Idiosyncratic and Esoteric Presentations at This Year's AAN Meeting


The history of the neurologic examination, referral pattern among neurologists for neurointerventional procedures, Parkinson's disease on the Internet, and online learning are just a few of the many topics discussed during the Day 2 sessions at the AAN meeting.

History of Neurology: The Origins of the Neurologic Examination

How and why did the structured neurologic examination and other facets of common neurologic practice evolve? Peter J. Koehler, MD, PhD, discussed the origins of the neurologic exam, key moments and physicians in the past who were instrumental in advancing the practice of neurology, and placing into context the unique insights and application of knowledge that are at the heart of practice.

Referral Pattern among Neurologists for Neurointerventional Procedures

The growing, if still low-visibility, subspecialty of neurology known as interventional neurology (IN) includes several classes of practitioners, including endovascular neurosurgeons and interventional neuroradiologists. The authors of this study looked at how established neurologists view practitioners of this subspecialty and what are the factors that influence their decision to refer (or not) patients to an interventional neurologist. Perhaps a bit surprisingly, the authors report that their survey of 1,000 neurologists revealed that general neurologists “are widely aware of Interventional neurology as a subspecialty,” but (not surprisingly), referral to these subspecialists is “limited by limited numbers of IN practitioners.” In communities that do have access to IN practitioners, referral is also “limited by conceptions of lack of expertise of these neurologists compared with neurosurgeon and radiologist interventionalists.”

Parkinson's Disease on the Internet: An Evaluation of the Readability, Quality, and Technical Content of Patient Information

According to the author, “As the use of the internet to access medical information becomes increasingly more popular and common, online patient-accessible health information requires critical evaluation. While there are no standardized tools for this purpose, general quality principles have been previously proposed. Evaluation of PD websites has not been performed.” After searching using the term “Parkinson’s disease” on popular search engines, and evaluating the search results for readability (by calculating the site’s Flesch-Kincaid Grade Level Score), overall website quality (using the Sandvik adaptation of the Health on the Net Foundation Code), and quality of technical information (using an adapted PD-specific scale), the author reports that “Readability levels of easily located PD websites were too advanced for education of the general public. While more accurate and detailed in technical content, compliance with HON quality standards was less stringent. Online patient resources for PD require revision for compliance with ideal standards of health information quality.” A Website for Online Learning in Neurology

This is one study that was sure to attract our editors’ notice here at MDNG. The author undertook to “create a physician-edited website that is free of charge, available to anyone, anywhere, which provides accurate, verifiable information, incorporates active, multimodal learning techniques, and serves the educational needs of medical students, residents, and fellows studying neurology.” In an early bid for “Forward-thinking Statement of the Year, Online Education Category,” the author claimed “Online learning is a significant part of medical education. With declining funding and rising enrollment, its importance is expected to increase.” Not only that, but “many medical education websites fail to incorporate active learning techniques, which improve retention,” and many medical education websites “are not available to the public.” Thus there is a need for “freely available online educational tools in neurology that incorporate active learning.”

Enter, a website that allows users to “contribute educational content, including text, images, audio, video, and multiple-choice questions,” and arrange that content to create interactive, multimedia courses. All content is moderated and edited by a physician administrator, “ensuring editorial standards, including citation of verifiable references.” incorporates “dynamic questions computer programs that draw content fragments from a database and combine them to generate novel multiple-choice questions.”

According to the author, as of late last year, contained more than 300 multiple-choice questions and an interactive, multi-media neuropathology course that incorporated more than 1,000 images.

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