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.

diagnosis. Although confirmatory laboratory data, including modern imaging techniques such as CT scanning and magnetic resonance imaging, have provided further accuracy in neurologic diagnosis, the history and physical examination remain the mainstays. Neurologic diagnosis can be divided into two types, anatomic and etiologic:

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