Neurological Exam

What Is It?

A neurological exam is a physical examination conducted by a health care provider which is focused on the nervous system. It is a common part of a complete neurological assessment as may be conducted by various physicians, most commonly a neurologist or neurosurgeon. The goal of the examination is to detect any signs or symptoms related to the nervous system and its functioning.

The neurological exam can be conducted by anyone, including primary care providers such as family practitioners and internal medicine doctors. However, it is most commonly part of a neurological evaluation by a physician specializing in diseases of the nervous system, such as a neurologist or a neurosurgeon.

What Are the Parts of a Typical Neurological Exam?

  • Behavioral, Cognitive and Mental Status: This part of the neurological evaluation helps to determine the higher functioning of a patient's brain. It is an assessment of their mental status, or level of alertness and consciousness, as well as their higher functions of memory, reasoning, logic and general behavior. While some of this overlaps with a psychological assessment, it is, at least in part, a part of the complete neurological examination.
  • Head and Neck Exam: Because the brain and spinal cord are in the head and neck, a general examination of the head and neck for malformations, abnormal anatomy, masses and other findings is often undertaken.
  • Cranial Nerve Exam: There are 12 cranial nerves which are nerves that originate in the head, coming off the brain and brain stem. The examination of these nerves and their functions is complex but includes areas such as smell, vision and eye movements, facial sensation, reflexes and movement, hearing, taste, tongue and palate movements and even movements of the head, neck and shoulders.
  • Motor Exam: This part of the examination tests the motor function, or movement, of the major muscle groups, most notably in the shoulders, arms, hips and legs. The muscles are tested for mass, muscle tone, and strength.
  • Reflex Exam: Various reflexes are tested throughout the body. While these can indicate problems with sensation and/or motor function, they can also reveal other aspects of nervous system dysfunction as well.
  • Coordination and Gait: Coordination testing and evaluating a patient's gait reveal much about various aspects of their nervous system. While they involve motor function they also reveal aspects of other more subtle components of brain function which controls these things.
  • Sensory Exam: Finally, the sensory exam part of the neurological exam evaluates the sensation of the patient. This includes not just normal touch but also pain and temperature and sensation of limb position and movement.

The neuro exam is just one part of a complete neurological assessment. While in some patients the complete neurological exam is undertaken, in others a focused exam is used to evaluate only those aspects of the nervous system which are most concerning because of the patient's presenting complaints or symptoms. While some diagnoses can be made simply on the basis of the physical examination, most require further testing or studies, such as a CT scan or MRI scan, to make or confirm the diagnosis.

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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