Communication and neurology--bad news and how to break them

How to deliver bad news to patients is a crucial part of medical practice. Many neurological diseases are incurable, progressive and result in physical or cognitive disabilities, which pose special challenges in the process of communication. Information about diagnosis, therapy and prognosis should be given in an appropriate setting and tailored to the patient's needs and cognitive level of functioning. Support and advice to the family and a team-oriented approach in the follow-up of neurological patients are of high importance. Patient autonomy, truth disclosure expectations and the access to other sources of information is important aspects that influence communication. There is a need for a special and continuous focus on communication in the education of neurologists with regard to the specific needs of this field. Attention should be given to the consequences of neurological disease as well as to therapy and prognosis.