Overview

A quick assessment of the normal nervous system is provided by finding a normal gait with normal associated movements, a normal speech process and content, and a normal mental status. Conversely, many neurologic deficits can be quickly ascertained by simply looking at the patient. There may be a dense hemiparesis, or there may be neglect of one side. A conversation with the patient may demonstrate a significant mental status abnormality or speech deficit.

There is no universally accepted neurologic screening examination for the emergency setting. However, the brief neurologic screening examination should include as a minimum these components:

1. Mental Status

2. Cranial Nerves S. Motor System

4. Sensation

5. Coordination B. Reflexes

Orientation, affect, speech (content and process)

Pupillary response, fundoscopy, extraocular movements, facial muscle strength, visual fields as appropriate

Strength in basic muscle groups, resistance to passive movement (tone), pronator drift

Light touch, proprioception, pain, as appropriate

Gait, finger-to-nose or other cerebellar testing, Romberg

Deep tendon reflexes (biceps, triceps, knees, ankles), plantar reflexes

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