Neurological examination

Obtaining the patient's history is the most important part of a neurological examination, provided that the patient’s level of consciousness is normal. By carefully listening to the patient, and asking questions, unnecessary further tests can usually be eliminated. If the findings in a basic neurological examination are normal, a significant portion of neurological conditions can be excluded with high probability. A neurological examination involves an assessment of both the patient’s general status (higher mental functions) (not discussed in detail in this article) as well as the neurological status. The examination should always be carried out in the same logical order so as to minimise the possibility of omitting a part of it, for example after being distracted by the patient’s questions. All findings should be documented immediately since it can be surprisingly difficult to remember afterwards, for example, which side was affected by a symptom. The neurological status helps to establish an anatomical diagnosis, i.e. do the symptoms originate from the brain spinal cord peripheral nervous system neuromuscular system or muscles? After the anatomical diagnosis has been made, the examination is focused towards localising more closely the origins of the symptoms within the central or peripheral nervous system. At this stage, particular attention is paid to any neurological asymmetry between sides in the upper and lower extremities.