What is a neurological examination?

A neurological (neuro) examination is a physical examination to check for signs of disorders in your brain, spinal cord, and nerves, commonly known as the nervous system. It is the only professional way healthcare providers can check the functioning of your brain and nervous system to determine what to test for. Every neurological examination varies regarding a patient's symptoms. Sometimes, it takes you long to complete the physical examination and the interview because your nervous system is quite complex.

If you already have a neurological disorder, a neuro exam helps healthcare providers track your response to treatment.

What's involved in a neuro exam?

It involves a step-by-step process during the physical examination to observe the functionality of the nervous system. These include the evaluation of you're:

• Speech and mental state.
• The function of cranial nerves, which are the nerves in your head and face.
• Muscular tone, strength, and coordination.
• The "knee jerk" and other reflexes.
• Different stimuli, such as touch and vibration, have an impact on how you feel in different body areas.
• Movement and gait.
• Spine.
• For instance, the state of consciousness following a catastrophic brain injury.

Who would require a neurological examination?

A neurological examination might be helpful if you exhibit any of the following signs of neurological dysfunction:

• Modified consciousness, such as a coma.
• Decreased cognitive functioning may include confusion, memory loss or changes in behaviour.
• Disorientation, dulled hearing or lost sense of smell.
• Speaking difficulty (dysarthria or aphasia).
• Trouble balancing or coordinating.
• Dizziness
• Headache
• Muscle weakness.
• Tingling or numbness in the legs and arms.
• Seizures.

How can I benefit from a neurological exam?

Neurological exams determine whether symptoms are caused by a nervous system disorder or another medical problem. They also act as a platform upon which other tests are conducted.

Infections diagnosed by neuro exam may include:

• Meningitis or Encephalitis
• Movement disorders like Parkinson's disease
• Neurodegenerative disorders such as Alzheimer's disease, among others
• Neuromuscular disorders, including amyotrophic lateral sclerosis (ALS)
• Stroke
• Multiple sclerosis and similar diseases
• Traumatic injury to the brain
• Seizure diseases and epilepsy.
• Headache conditions including cluster headaches and migraines.

Who administers a neurologic exam?

A neurologist or a specially trained physician extender, such as a certified nurse practitioner or physician assistant, administers the exam. This specialist diagnoses and treats disorders in the brain, nerves, and spinal cord. Many neurologists specialize in movement disorders, epilepsy, or pediatric neurology.

How should I prepare for a neurologic exam?

There is little preparation needed. You may want to wear loose clothing. It can also be helpful to write down information about your symptoms and health history. This can help protect you against forgetting essential points that might guide the exam.

How is a neurological exam conducted?

This begins with an interview about your symptoms, including how long you've had them and how they affect your life. Your neurologist will also be interested in other medical issues. Then, your neurologist will conduct a physical examination.

Your healthcare professional will perform a physical examination as part of your neurology exam to assess how well one or more components of your nervous system are working. These include:

Cognitive status

Testing your cognition provides useful information about thinking, memory and your emotional state. You may be asked to:

• Repeat the date, time, and place.
• Count out loud.
• Describe how you're feeling.
• Repeat a short sequence of words.
• Cranial nerve examination

Your cranial nerves transmit signals from your brain to your upper body. This examination helps identify diseases and conditions that damage particular areas of your brain. This might include:

• Your tongue, eyes and facial expressions will be tested.
• Your vision and pupils will be tested.
• Your sense of smell and hearing will be tested.
• Balance, coordination and mobility will be tested.

These tests determine whether your brain is correctly communicating with the muscles that enable you to move, stand and hold yourself up. They might include:

• Closing your eyes and reaching out to touch your nose with your finger
• Moving your arms and legs
• Performing fine motor skills, such as writing your name.
• You are walking straight or making a few steps on your heels or toes.

Reflexes

Your neurologist checks your automatic response to specific stimuli. These tests show how much communication there is between nerves, communicating with your brain and the rest of your body. This might include:

• She was rubbing the sole of your foot.
• Tap your knee or other tendons with a rubber hammer to observe whether your limb will move.
• I was checking your muscles by lightly tapping your stomach to see if your muscles have strengthened or not.

Sensory exam

This part of the test looks to see if you can detect pain, temperature and other sensations. This may involve:

• I am asking you to close your eyes and lift your toes.
• You are placing a hot or cold object on your skin.
• You brush against your skin with a cotton swab while asking if you feel it.
• You touch different body areas with a pin or a vibrating tuning fork.

Level of consciousness

If you're not fully conscious, the test evaluates brain activity. It scores your ability to carry out simple commands (Glasgow Coma Scale), including:

• Commanding movements.
• Opening your eyes.
• Speaking.
• Autonomic nervous system

Your autonomic nervous system controls involuntary functions such as breathing and blood pressure. This part of the test may include:

• Do you have bowel and bladder control?
• You are checking your blood pressure in various positions.
• Other tests as needed.

How long will it take to get the results from my neurological exam?

Your neurologist will discuss the findings with you when the exam is complete.

Do I need further testing?

If your test results are not within normal limits, your neurologist will want additional tests for further understanding. Such tests could be:

• Other conditions, such as vitamin deficiency, are usually ruled out by doing a blood test.
• Imaging studies may be performed, such as an MRI or CT scan.
• EEG: checks the electrical function of the brain
• EMG and nerve conduction studies: muscle and nerve.
• Lumbar puncture.

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