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Internet educational tools are often full of fancy graphics displays but short on thought. The Baylor College of Medicine’s neurology department’s case of the month site is the antithesis of this approach. Each month a case that residents have found interesting is posted on this simple, well thought out site.
First a detailed history and examination is presented for each case, from which it is sometimes possible to make a clinical diagnosis. It is usually necessary, however, to proceed to the test result page. Here, a plan of investigation can be drawn up, by choosing 14 tests from a list of about 80 possible laboratory, radiological, and neurophysiological studies. Radiological and pathological images can be reviewed and, at the cost of one investigation, an interpretation provided.
Hopefully, with a careful analysis of the history and examination findings, and interpretation of the test results, you can reach a diagnosis. Your diagnosis is then submitted by email. Later, the correct diagnosis is sent out and, if you sign up for the mailing list, you are told when new cases are posted. There is a short multiple choice test following each case. There are now more than 70 old cases to work through, each with a detailed discussion—anyone who enjoys clinical conundrums should start with case number 64.
There are not many case based neurology websites, and of those that are available, this is by far the best. An old neurologist said that given a spare half an hour, one should see a patient rather than read a paper—perhaps if there are no patients to hand 30 minutes at www.bcm.tmc.edu/neurol/case.html would be time well spent.