Investigation of neurological disease

 Investigation of neurological disease

Experienced clinicians make most neurological diagnosis on history alone, with a lesser contribution from examination and investigation. As investigations become more complex and more easily available, it is tempting to adopt a 'scan first, think later' approach to neurological symptoms. The frequency of 'false-positive' results, the wide range of normality, and the negative implications for patients (unnecessary expense, inconvenience, discomfort and worry) necessitate a more thoughtful approach. Investigation may include assessment of structure (imaging) and function (neurophysiology). Neurophysiological testing has become so complex that in some countries it constitutes a separate specialty focusing on electroencephalography, evoked potentials, nerve conduction studies and electromyography.

Figure: The main somatic sensory pathways.