Augenblickdiagnose in neurology: revisiting "diagnosis in the blink of an eye".

Abstract

The art of diagnosis in clinical neurology requires attentive listening and careful observation. In certain situations, a fragment of the history or a physical sign may be so distinctive that it allows clinicians to evoke a specific diagnosis. This quick mental process was previously referred to as "augenblickdiagnose" ("diagnosis in the blink of an eye") in a seminal paper by Dr. William Campbell in 1998. We aim to revisit this concept by providing additional clinical vignettes. The authors wrote clinical vignettes using examples from their own clinical practice and performed a non-systematic review of influential Neurology textbooks using the words "pathognomonic" and "highly suggestive". Twenty examples from various fields of neurology are presented in a table, allocated to major fields of Neurology. A short educational reflection is provided for each diagnosis considered. "Augenblickdiagnose" is an engaging teaching resource, also contributing to "neurophilia", i.e., generating fascination about neurology, perhaps even more so in today's modern neurology practice. However, multiple cognitive biases underlying mental shortcuts may lead to an incorrect diagnosis. It is important to stress that good clinical practice in neurology requires taking a thorough history and performing a careful neurological examination.