Forbes Quick Neurological Examination

A quick neurological examination to screen for important clinical signs.

Category:

Education

Tags:

• neurology
• examination
• clinical
• medicine

[andocrates]

This isn't intended to teach other neurologist (they go straight to the MRI), I think he's teaching other disciplines (GP, Dermatologist, Paediatrician) how to include some useful eponymous medical signs into routine exams.

Indeed it was an internist who first found myoclonus iin me.

[raeburnforbes]

@andocrates Thanks - you are right that this is directed to the non-neurologist,although most neurologists will do targetted examinations and go for signs that are deal-breakers or deal-makers.

Regards.

[apmahs]

strength done, reflexes done, but what about other cranial nerves, like trigeminal, then 12th. what about gait, rombergs, MMSE,

And for before using opthalmoscope, arent we supposed to move glasses?

[raeburnforbes]

@apmahs

The whole point of this exam is to screen a person in whom there is a low pre-examination risk of serious neurological disease. There is no need whatsoever to do lengthy comprehensive examinations in all people, as it is the history that is the key to diagnosis. If the detection of a hypopglossal weakness would be relevant diagnostically, then go ahead and look! If it is not relevant, then spend your time on something more beneficial like discussing your management with your patient

[drbilalrizvi]

this guy would fail the csa for rushing things :P

[raeburnforbes]

@drbilalrizvi

HI - I wold only fail an exam if I was unable to take a neurological history, or if I did not think on my feet and go on to elicit other relevant clinical signs. In 17 years of neurological practice this type of examination, supplemented by targetted relevant signs stands me in good stead. If you want to pass exams, that is a different matter.

Cheers.

R

[obmitty1]

@drbilalrizvi For the CSA if anything you could do less and more targeted depending on the case.

[multidoc666]

Hey, that was good! And the comments and answers just made it better. Thanks!

[raeburnforbes]

@apmahs

Dear Apmahs - if you keep someones glasses on you correct for their refractive error and more often than not you will get a very good view. Some types of lenses are impossible to see through, and then you need to remove the glasses and try and go through the rakc of lenses on the ophthalmoscope before arriving in focus on the retina. Some people have such high refractive error that a standard ophthalmoscope will not suffice and you have to keep thier glasses on.

[raeburnforbes]

@nwafboi

Hi NWAFBOI - thanks for leaving a comment - the idea of this exam is to make a brief targetted assessment of the nervous system. By the time you do a neurological exam you should already have a 80-90% idea of the actual diagnosis if you have taken a proper neurological history. If you know what you are loking for a targetted approach makes a lot more sense. Sorry if it is too quick - this does not mean that I do not care!

R

[nwafboi]

too quick xD

[apmahs]

he is supposed to remove her glasses.