Ibrahim Imam TOOLS OF THE TRADE

The 10 most viewed neurology videos on Youtube

Learning neurology is a very visual and hands-on affair. Neurological assessments are complex and steeped in ritual. Tomes have been written about the best way to take a neurological history. A lot of ink has been spilt in describing great eponymous neurological signs. But nothing comes close to learning from the masters. Observation and apprenticeship have been key to transmitting neurological skills since the time of Charcot.

“Une leçon clinique à la Salpêtrière” by André Brouillet – Photo prise dans un couloir de l’université Paris V. Licensed under Public Domain via Commons – https://commons.wikimedia.org/wiki/File:Une_le%C3%A7on_clinique_%C3%A0_la_Salp%C3%AAtri%C3%A8re.jpg#/media/File:Une_le%C3%A7on_clinique_%C3%A0_la_Salp%C3%AAtri%C3%A8re.jpg

There is no doubt that neurological disorders are mushrooming, and the skills required to master them are becoming more intricate. But this has flamed rather than dampened the desire of learners to acquire them…by all means possible. But only the privileged can witness the artistry on display at the grand rounds of Queen’s Square; the exhibition of finesse in the teaching halls of the Pitié-Salpêtrière; or the sublime virtuosity evident on the wards of The Brigham.

Reunion of neurologists at the Salpêtrière hospital. Photograph, 1926 http://wellcomeimages.org/indexplus/obf_images/03/de/5ebbbcfa56d021dda69b21761b96.jpgGallery: http://wellcomeimages.org/indexplus/image/M0005197.html, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=36322408

 

What then to do in the digital age? Online videos of course. These are now playing a major, perhaps unconventional, teaching role in neurology. 

The Neurology Lounge has already reviewed the changing terrain of neurology, throwing a light on the increasing role of social media, online video sites, and online databases, all competing and complementing the classroom and the clinic. Our previous posts on this subject include:

Outstanding neurology video channels and sites

What is the state of neurology on the blogosphere?

How is social media enriching neurological practice?

Which are the most reliable neurology reference sources?

Which are the most useful neurological applications?

Youtube remains the clear leader when it comes to videos. Buried among the cat and dog snippets, hiding behind the crazy stunts and funny clips, and camouflaged by the ubiquitous vlogs, are many enlightening neurological stuff. And of the many neurology videos on Youtube, some have attracted more attention than others. Is there a secret? There’s only one way to find out!

Here then are the top 10 most viewed neurology videos on Youtube:

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If there is any lesson here, it’s all about the simple things. No complicated syndromes, no convoluted guidelines. In some cases, no master at all! Viewers just want to see the complex simplified!

PS. To widen the variety of video sources, I have restricted each source to one video.

 

Ibrahim Imam CHECKLISTS, GENERAL NEUROLOGY, TOOLS OF THE TRADE

What do neurology information seekers really want?

A few months ago, Neurochecklists set out to discover how people go about searching for neurology information. We therefore carried out an online survey of neurology information users. We asked 10 critical questions about the who, what, where, why, and how of neurology information quest.

https://pixabay.com/en/questions-who-what-how-why-where-1328465/

 

We asked these question specifically to guide a major Neurochecklists upgrade. This knowledge is, after all, critical for a website which has set out to be the best source of clear, concise, and comprehensive neurology information. But we needed help to know what really matters to people when they go foraging for neurology. What do they really want, and how do they go about satisfying their need?

Search Key. GotCredit on Flickr. https://www.flickr.com/photos/gotcredit/32943606783/

 

The response we got was heart-warming; about 190 people answered our online questions. Below are the questions along with the insights we gained from the answers.

Q&A. opensource.com on Flickr. https://www.flickr.com/photos/opensourceway/5556249000

 

Who searches for neurology information?

More than 50% of our responders were consultant neurologists, and about 15% were medical consultants. Neurology trainees constituted about 7%. The range of users is however quite broad, including nurses, surgeons, medical students, and patients! See the breakdown in the pie chart below:

Insight: There are diverse neurology information seekers!

How often do we forage for neurology information?

