Neurology

Neurologists and physicians writing on KevinMD about the brain: dementia and Alzheimer's disease and the biomarkers that now find it early, stroke and what recovery really allows, autism, Parkinson's disease, gait and balance as vital signs, and caring for a spouse or parent with a neurological illness. Three maintained records draw on this archive: Aging and dementia: what physicians say, in their own words, Heart disease: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.

How to build a dementia care pathway, not a referral sheet

Gerald Kuo

Health Policy

September 22, 2026

On the 13th floor of the Jen Chi station-front building in Taipei, a school bell rings. The room does not feel like a hospital.

Older adults move through simple exercise, cognitive activities, music, conversation, and the small rituals that make a day feel like a day. Some need prompting. Some repeat a question. Some are stronger than their families expected. Nearby, caregivers finally have a little room to breathe.

What stays with …

AI in dementia care could give doctors time to listen

American Brain Foundation

Conditions and Diseases

September 15, 2026

The questions a doctor asks a patient and their family are particularly important for a diagnosis in Alzheimer’s disease and related dementias, but the demand for care is rapidly outpacing the supply of clinicians, and the time to truly listen keeps shrinking. My colleagues and I have been testing a possible way to protect that conversation: a voice-based artificial intelligence “agent” that interviews patients before they ever see a clinician, …

Post-stroke pain management: what the 2026 guidelines say

Kayvan Haddadan, MD

Conditions and Diseases

September 12, 2026

Pain management is rarely a blanket approach. Effective relief depends on the specific type of pain, its underlying mechanism, the patient’s comorbidities, age, functional goals, and overall clinical context. This principle is especially important after stroke, where pain is common, often under-recognized, and can significantly hinder rehabilitation, sleep, mood, and quality of life.

Stroke survivors experience several distinct pain syndromes. Distinguishing them matters because treatments differ.

Central post-stroke pain (CPSP)

Central post-stroke pain …

Sensory processing in autism and the brain’s volume control

Josette Pelatan, PhD

Conditions and Diseases

September 10, 2026

For most of my life, I knew I was experiencing the world differently.

Before I understood the words someone was saying, I noticed subtle changes in their tone of voice. I registered the hum of fluorescent lights, the texture of clothing, faint odors that others seemed unaware of, and shifts in a room’s emotional atmosphere. My attention was drawn almost automatically to inconsistencies, patterns, and small details that often escaped those …

Balance as a vital sign: 4 reasons to track it routinely

Sanjeev Sharma, MD, MBA

Conditions and Diseases

September 9, 2026

Physicians routinely track measures that can reveal changes in a patient’s health long before those changes become symptomatic. Blood pressure, heart rate, weight, and other familiar measures have earned a place in clinical care because following them over time provides information that can guide intervention. For an aging population, balance deserves similar attention because it can reveal changes in functional health before they result in injury or loss of independence.

Balance …

Gait as a vital sign: What a 20-second video reveals

Narinder Singh Parhar, MD

Conditions and Diseases

September 3, 2026

Medicine has become remarkably sophisticated at measuring the human body. We measure blood pressure, heart rate, temperature, oxygen saturation, laboratory values, imaging findings, and increasingly complex biomarkers. Yet one of the richest sources of information about a patient’s functional health may pass directly in front of us every day without being systematically captured:

How the patient walks.

I believe a brief gait video deserves consideration as a functional vital sign. A 10- …

Is chronic stroke recovery really capped at 6 months?

Leo Petrossian, PhD, MBA

Conditions and Diseases

September 1, 2026

For decades, stroke survivors have been told the same thing: Whatever function you haven’t recovered in six months, you likely never will. That assumption is now being dismantled. The American Stroke Association estimates that 1 in 4 American adults will experience stroke in their lifetime, often with devastating consequences. The 2011-2018 National Health and Nutrition Examination Survey estimated approximately 5.7 million U.S. adults living with at least one disability due …

Understanding a dementia diagnosis when you feel lost

Tim Hayden

Conditions and Diseases

August 25, 2026

My mother was diagnosed with dementia when she was 66. What followed was a five-year decline that ended when she died at 71. Years later, my father received the same diagnosis.

I am telling you this not because it is unusual. It is not. It is because for most of a decade, my family lived inside the exact gap I eventually built a company to fix: the space between getting a …

Caring for my wife with Alzheimer’s taught me to surrender

Scott Yates

Conditions and Diseases

August 24, 2026

An excerpt from Everything Is Going to Be All Right: A Faith Journey Through Alzheimer’s.

Listening to Christian music in her room in the nursing home, I turned to my wife. “Isn’t it going to be amazing when we see Jesus face-to-face?”

She smiled and leaned forward to look directly into my eyes. She told me, “Everything is going to be all right.”

Crystal clear. In a season when words are garbled …

The system isn’t broken. It was built this way.

Melissa Houser, MD

Conditions and Diseases

August 23, 2026

An excerpt from A Failure of Imagination: How the Healthcare System Fails Neurodivergent People—and What We’re Doing Instead.

