• Neuromythology

A stereotype of neurologists is their focus on the pedantry and pomposity of the diagnostic chase. Neurologists do, perhaps uniquely, recognise the primacy of a history well taken. The physical examination of the nervous system is a highly prized skill among medical students, but typically becomes radically honed in specialist training and beyond; extremely so for some.1 As a trainee, I recall a teaching session where two senior consultants offered to demonstrate ‘the definitive neurological examination’. Forty-five minutes in, they were raging in argument over the optimal method to test olfactory function. The passion of specialists was obvious; they inevitably identify aspects of history-taking, examination or investigation that they feel strongly enough about to reject any dogma taught as medical students. Few consultant neurologists respect the medical student's anatomical division about an imaginary line at the neck, which is testament to a wider need to reappraise fully what is taught to undergraduates.2 That the student bemoans neurologist X telling them to test it this way but neurologist Y another way is a (healthy) sign that there is still a great art to the clinical encounter as a whole. Long live intuitive neurology!3

The idea for an irreverent series of short opinion pieces on aspects of neurological examination was inspired in part by a memorable article in this journal.4 Neuropoppycockology appeared under a section entitled ‘Neurological rant’, which disappointingly did not become a regular feature. Tempting as it was to resurrect this title, we agreed instead that ‘Neuromythology’—acknowledging the collected writings of William Landau5— might serve to provide a column that provoked thought and online debate about what neurologists do and, hopefully also, what they teach. The first of these calls into question the ongoing value of Romberg's test.