Print
PDF
Introduces self
|
0
|
1
|
|
Confirms name & age of patient
|
0
|
1
|
|
Explains & gains consent
|
0
|
1
|
|
Checks pain/numbness/paraesthesia/handedness
|
0
|
1
|
|
Exposes patient from waist up
|
0
|
1
|
|
General inspection for walking aids, deformities, asymmetries,
resting tremor, dyskinesia
|
0
|
1
|
|
Closer inspection for fasciculations, cafe au lait spots, scars,
wasting
|
0
|
1
|
|
Checks tone in all muscles with patient relaxed. Checks for cogwheel
rigidity
|
0
|
1
|
|
MRC graded power of shoulder abduction
|
0
|
1
|
|
MRC graded power of extension and flexion at the elbows
|
0
|
1
|
|
MRC graded power of extension and flexion at the wrist
|
0
|
1
|
|
MRC graded power of finger extension and grip for flexion
|
0
|
1
|
|
MRC graded power for finger and thumb abduction
|
0
|
1
|
|
Supinator reflex using reinforcement if needed
|
0
|
1
|
|
Biceps reflex using reinforcement if needed
|
0
|
1
|
|
Triceps reflex using reinforcement if needed
|
0
|
1
|
|
Tests for dysdiadokinesia
|
0
|
1
|
|
Looks for pronator drift and rebound
|
0
|
1
|
|
Tests coordination with finger to nose test
|
0
|
1
|
|
Looks for Hoffman's sign, tests Phalen/Tinel's and Froment's test if
appropriate
|
0
|
1
|
|
Thanks patient and offers help to redress
|
0
|
1
|
|
Washes hands
|
0
|
1
|
|
Requests full neurological exam
|
0
|
1
|
|
Summarises appropriately with only key findings
|
0
|
1
|
|
Offers appropriate differential diagnoses
|
0
|
1
|
|
Patient global score
|
0
|
1
|
2
|
Potential differentials
- Stroke
- Walking aids
- Flexed upper limb and extended lower limb posturing
- Spastic rigidity
- Unilateral upper motor neurone lesion
- Gait & Coordination abnormalities (see G&C examination for differentials)
- Bilateral weakness
- Multiple sclerosis (may be asymmetrical)
- Spinal cord compression
- Motor neurone lesion (no sensory component)