Objectives The case records at Queen Square afford a unique opportunity to understand the evolution of neurological diagnosis between 1870 and 1920. This period witnessed a shift from the descriptive and observational to a sophisticated and detailed understanding of discrete disease patterns.
Results By 1870, the introduction of microscopic pathological analysis of the nervous system had led to the recognition of disease processes including tumour, haemorrhage, infarction, meningitis and sclerosis. However, the most frequent diagnoses remained symptomatic (epilepsy, movement and functional disorders, visual loss and paralysis). Syphilis, paralysis agitans, and poliomyelitis were amongst the few specific diagnoses. The final decade of the 19th century saw the description of disease patterns, particularly in France, Germany and the US. These included disseminated and amyotrophic lateral sclerosis, myasthenia gravis and latterly eponymous disorders and signs attributed to Dejerine, Duchenne, Sanger Brown, Huntington, Marie, Romberg, Wernicke, Babinski and Charcot as well as Bright, Jackson, Gowers and Wilson in the UK.
Conclusions The case record diagnoses, as well as the writings of Gowers and others, show how rapidly neurological thought evolved over 50 years. Queen Square was able to systematise neurological disease but was also remarkably responsive in understanding, accepting and adopting the neurological advances made across Europe.
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