In Reply: The history of the kernohan notch revisited
To the Editor:
We thank Dr. Derakhshan for his reading and critical appreciation of our paper on the history of the Kernohan notch phenomenon.
His deep understanding and research into the concepts of laterality, the importance of the dominant hemisphere in initiation and control of movement and its implications in pathological processes such as epilepsy are well known to us.
However, it was never our intention to delve into the more subtle physiological aspects of laterality, false localizing signs or, indeed, the Kernohan notch phenomenon. The main objective of our contribution was neither to change the name of the classic neurological sign nor to discuss the present relevance or the current physiological mechanisms underlying the correct explanation. Our message was one of respect directed toward those who have written pages in the history of localizing signs and early neurology and who have helped build the foundations of both neurology and neurosurgery, as well as neurosciences in general, and to incite the curious into further reading on the matter, including such in-depth works as those by Dr. Derakhshan.
While we agree with Dr. Derakhshan that many neurologists and neurosurgeons are not aware of the details of Kernohan’s work, we feel our contribution sends the same message: that we must know the past to understand the present, remain sharp, critical, but open minded, so that we may be able to develop and shape the future.