Doctors can perform a number of non-invasive, painless tests to find out if a patient has a neurological disorder or disease.
Before beginning a neurological exam, the doctor will take a detailed history of the patient's symptoms such as when they appeared and how they developed. The doctor will then ask about the family’s medical history for further clues. Finally, the doctor is ready to perform a neurological examination.
The examination tests how well the different parts of the nervous system are functioning, providing further details about the patient’s symptoms. The following are some of the most common tests.
- Tendon reflexes — Tests of tendon reflexes provide information on spinal cord connections, motor nerve functions and the health of peripheral nerves. A familiar example of tendon reflex tests is when the doctor taps the patient’s knee with a special rubber hammer.
- Muscle strength — Weakness of a muscle or group of muscles can be a symptom of a neurological problem. For that reason, the physician may test the patient’s muscle strength.
- Muscle tone — Spasticity, rigidity or flaccidity of groups of muscles can indicate problems with the nerves that stimulate them. To test muscle tone, the doctor moves the patient’s limbs, taking careful note of strength, flexibility and range of movement on both sides of the body.
- Babinski reflex — The doctor strokes the sole of a patient’s foot lightly, testing for an involuntary movement of the big toe. This can indicate a problem with nerve tracts that originate in the brain.
- Sensory functions — Due to sensations such as touch, pain and temperature that travel through peripheral nerves to the brain, sensory tests are an important part of a neurological exam. The doctor evaluates the patient’s responses using stimuli such as cotton balls, light pinpricks and vibrating tuning forks. Taste, smell, hearing and, especially, vision also may be tested. Finally, the doctor will test coordination, sense of balance, posture and gait by asking the patient to stand, walk or move in a particular way.
- Mental status — The doctor may ask the patient a series of questions to help determine if thinking, judgment or long- or short-term memory is affected.