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A Typical Neurological ‘Case’

Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, UK; E-mail: graham.warner{at}royalsurrey.nhs.uk

EXTRACT

As a medical student and junior doctor I was always captivated, somewhat like watching a magician taking a rabbit from a hat or Harry Potter entering Hogwarts, by the array of equipment the attending neurologist liberated from their bag and the diagnoses they pulled from the clinical hat. However, whilst neurological texts, both new (Patten 1996; Adams 1997; Bradley et al. 1999) and old (Monrad-Krohn and Refsum 1964; Holmes 1960), offer any amount of advice on how to elicit signs, the guidance on what tools to use is very limited, typically just mentioning cotton wool and pins (Medical Research Council’s 1943, 2000). Books specifically on clinical examination may give a cursory list of equipment (Munro & Edwards 1990) or mention it when discussing particular tests (Holmes 1960; Monrad-Krohn and Refsum 1964; Munro & Edwards 1990; Swash 1995). But certainly there is no up-to-date recommended list. With this in mind I ...

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