Developing a Curriculum for Functional Neurologic Disorder in Neurology Training: Questions and Answers
Functional neurologic disorder (FND) is a common condition for which neurology residents often receive little to no formal teaching. Using a question-and-answer format, this article puts forward a case for why an FND curriculum is needed and aims to provide guidance on possible curricular content including medical knowledge, clinical skills, communication, and team-based collaboration. The authors also discuss methods for teaching and evaluating this knowledge and associated clinical skills, linking this to current Accreditation Council for Graduate Medical Education neurology milestones. Finally, the authors consider how ...
Source: Neurologic Clinics - March 15, 2023 Category: Neurology Authors: Sara A. Finkelstein, Angela O ’Neal, Gaston Baslet, Barbara A. Dworetzky, Ellen Godena, Julie Maggio, Daniel Millstein, Tracey Milligan, David L. Perez Source Type: research
Are America ’s Caregivers on the Brink of Extinction? The Pandemic Straw that Broke the Nurses’ Back
The coronavirus disease 2019 pandemic has drawn attention to many of the inadequacies of the US health-care system. Perhaps, no profession has felt these shortcomings more than nurses. This female-dominated profession has the potential to suffer a high attrition rate for several reasons, including declining mental health and increasing workplace violence. Nurses have already begun to leave the bedside. Unless significant changes can be made quickly to prevent more of these caregivers from leaving the profession, the health and safety of the US population are at risk. (Source: Neurologic Clinics)
Source: Neurologic Clinics - February 20, 2023 Category: Neurology Authors: Rachel Elana Norris Source Type: research
Challenges Training Women in Neurology
The challenges that current women neurologists in training face remain similar to a certain extent to those experienced by their women neurologists ’ mentors. The key challenge that often coincides with residency or fellowship is childbearing. This has the potential to prolong training time and delaying graduation. Women neurologists in training face additional challenges of juggling between family responsibilities––as caregivers––and professional roles. (Source: Neurologic Clinics)
Source: Neurologic Clinics - February 20, 2023 Category: Neurology Authors: Stasia Rouse, Ashley Raedy, Farah Khan Source Type: research
Sex-Specific Neurocognitive Impairment
This article explores sex-specific neurocognitive impairment. It first defines relevant terms such as gender and sex. Next, it describes the nature of the problem including under-representation of women and other gender and sexual minorities in neuroscience research, including cognitive studies. A biopsychosocial framework is employed to account for structural and social determinants of health in sex/gender-specific neurocognitive impairment. Issues in assessment including the use of gender/sex-specific normative data are also discussed. Lastly, the article covers the current state of research as it relates to sex/gender-s...
Source: Neurologic Clinics - February 20, 2023 Category: Neurology Authors: Sharlet A. Anderson, Maria A. Rossetti Source Type: research
Autism in Women
Relative to males, women with autism spectrum disorder (ASD) have neurobiological and clinical presentation differences. Recent research suggests that the male/female ASD prevalence gap is smaller than previously reported. Sex differences in symptom presentation as well as the male bias of ASD account for delayed/missed diagnosis among women. Investigating ASD and providing psychological evaluation referrals for women who are struggling socially and present with complex mental health conditions (e.g., ADHD, depression), even when they do not show typical autistic characteristics, is important. Accurate diagnosis facilitate...
Source: Neurologic Clinics - February 19, 2023 Category: Neurology Authors: Cesar Ochoa-Lubinoff, Bridget A. Makol, Emily F. Dillon Source Type: research
Sex and Gender Differences in Parkinson's Disease
The lower prevalence of Parkinson disease (PD) in females is not well understood but may be partially explained by sex differences in nigrostriatal circuitry and possible neuroprotective effects of estrogen. PD motor and nonmotor symptoms differ between sexes, and women experience disparities in care including undertreatment with DBS and less access to caregiving. Our knowledge about PD in gender diverse individuals is limited. Future studies should improve our understanding of the role of hormone replacement therapy in PD, address gender-based inequities in PD care and expand our understanding of PD in SGM and marginalize...
Source: Neurologic Clinics - February 19, 2023 Category: Neurology Authors: Roshni Patel, Katie Kompoliti Source Type: research
Current State of Sex and Gender Influence in Neurology
Sex and gender disparities in health care are frequently encountered.1 The understanding of neurophysiologic differences between men and women and the emerging role of sex-related effect on brain structure and function are very intriguing, and both sex and gender independently play an important role in the prevalence and natural course of common neurologic diseases. Several neurologic conditions affect women differently than men, based on disease susceptibility, prevalence, pathophysiology, as well as clinical symptoms and disease severity. (Source: Neurologic Clinics)
Source: Neurologic Clinics - February 19, 2023 Category: Neurology Authors: Rima M. Dafer Tags: Preface Source Type: research
Neuroimmunological Disorders
Multiple sclerosis is a disease that tends to affect women during their childbearing years. Although relapse risk decreases during pregnancy, patients should still be optimized on disease-modifying therapy before and after pregnancy to minimize gaps in treatment. Exclusive breastfeeding may reduce the chances of disease relapse postpartum, and many disease-modifying therapies are considered to be safe while breastfeeding. Treatments for other neuroimmunologic disorders such as neuromyelitis optica spectrum disorder, myelin oligodendrocyte glycoprotein antibody-associated disease, neurosarcoidosis, and central nervous syste...
