A neurological examination
assesses motor and sensory skills, the functioning of one or more cranial nerves, hearing and speech, vision, coordination and balance, mental status, and changes in mood or behavior, among other abilities.
Here is a link to a neurological examination:
https://www.youtube.com/watch?v=5UuQV-0o4CE
Eyes and Ears Assessment:
https://www.youtube.com/watch?v=a9NS_RvobJw
Items including a tuning fork, flashlight, reflex hammer, ophthalmoscope, and needles are used to help diagnose brain tumors, infections such as encephalitis and meningitis, and diseases such as Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis (ALS), and epilepsy. Some tests require the services of a specialist to perform and analyze results.
X-ray (Radiography)
Radiology is a branch of medicine that uses imaging technology to diagnose and treat disease.
Radiology may be divided into two different areas, diagnostic radiology and interventional radiology.
Doctors who specialize in radiology are called radiologists.
X-rays of the patient’s chest and skull are often taken as part of a neurological work-up.
X-rays can be used to view any part of the body, such as a joint or major organ system. In a conventional x-ray, also called a radiograph, an x-ray technician passes a concentrated burst of low-dose ionized radiation through the body and onto a photographic plate.
Since calcium in bones absorbs x-rays more easily than soft tissue or muscle, the bony structure appears white on the film.
Any vertebral misalignment or fractures can be seen within minutes.
Tissue masses such as injured ligaments or a bulging disc are not visible on conventional x-rays.
This fast, noninvasive, painless procedure is usually performed in a doctor’s office or at a clinic.
Fluoroscopy
is a type of x-ray that uses a continuous or pulsed beam of low-dose radiation to produce continuous images of a body part in motion. The fluoroscope (x-ray tube) is focused on the area of interest and pictures are either videotaped or sent to a monitor for viewing. A contrast medium may be used to highlight the images. Fluoroscopy can be used to evaluate the flow of blood through arteries.
What are some diagnostic tests used to diagnose neurological disorders?
Based on the result of a neurological exam, physical exam, patient history, x-rays of the patient’s chest and skull, and any previous screening or testing, physicians may order one or more of the following diagnostic tests to determine the specific nature of a suspected neurological disorder or injury. These diagnostics generally involve either nuclear medicine imaging, in which very small amounts of radioactive materials are used to study organ function and structure, or diagnostic imaging, which uses magnets and electrical charges to study human anatomy.
The following list of available procedures—in alphabetical rather than sequential order—includes some of the more common tests used to help diagnose a neurological condition.
Angiography
is a test used to detect blockages of the arteries or veins.
A cerebral angiography
can detect the degree of narrowing or obstruction of an artery or blood vessel in the brain, head, or neck. It is used to diagnose stroke and to determine the location and size of a brain tumor, aneurysm, or vascular malformation.
This test is usually performed in a hospital outpatient setting and takes up to 3 hours, followed by a 6- to 8-hour resting period.
The patient, wearing a hospital or imaging gown, lies on a table that is wheeled into the imaging area.
While the patient is awake, a physician anesthetizes a small area of the leg near the groin and then inserts a catheter into a major artery located there.
The catheter is threaded through the body and into an artery in the neck. Once the catheter is in place, the needle is removed and a guide wire is inserted. A small capsule containing a radiopaque dye (one that is highlighted on x-rays) is passed over the guide wire to the site of release.
The dye is released and travels through the bloodstream into the head and neck. A series of x-rays is taken and any obstruction is noted. Patients may feel a warm to hot sensation or slight discomfort as the dye is released.
Biopsy
involves the removal and examination of a small piece of tissue from the body.
Muscle or nerve biopsies are used to diagnose neuromuscular disorders and may also reveal if a person is a carrier of a defective gene that could be passed on to children. A small sample of muscle or nerve is removed under local anesthetic and studied under a microscope.
The sample may be removed either surgically, through a slit made in the skin, or by needle biopsy, in which a thin hollow needle is inserted through the skin and into the muscle. A small piece of muscle or nerve remains in the hollow needle when it is removed from the body. The biopsy is usually performed at an outpatient testing facility. A brain biopsy, used to determine tumor type, requires surgery to remove a small piece of the brain or tumor. Performed in a hospital, this operation is riskier than a muscle biopsy and involves a longer recovery period.
Brain scans
are imaging techniques used to diagnose tumors, blood vessel malformations, or hemorrhage in the brain. These scans are used to study organ function or injury or disease to tissue or muscle. Types of brain scans include computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET Scan).
Cerebrospinal fluid analysis (Lumbar Puncture)
involves the removal of a small amount of the fluid that protects the brain and spinal cord. The fluid is tested to detect any bleeding or brain hemorrhage, diagnose infection to the brain and/or spinal cord, identify some cases of multiple sclerosis and other neurological conditions, and measure intracranial pressure.
The procedure is usually done in a hospital.
The sample of fluid is commonly removed by a procedure known as a lumbar puncture, or spinal tap.
The patient is asked to either lie on one side, in a ball position with knees close to the chest, or lean forward while sitting on a table or bed. The doctor will locate a puncture site in the lower back, between two vertebrate, then clean the area and inject a local anesthetic. The patient may feel a slight stinging sensation from this injection. Once the anesthetic has taken effect, the doctor will insert a special needle into the spinal sac and remove a small amount of fluid (usually about three teaspoons) for testing. Most patients will feel a sensation of pressure only as the needle is inserted.
A common after-effect of a lumbar puncture is headache, which can be lessened by having the patient lie flat. Risk of nerve root injury or infection from the puncture can occur but it is rare. The entire procedure takes about 45 minutes.
Interventional Radiology
Interventional radiology is a medical subspecialty that performs various minimally-invasive procedures using medical imaging guidance, such as x-ray fluoroscopy, computed tomography, magnetic resonance imaging, or ultrasound.