The Magic of the Neuro Exam
One of my teachers, Prof Koelmeyer, used to say that the correctly performed neurological examination was one of the highest forms of art. Thanks to a tweet from Cliff Reid, I came across this magical demonstration of the neurological exam posted on YouTube by Dr Michael Ingram.
One wonders if the bow tie, English accent, and the recurrent use of the expression ‘lovely’ are necessary components of the exam… Oh yes, and don’t forget to look for the ‘quizzical eyebrows’ of Horner syndrome.
Of course, you can reduce the 3 minute neuro exam to to 3 seconds by asking your patient to perform a backward flip. If that test is positive I generally say, ‘That’s lovely’ and terminate my examination at that point.
LITFL Links
- Brainstem Rules of 4 (original rules)
- Helpful Brainstem Figures (original figures)
- The rule of 4 of the brainstem (Rules re-imagined)
- Using the Brainstem 1
- Using the Brainstem 2
- The Magic of the Neuro Exam
- Look Left, Look Right (Internuclear Ophthalmoplegia)
- More Befuddling Pupillary Asymmetry (Horner Syndrome)
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
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