Emerging subspecialties in neurology: neuropalliative care.

Abstract

Palliative medicine, as defined by World Health Organization, is the specialty that recognizes and attempts to prevent or alleviate physical, social, psychological, and spiritual suffering.¹ Understanding the principles of palliative care should be an essential component of neurologic training, as the trajectory of many neurologic illnesses is progressive and incurable.² Given the delicate nature of many of the conversations that neurologists have with patients at the time of diagnosis or during acute illness and hospitalization, expertise in discussing a patient's wishes, handling difficult conversations, and providing adequate symptom-based management is critical. Neurologists are often viewed as consulting physicians; however, patients living with chronic neurologic diseases such as multiple sclerosis, dementia, Parkinson disease, amyotrophic lateral sclerosis (ALS), or sequelae of stroke often consider their neurologist as one of their primary physicians. Therefore, neurologists are positioned in both the outpatient and inpatient care settings not only to address symptoms referable to the disease but also to improve overall quality of life for patients and caregivers and to facilitate end-of-life care.