Neurology information is in high demand, with >50% of responders seeking information at least once a day, and >80% at least once a week. Below is the breakdown:

Insight: There is a huge craving for neurology information!

Where do we go when we need neurology information?

Online websites are by far the most popular source of quick neurology information, accounting for >50% of responses. This is followed by journals which account for just over 25% of responses. Very few responders access textbooks, handbooks, downloadable apps or online videos. Below is the breakdown:

Insight: Neurology source information is now mainly online

Where are we when we most crave neurology information?

In a question which allowed multiple answers, the clinic was by far the most common setting for looking up neurology information. We however also have a strong urge for neurology on the ward, and at home! Below is the breakdown:

Insight: The need for neurology information has no boundaries

Why do we access neurology information?

The most frequent reasons responders access neurology information were to answer clinical questions and for personal study. Other reasons were to aid discussions with patients, and to look for relevant references.

Insight: the checklist approach is the best solution

What devices do we use to access neurology information?

In another multiple answer question, responders most often use their phones to access online neurology information. Laptops and desktops are also favoured, but tablets much less so.

Insight: neurology information must be device-compatible

What features do we most favour in an online neurology database?

We asked what features responders most desire in an online neurology database, and the front-runners here are accuracy and currency of information, followed by conciseness, adequacy, ease of navigation, and link to references.

 

Insight: Neurochecklists is on the right track

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We wish to extend our thanks to everybody who took part in the survey, including the many who attempted it after the closing date! We have taken all the responses on board, and we have been working night and day to provide an enhanced Neurochecklists. Watch out for our next blog post to find out the changes we will be launching soon. Neurology seekers, watch this space!

By Ansonlobo – Own work, CC BY-SA 4.0, Link
Ibrahim Imam APPS, CHECKLISTS, CUTTING EDGE, GENERAL, GENERAL NEUROLOGY, TOOLS OF THE TRADE

How will neurology checklists unlock excellent practice?

Launching neurochecklists

After 5 years of data gathering and sorting, neurochecklists launches today. This is a web-based application which covers the spectrum of neurological practice. I was prompted by Atul Gawande‘s call to physicians to develop checklist-driven medicine, as I discussed in my previous blog post, What is the value of checklists in medical practice? Conceived in libraries and coffee shops, lay-bys and terminals, neurochecklists is the culmination of a vision to commit the whole of neurology to checklists.

 

Neurochecklists image

 

What exactly is neurochecklists?

Neurochecklists is a comprehensive and easy-to-search database consisting of thousands of checklists. It is conceived as a mobile resource to aid all cadres of medical professionals. It has 18 categories, each consisting of chapters divided into topics. All checklists are brief and divided into sub-checklists as required. Users may explore topics either through the search boxes available on all webpages, or via the Index. Each checklist is fully referenced, and all articles are hyperlinked to their PubMed abstracts, and books to their Amazon.com page.

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How can neurochecklists help neurological practice?

1. By quickly checking up a topic in the clinic or on a ward round

And you haven't been to your doctor because? Alex Proimos on Flikr. https://www.flickr.com/photos/proimos/6870109454
And you haven’t been to your doctor because? Alex Proimos on Flikr. https://www.flickr.com/photos/proimos/6870109454

2. By helping the preparation of presentations or teachings

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3. By making reading for examinations and researching a topic easier

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4. By complementing the search for relevant and up-to-date references

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5. Facilitating neurology discussions with patients 

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What exactly does neurochecklists contain?

Neurochecklists is extensive, covering all the core neurological subspecialties:

  • Disorders of Cranial Nerves
  • Disorders of Cognition
  • Disorders of Consciousness
  • Neurological Infections and Toxicity
  • Epilepsy
  • Parkinsonism
  • Non-Parkinsonian Movement Disorders
  • Headache Disorders
  • Neuroinflammatory Disorders
  • Anterior Horn Cell Disorders
  • Peripheral Nerve and Radicular Disorders
  • Neuromuscular Junction and Muscle Diseases
  • Stroke
  • Nervous System Tumours
  • Spinal Cord Disorders
  • Autoimmune and Metabolic Disorders
Binaural-beat-digital-drug. Digitalbob8 on Flikr. https://www.flickr.com/photos/44568283@N02/4098316274
Binaural-beat-digital-drug. Digitalbob8 on Flikr. https://www.flickr.com/photos/44568283@N02/4098316274

