A neurological examination is used to diagnose disorders of the brain, nerves, muscles and spinal cord. A neurological examination may be performed to detect any damage after an injury to the head – such as a concussion or brain aneurysm – or to locate the source of headaches. Patients who present symptoms of neurological conditions and diseases may also undergo neurological examinations.

Initially, a physician will compile a thorough medical history of the patient by asking questions about previous illnesses and current symptoms. After a medical history has been established, the physician will perform a specific type of physical examination and mental assessment of the patient. The neurological examination is the combination of this physical and mental assessment.

The neurological examination consists of six distinct parts:

• Mental status. Awareness and responsiveness to both the environment and the senses are observed in patients. Appearance and behavior, mood, thought content and intellectual abilities are also observed and tested.
  
  
• Cranial nerves. A specific examination of the functions of a dozen nerves that send messages between the brain, head and body. A patient’s vision, smell and facial muscle strength are among the functions evaluated.
  
  
• Motor exam. Examination of the motor system, which consists of nerves that activate the voluntary muscles that produce movement. Tests of muscle strength and tone make up this part of the assessment.
  
  
• Reflexes. The first signs of a neurological problem may be changes in reflexes, either failure to respond to stimuli or exacerbated responses to stimuli. This examination targets the deep tendon reflexes, which cause a contraction in the muscle when the attached tendon has been intentionally stimulated by a reflex hammer (e.g., knee-jerk test).
  
  
• Coordination and gait. A lack of coordination and an unusual pattern of walking may indicate signs of a neurological problem.
  
  
• Sensory exam. Neurological damage sometimes causes a loss of feeling or abnormal sensations in certain areas of the body. A patient’s reaction to minor pain and temperature changes can reveal if damage is present.

Certain additional diagnostic tests may also be performed. These may be used to make or confirm a diagnosis after the physical examination and mental assessment of the neurological examination are completed. These additional tests may include various types of imaging tests, electrodiagnostic testing, laboratory tests and spinal tap.