Examination to detect neurological symptoms

Examination to detect neurological symptoms in patients to ensure accurate results, needs to be performed meticulously and in many times. Not only based on information extracted from patients, but also need to combine with medical technical methods to examine. The purpose of the neurologic examination is to find answers to 3 questions: Does the patient have a neurological disease? Where is the problem in the nervous system? What is that disease?

Focal neurological signs are signs related to cognition and behavior from patients due to localized lesions in an area of ​​the central nervous system.
Frontal lobe signs are often motor related. Patients have signs: Unsteady walking, muscle stiffness, aphasia, paralysis of one limb or half of the body Uncontrollable consciousness such as speech, laughter Sensory symptoms: Emotional disturbance, passive motor, cannot identify objects by touch visual Cerebellar signs: affects balance, coordination of movements Clumsier gestures, slow reflexes, e.g. inability to face down, rapid hand flip

2.1 Collecting information from the patient, making general observations Asking the patient's history
In the process of asking the patient, not only based on the information available, it is necessary to pay attention to facial expressions and attitudes to guide the diagnosis. . Because there are many people who declare incorrect information, it may be due to psychology and anxiety, so the declaration is not correct. This requires a doctor's experience.
2.2 Assess level of consciousness If the patient is not fully awake, ask a loved one to gently support the patient or speak louder.
Neurological examination also needs a comprehensive, systematic examination, always paying attention to other parts.
Examination according to general principles: compare two diseases, examine each limb, examine in the following order; Postural examination (sitting, lying, standing and walking).
Should be examined in the following order: head, cranial nerves, motor, reflex... to avoid errors and have a reasonable system.
2.3 Examining the head area Touching the head, looking for cracks, protrusions, noticing skull injuries?
Head - neck posture, stiff neck, turning head and neck: pay attention to dizziness and nausea when turning the head and neck.
Check the cranial nerves.
Check the movement: Pay attention to the phenomenon of irritation with stiffness of the jaw. To evaluate, the patient's teeth are required to bite, check the chewing muscles, temporal muscles, opening the mouth - deviating the jaw to the affected side when there is motor V paralysis.

2.4 Mobility examination Voluntary motor examination Ask the patient to perform common movements such as lying on the palm of the hand, flexing and extending the forearm, raising the arm, and flexing the leg. If this is not possible, evaluate the patient for severe paralysis. Physical examination: assess muscle strength through the contraction between the patient and the examiner (pincer test). If muscle strength is reduced, evaluate for moderate paralysis. Coordination movement examination The patient performs both sides, at the same time, with fingers pointing to the nose, fingers pointing to the earlobes, heels resting on the knees, repeatedly turning the hands upside down. Evaluation of reflexes Tendon reflexes Abdominal skin reflexes Pathological reflexes Sensory examination After completion of examination, general assessment. To determine the cause of injury – conduct further tests, consult specialists, use non-hazardous and hazardous probes. From there, proceed with the steps of diagnosis and treatment with follow-up.