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Neurological examination identified 61% of patients with focal cerebral hemisphere lesions but without obvious focal signs

Clinical impact ratings Neurology

Key Words: neurologic examination • apraxias • hemianopsia • sensation disorders

The first 150 words of the full text of this article appear below.

METHODS
Design: blinded comparison of a clinical neurological examination with imaging studies.

Setting: university hospital in Auckland, New Zealand.

Patients: 65 patients who were referred for investigation of neurological symptoms, such as headache or transient neurological events, without obvious focal signs. Patients with obvious focal signs, cognitive impairment, brain stem or cerebellar lesions, movement disorders, non-neurological disorders that would affect assessment, or a marked midline shift on imaging were excluded. 46 patients, aged 21–83 years (mean 51 y, 61% men), had a single cerebral hemisphere lesion and 19 patients had no lesion.

Description of test: a clinical neurological examination, consisting of 23 motor signs in the upper and lower limbs, 12 sensory signs, 3 cranial nerve signs, and 9 cognitive tests, was administered {by a neurologist or senior neurology registrar}^*. From these results, the examiner {used clinical judgement}* to conclude whether or not there was a focal lesion and, if . . . [Full text of this article]

Robert G Holloway, MD, MPH

University of Rochester School of Medicine
Rochester, New York, USA