Cary Groner

Neurologists have always faced tough decisions when it comes to sudden unexpected death in epilepsy (SUDEP). Not the least of these is how to explain to bereaved family members what happened to their loved one and how it could have been prevented, because no one really knows.

Obesity has long been recognized as increasing the risk of associated conditions, including hypertension, diabetes, and cardiovascular disease. Now another disorder has been added to this chilling list: Alzheimer disease (AD).

Patients with chronic pain have always posed big challenges for neurologists, both in diagnosis and in treatment strategies. Why and how neurologists treat pain, however, is dynamically changing.

Since its 1999 appearance in New York, West Nile virus (WNV) has spread relentlessly westward each year, opening up new fronts in the Midwest and the mountain states until pummeling California in the summer of 2004. The flavivirus, which is spread primarily by mosquitos, affects a variety of animals, including humans, horses, and nearly 300 bird species. As of October 15, 2004, about 940,000 Americans had been infected, of whom 190,000 became ill and 6790 developed WNV's most feared complications: neuroinvasive disease, including meningitis, encephalitis, and acute flaccid paralysis.1

Neurologists, neurosurgeons, and other physicians are feeling a squeeze, and it isn’t the magical shrinking belts that follow holiday feasting. It is rising medical liability premiums. Some doctors are leaving states where escalating liability rates are making it harder to keep a practice open. In early November, no one was performing brain surgery in southern Illinois because the last holdout, B. Theo Mellion, MD, of Carbondale, left when his malpractice insurance carrier refused to renew his coverage and those carriers willing to provide coverage were quoting annual premiums of $200,000 to $300,000