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Introduces self
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Confirms name & age of patient
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Explains & gains consent
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Checks pain/numbness/paraesthesia/handedness
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Exposes patient from waist up
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General inspection for walking aids, deformities, asymmetries,
resting tremor, dyskinesia
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Closer inspection for fasciculations, cafe au lait spots, scars,
wasting
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Assesses light touch (comparing both sides and comparing with
sternum) for C4, C5
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Assesses light touch for C6, C7
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Assesses light touch for C8, T1, T2
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Maps out any abnormality
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Assesses or offers sharp touch with neurotip over C4, C5, C6
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Assesses or offers sharp touch with neurotip over C8, T1, T2
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Maps out any abnormality
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Vibration sense on distal joint of index finger. Ask patient to
report when vibration stops before stopping it manually. Moves proximally if
absent.
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Tests proprioception in index finger moving proximally if absent
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Tests Phalen, Tinel's, Froment's tests if appropriate and offers to
test 2 point discrimination, inattention and temperature with hot/cold rods
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Thanks patient and offers help to redress
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Washes hands
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Requests full neurological exam
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Summarises appropriately with only key findings
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Offers appropriate differential diagnoses
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Patient global score
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2
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- Bilateral distal sensory loss (glove and stocking distribution)
- Diabetes/B12 and folate/Drugs etc.