Introduction to the Neurologic Screen and Observation Webinar

Presenter

• Dr. Lily Jimenez: Physical therapist specializing in neurologic care.

Overview of the Webinar

• Understanding differences between neurologic screen vs. neurologic exam.
• Components of an efficient neuroscreen.
• Interpreting results of a neuroscreen.

Importance of Neurologic Screen

• Screens for red flags and changes in patient status.
• Used for referral screening and differential diagnostic tool.
• Identifies altered sensory and motor functions.

Difference Between Screen and Examination

• Screen: Quick assessment used to detect red flags and determine the need for further testing.
• Examination: More detailed and varies based on experience and practice.
• Both screen and exam have similar components but differ in detail.

Components of Neural Screen

1. Observation

   • Posture, symmetry, involuntary movements, muscle bulk.
   • Indicators of basal ganglia disorders (decreased/excessive movement).

2. Mental Status

   • Level of consciousness, orientation, memory, unusual behavior.
   • Use of FOGS acronym for cognition screening.
   • Assessment of speech quality (related to cranial nerves 7, 9, 10, 11, 12).

3. Cranial Nerve Screen

   • Questions and tests related to smell, pupils, vision, facial sensation, and movements.
   • Quick assessment of nerve function from CN I through CN XII.

4. Motor Function

   • Observation of arms and hands for atrophy, fasciculations, muscle bulk.
   • Pronator drift: Indicates stroke (upward drift for cerebellar involvement).
   • Quick strength screen for major myotomes.

5. Tone

   • Passively move limbs to assess hypotonia or hypertonia.

6. Reflexes

   • Normal reflex tests and screening for abnormal reflexes (clonus, Babinski, Hoffman).

7. Sensation

   • Questions about numbness, tingling, and screening with light touch.
   • Sensory loss patterns indicate pathway issues, e.g., CNS or peripheral nerve issues.

8. Coordination and Balance

   • Coordination tests: Fingertip, heel-to-shin, rapid alternating movements.
   • Balance tests: Romberg test.

9. Gait

   • Observation of walking and balance during ambulation.

Quick Neuro Screen Procedure

• Can be completed in less than 15 minutes.
• Any abnormal findings lead to more detailed examinations.

Video Demonstration

• Brief neurologic exam used for general screening or undifferentiated neurologic complaints.
• Steps include cranial nerve exam, motor function, reflexes, sensory functions, coordination, and gait/balance tests.

Conclusion

• Neurologic screens are essential for quick assessment and can lead to further detailed examinations if abnormalities are detected.