NEUROLOGICAL ASSESSMENT

*NEUROLOGICAL ASSESSMENT*

Reg. No., Name, Age/sex
Date of admission, Address, Occupation
Referred by (consultant) and hospital
Consultant’s probable diagnosis
Type of operation/illness
Date of discharge
Discharge summary
Instruction for physiotherapist
Subjective examination
History of present condition
Past medical history
Drug history
Social situation
Normal daily routine

 *GENERAL EXAMINATION*
• Pulse rate
• Respiratory rate
• Temperature
• Blood pressure
• State of consciousness—Glasgow Coma Scale

*On Observation*
• Attitude of limbs
• Facial expression
• Deformity
• Posture
– Lying
– Sitting
– Standing
• Pain
– Type
– Onset
– Nature
– Radiation
– Intensity
– Aggravating/relieving factor
– Associated symptoms
– Severity: Visual analog scale

*On Palpation*
• Temperature
• Tenderness
• Edema: Pitting/non-pitting
Inflammatory sign • Muscle wasting • Contractures

*On Examination*
• Range of movement
• Muscle girth
• Limb length
• End feel – Capsular – Noncapsular • Differential tests
• Gait – Pattern – Distance – Velocity – Walking aids – Orthoses
• MMT
• Reflexes – Superficial – Deep

 *STATES OF HIGHER FUNCTION*
• Orientation • Consciousness • Behavior • Memory • Intelligent capacity
• Counting and calculation
• Speech
• Reading and writing
• Vision
• Speech and articulation
• Cranial nerve examination
• Muscle tone
– Spasticity
– Rigidity
– Flaccidity

SENSORY ASSESSMENT
• Pain
• Temperature
• Vibration
• Touch
– Light
– Crude
• Pressure
• Two-point discrimination
• Spine
– Tenderness
– Deformity
• Limb attitude
– Lying
– Sitting
– Standing
• Co-ordination (UL/LL)
• Balance
• Bladder and bowel
• Dermatomes and myotomes
• Exercise tolerance test
• Fatigue
• Specific investigations/blood test/X-rays/CT
scan/MRI