The Neurological Examination
You will probably be given a thorough neurological examination to look for abnormalities in the way the nervous system is functioning. These abnormalities may be very subtle and not obvious to the non-specialist. This type of testing is known as ‘clinical’, i.e. based on observation of the person. Laboratory or imaging tests are used to back up clinical findings. The examination will cover the areas of motor function (movement), sensory function, eye movement, co-ordination, balance and reflexes. It will also check for any signs of weakness and will assess basic mental alertness. Limb reflexes are checked by tapping or stroking at certain points that should provoke a standard reaction. Loss of sensation at the extremities may be tested by using a vibrating tuning fork placed against the skin. You may be asked to perform tasks like closing your eyes, circling your hand away from your body and then touching your nose with your finger; failure to touch the nose can indicate damage in a specific area of the brain. The neurologist may ask you questions about, for example, the current Prime Minister, or what you wore on your wedding day. This is to check for orientation and memory, and does not mean the neurologist thinks you are stupid.
A neurological examination shows up abnormalities in the nervous system but does not reveal what is causing them.