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Doctors should listen to the whole patient: don’t forget the stethoscope in neurological examination

BMJ 2013; 347 doi: (Published 05 August 2013) Cite this as: BMJ 2013;347:f4625
  1. Christian M Burd, foundation year 1 doctor, Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, Middlesex HA1 3UJ, UK
  1. cburd66{at}

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. …

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