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A neurological examination may not reveal any localizing signs.
Sixth nerve palsies are infamous as "false localizing signs."
The work of Collier and Meyer described ipsilateral hemiparesis, a false localizing sign.
The ipsilateral and false localizing signs characteristic of Kernohan's notch sometimes cause confusion and result in misdiagnosis.
The Kernohan's notch phenomenon is unique in that it is not only a false localizing sign, but is also ipsilateral or same-sided.
Because of the fact that a Kernohan's notch is caused by an injury creating pressure on the opposite hemisphere of the brain, it is characterized as a false localizing sign.
Another important finding is a false localizing sign, the so called Kernohan's notch, which results from compression of the contralateral cerebral crus containing descending corticospinal and some corticobulbar tract fibers.
Owing to the non-specific nature of the presentation, diagnosis of malaria in non-endemic areas requires a high degree of suspicion, which might be elicited by any of the following: recent travel history, enlarged spleen, fever without localizing signs, low platelets, and hyperbilirubinemia combined with a normal peripheral blood leukocyte count.