Do you often get headaches? Or do you suddenly feel like you're losing your balance or losing your balance when you walk? There is a special test that a doctor does to find the cause of these things. Today we are talking about this special test that is done on the nervous system, which acts like the control room of our body, that is, a neurological exam. Don't be afraid when you hear this name, it is very simple.
Simply put, what is a neurological exam?
Simply put, this is a physical exam that a doctor does to check how well your brain, spinal cord, and nerves are working. Just like checking the engine of a car, the doctor is checking your body's control system. This is the best way to find out if there is a problem with your nervous system.
The information from this test will help your doctor decide what tests (such as a scan) you need to do next. These tests may vary depending on the symptoms you have. So you may not be able to do the same tests that your friend did. Sometimes this test can take a while, because our nervous system is a very complex system.
If you are already receiving treatment for a nervous system condition, your doctor will often perform this test to check if the treatment is working properly.
Who needs to do this test?
If you have one or more of the following common symptoms, your doctor may suggest that you have a neurological exam. Let's take a look at what they are.
| Symptom | What does this mean? |
|---|---|
| Frequent headaches | A severe, persistent headache, different from a normal headache. |
| Dizziness and difficulty walking | Feeling like the room is spinning, losing balance when walking, and feeling dizzy. |
| Numbness or loss of sensation in the limbs | Feeling a tingling sensation in an arm, leg, or part of the face, or a feeling that that part is lifeless. |
| Vision changes | Sudden blurred vision, double vision, inability to turn both eyes in one direction. |
| Memory and behavior changes | Memory loss, restlessness, confusion, unexplained changes in behavior. |
| Difficulty speaking | Slurring of words, inability to put words together (Dysarthria or Aphasia), inability to understand what is being said. |
| Seizure | Sudden loss of consciousness and body tremors or other unusual movements. |
| Unconscious states | Deep states of unconsciousness, such as coma. |
Just because you have a symptom like this doesn't mean you have a serious illness. But it's not a good idea to ignore things like this. It's wise to see a doctor and find out the cause.
What does the doctor do during the examination?
Okay, now let's see what happens in this test. It consists of several parts. Doctor, depending on your symptoms, you may do some or all of these parts.
First, the doctor will ask you a few questions. They will ask you a lot of questions about your symptoms, when they started, how you feel, other illnesses you have, and the medications you take. Then, the physical examination will begin.
| Inspection section | Things you are asked to do and things you are tested for |
|---|---|
| Mental Status/Cognition | This is to check your memory, thinking ability, and attention. The doctor will ask you questions about the day, time, and where you are. He will ask you to repeat a few words. He will ask you to do simple calculations. |
| Cranial Nerves | There are 12 nerves that run directly from our brain to our face, eyes, and ears. To see if these are working properly, the doctor will ask you to roll your eyes back and forth, scrunch your face, stick out your tongue, and look at something. He will shine a flashlight and watch the reaction of the black ring of your eye. |
| Movement, Balance & Coordination | This is where they test whether the brain can communicate properly with the muscles. They tell you to close your eyes and touch your nose with your finger. They make you move your arms and legs. They tell you to walk in a straight line, to walk on your heels. |
| Reflexes | You've probably seen this before. The doctor takes a small rubber mallet and taps your knee, elbow, or other areas. Then he watches your limbs move spontaneously. This shows how quickly and efficiently nerve messages are traveling. |
| Sensory Exam | This is where you are tested to see if you can feel things like touch, pain, and temperature. They will ask you to close your eyes and ask if you can feel a piece of cotton on your skin. They may prick you with a small needle to see if you can feel pain. They will test if you can feel something hot or cold on your skin. |
| Autonomic Nervous System | This controls things we can't control. That means things like breathing, heart rate, and blood pressure. The doctor may ask you questions about bowel and bladder control. He or she may also measure your blood pressure as you change positions. |
How do you check if you are unconscious?
If someone is unconscious after a head injury, such as in an accident, doctors use a special method to measure the person's brain function. It's called the Glasgow Coma Scale (GCS) . It looks at:
- Are you opening your eyes?
- Are you talking?
- Do you move your limbs according to what is said?
By scoring these responses, an idea of the extent of damage to the brain is obtained.
What diseases can be detected with this test?
This test is the first and most important step in the journey to diagnose a disease. With the information obtained from this, the doctor can suspect a certain medical condition.
- Stroke: A condition that occurs when blood flow to the brain stops or a blood vessel in the brain bursts.
- Infections: Infections that affect the brain and spinal cord, such as meningitis or encephalitis.
- Movement Disorders: Diseases that affect body movements, such as Parkinson's disease.
- Neurodegenerative Disorders: Diseases that cause a gradual loss of memory and brain function, such as Alzheimer's disease.
- Epilepsy and Seizure Disorders: A fit caused by abnormal electrical activity in the brain.
- Multiple Sclerosis: A disease caused by damage to the protective covering around the nerves.
- Headache Disorders: Severe headache conditions such as migraine.
- Traumatic Brain Injury: Damage to the head caused by an accident.
How do I prepare before the test?
This doesn't require much preparation, but doing these things will make things much easier for you and the doctor.
1. Clothing: Wear comfortable, loose-fitting clothing because the doctor will need to move your limbs.
2. Write down information: Write down your symptoms on a small piece of paper.
- When did the symptoms start?
- How does it feel? (e.g., burning? tingling?)
- When does it increase?
- Will doing something about it make it less?
3. Medication details: Keep a record of all the medications you are taking (including medications for other conditions).
4. Old reports: If you have any previous test reports, bring them with you.
When you're prepared like this, you won't forget anything. It's also much easier for the doctor to get a clear picture of you.
What happens after the test?
Usually, as soon as the examination is finished, the doctor will talk to you about what he thinks and his observations.
If the test results are not normal, meaning there is a suspicion of a problem, the doctor will order additional tests to further confirm the cause. Such tests include:
- Blood Test: Check for other causes, such as vitamin deficiencies.
- Imaging Studies: These can take clear pictures of the brain or spinal cord. For example , MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans .
- EEG (Electroencephalogram): This tests the electrical activity of your brain. This is especially helpful in detecting conditions like seizures.
- EMG (Electromyogram) and Nerve Conduction Studies: These check how well your nerves and muscles are working.
- Lumbar Puncture: This involves taking a sample of the fluid around the spinal cord from your spine. This is important for detecting infections such as meningitis.
It is only after these tests that the doctor will tell you exactly what your medical condition is and begin the necessary treatment.
Take-Home Message
- A neurological exam is nothing to be afraid of. It's a routine physical exam that checks the health of your nervous system.
- Don't ignore symptoms like frequent headaches, dizziness, numbness in the limbs, and memory loss. These could be early signs of an illness.
- When you go for a checkup, write down details about your symptoms and the medications you are taking. It will be a great help to the doctor.
- This test alone cannot detect every disease, but it is the most important first step on the journey to an accurate diagnosis.
- If you have any doubts about any symptoms, be sure to see your doctor for advice.
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