THE CLINICAL METHOD OF NEUROLOGY

Neurology is regarded by many as one of the most difficult and exacting specialties of medicine.
Students and residents coming to the neurology ward or clinic for the first time are easily
discouraged by what they see. Having had brief contact with neuroanatomy, neurophysiology, they
are already somewhat intimidated by the complexity of the nervous system. The ritual they then
witness of putting the patient through a series of maneuvers designed to evoke certain mysterious
signs the names of which are difficult to pronounce is hardly reassuring; in fact, the procedure by
which neurologic diagnosis is attained. Moreover, the students have had no experience with the
many special tests used in neurologic diagnosis – such as lumbar puncture, as well as
electroencephalographic, angiographic, and imaging procedures – nor do they know how to
interpret the results of such tests. Neurology textbooks only confirm their fears as they read the
myriad details of the many rare disease of the nervous system.
The authors believe that many of the difficulties in comprehending neurology can be overcome by
adhering to the basic principles of clinical medicine. First and foremost it is necessary to learn and
acquire facility in the use of the clinical method. Without a clear comprehension of this method,
the student is virtually as helpless with a new clinical problem as a botanist or chemist who