Appendix 3
Guidelines for the Neurological Examination in Patients with Altered Level of
Consciousness
Mental Status
- Level of arousal
- Response to auditory stimuli (including voice)
- Response to visual stimuli
- Response to noxious stimuli (applied centrally and to each limb individually)
Cranial Nerves
- Response to visual threat
- Papillary light reflex
- Oculocephalic (doll’s eyes) reflex
- Vestibulo-ocular (cold caloric) reflex
- Corneal reflex
- Gag reflex
Motor Function
- Voluntary movements
- Reflex withdrawal
- Spontaneous, involuntary movements
- Tone (resistance to passive manipulation)
Reflexes
- Deep tendon reflexes
- Plantar responses
Sensation (to noxious stimuli)