Appendix 1
Guidelines for a Comprehensive Neurological Examination
All medical students should be able to perform the following parts of the neurologic examination.
Mental Status
- Level of alertness
- Language function (fluency, comprehension, repetition, and naming)
- Memory (short-term and long-term)
- Calculation
- Visuospatial processing
- Abstract reasoning
Cranial Nerves
- Vision (visual fields, visual acuity, and fundoscopic examination)
- Pupillary light reflex
- Eye movements
- Facial sensation
- Facial strength (muscles of facial expression)
- Hearing
- Palatal movement
- Speech
- Neck movement (head rotation, shoulder elevation)
- Tongue movement
Motor Function
- Gait (casual, on toes, on heels, and tandem gait)
- Coordinator (fine finger movements, rapid alternating movements, finger-to-nose, and heel-to-shin)
- Involuntary movements
- Pronator Drift
- Tone (resistance to passive manipulation)
- Bulk
- Strength (shoulder abduction, elbow flexion/extension, wrist flexion/extension, finger flexion/extension/abduction, hip flexion/extension, knee flexion/extension, ankle dorsiflexion/plantar flexion)
Reflexes
- Deep tendon reflexes (biceps, triceps, brachioradialis, patellar, Achilles)
- Plantar responses
Sensation
- Light touch
- Pain or temperature
- Proprioception
- Vibration