Neurological Assessment

Question 1

Focussed Neuro History

Answer 1

1. Headaches
2. Dizziness
3. Vertigo
4. Faints
5. Visual disturbance
6. Hearing loss
7. Ringing in your ears (Tinnitus)
8. Loss of balance
9. Change in smell/taste
10. Seizures
11. Numbness
12. Tingling
13. Muscle weakness
14. Inability to swallow (dysphagia)

Question 2

Overall Neurological Assessment

Answer 2

1. Focussed History
2. Higher Functions (Mentation, Speech, Gait, Coordination

Peripheral NS (Arms or legs)

1. Inspect (symetrical muscle mass)
2. Tone (Passive movement)
3. Power (Movment against resistance & Arm drift)
4. Sensation (light touch & proprioception)

Cranial Nerves :

10 Tests

Question 3

Higher functions Assessment

Answer 3

Mentation (GCS 15, Orientated)

Speech (Clear, unslurred, appropriate content, appropriate volume)

Gait & Coordination:

1. Walk normally
2. Heel to toe
3. Stand on toes
4. Stand on heels
5. Feet together, eyes closed (Rhomburg’s test)
6. Heel to shin (coordination & balance)
7. Finger to nose (coordination)
8. Pronator drift (motor neuron disorder)

Question 4

Peripheral Nervous System (Inspection)

Answer 4

1. Body postion (abnormal = ? neuro deifict or paralysis)
2. Involuntary movements
3. Muscle bulk

Upper or lower body in OSCE

Question 5

Peripheral Nervous System (Tone)

Answer 5

Passive movement of joints

Should be some residual tension (muscle tone), but should not be

• Hypertonicity
• Hypotoniticity

Question 6

Peripheral Nervous System (Power/Strength)

Answer 6

Movements against resistance

Bilateral for all (just state as unilateral in OSCE)

Question 7

Peripheral Nervous System (Sensation)

Answer 7

Light touch – eyes closed

Proprioception (position) – eyes closed

1. Shoulder (cervical)
2. Upper arm - medial & lateral (cervical)
3. Forearm - medial & Lateral(cervical)
4. Hand - medial & lateral (cervical)
5. Body –superior and inferior (thoracic)