Appendix 2
Guidelines for Screening Neurologic Examination
All medical students should be able to perform a brief, screening neurologic examination that is sufficient to detect significant neurologic disease even in patients with no neurologic complaints. Although the exact format of such a screening examination may vary, it should contain at least some assessment of mental status, cranial nerves, gait, coordination, strength, reflexes, and sensation. One example of a screening examination is given here.
Mental Status (level of alertness, appropriateness of responses, orientation to date and place)
Cranial Nerves
- Visual acuity
- Pupillary light reflex
- Eye movements
- Hearing
- Facial strength (smile, eye closure)
Motor Function
- Gait (casual, tandem)
- Coordination (fine finger movements, finger-to-nose)
- Strength (shoulder abduction, elbow extension, wrist extension, finger abduction, hip flexion, knee flexion, ankle dorsiflexion)
Reflexes
- Deep tendon reflexes (biceps, patellar, Achilles)
- Plantar responses
Sensation (one modality at toes–can be light touch, pain/temperature, or proprioception)
Note: If there is reason to suspect neurologic disease
based on the patient’s history or the results of any components of the
screening examination, a more complex neurologic examination may be necessary.