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The neurological examination adapted for neuropsychiatry

Published online by Cambridge University Press:  23 May 2018

Sheldon Benjamin*
Affiliation:
Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
Margo D. Lauterbach*
Affiliation:
Sheppard Pratt Health System, Neuropsychiatry Program, Towson, Maryland, USA
*
*Address for correspondence: Margo D. Lauterbach, MD, Sheppard Pratt Health System, Neuropsychiatry Program, 6501 N. Charles St. PO BOX 6815, Baltimore, MD 21285-6815 Sheldon Benjamin, MD, UMass Medical School, Dept. of Psychiatry, 55 Lake Avenue North, Worcester, MA 01655. (Email: sheldon.benjamin@umassmed.edu)
*Address for correspondence: Margo D. Lauterbach, MD, Sheppard Pratt Health System, Neuropsychiatry Program, 6501 N. Charles St. PO BOX 6815, Baltimore, MD 21285-6815 Sheldon Benjamin, MD, UMass Medical School, Dept. of Psychiatry, 55 Lake Avenue North, Worcester, MA 01655. (Email: sheldon.benjamin@umassmed.edu)

Abstract

The neuropsychiatric examination includes standard neurological and cognitive examination techniques with several additional observations and tasks designed to capture abnormalities common among patients with neuropsychiatric disorders or neurocognitive complaints. Although useful as a screening tool, a single standardized rating scale such as the Mini Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA) is insufficient to establish a neuropsychiatric diagnosis. Extra attention is paid to findings commonly seen in the setting of psychiatric disorders, dementias, movement disorders, or dysfunction of cortical or subcortical structures. Dysmorphic features, dermatologic findings, neurodevelopmental signs, signs of embellishment, and expanded neurocognitive testing are included. The neuropsychiatric clinician utilizes the techniques described in this article to adapt the examination to each patient’s situation, choosing the most appropriate techniques to supplement the basic neurological and psychiatric examinations in support of diagnostic hypotheses being considered. The added examination techniques facilitate diagnosis of neurocognitive disorders and enable neuropsychiatric formulation.

Type
Review Articles
Copyright
© Cambridge University Press 2018 

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