Welcome to the Clinical Reasoning Subsection!

The art of clinical reasoning is the essence of what makes us physicians.  As trainees we learn to sift through a multitude of data to glean the relevant information, and then analyze that information to develop a hypothesis about our patient which will later be tested and revised.  Part of the training process is not only learning the facts of medicine but also developing our intuition and ultimately learning the proper balance between intuitive and analytical reasoning to diagnose and treat our patients.

How is it that we develop these clinical reasoning skills?  One way is by learning from our faculty and colleagues.  We learn how our mentors think and approach cases by discussing patients with them, often asking them to review their own decision-making process.  The Clinical Reasoning subsection is designed to mirror and augment these discussions with a focus on clinical cases of uncommon presentations of common neurological disorders and also typical presentations of more exotic disorders.

In the Clinical Reasoning subsection, the cases are typically presented serially in 2-4 segments.  At the conclusion of each section are questions designed to challenge the reader to think through the differential diagnosis, next diagnostic steps, or treatment options.  The answers to these questions should be found in the subsequent section, making the authors’ expert clinical reasoning explicit to the reader.   The article concludes with a summative discussion of the case including key teaching points.

Have you come across a case that generated significant discussion surrounding the differential diagnosis or treatment decisions?  We hope you will share your case with us and help others learn from your case as well!