Neurological Examination Checklist
## Mental Status
– [ ] Level of consciousness (alert, drowsy, stuporous, comatose, Glasgow Coma Scale)
– [ ] Orientation to time, place, and person
– [ ] Attention and concentration (serial 7s, spelling backwards)
– [ ] Memory (immediate, short-term, long-term)
– [ ] Language (fluency, comprehension, repetition, naming, reading, writing)
– [ ] Higher cognitive functions (calculation, abstraction, reasoning, judgment)
## Cranial Nerves
– [ ] CN I: Olfactory (smell test)
– [ ] CN II: Optic (visual acuity, visual fields, fundoscopy)
– [ ] CN III, IV, VI: Oculomotor, Trochlear, Abducens (pupils, eye movements, convergence, accommodation)
– [ ] CN V: Trigeminal (facial sensation, corneal reflex, jaw movements)
– [ ] CN VII: Facial (facial expression, taste)
– [ ] CN VIII: Vestibulocochlear (hearing, balance)
– [ ] CN IX, X: Glossopharyngeal, Vagus (palate elevation, gag reflex, voice quality, swallowing)
– [ ] CN XI: Accessory (shoulder shrug, head turn)
– [ ] CN XII: Hypoglossal (tongue movements, speech)
## Motor Examination
– [ ] Inspection (posture, gait, spontaneous movements, muscle bulk, fasciculations)
– [ ] Tone (resistance to passive movement, spasticity, rigidity, cogwheeling)
– [ ] Power (Pronator drift (arm drift with eyes closed), Mingazzini Strumpel Test, muscle strength against resistance, MRC scale)
– [ ] Coordination (finger-nose test, heel-shin test, rapid alternating movements)
– [ ] Involuntary movements (tremors, tics, chorea, athetosis, dystonia)
## Sensory Examination
– [ ] Light touch (cotton swab)
– [ ] Pain (pinprick)
– [ ] Temperature (hot and cold objects)
– [ ] Vibration (tuning fork)
– [ ] Position (joint position test)
– [ ] Cortical sensation (stereognosis, graphesthesia, two-point discrimination, extinction)
## Reflexes
– [ ] Biceps reflex (C5, C6)
– [ ] Triceps reflex (C6, C7)
– [ ] Brachioradialis reflex (C5, C6)
– [ ] Patellar reflex (L2, L3, L4)
– [ ] Achilles reflex (S1, S2)
– [ ] Plantar response (Babinski sign)
## Special Tests
– [ ] Cerebellar signs (dysdiadochokinesia, dysmetria, ataxia, nystagmus, intention tremor)
– [ ] Meningeal signs (neck stiffness, Kernig sign, Brudzinski sign)
– [ ] Romberg test (balance with eyes open and closed)
– [ ] Other tests (specify)
By the end of the general neurology course medical students should be able to perform a neurological examination and basic interpretation of the neurological symptoms observed.
Verified by Dr. Petya Stefanova
