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1 - Neurological Examination

from SECTION I - NEUROLOGICAL EXAMINATION AND NEURODIAGNOSTIC TESTING

Published online by Cambridge University Press:  06 August 2009

Thomas F. Scott
Affiliation:
Department of Neurology Allegheny General Hospital Pittusburgh, Pennsylvania
Sid M. Shah
Affiliation:
Assistant Clinical Professor Michigan State University; Faculty member of Sparrow/MSU Emergency Medicine Residency Program Lansing, Michigan
Sid M. Shah
Affiliation:
Michigan State University
Kevin M. Kelly
Affiliation:
Drexel University, Philadelphia
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Summary

A detailed neurological history allows one to focus on important components of the neurological examination and for saving time and resources. The important elements of a focused neurological examination include onset of symptoms, temporal relationships of symptoms, progression of symptoms, associated symptoms, exacerbating and alleviating factors, symptoms that indicate involvement of a particular region of central nervous system (CNS), history of similar event and history of medication use. This chapter describes the examination of mental status, cranial nerve function, motor function, deep tendon reflexes, cutaneous reflexes, and miscellaneous signs, sensory modalities, and pathological reflexes. The Glasgow Coma Scale is often used as a method of briefly quantitating neurological dysfunction. A simple method to remember the anatomic basis of neurological examination is to focus on five levels of the CNS, which are the brain, the brainstem, the spinal cord, the peripheral nerves, and the muscles.
Type
Chapter
Information
Principles and Practice of Emergency Neurology
Handbook for Emergency Physicians
, pp. 1 - 11
Publisher: Cambridge University Press
Print publication year: 2003

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References

Adams R D, Victor M. Principles of Neurology, 3rd ed. New York, NY: McGraw-Hill; 1985
American College of Emergency Physicians. Clinical policy for the initial approach to patients presenting with altered mental status. Ann Emerg Med. 1999; 33: 251–81
Haerer A F. DeJong's The Neurologic Examination, 5th ed. Philadelphia, Pa: JB Lippincott; 1992
Kaufman, D M, Zun, L. A quantifiable, brief mental status examination for emergency patients. J Emerg Med. 1995; 13: 449–56Google Scholar
O'Keefe, K P, Sanson, T G. Elderly patients with altered mental status. Emerg Med Cl N Am. 1998; 16: 701–15Google Scholar
Mancall E. Alpers and Mancall's Essentials of the Neurologic Examination, 2nd ed. Philadelphia, Pa: FA Davis; 1981
Plum F, Posner J B. The Diagnosis of Stupor and Coma, 3rd ed. Philadelphia, Pa: FA Davis; 1982
Zun, L, Howes, D S. The mental status examination: application in the emergency department. Am J Emerg Med. 1988; 6: 165–72Google Scholar

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  • Neurological Examination
    • By Thomas F. Scott, Department of Neurology Allegheny General Hospital Pittusburgh, Pennsylvania, Sid M. Shah, Assistant Clinical Professor Michigan State University; Faculty member of Sparrow/MSU Emergency Medicine Residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.002
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Neurological Examination
    • By Thomas F. Scott, Department of Neurology Allegheny General Hospital Pittusburgh, Pennsylvania, Sid M. Shah, Assistant Clinical Professor Michigan State University; Faculty member of Sparrow/MSU Emergency Medicine Residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.002
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Neurological Examination
    • By Thomas F. Scott, Department of Neurology Allegheny General Hospital Pittusburgh, Pennsylvania, Sid M. Shah, Assistant Clinical Professor Michigan State University; Faculty member of Sparrow/MSU Emergency Medicine Residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.002
Available formats
×