Doctors should listen to the whole patient: don’t forget the stethoscope in neurological examinationBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4625 (Published 05 August 2013) Cite this as: BMJ 2013;347:f4625
- Christian M Burd, foundation year 1 doctor, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, Middlesex HA1 3UJ, UK
John Forbes, physician to Queen Victoria, said of the newly invented stethoscope, “I have no doubt whatever . . . that it will be acknowledged to be one of the greatest discoveries in medicine by all those . . . to give it a fair trial.” The humble stethoscope is already a key part of cardiovascular, respiratory, and abdominal examinations. It can also be of great value in diagnosing a multitude of neurological disorders, from stroke to tremor.
Hearing a carotid bruit has a sensitivity of 56% and specificity of 98% in detecting carotid stenosis at at least 60% occlusion,1 and it may help identify patients with worse prognoses. …