Neurochecklists also addresses the range of allied neurological specialities such as:

  • Neurophysiology
  • Neurosurgery
  • Neuroradiology
  • Neuropsychiatry
  • Neuroophthalmology
  • Neurootology
  • Pain Disorders
  • General medicine
  • Surgery
  • Pregnancy

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These diseases are all reviewed from diverse perspectives:

  • Epidemiology
  • Genetics
  • Pathology
  • Clinical Features
  • Investigations 
  • Treatment
Human brain illustrated with millions of small nerves. Ars Electronica on Flikr. https://www.flickr.com/photos/arselectronica/13994747444
Human brain illustrated with millions of small nerves. Ars Electronica on Flikr. https://www.flickr.com/photos/arselectronica/13994747444

 

How reliable are neurochecklists?

In developing neurochecklists, I took into consideration the challenges of such a project as discussed in my previous blog, What are the obstacles to creating reliable neurology checklists? Neurochecklists has also gone through a beta-testing stage, and the feedback has influenced the final version. This is however the beginning of the journey to maintain and improve the database. This on-going challenge will require feedback from users which will be invaluable in advancing the app to higher levels.

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What will it cost to access neurochecklists?

Neurochecklists comes with two levels of access. There is a free version which entitles users to 15 free searches a month. There is therefore no excuse not to have a neurochecklists account! To get the maximum benefit of neurochecklists, a premium account is required, and this comes at the equivalent cost of a coffee and cake a month, and even less with an annual subscription.

 

Cake and coffee. Jeremey keith on Flikr. https://www.flickr.com/photos/adactio/4925134798
Cake and coffee. Jeremey keith on Flikr. https://www.flickr.com/photos/adactio/4925134798

 

The reason for paid subscriptions is to help offset the heavy financial cost of app development and future improvement and enhancement plans. One such plan is to develop android and ios platforms. I am however open to suggestions to make this a completely free resource.

 

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Who helped to develop neurochecklists?

Neurochecklists is the result of a collaborative effort in many ways. My wife Zainab has been invaluable in encouraging and supporting me throughout the journey. To Jafaru Dori for invaluable guidance, support and connections. To the bright young men at Studio 14, Stephen, Tobi and Timi for their great imagination and passion for the project. My gratitude to my work colleagues and the hundreds of social media friends who share so much knowledge, much of which has found its way into neurochecklists. And finally my apologies to Aminah, Safiyyah, Ja’far, and Maryam for not having their dad’s full attention for so long. Hopefully it’s been worth the while.

Feedback checklist. AJ Cann on Flikr. https://www.flickr.com/photos/ajc1/9568156463
Feedback checklist. AJ Cann on Flikr. https://www.flickr.com/photos/ajc1/9568156463

How to get to neurochecklists?

If you have so far resisted the dozen opportunities to click on neurochecklists, go on now and click on the image or text below to check it out! Don’t forget to leave your feedback.

Neurochecklists image

  neurochecklists

 

Ibrahim Imam APPS, CHECKLISTS, GENERAL, GENERAL NEUROLOGY, TOOLS OF THE TRADE

What is the value of checklists in medical practice?

Checklists

We all know how important checklists are in our day-to-day lives. We cannot survive the day without a to-do list reminding us of the tasks that make our lives go round. It is clearly not an exaggeration to say we live by the checklist.

Feedback checklist. AJ Cann on Flikr. https://www.flickr.com/photos/ajc1/9568156463
Feedback checklist. AJ Cann on Flikr. https://www.flickr.com/photos/ajc1/9568156463

Airline safety

But checklists perform far more important roles than reminding us to buy the milk, or to pick junior after football practice. Checklists are central to the maintenance of safe practice in many industries. Checklists are best celebrated in aviation where they are indispensable to airline safety.

