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

1. Level of alertness

2. Language function (fluency, comprehension, repetition, and naming)

3. Memory (short-term and long-term)

4. Calculation

5. Visuospatial processing

6. Abstract reasoning

Cranial Nerves

1. Vision (visual fields, visual acuity, and fundoscopic examination)

2. Pupillary light reflex

3. Eye movements

4. Facial sensation

5. Facial strength (muscles of facial expression)

6. Hearing

7. Palatal movement

8. Speech

9. Neck movement (head rotation, shoulder elevation)

10. Tongue movement

Motor Function

1. Gait (casual, on toes, on heels, and tandem gait)

2. Coordinator (fine finger movements, rapid alternating movements, finger-to-nose, and heel-to-shin)

3. Involuntary movements

4. Pronator Drift

5. Tone (resistance to passive manipulation)

6. Bulk

7. Strength (shoulder abduction, elbow flexion/extension, wrist flexion/extension, finger flexion/extension/abduction, hip flexion/extension, knee flexion/extension, ankle dorsiflexion/plantar flexion)

Reflexes

1. Deep tendon reflexes (biceps, triceps, brachioradialis, patellar, Achilles)

2. Plantar responses

Sensation

1. Light touch

2. Pain or temperature

3. Proprioception

4. Vibration