I’m a physician. That’s the only formal training I have. When I set out, I didn’t know how to start or run a nonprofit. I didn’t know how to build a medical practice, let alone a model of health care delivery from scratch. But I did know this: If you want to …

Concussion counts miss what repetitive head impacts do

Julian Bailes, MD

Conditions and Diseases

August 21, 2026

During this summer’s World Cup, we all watched players redirect the ball with remarkable precision. Our first reaction to a well-executed header was probably, “What a play.” But as a neurosurgeon who has spent much of my career studying head trauma among athletes, I also view those moments through a more clinical lens.

The concern around head impact is not limited to a dramatic collision that produces symptoms or a diagnosed …

A stroke survivor’s case for disability in medical training

Hamna Irfan, RT

Medical Education

August 21, 2026

As a radiology technician and a stroke survivor, my professional journey has been deeply shaped by my personal experiences. In clinical education, we often focus on technical proficiency, but we rarely discuss the structural and social barriers faced by health care professionals with disabilities. This reflection is not a piece of research, but a call to re-evaluate our approach to inclusion in medical training.

When I was just six years old, …

Bias in peer review can protect institutions, not evidence

Ronald L. Lindsay, MD

Conditions and Diseases

August 16, 2026

Peer review is often described as the safeguard of scientific integrity: the mechanism that ensures rigor, accuracy, and accountability. In medicine, we teach trainees that peer review is the backbone of trustworthy science. But peer review is also a human system, shaped by the same institutional pressures, assumptions, and blind spots that shape clinical practice. When those pressures dominate, peer review can stop protecting evidence and start protecting institutions. My …

The neuroscience of physician burnout nobody teaches

Alex P. Michael, MD

Physician

August 16, 2026

There is a moment every surgeon remembers.

A minute earlier, it was an ordinary case, someone complaining about the overnight appendectomy they had to come in for, someone else describing upcoming vacation plans. Yacht rock playing quietly in the background. Then everything quickly changes. A vessel tears, filling the field with blood midsentence. The anesthesiologist’s tone sharpened as the blood pressure began to fall, and every eye in the room turned …

Why every ICU needs point-of-care EEG at the bedside

Chitra Venkatasubramanian, MD

Conditions and Diseases

August 15, 2026

As a neurocritical care and stroke neurologist at a leading academic medical center, I’ve spent over two decades on the front lines, working with major community hospitals in triaging and receiving critically ill patients from the emergency department (ED) and intensive care unit (ICU). In my world, “Time is Brain” is not just a slogan but a mandate.

Whether it’s stroke or seizure or any acute brain injury, rapid detection of …

Medicaid discrimination starts with a misread rule

Ronald L. Lindsay, MD

Conditions and Diseases

August 9, 2026

More than a decade ago, at a national pediatrics meeting, I was introduced to the Screening Tool for Autism in Toddlers-Primary Care (STAT-MD). I completed certification immediately and bought my own kit. I didn’t know it then, but that tool would become the clearest lens through which I would understand why some diagnostic systems thrive, and why others collapse under the weight of their own misunderstanding of CMS rules.

Before STAT-MD, …

The genetic data Charcot-Marie-Tooth research overlooks

Dr. Priyanshu Agrawal

Conditions and Diseases

August 8, 2026

Imagine trying to complete a complex jigsaw puzzle when most of the pieces are missing. For decades, that has been the reality of genetic research in Charcot-Marie-Tooth (CMT) disease. Much of what the world knows about CMT has been built from Western patient populations, creating a knowledge base that is valuable but incomplete. If we are serious about developing treatments that work for everyone, the global scientific community must pay …

Why clinical judgment alone is not enough for autism

Ronald L. Lindsay, MD

Conditions and Diseases

August 8, 2026

A recent JAMA Pediatrics article concludes that the Autism Diagnostic Observation Schedule (ADOS) is “generally not required” for diagnosing autism in young children. The authors report 90 percent agreement between a clinician’s initial diagnosis and the diagnosis made after reviewing ADOS results. They argue that experienced developmental-behavioral pediatricians (DBPs) can diagnose autism accurately without structured tools.

That conclusion may hold inside the eight academic centers included in the study. It does …

Dance and brain health: a physician’s prescription

Geeta Maker-Clark, MD

Conditions and Diseases

August 5, 2026

In many shamanic societies, if you came to a medicine person disheartened, dispirited, or depressed, they would ask one of four questions: When did you stop dancing? When did you stop singing? When did you stop being enchanted by stories? When did you stop being comforted by silence? I think about those questions often as a physician, and almost nothing I was trained to do begins with any of them.

Most …

Why there is no test for mental illness, and won’t be

Nebyou Belay, MD

Conditions and Diseases

August 3, 2026

A mother sat across from me recently, her twelve-year-old beside her, and asked a question I have heard in one form or another hundreds of times over two decades of practicing psychiatry: “Can we just get her tested? I want to know, scientifically, what she has.”

She wasn’t asking for a diagnostic interview. She was picturing something closer to what happens elsewhere in medicine when a symptom is uncertain: a scan, …

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