Patient demand continues to outpace growth of the neurology workforce, especially in its subspecialties such as movement disorders. Various strategies have been deployed to address this. The COVID-19 pandemic accentuated the mismatch by propelling telemedicine and access demands to the forefront. Previously, we reported improving general neurology access using a physician-advanced practice provider (APP) team model. Here, we share our experiences of piloting a similar model in subspecialty care (movement disorders) between September 1 and December 17, 2020. Before the pilot, the wait time to be seen by movement disorders subspecialists exceeded four months. Our data show marked improvement in new patient access (23.8% improvement as well as 214% increase in number of new patients seen) with excellent patient acceptance. Our approach and the lessons learned may be useful to address access for other neurology subspecialties.
Neurologic involvement has been reported in primary Sjogren’s syndrome (SS) in approximately 10–25% of cases 1, 2, 3. Peripheral neuropathy is a major neurological manifestation of Sjögren's syndrome 4 and its etiology has been considered to be vasculitis in the peripheral nerves 2. While neuropathic symptoms of SS can be varied, it is unusual to have two different types of neuropathic presentations simultaneously in a patient. We describe a case of Sjogren’s syndrome presenting with autonomic symptoms who was noted to have large fiber neuropathy on EMG and inflammatory changes on nerve biopsy.
Background: Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative spongiform encephalopathy. Findings are usually consistent with basal ganglia and frontal lobe destruction. However in certain variants, the clinical and diagnostic findings can differ. This case illustrates the occipital findings of the rare Heidenhain variant of CJD.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.