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A detailed guide to conducting a five-minute neurological examination. It covers various aspects of the examination, including mental status, cranial nerves, motor examination, sensory examination, coordination, reflexes, gait, and examination order. The document also includes five case studies to help illustrate the application of the examination techniques.
Typology: Exercises
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A 68-year-old woman with hypertension was brought to the emergency department by her friend because of dizziness, vertigo and difficulty walking, which she first noted when she awoke from a nap that evening. BP=200/130 mm Hg and P=76/min. She is examined lying on a gurney in the emergency department. There is minimal nystagmus with right gaze. Facial strength and sensation are normal. Motor and sensory examinations are entirely normal. Finger-to-nose testing is normal bilaterally. Muscle stretch reflexes are normal throughout.
A 55-year-old man with hypertension and diabetes mellitus is admitted for cardiac catheterization because of worsening angina and an abnormal exercise tolerance test. Following the procedure, which demonstrates severe LAD disease, he is noted to be confused, and a neurological consultation is obtained. BP=150/90 mm Hg, and P=80/min and regular. He is awake, alert and fully oriented. He appears confused when asked to describe what happened to him that day. His face is symmetrical. He has full power in all four limbs. Sensory examination is entirely normal. Muscle stretch reflexes are symmetrical.