The Five-Minute Neurological Examination

1 THE Five-Minute Neurological Examination Ralph F. J zefowicz, MD Introduction The neurologic Examination is considered by many to be daunting. It may seem tedious, time consuming, overly detailed, idiosyncratic, and even capricious. Every neurologist has his/her own version of the Examination , and may appear to use magical thinking to come up with a diagnosis at the end. In reality, the Examination is quite simple. When performing the Neurological Examination , it is important to keep the purpose of the Examination in mind, namely to localize the lesion. A basic knowledge of neuroanatomy is necessary to interpret the Examination . The key to performing an efficient Neurological Examination is observation. More than half of the Neurological Examination is performed by simply observing the patient how he/she speaks, thinks, walks, moves, and simply interacts with the examiner. A skillful observer will already localize a lesion, based on simple observations. Formalized testing merely refines the diagnosis, and may only require several additional steps.

examination, followed by a suggested order for performing this examination. I have also included a detailed handout describing the components of a comprehensive neurological examination, as well as the significance of abnormal findings. Numerous tables are included in this handout to aid in neurological diagnosis.

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