By Janke - Janke, CC BY 3.0, https://en.wikipedia.org/w/index.php?curid=27079600
By Janke – Janke, CC BY 3.0, https://en.wikipedia.org/w/index.php?curid=27079600

The Checklist Manifesto

Despite their recognised value, checklists are not applied widely enough in medicine. One person who has passionately addressed this shortcoming is Atul Gawande in his highly acclaimed book, The Checklist Manifesto. In this book, the author explored the positive impact of checklists based on his own research into surgical safety. His view of checklists is quite instructive, for example when he says:

  • Checklists translate knowledge into a simple, usable, and systematic form
  • Checklists are quick and simple tools aimed to buttress the skills of expert professionals.
  • Good checklists could become as important for doctors and nurses as good stethoscopes
By Courtesy of the John D. and Catherine T. MacArthur Foundation, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=35497665
By Courtesy of the John D. and Catherine T. MacArthur Foundation, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=35497665

 

The WHO surgical safety checklist

Gawande’s major contribution to patient safety is the development of the acclaimed WHO Surgical Safety Checklist. This simple tool is now a key component of surgical operating procedures globally.

WHO Surgical Safety Checklist. John Sloan on Flikr. https://www.flickr.com/photos/johnlsloan/8485508277
WHO Surgical Safety Checklist. John Sloan on Flikr. https://www.flickr.com/photos/johnlsloan/8485508277

 

Gawande’s own experience of using the checklist shows how important this tool is. He says:

  • I have yet to get through a week in surgery without the checklist’s leading us to catch something we would have missed
  • With the checklist in place, we have caught unrecognized drug allergies, equipment problems, confusion about medications, mistakes on labels for biopsy specimens
  • We have made better plans and been better prepared for patients

Beyond the operating room

Atul Gawande made the important observation that checklists have potential applications “beyond the operating room“. He said “…there are hundreds, perhaps thousands, of things doctors do that are as dangerous and prone to error as surgery“. He gave several examples of these such as the evaluation of headache, chest pain, lung nodules and breast lumps. He also pointed to the treatment of heart attacks, strokes, drug overdoses, pneumonias, kidney failures, seizures, and headache.

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Addressing Gawande’s challenge

Gawande appreciates that all medical activities involve risk, uncertainty, and complexity. His simple recommendation is to commit them all to checklists. He urges the medical fraternity to seize the opportunity and do this. Apart from Anaesthesia which is probably ahead of the curve, there are only few medical checklists such as:

By http://wellcomeimages.org/indexplus/obf_images/7e/71/50f93b8f2f172d5b4544ddbe42b6.jpgGallery: http://wellcomeimages.org/indexplus/image/L0040163.html, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=36095194
By http://wellcomeimages.org/indexplus/obf_images/7e/71/50f93b8f2f172d5b4544ddbe42b6.jpgGallery: http://wellcomeimages.org/indexplus/image/L0040163.html, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=36095194

 

Neurology checklists

Gawande’s vision of a checklist-led approach to medicine, encompassing the spectrum of clinical practice, is indeed challenging. As a neurologist who is keen on patient safety, I was intrigued by this perspective, and I wondered if it was possible to commit the whole of neurology to checklists. In taking up the challenge, I imagined a neurology checklist application that is practical, comprehensive, easy to search, evidence-based, and up-to-date. After five years of collecting and distilling articles, reviews and guidelines, and after months of engagement with software developers, the dream is becoming reality. In my next blog post I will describe the outcome of the journey and discuss how simple checklists may unlock excellent neurological practice.

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Ibrahim Imam APPS, GENERAL, TOOLS OF THE TRADE

Which are the most useful neurological applications?

It is no exaggeration to say our lives revolve around apps. These handy devices bring knowledge to our fingertips at the tap of the finger, or the click of a mouse . They promise easy access to a world of information, often digested to size. Some offer tools to simplify our practice. Neurology is, or should be, no exception.

Apple Store according to the New York Times. Wolf Gang on Flikr. https://www.flickr.com/photos/wolfgangkuhnle/4163909778
Apple Store according to the New York Times. Wolf Gang on Flikr. https://www.flickr.com/photos/wolfgangkuhnle/4163909778

 

So what are the tools out there making neurological practice easier and handier? What are these practical shortcuts making clinical work more efficient? I browsed the web to and found some useful neurology applications and have grouped them as below.

