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

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 Q In patients with neurological symptoms but without obvious focal signs, how well does a clinical neurological examination identify those with a focal cerebral hemisphere lesion?

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Embedded ImageDesign:

blinded comparison of a clinical neurological examination with imaging studies.

Embedded ImageSetting:

university hospital in Auckland, New Zealand.

Embedded ImagePatients:

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.

Embedded ImageDescription of test:

a clinical neurological examination, consisting of 23 motor signs in the …

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  • * Information provided by author.

  • For correspondence: Dr N Anderson, Auckland Hospital, Auckland,New Zealand. neila{at}

  • Source of funding: none stated.