NEUROLOGICAL NEUROLOGICAL EXAMINATIONEXAMINATION

A FEW STEPS TO DIAGNOSEA FEW STEPS TO DIAGNOSE

HISTORY TAKINGHISTORY TAKING

NEUROLOGICAL EXAMINATIONNEUROLOGICAL EXAMINATION

DIAGNOSIS DIAGNOSIS FURTHER EXAMINATION : LAB, LP, FURTHER EXAMINATION : LAB, LP,

EEG, EMG, RADIOLOGIC, BIOPSYEEG, EMG, RADIOLOGIC, BIOPSY

DIAGNOSISDIAGNOSIS

HISTORY TAKINGHISTORY TAKING

HELPING TO MAKE DIAGNOSISHELPING TO MAKE DIAGNOSIS EXP : EPILEPTIC, EEG AS A TOOLEXP : EPILEPTIC, EEG AS A TOOL HISTORY TAKING SHOULD BE :HISTORY TAKING SHOULD BE :

CLEAR / CORRECTCLEAR / CORRECT AIMEDAIMED DETAILDETAIL

CONCLUDECONCLUDE

SENSORIUMSENSORIUM CRANIUMCRANIUM MENINGEAL IRRITATIONMENINGEAL IRRITATION ARISING OF INTRACRANIAL PRESSUREARISING OF INTRACRANIAL PRESSURE CRANIAL NERVECRANIAL NERVE MOTOR SYSTEMMOTOR SYSTEM ABNORMAL REFLEXABNORMAL REFLEX SENSORY SYSTEMSENSORY SYSTEM

REFLEXREFLEX CO-ORDINATIONCO-ORDINATION VEGETATIVEVEGETATIVE VERTEBRAEVERTEBRAE RADICULAR SIGNRADICULAR SIGN CEREBELLAR SIGNCEREBELLAR SIGN EXTRAPYRAMIDAL SIGNEXTRAPYRAMIDAL SIGN CORTICAL FUNCTIONCORTICAL FUNCTION

SENSORIUMSENSORIUM

COMPOS MENTISCOMPOS MENTIS APATHYAPATHY SOMNOLENCESOMNOLENCE SOPORSOPOR COMACOMA

CRANIUMCRANIUM

HEAD SHAPEHEAD SHAPE FONTANELLAFONTANELLA PALPATIONPALPATION PERCUSSIONPERCUSSION AUSCULTATORYAUSCULTATORY

MENINGEAL IRRITATIONMENINGEAL IRRITATION

NUCHAL RIGIDITYNUCHAL RIGIDITY KERNIG SIGNKERNIG SIGN LASEQUE SIGNLASEQUE SIGN BRUDZINSKI IBRUDZINSKI I BRUDZINSKI IIBRUDZINSKI II

ARISING OF INTRACRANIAL ARISING OF INTRACRANIAL PRESSUREPRESSURE

VOMITING VOMITING HEADACHEHEADACHE SEIZURESEIZURE

CRANIAL NERVESCRANIAL NERVES

N I (OLFACTORY)N I (OLFACTORY)

NORMOSMIANORMOSMIA ANOSMIAANOSMIA PAROSMIAPAROSMIA HYPOSMIAHYPOSMIA

N II (OPTIC)N II (OPTIC)

VISUAL ACUITYVISUAL ACUITYVISUAL FIELD : NORMAL / NARROWVISUAL FIELD : NORMAL / NARROWHEMYANOPSIA HEMYANOPSIA SCOTOMASCOTOMAFUNDUSCOPY : FUNDUSCOPY : - COLOR - COLOR

- BORDER - BORDER - ARTERY - ARTERY

- VEIN - VEIN - EXCAVATIO- EXCAVATIO

VISUAL FIELDVISUAL FIELD

FUNDOSCOPYFUNDOSCOPY

N III, IV, VI (OCULOMOTOR, N III, IV, VI (OCULOMOTOR, TROCHLEAR, ABDUCENS)TROCHLEAR, ABDUCENS)

EYE MOVEMENTEYE MOVEMENTNYSTAGMUSNYSTAGMUSPUPIL : WIDE, SHAPE, DIRECT/INDIRECTPUPIL : WIDE, SHAPE, DIRECT/INDIRECT LIGHT REFLEX LIGHT REFLEX RIMA PALPEBRA : RIMA PALPEBRA : PTOSIS, LAGOPTHALMOSPTOSIS, LAGOPTHALMOSCONJUGATE DEVIATIONCONJUGATE DEVIATIONDOLL’S EYE PHENOMENONDOLL’S EYE PHENOMENONSTRABISMUSSTRABISMUS

