Interesting Neuro Exam?

[ChildNeuro]

Advertisement - Members don't see this ad

Hi all, I was wondering if anyone has an interesting neuro-exam case to share, or special aspects of the neurologic exam that medical students may misinterpret or any clinical pearls. I have seen alot of nystagmus, hemiparesis, decreased sensation, but nothing very rare. Also, how long does it take a neurologic resident in a real-world situation to do the neurologic examination on say an inpatient? thanks!

 

[Nerdoscience]

I have seen some interesting things -- have a lady right now with anosognosia regarding a left homonymous hemianopia. As for how long the exam takes, it really depends on how much time I have. That's the honest answer. As long as 45 minutes. As short as 5. Patient cooperation, LOC, and some other things also play into it.

 

[ChildNeuro]

I have seen some interesting things -- have a lady right now with anosognosia regarding a left homonymous hemianopia. As for how long the exam takes, it really depends on how much time I have. That's the honest answer. As long as 45 minutes. As short as 5. Patient cooperation, LOC, and some other things also play into it.

I could see where when admiting a patient with a neurologic condition you would want to do the whole nine yards, or a patient new to a neurologist in private practice, and observe gait and do reflexes etc. . . for following patients in medicine I would just do a cranial nerve exam, EOMI, PERRL, visual fields, muscle strength and sensation, and just check to see if they are alert and oriented x 3, but even this seems to much for following a patient without major neurological problems on medicine, but it only takes me about 5-10minutes. It feels slightly unecessary doing the whole muscle strength test each day, but I don't mind being interested in neurology, I guess I am really just looking for altered mental status or a new stroke. The finding of anosognosia is interesting, I heard that if you do caloric otological testing, i.e. squirting cold water into the ears, this will temporarily relieve the disorder in some cases,