Clinical neurology

Question 1

What is the role of a neurologist?

Answer 1

They diagnose and treat disorders of the nervous system.

Question 2

How do neurologists carry out a neurological assessment (this is different from a neurological examination)?

Answer 2

1. Neurological assessment completed which helps determine sensory and motor neurone responses.
2. It typically includes a full patient history – What is going on? How bad? Family relations? Smoking? Holistic approach to medicine.
3. Use the presenting signs and symptoms to identify the underlying anatomy (neuroanatomical location).
4. From all the current assessments, determine whether these findings combine to form a recognizable medical syndrome (a syndrome is a group of symptoms which consistently occur together and have one cause).
5. Use the mode of onset to determine the most likely underlying aetiology (PATHOLOGICAL cause).

Sensory and Motor
Patient History
Underlying anatomical issue
Determine a syndrome for symptoms
Use mode of onset for pathological cause

S&M

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A
S

P

Question 3

What are the main components of a neurological examination (this is different from a neurological assessment)?

Answer 3

Cognitive/thinking abilities: ‘Mini Mental State Examination’
Cranial Nerves – determined by judging smell, vision, eye movements, facial sensation and movements.
Limbs-power, coordination, reflexes and sensation.

Mental status testing (covered in a separate section of this web site)
Cranial Nerves.
Muscle strength, tone and bulk.
Reflexes.
Coordination.
Sensory Function.
Gait.

S
S
C
C
M
R
G

Question 4

What are the key diagnostic techniques used in neurological diagnosis?

Answer 4

□ CT scans (computerised tomography) – X-rays that go around the body and take cross-sectional images of the body. Can diagnose issues such as infarctions and tumours in the brain.
□ MRI scans (magnetic resonance imaging), used to diagnose issues in relation to the brain.
□ Lumbar puncture diagnoses diseases of the spine and brain by taking a sample of cerebrospinal fluid.
□ Electroencephalogram (EEG) records electrical activity of the brain – diagnoses things like epilepsy.
□ Electromyography (EMG) records the electoral activity of skeletal muscles and therefore diagnoses conditions relating to neuromuscular diseases.
□ Nerve conduction studies (NCS) measure electrical conduction of the sensory and motor neurones.