Summary – Neurological System

The neurological system is divided into the central and peripheral nervous systems. Through a complex interaction of neurons and pathways, messages are transmitted from the brain to the spinal cord and peripheral nerves and from the nerve endings in the periphery to the spinal cord and cerebral cortex.

A neurological screening exam includes:

1. Mental Status (level of alertness, appropriateness of responses, orientation to date and place)
2. Cranial nerves, visual acuity, pupillary light reflex, eye movements, hearing, facial strength (smile, eye closure), speech
3. Motor function, strength (shoulder abduction, elbow flexion/extension, wrist extension, finger abduction, hip flexion, knee flexion/extension, ankle dorsiflexion) (Odia, 2019).
4. Sensation (one modality at toes—can be light touch, pain, temperature, vibration, or proprioception), coordination (fine finger movements, finger-to-nose or finger-to-chin), and gait (casual and tandem) (Odia, 2019).
5. Deep tendon reflexes (biceps, patellar, Achilles), plantar responses

Common or concerning neurological symptoms: Headache, dizziness or lightheadedness, weakness (generalized, proximal, distal), numbness or abnormal or absent sensation, fainting or blacking out (near syncope and syncope), seizures, tremors, or involuntary movements.