Behavioral neurology Puns

Hello! I am a newly minted M1 who wants to do a neurology residency (although the brachial plexus nearly broke that desire) some day.

I've been reading about behavioral neurology as a fellowship and it sounds exactly like the thing that I want to do. You are a fully trained neurologist with the added specialty in injuries/diseases that have a cognitive or behavioral component, essentially straddling the line between neurology and our wonderful friends over in the shrink department.

I am curious what people think about this as a fellowship or if there are any fellows who want to share their experience. I have read (on this sub I believe) that behavioral neuro is considered an "unrecognized" fellowship by either the AMA or AAN. What does this mean really? I've read that places such as the Cleveland Clinic and Stanford both have a behav. neuro./neuropsychiatry fellowship; how does this mean it's not recognized?

Any other thoughts, pro or con, would be very much appreciated!

Thanks.

Is it a general known subfield most people have access to? It seems other subfields like "movement" and "stroke" are discussed much more than behavioral neuology.

Why do a lot of people bundle it together with neuropsychiatry a lot? Hell, even the "Neuropsychiatry " subreddit has it on its description. Wouldn't it be closer to neuropsychology?

How long does it take to become a behavioral neurologist? From what someone told me, it takes around 11-14 Years. (4 Med school, 5-7 of interships and neuro residency and 2-3 of behavioral neurology)

What are the differences between a general neurologist and a behavioral neurologist?

Is it true the pay is considerabely low compared to other sub-specialities like movement?

Thanks!

To me it seems that this distinction is made between effects on brain dysfunction that are beyond conscious control (such as a metabolic problems at the neuron level that affect then the brain overall which there is no internal mechanism to change your metabolic functioning) vs brain dysfunction at the ‘thought’ level.

This is what the distinction appears to be but i pose the question because these seem like very poor definitions with so many unknowns and exceptions that it appears there may not really be functional way to make a claim of under consciousness control vs not. It seems that this is not a distinction that can be made in kind, but more in amount. But it also then begs the bigger philosophical questions of ‘free will’ in terms of asking, how much control do different people really have even at the thought level, especially those who have not developed in enriched environments or even in natural variation of concepts like self awareness or intellect (which in themselves are slippery topics to define).

As a pediatric health professional, I think a lot about this when families state that a child has trouble paying attention to what they would like them to or not able to move in the way hey want them to resulting in sloppy handwriting or not behaving well, aka hitting others when mad. But with children, especially those who are non verbal or have low IQ or just have poor self awareness and memory, it is hard sometimes to think of them making independent from their physical and social environments that are all controlled mainly by adults around them. Some of these children have psychiatric disorders/ psychological disorders like ADHD or Autism or Anxiety. Many of them can definitely learn to do some things differently which is often exciting to see but some of them it seems like we are teaching and practicing against a brick wall. And overall we know that all the changes we see in the behavior (attention, handwriting, aggression) are preceded by changes in the brain because we are our brains.

As I write this, I guess I am seeing that we may be making this distinction based on whether “learning” and social (not just physiological) environment can impact these brain dysfunctions, but again this is an impact in amount not kind. Often we do not know exactly or know reliably how to change the dysfunctions we are seeing that stem from the brain, but those that we do have some tools like surgery or medications along with a more clear pathophysiol

Medical student here and my current subspecialty obsession is Behavioral Neurology. It seems to fit exactly what I would want in a future practice, both with patient populations and intellectual curiosity.

If anyone has experience or know's someone who does, I would love to hear about it! There aren't any Behavioral Neurology/Neuropsychiatry fellowships in my current city so I don't have readily accessible contacts to get some general info.

A new hypothesis of mine about the origin of PTSD:

That PTSD in primary state is neurological and not psychiatric and the psychiatric symptoms are secondary. My reasoning:

•When trauma occurs and later evolves to PTSD due to inability to process the event, the first thing that happens is that our brain splits the memory of the event and stores it in a different place in the brain where it is suppressed so that the painful memory is manageable for the individual.

•This is also called: fragmentation. This memory can later be brought back to life in the form of a flashback if the individual comes to a place that is similar to the traumatic event which triggers the memory.

•Trauma literally changes our brain also in the sense that the amygdala is increased in size. The amygdala is responsible for managing the emotions of a individual. An increased and thus overactive amygdala can make emotions harder to handle because the brain is more sensitive to emotional stimuli.

•Because all these changes in combination with a different path for our brain neuro pathways happen after an traumatic event when an individual cannot process the memory properly, that is my argument for treating PTSD as an neurological disorder instead of psychiatric disorder.

•I also have to add that EMDR, one of the most common therapies for treating PTSD/trauma is literally aimed at changing memory localization in the brain by ticking noises therewith focusing on changing brain structures rather then changing an individual’s behavior. Earlier MRI scans also showed a change in brain structure in individuals with PTSD/trauma. Thats my hypothesis. I have sources which are scientific based researches for my hypothesis if anyone is interested in this.

I am looking for a book or ideally a sort of cheat sheet I can reference with evidence based information on when children hit emotional/ neurological or behavioral developments i/e at what age they develop empathy, when they start to understand cause and effect, when they can understand concepts like time. Basically I want to make sure as we move forward in our parenting journey that my expectations are age appropriate and I am looking for a good source to quickly reference