Emerging Subspecialties: Neurorehabilitation

If not newly emerging, the subspecialty of neurorehabilitation is definitely burgeoning, and neurology trainees may not be aware of the exciting career opportunities within the field. The contemporary neurology resident is trained in a discipline that has changed dramatically in the last two decades. The modern day neurologist has a slew of treatment options at hand, from r-tPA to multiple immune-modulating medications, and practices with this arsenal of treatments from the emergency room to the outpatient clinic. Despite these advances, many patients still leave the hospital or clinic with debilitating cognitive and sensorimotor impairments and ask what we can do to help them walk or use a hand again or regain enough function to return to their ordinary life activities. Some want advice regarding the prevention of further neurologic deterioration. The discipline of neurorehabilitation is the field concerned with these reminders of past and present neurologic illness and the improvement of neurologic function. Yet it is not uncommon for many neurology residents to get only a glimpse of this discipline, caught perhaps during a short spinal cord or traumatic brain injury rotation. Beyond the first 72 hours of acute stroke care, most residents will have no interaction with patients to help them swallow, walk, reach and grasp, or manage language and hemineglect disorders. For many residents and practicing neurologists, the team-based approach to therapy characteristic of rehabilitation medicine, and the lack of focus on “localize the lesion” discussions, may seem foreign and fail to inspire a vision of …