Introduction

Having systematically examined the patient, one is then left with the decision as to how to record the information for posterity – although, in fact, this decision is one that will have, or ought to have, been taken well in advance.

It may be that in routine practice one opts for simply describing what one has observed. If so, the author wishes you well! As far as the signs are concerned, not only does this result in pages of script that few are ever likely to read, it presents data that are unstandardised and of limited meaning to others, and that do not allow reliable comparisons of findings from serial evaluations. It is also an extremely inefficient method, with the very real risk that important information will be omitted or inadequately presented. Furthermore, there are quite simply no words – in the English language at least – to describe much of what you will encounter in patients with drug-related movement disorder.

One is on surer ground using descriptive methods to note subjective symptomatology and the impact of features on, for example, the activities of daily living, not least because, in a psychiatric context, standardized recording schedules afford little opportunity for noting information of this sort at present.

There are few things more hazardous in this world than an ‘expert’ with little expertise, and the use of standardised recording instruments does require some expertise.