• Carolina Brain Center, PC, Chiropractors D.C., Raleigh, NC

The Exam

My exams are the most important thing I do!

Further, it goes way beyond running through a physical examination. It is my specialized training that enables me to:

Do a meaningful exam
Interpret the data ascertained during the exam
Correlate exam, lab, and subjective complaints
Diagnose
Make appropriate referrals
Order differential diagnostic labs, imagining, and/or other special tests
Develop a course of treatment

The main objective of a neurological exam is twofold:

To identify an abnormality in the nervous system.
To differentiate peripheral from central nervous system lesions.

Videonystagmography:

VNG or videonystagmography. This 20 minute test is a superior objective diagnostic tool. We run VNGs throughout the course of treatment so that we KNOW that we KNOW we are making the changes we want to make. For more information on the VNG click here.

The basic components of the physical neurological exam:

I. General Appearance

Habitus
Posture
Vital Signs
Motor Activity

II. Mini Mental Status

Memory
Speech

III. Cranial Nerves I-XII

All but CN I & II exit the brainstem. Examining the cranial nerves is an excellent way to evaluate the functionality of the brainstem.

IV. Motor System

Tone
Strength
Atrophy

V. Sensory System

Vibration
Joint Position
Pin Prick
Temperature
Light touch
Higher sensory function

VI. Reflexes

Deep tendon reflexes
Primitive reflexes
Pathological reflexes

VII. Cerebellar

Coordination
Gait
Balance

Exams run anywhere from 1 to 2 hours depending upon the age and functional ability of the patient. After the exam is completed and reviewed and other information (labs etc.) has been collected and subsequently reviewed, the patient is scheduled for a “Report of Findings.” During the ROF, I go over in detail what the problem is so that the patient understands exactly what is going on and what needs to happen by way of treatment.

I hope you have found this helpful!