Introduction

In this issue of Practical Neurology, Araújo and colleagues provide two case examples to illustrate the not-uncommon clinical situation when patients under the care of a neurological subspecialist present with, or develop, a neurological disorder deemed to be outside of that neurologist’s subspecialty.1 Their proposed solutions include thoughtful communication and appropriate referral to a subsequent consultant, building interdisciplinary ‘bridges’ between the ‘islands’ of subspecialty neurological expertise, as specifically illustrated by their two case examples. The authors also recognise and emphasise the critical role that general neurologists can play as an alternative and even optimal ‘mainland’ solution in this scenario, given their ‘broader range of expertise’ and less restrictive neurological frame of reference.1

In this accompanying opinion piece written from the standpoint of a general neurologist, I provide additional support for preferential and more frequent involvement of the general neurologist when a patient’s diagnosis seemingly evades the diagnostic expertise, experience or interest of the subspecialist.