The neurological examination is undertaken to examine if there is any disorder in the central nervous system. The central nervous system comprises the brain, spinal cord and nerves. It is in charge of everything you do, which includes muscle movement, functioning of the organs and even thinking and planning. There are approximately more than 600 types of central nervous system disorders, amongst which the most common ones are:

  • Parkinson’s disease
  • Multiple sclerosis
  • Meningitis
  • Epilepsy
  • Stroke
  • Migraine headaches

An examination of the nervous system comprises tests designed to examine the strength of the muscles, balance, and various aspects of the  nervous system. Diagnosis at an early stage helps in determining the proper treatment and may also decrease the long-term complications. 

When does one need a neurological exam?

Although symptoms depend more on the disorder, the most common symptoms are:

  • Headache
  • Problems in balance and coordination
  • Blurred vision
  • Numbness in arms or legs
  • Behavioural changes
  • Changes in ability to smell and in hearing
  • The confused state of mind
  • Weakness
  • Fatigue
  • Fever
  • Seizures

What happens during a neurological examination?

A neurologist performs the examination and helps in treating neurological conditions once diagnosed. The neurologist tests different nervous system functions during the exam, and the type of tests depend on the symptoms. Still, most neurological exams include tests of some or all of the following:

  1. Mental status

The doctor may ask general questions such as date, time or place. You may even be asked to perform tasks that may include remembering a list of items, naming objects or drawing specific shapes. 

      2. Coordination and balance

The neurologist may ask you to walk in a straight line and do other such balancing exercises. Other tests may include closing eyes and trying to touch your nose with your index finger.

      3. Reflexes

A reflex is referred to as an automatic response to stimulation. They are tested by tapping different parts of the body using a small rubber hammer. If the reflexes are normal, the body will move a certain way or respond when tapped with a hammer. The neurologist may tap several areas on your body during the exam, including below the kneecap and areas around your elbow and ankle. 

       4. Sensation

The doctor may touch your legs, arms and other different body parts with various instruments, which may include a tuning fork, dull needle or alcohol swabs. You will then be asked to recognize the sensations such as cold, heat and pain.

       5. Cranial nerves

These nerves connect the brain with eyes, nose, ears, face, tongue, neck, throat, upper shoulders and some organs. There are 12 pairs of these nerves. The neurological examination will determine which nerves are involved in the symptoms. You may be asked to identify specific smells, stick your tongue out and try to speak and move your head from side to side. There could also be hearing and vision tests. 

         6. Autonomic nervous system

This system controls essential functions such as breathing, heart rate, blood pressure and body temperature. The neurologist may check the blood pressure, pulse, and heart rate while sitting, standing, or lying down to test this system. Other tests include checking pupils in response to light and a test to check your ability to sweat normally.

What do the test results mean?

If the examination result does not look normal, the doctor might order more tests to help make a more accurate diagnosis. The tests may include one or more of the following:

  • Blood and urine test
  • Imaging tests such as an x-ray or an MRI
  • A biopsy removes a small piece of tissue for further testing
  • A cerebrospinal fluid (CSF) test. CSF is a clear fluid that surrounds the brain and spinal cord. This test takes a small sample of this fluid.
  • Electroencephalography (EEG) and electromyography (EMG) analyses brain activity and nerve function by using small electrical sensors.

Nervous system disorders and mental health problems may have similar or no symptoms. This is because some behavioural symptoms are signs of nervous system disorder. If a mental health screening doesn’t have regular or prominent changes in behaviour, you may be recommended a neurological exam. 

Neurological examination may take a long time as so much in the body is controlled by the nervous system, from breathing to a sense of touch. While they can be unpleasant, they do not hurt and are safe to take. The examination follows a structure, so the patient usually knows the steps the doctor will undertake, which helps calm the anxiety and nervousness. Most tests can be performed at a physician’s office or an outpatient testing facility with no risk to the patient. A century ago, the only way of making a definite diagnosis was by performing an autopsy after someone died. Today, with the advancement in science and technology, doctors are well-equipped with the tools to monitor and assess living brain and nervous system activities. Scientists are keen to develop more advanced and improved screening methods for quick and accurate results with minimum risk to the patient. 

Fortunately, we are in a century where science has found solutions to most of the problems. Humans can save their lives by opting for the proper treatment at the right time. Therefore, it is advisable to keep a close watch on yourself and your loved ones. In case there is an unexplained change in behaviour, take the test.