1. Neurological Exam
Duc Tran, M.D.
August 2003

2. Neurological Exam Mental Status Cranial Nerves Motor Sensory Reflexes
Coordination
Gait

3. Neuroaxis Central Peripheral Brain Spinal Cord Root Plexus Nerve
Neuromuscular Junction
Muscle

6. Intracranial Supratentorial Infratentorial Frontal Parietal Temporal
Occipital
Infratentorial
Cerebellum
Brainstem

7. Supratentorial Aphasia - dominant Aprosodias – nondominant Alexia
Agnosia
Apraxia
Consciousness
Memory
Motor – cortical vs. subcortical
Personality
Seizures - cortical
Sensation - parietal
Vision – occipital

15. Infratentorial Diplopia Dysarthria Dysphagia
Decreased facial sensation/perioral numbness
Dystaxia/Ataxia
Dizziness/Vertigo
Nystagmus
Consciousness
Cross findings

17. Cranial Nerves I - Olfactory. II - Optic. Vision. Pupil reflex.
III - Eye movement. Pupil response.
IV - Eye movement.
V - Facial sensation. Mastication.
VI - Eye movement.
VII - Facial movement.
VIII - Balance/Hearing.
IX - Taste. Sensation pharyngeal muscles.
X - Sensation larynx, gut. Motor to larynx, pharynx, palate.
XI - Motor to sternocleidomastoid/trapezius.
XII - Motor to tongue.

19. Hemangiomablastoma

20. Myelopathy Weakness Reflex changes Sensory loss B/B dysfunction
Ascending Level of Dysfunction

21. Motor Neuron UMN LMN Weakness Spastic Hyperreflexia Weakness Flacid
Atrophy
Fasciculations
Hyporeflexia
EMG/NCV

22. Root/Radiculopathy Pain Weakness in distribution of root
Sensory loss – may not be dense
Reflex changes – helps to localize the level
Rule of 7

26. Nerve Polyneuropathy – eg. diabetes Mononeuropathy – eg. CTS
Multiple mononeuropathies – eg. lead

27. Polyneuropathies Weakness – distal>proximal
Sensory loss – distal>proximal
Reflex changes – distal>proximal
Exceptions - CIDP

29. Mononeuropathies Cardinal movements of the thumb
Extension
Opposition
Adduction
Cardinal movements of the lower extremity
Hip flexion/knee extension
Hip adduction
Hip abduction/hip extension
Knee flexion/ankle dorsi-flexion/ankle plantar flexion/inversion/eversion.

30. NMJ Weakness – proximal>distal No sensory loss No reflex changes
Fatigue

31. Myopathy Weakness – proximal>distal No sensory changes
No reflex changes
Atrophy
Myotonia
Cramping

45. VITAMIN DEC