Student Selected Module in Stroke Medicine

NEUROLOGICAL EXAMINATION


NEUROLOGICAL SYMPTOMS:


NEUROLOGICAL EXAMINATION:


Glasgow Coma Scale

Eye Opening Score
spontaneously 4
to verbal stimuli 3
to pain 2
never 1
Best Verbal Response Score
oriented and converses 5
disoriented and converses 4
inappropriate words 3
incomprehensible sounds 2
no response 1
Best Motor Response Score
obeys commands 6
localises pain 5
flexion withdrawal 4
abnormal flexion (decorticate rigidity) 3
extension (decerebrate rigidity) 2
no response 1
  •  
  • • young children may be nonverbal, requiring a modification of the coma scale for evaluation.

  • Abbreviated Mental Test

    Overview:

    The Abbreviated Mental Test can be used to quickly test the cognitive function in elderly patients. This is also referred to as the Hodkinson's Mental Test Score.

    Item

    Score

    age

    1

    time to the nearest hour

    1

    year

    1

    name of place

    1

    recognition of 2 persons

    1

    birthday (date and month)

    1

    date of World War I

    1

    name of your country's Ruler, President or Prime Minister

    1

    able to count from 20 to 1 backwards

    1

    address - 42 West Street

    1

    Interpretation

    • minimum score: 0

    • maximum score: 10

    • a higher score indicates greater cognitive function

    • a score of 6 is used as the cut-off to separate normal elderly persons from those who are confused or demented with a correct assignment of 81.5%

    References:

  •  
  • Jitapunkul S, Pillay I, Ebrahim S. The Abbreviated Mental Test: Its use and validity. Age Aging. 1991; 20: 332-336.

    Kalra L, Crome P. The role of prognostic scores in targeting stroke rehabilitation in elderly patients. J Am Geriatr Soc. 1993; 41: 396-400.

    Qureshi KN, Hodkinson HM. Evaluation of a ten-question mental test in the institutionalised elderly. Age Ageing. 1974; 3: 152-157.

    Vardon VM, Blessed G. Confusion ratings and abbreviated mental test performance: A comparison. Age Ageing. 1986; 15: 139-144.


  • Mental Status Questionnaire

    Overview:

    The Mental Status Questionnaire can also be used to quickly test the cognitive function in elderly patients. This has similar roots to the Abbreviated Mental Test Score, but was developed in Scotland.

     

    Item

    Score

    Today's DATE

    1

    Today's MONTH

    1

    Today's YEAR

    1

    This TOWN

    1

    Present SITUATION

    1

    AGE

    1

    MONTH of BIRTH

    1

    YEAR of BIRTH

    1

    PRIME MINISTER

    1

    PREVIOUS PRIME MINISTER

    1

    Interpretation

    • minimum score: 0

    • maximum score: 10

    • a higher score indicates greater cognitive function

    • a score of 7 is used as the cut-off to separate normal elderly persons from those who are confused or

    References:

  •  
  • Wilson LA, Brass W. Brief assessment of the mental state in geriatric domiciliary practice. The usefulness of the mental status questionnaire. Age Ageing 2 (2):92-101, 1973.

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