Clinical management apps

Apps that aid the clinical examination

  • Neuro Toolkit. This is only available for the iphone or ipad. A review on Neurology Times says it is ‘an up-to-date, simple and straightforward app’ that contains medical calculators and clinical scoring scales. It also received a favourable review in Neurology journal.
  • 5-minute Neurology Consult. The blurb on google play says Neurology Consult ‘provides instant access to comprehensive, clinically-oriented, must-have information on all disorders of the nervous system’.
  • Neurology a-pocket cards.
  • Neurology Exam Tools promises a flashlight and tuning fork which should lighten the neurologists tool case but it is not clear how efficiently.
  • Neuro Localizer sounds self-explanatory and is developed by neurologists.
  • Neurology pocket app with explanatory video below:

Apps oriented towards clinical scoring

Patient self-management apps

Rubik apps. Cesar Poyatos on Flikr. https://www.flickr.com/photos/cpoyatos/5791320785
Rubik apps. Cesar Poyatos on Flikr. https://www.flickr.com/photos/cpoyatos/5791320785

Disease-specific apps 

Anatomy apps

Journal apps

Allied neurological specialties apps 

Want to explore further? You may check these links out:

Watch out for Neurochecklists… coming soon!

Know any useful apps I’ve missed out? Please leave a comment

 

 

Ibrahim Imam GENERAL, TOOLS OF THE TRADE

How is social media enriching neurological practice?

This is a follow up on my post, what is the state of neurology on the blogosphere. Social media is growing and pulling in professionals at a breath-taking pace. This phenomenon, which many have previously turned there noses up at, is now becoming an indispensable part of our personal and professional lives.

Social networks are important, and in today’s world, overwhelmingly digital. The importance of social networks is stressed in some books such as Linked and Connected. So what are the important social networks relevant to neurologists?

 

1. LinkedIn

The social network medium most professionals prefer is LinkedIn. It is probably the extreme lone-wolf who could afford not to have a presence on LinkedIn today. There are so many neurologists on LinkedIn, and it is a good medium to establish and broaden professional connections. These connections are almost impossible otherwise. There are quite a few valuable professional Neurology LinkedIn groups such as:

2. Twitter

Twitter is a multipurpose and open social medium which gives professionals an invaluable platform to do practically whatever they like. It is however very rapid fire, relying on quick and short messages, limited to 140 characters. These messages, called tweets, may be educative or inspirational, amusing or controversial. Anyone may follow you, but you may also block nuisance followers. You may unfollow anyone you wish, and sometimes this happens at an alarming pace. Many professionals use Twitter to circulate interesting and breaking research work or articles they come across. It is a veritable way of keeping abreast of developments across your patch, but you have to check your twitter feed frequently; unfortunately old tweets tend to fade away. Here is a list of active neurology Twitter accounts.

Right Relevance offers a fairly long List of top neurology influencers

 

3. Facebook

This is probably the most popular social network platform, perhaps considered less academically rigorous. Many Facebook accounts combine social and professional activities, but you may decide to make parts of your account private. There are some interesting Neurology Groups on Facebook worth following such as

The following accounts also give regular and prolific updates on Neurology issues

 

4. Researchgate
"ResearchGate Logo" by ResearchGate - http://researchgate.net. Licensed under Public Domain via Wikimedia Commons.
“ResearchGate Logo” by ResearchGate – http://researchgate.net. Licensed under Public Domain via Wikimedia Commons.

 

ReseacrhGate is a social medium entirely focussed on research output. It links professionals and researchers to others with similar interests. You could keep track of what your collaborators are doing (or up to), and you may follow the research output in your areas of interest. ResearchGate also has an interactive service where you could ask the experts. Indispensable.

 

5. Pinterest

Pinterest may appear, at first look, to be less relevant for academic and professional activities. It is however reported, along with Instagram, to be the fastest growing social network. Businesses are reporting its value, and I suspect academics and professionals may soon be. It is a graphic network, as demonstrated by my Pinterest page. Posts are called ‘pins‘, and these are place on ‘boards‘. Take a look for example at my Neurology Board on Pinterest.

