TY - JOUR T1 - All diagnoses are clinical, but some are more clinical than others JF - Practical Neurology JO - Pract Neurol SP - e1 LP - e1 DO - 10.1136/practneurol-2012-000472 VL - 13 IS - 1 AU - Roger Graham Whittaker Y1 - 2013/02/01 UR - http://pn.bmj.com/content/13/1/e1.abstract N2 - The authors take exception to my assertion that electromyography remains an ‘essential diagnostic test’ in motor neurone disease (MND), instead insisting that for most patients this is a clinical diagnosis. I agree. In fact I would go further; of course all diagnoses are clinical. However, for some diseases diagnostic tests are an essential part of making a clinical diagnosis, and MND is one such example.Neurophysiology has two roles in the context of suspected MND. First, it is to provide independent evidence in support of the diagnosis. I'd be the first to admit that the electrodiagnostic criteria for MND are far from perfect, and specifically I would agree that the nomenclature is clumsy. Recent refinements have increased … ER -