The Neurological Examination

The neurological examination is an evaluation of nervous system function. Its purposes are: (1) to determine if there is evidence of a neurologic problem; (2) to determine the possible neuroanatomical site of pathology (i.e., localize the lesion); (3) to determine the underlying etiology; and (4) to guide decisions for treatment plans. It evaluates several domains of function: mental status, cranial nerve function, motor function, sensory function, reflexes, coordination, station, and gait. While the neurological exam is tailored to the clinical question(s), each domain of function is touched upon to cover the entire neuraxis (i.e., the cerebral cortex, subcortical white matter, deep gray matter structures, cerebellum, brainstem, spinal cord, peripheral nerves, neuromuscular junction, and muscles). Other investigative studies, such as neuroimaging studies, neurophysiological studies, laboratory studies, and neuropsychological examination, may also contribute to localization and differential diagnosis.