Special Feature

Frequently Asked Questions: Neurology on the Internet

While it has been customary for Neurology Alert to focus on specific clinical issues of interest to neurologists, the editors felt that the recent explosion of the Internet as a global means of information dispersion makes some knowledge of this topic essential for the future practice of neurology. Recognizing that there might be great variability in computer literacy among our readers, we have decided to review this topic in the form of answers to several key questions that a novice user might ask regarding the Internet.

1. What is the Internet?

The Internet ("electronic superhighway") is a vast network of interconnected computers all communicating via a common protocol. Because of the common communication protocol, many different computer types (i.e., PC, Mac, UNIX) can all be connected to the Internet and communicate with one another. This is true "distributed computing" and in many ways resembles connectivity within the brain.

2. Of what potential value is the Internet to neurologists?

Here are a few key uses:

Neurological diagnosis: There are many resources (some of which are listed below) that aid in neurologic diagnosis. As an example, consider Online Mendelian Inheritance in Man (OMIM), a searchable (and continuously updated) database of genetic diseases of man. Suppose one encounters an individual with progressive ataxia and myoclonus; consulting OMIM with these two terms yields some 30 different conditions (all with detailed online descriptions) that feature ataxia and myoclonus. This is far more effective than a traditional approach using textbooks and journal resources; however powerful, it is only a resource to supplement, not replace, clinical skills.

Patient referrals/physician directories: There are multiple listings of physicians categorized by a number of specialties (see listing for AMA Online below). Thus, it is easy to locate a rheumatologist in Nova Scotia, should a patient require it.

Patient groups: Many disease-related organizations have developed an Internet presence. As an example, parents of a child diagnosed with muscular dystrophy can contact the Muscular Dystrophy Association home page at the address given below.

3. What do I need to access the Internet? How much does it cost?

The minimum that is required to access the Internet is a computer, a modem and an Internet service provider. This type of connection is called a "dial-up" (SLIP/PPP) connection; it is the most widely accessible, but also the slowest, way onto the Internet. The type of computer is not particularly important, but one should select a modem with a baud rate of at least 14.4 kilobytes/sec, and preferably 28.8 kilobytes/sec; use of slower modems may result in unacceptably slow performance. There are many Internet service providers, the most widely known being on-line services (America Online, CompuServe, Prodigy, etc.). Most of these providers can be accessed by a local phone call.

Individuals who access the Internet from academic settings may have the luxury of "direct" (TCP/IP) Internet access. Direct Internet access is much faster than dial-up access and does not require an external service provider. One should certainly use this if available; check with your institution.

Use of the Internet itself is free. Apart from the fixed hardware costs, it should be possible to access the Internet for approximately $10-20/month.

4. What is the World Wide Web, and how can I explore it?

The Internet is so vast that a number of mechanisms have been developed to explore it. One mechanism that has rapidly developed into a standard is the World Wide Web (WWW), which provides a graphical view of the Internet. Each site on the WWW view of the Internet has a unique address known as a Uniform Resource Locator (URL) of the form "http://www.domain.suffix." For example, http://www.cornell.med.edu is the address of the main WWW page at Cornell University Medical College. Each URL is requesting information from a specific computer on the Internet.

The likely reason for the emergence of the WWW as the standard Internet view has been the development of powerful "Web Browsers," which allow one to access the WWW through graphical mechanisms that feature "hypertext" on WWW "pages." Hypertext are frequently links or pointers to other pages; thus, it is possible to roam about the Internet with minimum effort. Many WWW Browsers (among which Netscape Navigator and Microsoft Internet Explorer are the best known) are either free or available at a nominal cost. It is important to realize that although one does not need a WWW Browser (or even the WWW) to access the Internet, use of a WWW Browser will make it a much more pleasant experience. Note that you must be using Windows 3.x or higher on a PC to use most browsers.

The Internet has many "search engines" that will enable you to rapidly find what you seek. We strongly advise that one of the very first things that you do after a first connection to the Internet is to thoroughly explore one or more of these engines (examples being AltaVista, WebCrawler, Yahoo, etc.) so that you become comfortable with their use.

5. What are some Web pages of interest to neurologists, and how can I access them?

In order to access the following, type the listed URL (http:// prefixed) into the "Location" box in the browser that you are using. Then follow the hyperlinks on the respective pages.

Rather than list Web pages, we will describe a sojourn through the Internet. There will be many more places to discover on your own. Please fire up your WWW Browser and follow along.

Start at www.aan.com. This is the home page of the American Academy of Neurology. Click on "Neurological conditions." Click on "American Academy of Neurology’s Patient Information Guide" to peruse materials available for a wide range of neurologic disease. Scroll down the page and click on "Muscular Dystrophy" for information on how to contact the MDA. Visit the MDA home page at www.mdausa.org. Backtrack to the referring page, www.aaa.com/public/con.html. Then click on "Other Intersting Sites" (www.aan.com/public/links. html). From there, click on "Online Mendelian Inheritance in Man" (www3.ncbi. nlm.nih.gov.omim). Click on "Search the OMIM Database" and enter "ataxia AND myoclonus" to retrieve 29 disorders featuring both. Read about a few. Then return to "Other Interesting Sites" and click on PubMed retrieval system (www4.ncbi. nlm.nih.gov/PubMed/) to perform a free MEDLINE search on the topic of your choice. Now move to www.ama-assn.org and choose "Physician Select" to locate all listed neurologists in the state of Idaho.

This completes our brief tour of the Internet. Please feel free to browse on your own! —rt