Neurology - OSCE overview part 1

Examining the nervous system

General rules

• Explain carefully to patients what you want them to do for each part of the examination and why
• Ask the patient to copy your actions, rather than trying to explain a complicated manoeuvre
• Always compare one side with the other
• Organise your examination into categories
• Mental state
• Cranial nerves
• Motor function
• Reflexes
• Coordination and gait
• Sensation

Equipment

• Pen torch
• Snellen eye chart or pocket vision card
• Ophthalmoscope
• Tendon hammer
• 128 and 512 Hz tuning forks
• Cotton wool
• 'Neuropins' or paper clips
• Orange stick

Mini-mental status examination

• Name
• Age
• Address
• Location
• Time
• Name of monarch
• Name of prime minister
• Dates of the Second World War
• Remember the following address and repeat it when asked: 42 Westminister street, London (ask the patient to recall this after asking of the rest of the questions)
• Count backwards from 20 to 10