The Neurologic Examination

2014 ◽  
pp. 935-940
Author(s):  
Galen V. Henderson
Keyword(s):  
Neurological Examination ◽  
Neurological Disease ◽  
Neurologic Examination ◽  
Patient History ◽  
Neurological Evaluation ◽  
Number Of Individuals

The neurological examination is not challenging or complex. It does have many components and includes a number of skills that can be mastered only through repetition of the same techniques on a large number of individuals with and without neurological disease. Please remember that the purpose of the examination is to simply localize the lesion. Based on patient history alone, 80% of lesion locations should be known, and then a very specific neurological examination is performed to confirm the location. The examination is the less time consuming of the two parts of the patient's neurological evaluation.

scholarly journals The Virtual Neurologic Exam: Instructional Videos and Guidance for the COVID-19 Era

2020 ◽  
Vol 47 (5) ◽  
pp. 598-603 ◽  
Author(s):  
Mariam Al Hussona ◽  
Monica Maher ◽  
David Chan ◽  
Jonathan A. Micieli ◽  
Jennifer D. Jain ◽  
...  
Keyword(s):  
Movement Disorder ◽  
Neurological Examination ◽  
Cognitive Testing ◽  
Practical Approach ◽  
Neurologic Examination ◽  
Instructional Videos ◽  
Clinical Assessments ◽  
Virtual Visits ◽  
Virtual Medicine

ABSTRACTObjective:To outline features of the neurologic examination that can be performed virtually through telemedicine platforms (the virtual neurological examination [VNE]), and provide guidance for rapidly pivoting in-person clinical assessments to virtual visits during the COVID-19 pandemic and beyond.Methods:The full neurologic examination is described with attention to components that can be performed virtually.Results:A screening VNE is outlined that can be performed on a wide variety of patients, along with detailed descriptions of virtual examination maneuvers for specific scenarios (cognitive testing, neuromuscular and movement disorder examinations).Conclusions:During the COVID-19 pandemic, rapid adoption of virtual medicine will be critical to provide ongoing and timely neurological care. Familiarity and mastery of a VNE will be critical for neurologists, and this article outlines a practical approach to implementation.

Diagnostic neuroimaging in migraine

2020 ◽  
pp. 17-33
Author(s):  
Mark C. Kruit ◽  
Arne May
Keyword(s):  
Risk Factor ◽  
Neurological Examination ◽  
Laboratory Tests ◽  
Brain Lesions ◽  
Complex Relationship ◽  
Patient History ◽  
Clinical Neurological Examination ◽  
Migraine Pathophysiology ◽  
Acute Headache

This chapter focuses on diagnostic clinical neuroimaging in migraine. In most migraine cases, patient history, details of symptoms, and careful clinical neurological examination are together the most important tools in diagnosing and treating migraine, and, consequently, there is mostly no need for further laboratory tests or neuroimaging. In selected non-acute headache cases, neuroimaging is warranted, and recommendations are provided. Good understanding of the migraine pathophysiology allows better interpretation of neuroimaging findings, notably when patients present acutely, in or outside an attack. The neuroradiological findings relevant in understanding the complex relationship between migraine and stroke will therefore be discussed. Similarly, knowledge of the epidemiological findings that have set migraine as a risk factor for (progressive) subclinical brain lesions is relevant in everyday neuroradiological practice.

Proposing the short Neurological Evaluation Scale

2016 ◽  
Vol 29 (4) ◽  
pp. 236-243 ◽  
Author(s):  
Akin Ojagbemi ◽  
Robin Emsley ◽  
Oye Gureje
Keyword(s):  
Neurological Examination ◽  
Rapid Screening ◽  
First Episode ◽  
Clinical Settings ◽  
Likelihood Ratios ◽  
Confirmatory Factor Analyses ◽  
Neurological Evaluation ◽  
Time Required ◽  
Test Probability ◽  
Existing Data

ObjectivesThe time required in completing the 26 items of neurological examinations in the standard Neurological Evaluation Scale (NES) may limit its utility in pragmatic clinical situations. We propose the Short Neurological Evaluation Scale (S-NES) for use in busy clinical settings, and in research.MethodsUsing confirmatory factor analyses, we identified 12 items of neurological examination showing significant overlap with previously reported theoretical and empirical categories of neurological soft signs (NSS) in schizophrenia. This provided justification for the development of a shorter version of the NES based on the empirically identified NSS. In the present study, we relied on existing data to present an initial validation of the S-NES against the referent standard 26-item NES. We determined sensitivity, specificity, and likelihood ratios. Posterior-test probability was estimated using a Bayesian nomogram plot.ResultsUsing data derived from 84 unmedicated or minimally treated patients with first-episode schizophrenia, 12 empirically determined items of neurological examinations showed high agreement with the 26 items in the standard NES battery (sensitivity=96.3%, specificity=100%, and posterior-test probability=100%).ConclusionsWithin limitations of validity estimates derived from existing data, the present results suggest that the design of the S-NES based on empirically identified 12 items of neurological examination is a logical step. If successful, the S-NES will be useful for rapid screening of NSS in busy clinical settings, and also in research.

