The document outlines the key areas examined during a clinical neurological examination, including: 1) General appearance, mood, facial expressions, handedness, and nutritional status. 2) Stance, gait, posture, and balance tests. 3) Examination of the back, neck, and skull. 4) Assessment of the cranial nerves and optic fundi. 5) Evaluation of motor functions, muscle tone, strength, coordination and reflexes. 6) Sensory testing including pain, temperature, position, vibration and discrimination. 7) Assessment of higher cerebral functions such as orientation, memory and speech.

1. CLINICAL EXAMINATION OF THE
NERVOUS SYSTEM
QURATULAIN MUGHAL
BATCH IV
ISRA UNIVERSITY
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2. OBSERVATION
• General appearance
• Mood (e.g. anxious, depressed)
• Facial expression (or lack thereof)
• Handedness(the tendency to use either the
right or the left hand more naturally than the
other).
• Nutritional status
• Blood pressure
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3. STANCE AND GAIT
• Posture
• Romberg’s test
• Arm swing
• Pattern of gait
• Tandem (heel-toe) gait
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4. BACK
• Scoliosis
• Operative scars
• Evidence of spina bifida occulta
• Winging of scapula
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5. NECK AND SKULL
• Skull size and shape
• Neck stiffness
• Kernig’s test
• Carotid bruit(A carotid bruit is a systolic sound
heard over the carotid artery area
during auscultation).
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6. CRANIAL NERVES
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7. OPTIC FUNDI
• Papilloedema
• Optic atrophy
• Cupping of disc (glaucoma)
• Hypertensive changes
• Signs of diabetes
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8. MOTOR
• Wasting, fasciculation
• Abnormal posture
• Abnormal movements
• Tone (including clonus)
• Strength
• Coordination
• Tendon reflexes
• Abdominal reflexes
• Plantar reflexes
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9. SENSORY
• Pin-prick
• Temperature
• Joint position
• Vibration
• Two-point discrimination
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10. HIGHER CEREBRAL FUNCTION
• Orientation
• Memory
• Speech and language
• Localised cortical functions
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11. REFERENCES
• Davidsons Principles & Practice of Medicine
22nd Edition.
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