Neurology Case Studies

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      Randolph W. Evans, MD Guest Editor
      Why bother with case-based reviews? We could just publish another Clinics of articles centered around evidence-based medicine. However, in clinical neurology, we treat patients one at a time and then try to apply evidence-based medicine. At times, the history, physical, or diagnostic testing may not fit into neat little diagnostic categories. Often, results from Class I studies are inconclusive, or the patient does not fit the study criteria. There is so much nuance in how we diagnose and treat. The art of medicine is alive and well in neurology practice. If evidence-based medicine were computer software, we'd currently be using version 2.0.
      In addition, actively working through case studies is, for us, akin to the use of flight simulators for pilots. I suspect we learn much more from case studies than we do from review articles, because we first consider each case as though he/she were our own patient, then we come to our own conclusions and compare them to those of the subspecialty experts who review the latest evidence and give their opinions.
      This issue of the Neurologic Clinics reviews cases and topics in cerebrovascular disease, multiple sclerosis, syncope, neuromuscular disorders, sleep disorders, epilepsy, spine disorders, neuro-ophthalmology, headache, movement disorders, functional symptoms, and critical care neurology. The disorders range from the rare to the mundane, and the issues range from the most controversial to those widely accepted. The authors enjoyed preparing their manuscripts. We hope this issue will educate and, perhaps, even entertain you.
      I thank our distinguished contributors for their outstanding articles. I also thank Donald Mumford, the Neurologic Clinics developmental editor, and the Elsevier production team for an excellent job. Finally, I am grateful for the support of my wife, Marilyn, and our children, Elliott, Rochelle, and Jonathan.