Neurological signs of possible diagnostic value in the cognitive clinic: past, present and future

The clinical assessment of patients with cognitive complaints may appear daunting to the non-specialist, partly because of the increasing sophistication of the investigations available for such assessment. But as with all aspects of neurology, history taking and clinical examination are the foundation of assessment, in which context several simple neurological signs may be elicited in the outpatient setting that can increase or decrease the index of clinical suspicion for a neurocognitive disorder. These signs include the ‘attended alone’ and ‘attended with’ signs, the head-turning sign, la maladie du petit papier , the applause sign, the shoulder-tapping sign, the anosognosia of cognitive impairment sign and the long-term memory sign. Here we review the available data on the utility of these signs, which are described as simple because of their ease of administration and categorisation. As such, these signs are highly practical in both their application and purpose.