EYE MOVEMENTEYE MOVEMENT

N V (TRIGEMINAL)N V (TRIGEMINAL)

MOTORICMOTORIC OPEN AND CLOSE MOUTHOPEN AND CLOSE MOUTHPALPATE MASSETER AND TEMPORAL PALPATE MASSETER AND TEMPORAL

MUSCLEMUSCLECLENCH TEETHCLENCH TEETH

SENSORICSENSORIC SKINSKIN, , MUCOSA, CORNEAL REFLEX DIRECT / MUCOSA, CORNEAL REFLEX DIRECT /

INDIRECT, MASSETER REFLEX, SNEEZE INDIRECT, MASSETER REFLEX, SNEEZE REFLEXREFLEX

N. TRIGEMINALN. TRIGEMINAL

PALPATE MASSETER AND PALPATE MASSETER AND TEMPORAL MUSCLETEMPORAL MUSCLE

N VII (FACIAL)N VII (FACIAL)

MOTORIC MOTORIC : : FACE EXPRESSION, FACE EXPRESSION, FURROW OF FOREHEAD, FURROW OF FOREHEAD,

CLOSE EYE, BLOWINGCLOSE EYE, BLOWING FORCE, SHOWING TEETH,FORCE, SHOWING TEETH, LAUGHLAUGH

SENSORYSENSORY : : TASTE OF ANTERIOR 2/3rd OF TASTE OF ANTERIOR 2/3rd OF

TONGUE, SALIVARY GLAND, TONGUE, SALIVARY GLAND,

LACRIMAL GLAND,HYPERACUSISLACRIMAL GLAND,HYPERACUSIS

N VIII (ACOUSTIC)N VIII (ACOUSTIC)

AUDITORIUSAUDITORIUS : : HEARING, RINNE TEST,HEARING, RINNE TEST,

WEBER TEST,WEBER TEST,

SCHWABACH TEST.SCHWABACH TEST.

VESTIBULARISVESTIBULARIS : : NYSTAGMUS, NYSTAGMUS, CALORICCALORIC

REACTION, VERTIGO, REACTION, VERTIGO,

TINNITUS.TINNITUS.

RINNE TESTRINNE TEST

SCHWABACH TEST.SCHWABACH TEST.

N IX, XN IX, X

SOFT PALATESOFT PALATEUVULAUVULADYSPHAGIADYSPHAGIADYSARTRIADYSARTRIADYSPHONIADYSPHONIAGAG REFLEXGAG REFLEXTASTE 1/3 rd BACK OF TONGUETASTE 1/3 rd BACK OF TONGUE

N XIN XI

LIFT SHOULDERLIFT SHOULDERFUNCTION OF FUNCTION OF

STRENOCLEIDOMASTOIDEUS MUSCLESTRENOCLEIDOMASTOIDEUS MUSCLE

N XIIN XII

TONGUE : TONGUE : TREMOR, FASCICULATION, TREMOR, FASCICULATION,

ATROPHYATROPHYTIP OF TONGUE WHILE RESTTIP OF TONGUE WHILE RESTTIP OF TONGUE WHILE STICK OUTWARDTIP OF TONGUE WHILE STICK OUTWARD

SYSTEM MOTORIC SYSTEM MOTORIC TROPYTROPY: EUTROPHY, DISTROPHY, ATROPHY, : EUTROPHY, DISTROPHY, ATROPHY, HYPERTROPHYHYPERTROPHY

TONUSTONUS : NORMOTONUS, HYPOTONUS, : NORMOTONUS, HYPOTONUS, HYPERTONUSHYPERTONUS

MUSCLE STRENGHTMUSCLE STRENGHT : 5-0 ( 5= NORMAL) : 5-0 ( 5= NORMAL)

ATTITUDEATTITUDE

GAITGAIT: WEDDLING GAIT, SCISSORS GAIT,: WEDDLING GAIT, SCISSORS GAIT, MARCE A PETIT PAS, HEMIPLEGIC MARCE A PETIT PAS, HEMIPLEGIC GAIT, STEPPAGE GAITGAIT, STEPPAGE GAIT

ABNORMAL SPONTANEOUS ABNORMAL SPONTANEOUS MOVEMENTSMOVEMENTS

TREMORTREMOR CHOREACHOREA BALLISMUSBALLISMUS MIOCLONUSMIOCLONUS ATHETOSISATHETOSIS DYSTONIADYSTONIA SPASMUSSPASMUS TICTIC

