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A short history of clinical neurology 

A short history of clinical neurology
A short history of clinical neurology

Alastair Compston

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date: 05 December 2020

More than any other branch of medicine, the practice of neurology depends on the classical methods of intuitive conversation, structured examination, and selective investigation. We teach the importance of eliciting an accurate neurological history. The key symptoms at onset are identified and their subsequent course defined. For the experienced clinician, this process becomes routine, efficient, and quick. The competent neurologist is the one who instinctively senses relevant components of the history, appreciates the most likely underlying disease mechanisms, reliably elicits the relevant physical signs, knows which investigations are necessary and assesses their relevance in the clinical context, provides a sensible clinical formulation, and communicates the situation accurately and sensitively to the patient and relatives. Rather than slavishly collecting an encyclopaedia of facts, in which the key issues may be lost in a surfeit of redundant information, the critical components are sifted and the subsequent conversation steered down an algorithm that seeks anatomical, physiological, and pathological explanations for what the patient describes.

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