Potential value of vestibular evoked myogenic potentials in paediatric neuropathies

2008 ◽  
Vol 18 (4) ◽  
pp. 231-237
Author(s):  
E. Jacot ◽  
S. Wiener-Vacher
Keyword(s):  
Neurological Examination ◽  
Neurological Recovery ◽  
Guillain Barre Syndrome ◽  
Vestibular Evoked Myogenic Potentials ◽  
Functional Evaluation ◽  
Testing Apparatus ◽  
Potential Value ◽  
Neurological Evaluation ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Purpose: Showing the interest of vestibular evoked myogenic potentials in paediatric neurological vestibulospinal pathology detection and followup. Materials and methods: The vestibular evoked myogenic potentials testing apparatus presented is now commonly used in ENT clinics for patients from 1 month of age. Our system and protocol permits control to evoke and select the best EMG level and makes possible a comparison of data from different sides or level of stimulation or different sessions. Normal vestibular evoked myogenic potentials latencies obtained with tone bursts were remarkably stable (P: 13 +/− 0.8 ms, N: 19.6 +/− 1.6 ms). The reported case illustrates abnormal vestibular evoked myogenic potentials latencies in neuropathy. Results: A 6 y.o. child with progressive imbalance was referred to the ENT department for vestibular functional evaluation. Abnormally long latencies in the vestibular evoked myogenic potentials and neurological examination oriented the diagnosis towards Guillain-Barre syndrome and immediate referral to a neurology department. Vestibular evoked myogenic potentials also helped to monitor the neurological recovery. Conclusion: The present case shows the potential value of vestibular evoked myogenic potentials in diagnosis and evaluation of descending brainstem pathways in neuropathies like Guillain-Barre syndrome in complement to neurological evaluation.

Neurological examination findings to predict limitations in mobility and falls in older persons without a history of neurological disease

2004 ◽  
Vol 116 (12) ◽  
pp. 807-815 ◽  
Author(s):  
Luigi Ferrucci ◽  
Stefania Bandinelli ◽  
Chiara Cavazzini ◽  
Fulvio Lauretani ◽  
Annamaria Corsi ◽  
...  
Keyword(s):  
Neurological Examination ◽  
Neurological Disease ◽  
Older Persons ◽  
History Of

FRONT DOOR NEUROLOGY: THE GP EXPERIENCE

2015 ◽  
Vol 86 (11) ◽  
pp. e4.156-e4
Author(s):  
Sophie Binks ◽  
Liz Green
Keyword(s):  
Primary Care ◽  
Neurological Examination ◽  
Neurological Disease ◽  
Cervical Radiculopathy ◽  
Neurological Symptoms ◽  
Large Component ◽  
Front Door ◽  
Post Concussion Syndrome ◽  
Neurological Problem ◽  
The Uk

IntroductionNeurological symptoms are common in primary care and may represent 10% of consultations. With fewer neurologists in the UK compared to other European nations, the RCGP encourages GP engagement with neurological disease. This project sought to delineate neurological presentations to a large Brighton GP practice.MethodDuring a four-month GP placement, an FY2 doctor recorded details of patients presenting with neurological symptoms. In tandem, six months of neurology referrals by the permanent GPs were analysed.ResultsCommon symptoms among 29 FY2 neurologically-oriented appointments included headache (n=8), paraesthesiae (n=4) and funny turns (n=3). Significant new diagnoses included right LACS, post-concussion syndrome and cervical radiculopathy. Most (65%) of patients were managed in GP. Those referred included two to TIA clinic, one to A&E and one to headache service. Of 12 GP referrals reviewed, no neurological examination was documented in 25%, and six provisional diagnoses were in agreement with neurological opinion. After neurology outpatient review, two patients were assessed as having no neurological problem.ConclusionsHeadache forms a large component of primary care neurology, but a variety of cases is seen. Acute presentations may be referred to TIA clinic or A&E. Where stated, GP opinion was frequently in line with neurology review.

scholarly journals Neurological examination in obsessive-compulsive disorder

1996 ◽  
Vol 114 (5) ◽  
pp. 1255-1258 ◽  
Author(s):  
Paulo Caramelli ◽  
Mauro Aranha de Lima ◽  
Emmanuel Stip ◽  
Luiz Alberto Bacheschi
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Neurological Examination ◽  
Neurological Dysfunction ◽  
Clinical Value ◽  
Obsessive Compulsive ◽  
Neurological Soft Signs ◽  
Compulsive Disorder ◽  
Mirror Movements ◽  
Neurological Evaluation ◽  
Preliminary Stress

Recent studies suggest the occurrence of a neurological dysfunction in Obsessive-Compulsive Disorder (OCD). The purpose of the present study was to verify the clinical value of a neurological evaluation in patients with the disease. We submitted 15 patients with OCD (five of whom were under clomipramine) and 15 controls in a detailed neurological examination, including assessment of the neurological soft-signs. Eleven patients (73.3 percent) and four controls (26.7 percent) presented abnormalities on examination. The main findings among the patients were: palmomental reflex (six cases); mirror movements (five cases); agraphestesia and dysdiadochokinesia (three cases). Three out of the four patients who had a normal examination were on clomipramine. Palmomental reflex was the main finding among the controls. These results, although preliminary, stress the interest and usefulness of performing a detailed neurological examination in OCD.

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