaluation of recent-onset low back pain. By following his case and answering multiple-choice questions corresponding to diagnostic and management decision points along his course, which parallel several of this issue’s teaching points, you will have the opportunity to earn up to 2 AMA PRA Category 1 CME Credits.
We are very pleased to announce that beginning with this issue, Continuum is an Accredited Self-Assessment Program (Section 3) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada and approved by the Office of Continuing Medical Education and Professional Development, University of Calgary. Canadian participants can now claim a maximum of 14 hours (credits are automatically calculated) for completing the Postreading Self-Assessment and CME Test and the Patient Management Problem.
I would like to thank Dr Zollinger and the many content-expert authors of this issue who so successfully ensured that the unsung disorders (the Professors and Mary Anns of neurologic clinical syndromes) are now included in our curriculum and given the top billing they deserve, just as television producer Sherwood Schwartz did in 1965 when acquiescing to include the less flashy but well-deserved audience favorites in his theme song.1
—Steven L. Lewis, MD, FAAN