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March 14, 2026Arquivos de Neuro-Psiquiatria0 citationsOpen Access

The historical evolution of the neurological examination

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BEBruno Bertoli EsmanhottoPontifícia Universidade Católica do ParanáGFGustavo L. FranklinPontifícia Universidade Católica do ParanáGAGabriel AlbiniPontifícia Universidade Católica do Paraná

Key Points

  • To examine the historical development of the neurological examination from ancient to modern practices.
  • Review of historical contributions from early medicine to contemporary practices.
  • Analysis of key figures and their impact on neurological examination.
  • Evaluation of changes in diagnostic approaches over time.
  • The neurological examination evolved from basic observations to a structured tool.
  • Key figures like Charcot and Babinski shaped modern techniques in the 19th century.
  • The integration of evidence-based approaches enhanced the examination's rigor.

Abstract

Abstract The neurological examination has evolved from rudimentary clinical observations in ancient civilizations to a structured and indispensable tool in modern medical diagnostics. Early contributions from Hippocratic medicine emphasized the brain as the seat of cognition and introduced systematic observation of neurological signs. In the 19th century, figures such as Jean-Martin Charcot, Wilhelm Erb, William Gowers, and Joseph Babinski established the foundations of the modern neurological exam through anatomoclinical correlations, standardization of reflex assessment, and structured clinical reasoning. Throughout the 20th century, seminal textbooks—such as those by Mills, McKendree, DeJong, and Wartenberg—helped consolidate and disseminate neurological semiology globally. More recently, evidence-based approaches, exemplified by Steven McGee's work, have introduced statistical rigor to bedside examinations. Despite advances in neuroimaging and electrophysiology, examinations remain a cornerstone of clinical neurology, guiding diagnosis, promoting cost-effective care, and reinforcing the doctor–patient relationship.

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Cite This Study

Esmanhotto et al. (2026) studied this question.

synapsesocial.com/papers/69b4ba0818185d8a398027c3https://doi.org/10.1055/s-0046-1817052
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