Source: Neurologic Clinics - February 14, 2023 Category: Neurology Authors: Edith L. Graham Source Type: research
Neuro-Oncology in Women
Sex differences play a large role in oncology. It has long been discussed that the incidence of different types of tumors varies by sex, and this holds in neuro-oncology. There are also profound survival sex differences, biologic factors, and treatment effects. This review aims to summarize some of the main sex differences observed in primary brain tumors and goes on to focus specifically on gliomas and meningiomas, as these are two commonly encountered primary brain tumors in clinical practice. Additionally, considerations unique to female individuals, including pregnancy and breastfeeding, are explored. This review sheds...
Source: Neurologic Clinics - February 14, 2023 Category: Neurology Authors: Lauren Singer, Ditte Primdahl, Priya Kumthekar Source Type: research
Women and Ischemic Stroke
Although men are at higher risk of stroke throughout most of their lifespan, the incidence of stroke in women climbs with age, increasing after menopause and rising sharply after 85 years. This, combined with women's longer life expectancy, results in most of the stroke deaths occurring in women. In addition to accounting for a larger proportion of strokes, women may also suffer a survival disadvantage, which may be due to several factors. In many families, women are the primary caretakers. When they become disabled, there may be limited options to care for them. Others suggest that some of the disparities in stroke outcom...
Source: Neurologic Clinics - February 13, 2023 Category: Neurology Authors: Laurel Cherian Source Type: research
Gender Issues in Epileptic Patients
Treatment approaches for epilepsy for both women and men are similar, however, there are special aspects that must be considered when caring for women with epilepsy. This includes how hormonal fluctuations may affect seizure frequency, contraception, and potential drug –drug interactions, and pregnancy planning to minimize and potentially mitigate any adverse neurodevelopmental outcomes and major congenital malformations. Adequate counseling for women across the lifespan can help prepare women for the future and optimize outcomes. (Source: Neurologic Clinics)
Source: Neurologic Clinics - February 13, 2023 Category: Neurology Authors: Maggie L. McNulty Source Type: research
Neurology of Systemic Disease
Sex differences exist within the neurologic complications of systemic disease. To promote new avenues for prevention and develop novel therapeutics, we highlight the role of sex in differential outcomes to infectious disease and cardiac arrest and educate the reader in paraneoplastic presentations that may herald underlying malignancies in women. (Source: Neurologic Clinics)
Source: Neurologic Clinics - February 11, 2023 Category: Neurology Authors: Faten El Ammar, Zachary B. Bulwa Source Type: research
Educating Residents and Students in the Clinic
Training of students and residents in outpatient settings requires adequate exposure to a broad range of neurologic diseases. A competency-based method has been frequently used to provide a framework for the design and assessment of medical curriculums. However, it is the responsibility of the faculty within a medical school to design the curriculum and ensure its quality. In this article, we review learning objectives, assessment of core competencies, the current status of outpatient neurology education, and the flaws that may affect its quality. We also discuss potential strategies and approaches for the improvement of e...
Source: Neurologic Clinics - November 16, 2022 Category: Neurology Authors: Erin Furr Stimming, Madhu Soni Source Type: research
Trigeminal Neuralgia
Trigeminal neuralgia is characterized classically by recurrent, evocable, unilateral brief, electric, shocklike pains with an abrupt onset and cessation that affects one or more divisions of the trigeminal nerve. In recent years, the classification of trigeminal neuralgia has been updated based on further understanding. In this manuscript, the authors aim to explain the current understanding of the pathophysiology of trigeminal neuralgia, current diagnosis criteria, and the pharmacologic management and surgical treatments of options currently available. (Source: Neurologic Clinics)
Source: Neurologic Clinics - November 16, 2022 Category: Neurology Authors: Anthony K. Allam, Himanshu Sharma, M. Benjamin Larkin, Ashwin Viswanathan Source Type: research
Outpatient Neurology
NEUROLOGIC CLINICS (Source: Neurologic Clinics)
Source: Neurologic Clinics - November 16, 2022 Category: Neurology Authors: Everton Edmondson, Doris Kung Source Type: research
