TEMPLATE: NEUROLOGICAL MENTAL STATUS EXAMINATION

 

FUNCTIONAL ANATOMY TEMPLATE: NEUROLOGICAL MENTAL STATUS EXAMINATION

 

Having a structured, systematic approach to the neurological mental status examination can greatly improve our diagnostic acumen.  Because this examination is long and complex, it helps to have a template. Unlike the mini-mental status examination, this template is organized by functional anatomy.

 

 

  1. GLOBAL BRAIN FUNCTION
    1. Arousal – alert (lethargy = drifts off, obtunded = difficult to arouse, stupor = requires constant vigorous stimulation, coma = unarousable.  If you can’t remember this, just document what stimulation is necessary for arousal)
    2. Attention – counts the months backward, spells globe backward (a problem with attention means delirium, assuming no dementia)
    3. Orientation – year, month, date, situation
  2. LOCAL BRAIN FUNCTION
    1. Frontal – no kinetic apraxia (test rock, paper, scissor), no disinhibition (naming Fs)
    2. Temporal
      1. Memory – 5 minute recall (note whether memory jogging required)
      2. Language – Naming items nl, receptive and expressive language nl (can test visual comprehension with reading aloud).  Test writing if you are unclear on aphasia vrs dysarthria.
    3. Parietal
      1. Constructional praxis – nl copy of cube, nl clock drawing
      2. Right inferior parietal lobe (+/- left): Double simultaneous stimulation – can check visual, tactile
      3. Left parietal: math (subtracting 7 from 100 serially)

 

 

References: Strub and Black’s The Mental Status Examination in Neurology

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