focal

[HotFratBoy]

what is meant exactly by a focal neurologic sign? Does that mean that you have to localize it exactly?

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[Nerdoscience]

It just means not general. Encephalopathy, for instance, is generalized, not focal. It involves slowing of all functions, as opposed to a problem in just one. "Decreased mental status" is not a focal neurologic deficit.

 

[typhoonegator]

I never liked the term "focal", because it does not imply import or usefulness, although plenty of people take it to mean those things. A diabetic CN III gives a "focal" exam, but AIDP may not.

Stupor, coma, and death are nonfocal.

 

[buckley]

Focal just means the presence of tht sign helps you localize the lesion, such as certain cranial nerve palsies or dermatomal sensory deficits

 

[neurodoc]

Focal just means the presence of tht sign helps you localize the lesion, such as certain cranial nerve palsies or dermatomal sensory deficits

This is exactly what is meant by a "focal" symptom/sign on neuro exam. A focal finding on exam is anything that would allow you to use the "neurologic method" of diagnosis to locate the site of the lesion within the central or peripheral nervous system, using your understanding of functional neuroanatomy.

There are many examples. The finding of an INO localizes the lesion to the brainstem MLF circuits. A stocking-glove loss of cutaneous sensation indicates a peripheral polyneuropathy. A sensory level indicates a segmental spinal cord lesion, and so forth.

Nick