The neurological examination is the fundamental stage in assessing complaints related to the brain, spinal cord, peripheral nerves and muscles. The examination consists of different headings such as the patient’s history, consciousness and cognitive functions, cranial nerves, muscle strength, the sensory system, reflexes, and balance and gait characteristics. Which sections are assessed in more detail varies according to the patient’s complaint.
Why is a neurological examination done?
In complaints such as headache, dizziness, numbness, loss of strength, tremor, gait disturbance, forgetfulness, seizure, loss of balance or slowness of movement, the neurological examination helps to understand which part of the nervous system the possible problem may originate from. Based on the examination findings, it is assessed whether additional tests such as MRI, CT, EEG, EMG or laboratory investigations are needed.
Taking a neurological history
The neurological assessment begins with listening in detail to the patient’s complaint. When the complaint began, whether it developed suddenly or slowly, whether it has changed over time, accompanying symptoms, medications used and past illnesses are assessed.
During the history, the following information is particularly important:
- The time of onset and duration of the complaint
- Whether the symptoms are one-sided or two-sided
- Whether the complaint is continuous or intermittent
- Situations that trigger or relieve it
- Accompanying headache, visual disturbance, speech disorder, numbness or loss of strength
- Medications used and other illnesses
Assessment of consciousness and cognitive functions
When necessary, the patient’s level of consciousness, orientation, attention and memory functions, speech and language are assessed. In complaints such as forgetfulness, confusion or speech disorder, this section can be done in more detail.
Cranial nerve examination
Functions such as vision, eye movements, facial sensation and expressions, hearing, swallowing and tongue movements are parts of the cranial nerve examination. Depending on the patient’s complaint, findings such as the visual field, the pupils’ response to light and eye movements can be assessed.
Muscle strength, sensation and reflexes
In the motor system examination, muscle strength, muscle tone and involuntary movements are examined. In the sensory examination, different sensory functions such as touch, pain, temperature, vibration and position sense can be assessed. The reflex examination, on the other hand, provides information about the function of the nerve pathways.
Balance, coordination and gait
Gait pattern, balance, coordination of fine movements and, when necessary, cerebellar tests are assessed. In Parkinson’s disease and other movement disorders, gait, arm swing, turns and movement speed are particularly important.
What happens after the examination?
The neurological examination findings are assessed together with the patient’s history. Imaging or advanced tests are not needed in every patient. In situations deemed necessary, EEG, EMG, MRI, CT or laboratory investigations may be planned.
This content has been prepared for general informational purposes. It does not replace personal diagnosis or treatment advice.