SENSIBILITY SYSTEM SENSIBILITY SYSTEM EXTEROCEPTIVEEXTEROCEPTIVE PROPRIOCEPTIVEPROPRIOCEPTIVE CORTICAL FUNCTION FOR SENSIBILITY:CORTICAL FUNCTION FOR SENSIBILITY:

STEREOGNOSIS, TWO POINT STEREOGNOSIS, TWO POINT

DISCRIMINATION, DISCRIMINATION, GRAPHESTESIAGRAPHESTESIA

REFLEXESREFLEXES

PHYSIOLOGICAL REFLEXESPHYSIOLOGICAL REFLEXES : :

- BICEPS/ TRICEPS- BICEPS/ TRICEPS - RADIOPERIOST - RADIOPERIOST

- APR/ KPR- APR/ KPR - STRUMPLE- STRUMPLE

PATOLOGICAL REFLEXESPATOLOGICAL REFLEXES::

- BABINSKI- BABINSKI - HOFFMAN TROMNER- HOFFMAN TROMNER

- CHADDOCK- CHADDOCK - KNEE CLONUS - KNEE CLONUS

- SCHAEFER- SCHAEFER - FOOT CLONUS- FOOT CLONUS

- OPPENHEIM- OPPENHEIM - PRIMITIVE REFLEXES- PRIMITIVE REFLEXES

- GORDON- GORDON - GONDA- GONDA

BICEPSBICEPS

TRICEPSTRICEPS

KPRKPR

KPRKPR

KPRKPR

APRAPR

BABINSKIBABINSKI

COORDINATIONCOORDINATION

COORDINATION (-)COORDINATION (-) : ATAXIA : ATAXIA

A MOVEMENT SHOULD HAVE A MOVEMENT SHOULD HAVE ::

- MOVEMENT PLANNING- MOVEMENT PLANNING

- FEEDBACK INFORMATION- FEEDBACK INFORMATION

TESTTEST: GAIT, WRITING, INDEX FINGER TEST, : GAIT, WRITING, INDEX FINGER TEST,

DIADOCHOKINESIA, SPEECH, FACIAL DIADOCHOKINESIA, SPEECH, FACIAL EXPRESSION,EXPRESSION,

SROMBERG TESTSROMBERG TEST

VEGETATIFVEGETATIF

VASOMOTORICVASOMOTORIC SUDOMOTORICSUDOMOTORIC PILO ERECTORPILO ERECTOR MICTURATIONMICTURATION DEFECATIONDEFECATION POTENSI AND LIBIDOPOTENSI AND LIBIDO

VERTEBRAVERTEBRA

FORMFORM: : - NORMAL- NORMAL

- SCOLIOSIS- SCOLIOSIS

- HYPERLORDOSIS - HYPERLORDOSIS

MOVEMENTMOVEMENT: - NECK: - NECK

- WAIST- WAIST

RADICULAR SIGNSRADICULAR SIGNS

LASEQUELASEQUE CROSS LASEQUECROSS LASEQUE LHERMITTE TESTLHERMITTE TEST NAFZIGER TESTNAFZIGER TEST

CEREBELLAR SIGNSCEREBELLAR SIGNS

ATAXIAATAXIA DISARTRIADISARTRIA TREMORTREMOR NYSTAGMUSNYSTAGMUS REBOUND PHENOMENONREBOUND PHENOMENON VERTIGOVERTIGO

EKSTRA PYRAMIDAL SIGNSEKSTRA PYRAMIDAL SIGNS

TREMORTREMOR RIGIDITYRIGIDITY BRADYKINESIABRADYKINESIA

CORTICAL FUNCTIONCORTICAL FUNCTION QUALITY OF CONSCIOUSNESSQUALITY OF CONSCIOUSNESS

MEMORYMEMORY : RECENT, SHORT TERM, LONG TERM : RECENT, SHORT TERM, LONG TERM

ORIENTATIONORIENTATION: SELF, SITUATION, PLACE, TIME: SELF, SITUATION, PLACE, TIME

INTELEGENSIAINTELEGENSIA

JUDGEMENTJUDGEMENT

EMOTIONAL REACTIONEMOTIONAL REACTION

APHASIAAPHASIA: EXPRESIVE, RECEPTIVE: EXPRESIVE, RECEPTIVE