A Guide to Common Neurological Examinations
Patient history
The process of differential diagnosis starts with the neurologist taking the patient history. Despite all of the advances in modern technology, the history is the most important part of the neurological examination.
The details are important
The ‘history’ is, in fact, the history of your illness: current and past symptoms, past history such as tingling, numbness or bladder and bowel problems and family history. The doctor looks for key signs and symptoms, based on what you tell him. Even seemingly unimportant details such as 'the tingling was so distracting that I had to miss my dental appointment' or 'the cramping started in my left leg but when it came back the second time it was more of a dull ache', may provide very useful information.
It is critical that the neurologist obtains as much information as possible to rule out any other possible causes of illness. For example, vertigo (a common symptom of MS) can also result from an inner-ear disorder. Blurred vision, loss of balance and slurred speech are all symptoms of MS, but can also be caused by other diseases and certain medications. The neurologist may therefore perform tests which are not specific for MS to exclude the possibility that you may have something else.
Various functions examined are:
• motor (controlling movement)
• sensory (controlling the senses, e.g. sense of touch or sense of pain)
• brainstem (cranial nerves, e.g. instinctive eye movements)
• cerebellar (controlling instinctive motor function, e.g. control of balance)
• visual (detection and processing of visual information)
• mental or cognitive ( functions like vigilance, speech or concentration)