 

 Instagram
Instagram loge. matt McGee on Flikr. https://www.flickr.com/photos/pleeker/15148524023
Instagram loge. matt McGee on Flikr. https://www.flickr.com/photos/pleeker/15148524023

 

This is another network focused around pictures. You may want to scoff at Instagram but you would be surprised at how many professionals are posting very interesting and enlightening images. Take a look for example at these posts by neuroradiology. I am very poor both behind and in front of the lens, and this is reflected by My Instagram page.

6. Tumblr
Tumblr. Esther Vargas on Flikr. https://www.flickr.com/photos/esthervargasc/9471571673
Tumblr. Esther Vargas on Flikr. https://www.flickr.com/photos/esthervargasc/9471571673

 

This is probably the network your children (and grandchildren?) find most fascinating. But don’t run away yet, there are serious stuff here. You wouldn’t believe, for example, that neuroscience is flourishing on Tumblr. This network allows you to play with unlimited space for photos and text. You may find yourself going there more often than you anticipated, but don’t tell the children you are on it!

 

"Social Network Analysis Visualization" by Martin Grandjean - Own work : http://www.martingrandjean.ch/wp-content/uploads/2013/10/Graphe3.png. Licensed under CC BY-SA 3.0 via Wikimedia Commons.
“Social Network Analysis Visualization” by Martin Grandjean – Own work : http://www.martingrandjean.ch/wp-content/uploads/2013/10/Graphe3.png. Licensed under CC BY-SA 3.0 via Wikimedia Commons.

 

Have I missed out an important platform? Please leave a comment.

 

 

Ibrahim Imam GENERAL, GENERAL NEUROLOGY, TOOLS OF THE TRADE

Outstanding neurology video channels and sites

Neurology is as much a verbal, as it is a visual, specialty. Whilst the history is the bedrock of the neurological diagnosis, some conditions are only diagnosed by observation. Epilepsy and movement disorders are classical examples. Neurologists are therefore trained to observe the subtle nuances that distinguish between many of the diseases they see.

Neurology is however a very broad specialty, and it is unlikely that any neurologist or medical student would have personal experience of the vast number of neurological conditions. For this reason the video is an important contributor to neurological experience and expertise. The video is also a great educational resource for teaching the fairly complex neurological examination, no easy feat.

Where then can we get the best neurological videos? Here is a selection.

YouTube-based video channels

Youtube is the veritable ‘go-to’ site for most videos. Many patients post their own interesting video clips, but there is no guarantee that these clips reflect the diseases attributed to them. YouTube however has a selection of creditable video channels and here are some credible ones.

  • JAMA Neurology Channel. This is the video channel of the Journal of the American Medical Association. It is an excellent collection of neurological examination videos, very good for basic neurological skills.
  • University of Denver Neurology Department Channel. This channel, with about 650 subscribers, provides a variety of neurology related videos covering basic clinical topics and recent advances. The videos are typically in the form of lectures.
  • Johns Hopkins Neurology and Neurosurgery Channel. With more than 18,000 subscribers, this is a very clinically oriented neurology and neurosurgery channel from Johns Hopkins.
  • Brain Journal Channel. This is the video site of Brain, a foremost neurology journal. It currently has just over 80 subscribers and has its focus on cutting-edge neuroscience.
  • AAN Channel. This is the video site of the American Academy of Neurology (AAN). This has more than 2,000 subscribers and is fairly regularly updated. It however doesn’t have a lot of clinical material for learning.

 

Neurology-specific video sites

 

 

General medicine video sites with neurology sections

  • The Doctor’s Channel This has a large selection of neurology videos sourced from other sites. It covers the wide range of neurology topics. Many videos are not clinical, but nevertheless interesting.
  • Medical Videos. This is a general medical video site but with a rather strong selection of diverse neurology videos
  • University of Toronto Faculty of Medicine videos. This is an excellent collection of teaching videos covering all aspects of the neurological examination.

Miscellaneous video sites

 

 

Looking for more? Then visit Internetmedicine.com i-Neurology-Videos page for more links to neurology video sites

Please leave a comment if you have any suggestions of helpful neurology video channels.