Preface
Differential Diagnosis in Neurology grew out of my taking daily morning report with neurology residents and examining patients in front of colleagues over the last 30 years. Dr. Eugene Stead, who was Chairman of Medicine for many years at Duke, taught me the importance of the fine points of the history and the significant details of the examination that separate one disease from another. Dr. G. Milton Shy was a master diagnostician melded each disease with its scientific basis and proposed diagnostic possibilities. It was a great privilege rounding with both and I hope a trace of their medical knowledge and scholarship comes through in these pages.
The essence of “differential diagnosis” is “splitting” rather than “lumping”. It requires bringing knowledge to the table and then adding experience.
The book is meant to be a skeleton that will give the clinician a general background with regard to the disease at hand. Molecular genetics, physiology and biochemistry will uncover mechanisms and associations that will further expand differential diagnosis of all neurological disease. There is no bibliography as it would be grossly out-of-date within one year. The reader is expected to utilize digital libraries to augment the basic information with the latest mechanism and treatment. It is hoped that the clinician will use the volume as a workbook in which new entities are added or older classifications revised.
A possible strength of the volume is that one person wrote it and therefore it is somewhat uniform. Its glaring weakness is that one person can not know the depth of information needed to be comprehensive for each entity described.
Acknowledgment
I gratefully acknowledge my present and former colleagues, fellows, residents and students who have enriched my career in medicine.
I thank my administrative assistants, Janet McCracken and Barbara Romm for helping me in all aspects of the project.
I am delighted that I actually finished the project Yale Altman suggested many years ago and Anne Marie de Rover saw through to completion.
I am especially pleased to acknowledge the support of Amy and Mark Tilly who made the volume possible.