Table Of ContentDeJong’s
The Neurologic
Examination
EIGHTH EDITION
William W. Campbell, MD, MSHA, COL, MC,
USA (Ret)
Professor Emeritus
Department of Neurology
Uniformed Services University of Health Sciences
Bethesda, Maryland
Richard J. Barohn, MD, Lt Col, USAFR, MC
(Ret)
Gertrude and Dewey Ziegler Professor of Neurology
University Distinguished Professor
Vice Chancellor for Research
University of Kansas Medical Center
Kansas City, Kansas
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Eighth edition
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Library of Congress Cataloging-in-Publication Data
Names: Campbell, William W., Jr. (William Wesley), author. | Barohn, Richard J., author.
Title: DeJong’s the neurologic examination / William W. Campbell, Richard J. Barohn.
Other titles: Neurologic examination
Description: Eighth edition. | Philadelphia : Wolters Kluwer, [2020] | Includes bibliographical references
and index.
Identifiers: LCCN 2018059855 | ISBN 9781496386168 (hardback)
Subjects: | MESH: Neurologic Examination—methods | Nervous System Diseases—diagnosis
Classification: LCC RC348 | NLM WL 141 | DDC 616.8/0475—dc23 LC record available at
https://lccn.loc.gov/2018059855
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RUSSEL N. DeJONG, MD
1907–1990
Dedication
To Rhonda, Robbie, Wes, Matt, Shannon, Ella, and Will. And to all our former
residents and fellows, for all they taught us.
FOREWORD
Standard textbooks of neurology commonly include an introductory chapter on
the clinical examination but otherwise provide little guidance as to how this is
best performed. The exception is De Jong’s The Neurologic Examination, first
published in 1950, which was intended to present in detail the information
necessary to perform a complete and clinically useful examination, accompanied
by limited descriptions of the findings in common neurologic entities or
disorders. If anything, the need for such an account has increased with the
passing years. The art of the neurologic examination is being lost as clinical
medicine becomes depersonalized and as new diagnostic and monitoring
techniques are used in its place. Moreover, little time is left to learn the
intricacies of the physical examination in today’s crowded medical school
curriculum. The publication of this new (eighth) edition of De Jong’s classic
text, authored by William Campbell and Richard Barohn, is therefore timely and
to be welcomed. It is a pleasure to introduce the book and its authors to another
generation of readers.
Dr. Campbell is professor emeritus and former chair of the neurology
department at the Uniformed Services University of the Health Sciences in
Bethesda, Maryland. I have known him since he was a resident in San Francisco
more than 40 years ago. He has had an illustrious career and is well known for
his clinical skills and diagnostic acumen. He has authored a number of clinical
studies on different aspects of neuromuscular disorders and received the
Distinguished Physician Award of the American Association of Neuromuscular
and Electrodiagnostic Medicine in 2011. Almost 20 years ago, he took over
DeJong’s book—the fortunes of which had declined as technologic advances
came to influence the practice of neurology—and single-handedly rewrote and
revived it. The sixth edition, the first that he authored, was published in 2005
and soon restored the reputation of the book, earning for it a well-deserved place
on the bookshelf of many neurologists. He remained the sole author for the
seventh edition, published in 2012, but now has been joined by Richard Barohn
in preparing this eighth edition.
Dr. Barohn, professor and former chair of the department of neurology at
University of Kansas Medical Center, is another accomplished neuromuscular
clinician and investigator. In 2013, he received the Distinguished Researcher
Award of the American Association of Neuromuscular and Electrodiagnostic
Medicine and was named a University Distinguished Professor at the University
of Kansas for his achievements.
The book that Campbell and Barohn have authored serves an important need
as a guide to both trainees and established physicians. The neurologic
examination can be lengthy, often requires much attention to detail, is sometimes
performed in difficult or unpleasant circumstances, and may be overwhelming to
trainees. Its importance, however, cannot be overemphasized. The findings
obtained thereby help to confirm a suspected diagnosis, determine whether any
further investigations are needed, indicate the clinical relevance of any
laboratory or imaging abnormalities, and suggest the extent and prognosis of
many disorders. The competently performed examination also helps to establish
a bond between patient and physician that is essential to the welfare of the
former and professionally satisfying to the latter.
The neurologic findings become especially meaningful as their relationship to
changes in the structure and function of the nervous system comes to be
understood. One of the goals of the present volume is to emphasize such a
relationship, and the authors have achieved this aim admirably. The text in this
new edition has been shortened slightly by reducing discussions of various
disease entities to focus on the clinical findings and their significance. Numerous
illustrations—most in color—increase the breadth of the book. Several of the
older figures from earlier editions have been replaced, and new figures have
been added. A number of videos are embedded in the text, with links to many
more, as well as to Dr. Campbell’s instructive neurosigns.org Web site. In
consequence, readers of this book will be able to learn more easily the intricacies
of the examination and what to seek when examining patients with different
neurologic disorders. They will come to understand the nature and importance of
different neurologic signs and will be able to learn from expert clinicians how
best to elicit them. Earlier editions have previously received wide recognition
and are deservedly familiar to many clinicians. This new edition, which is both
scholarly and practical, is even better. It is a mine of information and will be an
important resource for many years to come.
Perhaps remarkably in this 21st century but following in the tradition of its
predecessors, this new edition is written in its entirety by these two eminent
physicians and thus has a uniformity of style that is pleasing. The various
chapters fit seamlessly together to produce an integrated and well-rounded
