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  • Training Matters
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Clinical neurophysiology for neurologists: the importance of being trained

Nature Clinical Practice Neurology volume 3, pages 116–117 (2007)Cite this article

“Reciprocal recrimination between cousins” is a phrase that could be used to describe the relationship between neurologists and clinical neurophysiologists. On the one hand, neurologists often reproach clinical neurophysiologists with claims that they have made a separate discipline out of a simple neurological subspecialty, to which clinical neurophysiologists respond that the majority of their work is concerned with problems that a neurologist will hardly ever encounter, such as deafness, retinopathies, sleep apneas or surgical monitoring. The neurologist would argue that such problems, even in the context of other specialties, remain intrinsically neurological, and in turn, the clinical neurophysiologist might remind his or her colleague that the role also involves work in areas that are separate from neurology, such as orthopedics and rheumatology. He or she might also point out that clinical neurophysiologists—not neurologists—persuaded insurance companies that intraoperative neurophysiological monitoring of patients was essential to decrease surgical morbidity.1,2 Many neurologists conduct clinical neurophysiology (CN) procedures, but clinical neurophysiologists often consider neurologists to be incompetent in this area because they have never been adequately trained.

Is CN merely a subspeciality of neurology? This position is difficult to uphold. The contents of a subspecialty should—to a certain degree—be included in the curriculum of the 'mother' discipline; however, most of the scientific and technical background needed to become a certified clinical neurophysiologist, such as training in biophysics and electronics, and also in more-practical fields such as statistics, functional neuroanatomy or sleep physiology, is absent from a neurologist's curriculum. In addition, CN has a number of other clinical associations, such as those with orthopaedics, rheumatology, respiratory medicine, and ear, nose and throat medicine that make it no more of a subspecialty of neurology than are neuroradiology or neuropathology. Following this line, a number of European nations—led by those in Scandinavia, but also including countries such as Spain and Italy—have defined CN as a full specialty,3 a notion endorsed by the European political community, who have declared CN an European Medical Specialty.4

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  1. INSERM EMI-342, University Claude Bernard, Lyon 1, Hôpital Neurologique, rez-de-jardin, Hypnologie, 69003 Lyon, France larrea@univ-lyon1.fr

Authors and Affiliations

  1. L Garcia-Larrea is a clinical neurophysiologist, research director at the Insitut National de la Santé et de la Recherche Médicale (INSERM), Lyon, and Head of the 'Central Integration of Pain' Unit at the Neurological Hospital in Lyon, France.,

    Luis Garcia-Larrea

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  1. Luis Garcia-Larrea
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Garcia-Larrea, L. Clinical neurophysiology for neurologists: the importance of being trained. Nat Rev Neurol 3, 116–117 (2007). https://doi.org/10.1038/ncpneuro0405

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