From the Guidelines
I recommend searching for neurological examination videos on platforms like YouTube, MedEd Portal, or NEJM's clinical procedure videos, specifically those from medical schools, teaching hospitals, or respected neurologists that cover the complete neurological exam, including mental status, cranial nerves, motor system, reflexes, sensory system, coordination, and gait assessment, as this will provide the most comprehensive understanding of the examination technique, as suggested by the guidelines for acute stroke management 1. To perform a proper neurological examination, it is essential to follow a systematic approach, moving from head to toe in a logical sequence, as outlined in the National Institutes of Health Stroke Scale (NIHSS) 1. This methodical approach ensures that no important elements are missed during the examination.
- The examination should include:
- Mental status assessment, including level of consciousness, orientation, and response to commands
- Cranial nerve examination, including testing of cranial nerves I-XII
- Motor system assessment, including testing of muscle strength, tone, and reflexes
- Sensory system assessment, including testing of sensation, proprioception, and vibration
- Coordination and gait assessment, including testing of finger-to-nose, heel-to-shin, and walking
- The NIHSS is a widely used standardized stroke scale that can help quantify the degree of neurological deficit and facilitate communication between healthcare professionals, as recommended by the American Heart Association/American Stroke Association Stroke Council 1.
- Practice is essential after watching videos, as neurological examination requires both knowledge and technical skill to perform accurately, and subtle findings can have significant diagnostic implications, as emphasized in the Canadian Stroke Best Practice Recommendations for Acute Stroke Management 1.
From the Research
Neurological Examination Videos
There are no research papers to assist in answering this question, as the provided study 2 focuses on the clinical evaluation of neurologic disorders in the elderly, rather than providing videos on how to perform a neurological examination.
Key Components of a Neurological Examination
However, the study 2 highlights the importance of a thorough history and age-appropriate neurologic examination, which may include:
- Seeking a thorough history from the patient and collateral sources
- Performing an age-appropriate neurologic examination with special attention to changes that occur with normal aging
- Assessing cognitive difficulties, balance and gait disorders, tremors, and neuropathy
- Evaluating each cognitive domain, including attention, executive function, learning and memory, perceptual-motor function, and social cognition
Modifications for Older Adults
The study 2 also notes that the neurological examination in older adults may need to be modified to circumvent disabilities such as:
- Hearing and visual impairment
- Difficulty with ocular pursuit and up-gaze
- Reduced or absent distal reflexes
- Slower motor speed
- Reduced ability to tandem walk