ABSTRACT
Systematic testing of muscle tone, bulk, and strength and analysis of the distribution
of abnormal findings is a key element of bedside cerebral localization. A codified
neurological examination was developed in the 20th century, but physicians have commented
on weakness since antiquity. The ancient Egyptians, Greeks, and Romans described weakness
in patients with head injuries and strokes, explaining it in terms of the pathophysiology
of their times. Diagnostic principles of lateralization and localization developed
in the Enlightenment, alongside an understanding of the anatomy of the motor system.
In the 19th century, the work of Romberg, Todd, Charcot, and Gowers popularized the
use of motor localization by demonstrating the power of scientific reasoning at the
bedside. The concept of the upper motor neuron, as elaborated by Gowers, has enduring
clinical utility.
KEYWORD
Neurological examination - history of neurology - history of medicine - upper motor
neuron
