A Neurologist physical examination will evaluate several things
1) The patients awake status,
2) The alertness status,
3) The Patients orientation to time and place.
The Neurologist’s examine will consist of many factors including but not limited to physical evaluation of the
1) Eyes which should includes assessing normal eye movement, an appropriate and symmetric response of the pupils.
2) Ear canal (external auditory canal) and the ear drum (tympanic membrane).
3) An evaluation of the thyroid gland
4) lymph glands and other neck structures are often felt (palpated) to be sure there are no abnormal masses or painful areas.
5) Carotid arteries (in the front of the neck) to evaluate possible signs of vascular disease in the arteries that supply the brain.
6) Chest begins with observation to assure symmetric expansion as the patient breaths. Listening to the heart and lungs (auscultation) from both the front and back is often necessary to fully evaluate all aspects of the lungs.
7) Heart, the neurologist is noting the rhythm of the heart, the heart valve sounds, any abnormal murmurs, and other signs of heart disease.
8) The abdominal exam is performed with the patient lying down. The neurologist first looks at the abdomen for symmetry, surgical scars, and notices the vascular pattern of the skin (which can be increased in liver disease and certain other conditions).
Next the neurologist presses on the abdomen (palpates) in order to define areas of tenderness (if present), to look for abnormal masses, to measure the size of the
a) liver
b) spleen
c) Artery evaluation in this position, the neurologist will also evaluate the pulse of the artery that leaves the abdomen and supplies the leg (the femoral artery).
9) Evaluation of the upper extremities begins at the "arm pit" where the neurologist will usually assess the presence of lymph nodes.
10) The circulatory systems is assessed,
a) Radial pulse
b) Blood pressure
of great importance to the neurologist Sensation, joint range of motion, reflexes and strength may be assessed.
11) Fingernails are assessed; noticing the "return of pinkness" when gentle pressure is applied to a fingernail, which may be a indication of vascular status.
12) Lower body is similarly evaluated, noticing
a) Joint function
b) Pulses
c) Strength
d) Reflexes / Swelling.
Depending on the gender and age of the patient, gynecologic, groin, and rectal evaluations are completed to screen for common diseases and problems that may relate to A.D.H.D.
This is a general neurologist evaluation. Depending on complaints, findings, risk, and past medical history, different parts of the examination may be enhanced or reduced. Such test favored by are an E.E.G. given in a neurological examination to determine the cause of A.D.H.D. symptoms.
Finally, it is fitting to reemphasize that a neurologist’s evaluation is varied and dependent on the complaints of the patient, as well as the patient's risk factors, age, gender, past medical history and other factors.
The neurologist will often ask about a head injuries and motor skills, and history of mental health. Also the neurologist may complete a family history of physical and mental health.
The best test in my estimation is the TOVA that is usually administered by a Psychologist, Psychiatrist, or MSW. TOVA stands for (Test of Variables in Attention):
This testing method is a 21.6 minute computerized Continuous Performance Test (CPT) with claims that professionals can use it to “diagnose as well as monitor treatment of ADD/ADHD in children and adults.” There is NO valid test for ADD/ADHD. The TOVA is not exempt from this statement. The TOVA is not a valid test and does not prove that a child has ADD/ADHD, …it is an indicator. There is no neurological test that can diagnose ADD/ADHD again these/any tests are indicators only. (information istaken from many diffrent webpages and the DSM IV)
Best of Luck,
DrD
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Best Regards
God Bless & I wish you love, Joy and peace.
Dr. Dave, MBA, Ph.d
