False localising signs
- Dr A J Larner, Consultant Neurologist, Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazkerley, Liverpool L9 7LJ, UK; a.larner{at}thewaltoncentre.nhs.uk
- Received 11 December 2002
- Accepted 13 December 2002
Abstract
Neurological signs have been described as “false localising” if they reflect dysfunction distant or remote from the expected anatomical locus of pathology, hence challenging the traditional clinicoanatomical correlation paradigm on which neurological examination is based. False localising signs occur in two major contexts: as a consequence of raised intracranial pressure, and with spinal cord lesions. Cranial nerve palsies (especially sixth nerve palsy), hemiparesis, sensory features (such as truncal sensory levels), and muscle atrophy, may all occur as false localising signs. Awareness that signs may be false localising has implications for diagnostic investigation.
