دانلود کتابچه بالینیی پزشکی عصبی عضلانی – ویرایش دوم

I have often said that among all nonsurgical specialties, primary care providers are least comfortable managing neurological problems, and that among all neurological subspecialties, neurologists are least comfortable managing neuromuscular problems. To the extent that this may be true, it may reflect deficiencies in medical education. In the United States, where I have trained and worked until now, clinical neurology is sometimes optional, and rarely emphasized, in undergraduate medical education. Because neurology is not considered a subspecialty of internal medicine, specialists in internal medicine have less direct exposure to neurologists than to colleagues specializing in diseases of other organ systems. As for neurologists’ perception of neuromuscular medicine, this problem too may be a consequence of deficiencies in medical education. Postgraduate training in neurology in the United States currently involves an inordinate amount of time spent in hospitals, whereas neurologic practice does not. As a result, trainees in neurology quickly become competent at managing acute stroke, encephalopathy, and status epilepticus but are often baffled by the most common neuromuscular disorders. This front-loading of training in hospital practice also biases trainees’ choice of mentors and fellowships and often results in a knowledge gap when they enter practice. This book is designed to address these problems. Our target audience is postgraduate trainees in neurology, but to borrow a phrase from houses of worship, all are welcome. Perhaps an orthopedic surgeon interested in a better understanding of the causes of leg weakness will seek guidance here, or a primary care practitioner in a community with limited access to neurologists would like to learn more to help their patients. As for our tactical approach, it is as follows: we believe the best way to achieve our objective is to deliver all the essential information in one brief text. If you read this whole book and are reasonably attentive while doing so, you will have a framework for the approach to neuromuscular diagnosis and management and will have read, at least once, everything you need to know if you are in our target audience. At least, that’s our goal. We hope we succeed. Thank you for choosing to learn about this extraordinary subspecialty. I would like to acknowledge and thank Ben Bornzstein, Ph.D., for his help and encouragement, my co-authors, for their patience and commitment, and my wife, Missy Walk, for her guidance and wisdom.