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Some neurological signs

West London Neurosciences Centre, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK

Correspondence to:
Correspondence to:
Dr G D Perkin;
d.perkin@ic.ac.uk

Keywords: physical signs; investigative techniques

The first 150 words of the full text of this article appear below.

A series devoted to the value of particular physical signs in neurological practice needs no apology. Though one suspects that succeeding generations of neurologists have bemoaned the lack of clinical expertise among their juniors there can be no doubt that the remarkable advance in neuroimaging and allied techniques that has been seen over the past 20 years has altered the delicate balance between clinical appraisal and investigation. An overreliance on sophisticated investigative techniques has a number of potential pitfalls. The interpretation of those investigations remains a highly skilled process and is prone to error. Some of these techniques are of such sophistication that abnormalities are frequently discovered that bear no relation to the clinical problem. Without an appropriate level of history taking and examination, such abnormalities may be misinterpreted as being relevant to the patient’s presentation. Indeed there remains as much skill in the decision not to investigate . . . [Full text of this article]