Response to "Neurology remains a clinical discipline"
AmarDhand, Assistant Professor, Department of Neurologydhanda@neuro.wustl.edu
Amar Dhand, St. Louis, MO; John Engstrom, San Francisco, CA; Gurpreet Dhaliwal, San Francisco, CA
Submitted November 22, 2013
We appreciate Dr. Sethi's comments. Many diagnoses in neurology, like Parkinson disease, remain dependent on the clinical domain. However, other conditions are only suggested by clinical findings but absolutely require neuroimaging (e.g., multiple sclerosis) or laboratory analysis (e.g., meningitis) to make the diagnosis. As we observed in these disorders, the imaging and laboratory components were equally as important as the information elicited by the history and exam. Therefore, we caution against advancing an overly classical view of neurologic diagnosis; one of the important findings from our study was the variance among disease types. We agree with Dr. Sethi that similar studies in other settings would be valuable.
For disclosures, contact the editorial office at journal@neurology.org.
We appreciate Dr. Sethi's comments. Many diagnoses in neurology, like Parkinson disease, remain dependent on the clinical domain. However, other conditions are only suggested by clinical findings but absolutely require neuroimaging (e.g., multiple sclerosis) or laboratory analysis (e.g., meningitis) to make the diagnosis. As we observed in these disorders, the imaging and laboratory components were equally as important as the information elicited by the history and exam. Therefore, we caution against advancing an overly classical view of neurologic diagnosis; one of the important findings from our study was the variance among disease types. We agree with Dr. Sethi that similar studies in other settings would be valuable.
For disclosures, contact the editorial office at journal@neurology.org.