Could someone say what is meant by a normal or an abnormal clinical exam in simple terms? Thank you
A clinical exam involves lots of different tests to try and identify any part of the nervous system that isn’t working properly. An abnormal clinical exam is one in which the patient had an abnormal result, e.g. they couldn’t stand with their feet together and eyes closed, walk heel to toe, etc.
If you google “neurological clinical exam”, you are bound to find loads of sites that explain it all in detail.
Karen x
Thank you. I wanted to know if it was only abnormal reflexes that counted because for me the tests you mention are abnormal but my reflexes are normal. Is that usual?
Reflexes are just one type of test and it’s possible to have abnormal / normal reflexes and normal / abnormal other things.
The best way to explain might be with an example or two so… for example, a problem with the cerebellum might cause nystagmus, an inability to toe/heel walk, poor balance, tremor and jerky movements, but it wouldn’t really affect the way the knees or ankles etc responded in a reflex test. So this person would have a clearly abnormal clinical exam, but it just wouldn’t include that type of reflex. Alternatively, someone with lesions in their visual cortex and temporal lobe might have lots of problems with visual tasks, hearing, language skills, etc, but this wouldn’t affect any of their reflexes. So, again, they’d have an abnormal clinical exam, but their reflexes would be fine.
This is a really good site that explains about reflexes (and other things): http://www.dartmouth.edu/~dons/part_1/chapter_8.html#chpt_8_cerebellum
If this isn’t really what you want to know, maybe try being specific? I’m not a neuro, but I’ll tell you what I think (for what it’s worth :-))!
Kx
Hi,
If I had a neurological problem, should I have had some of the above tests done by him. Every time I go he has a quick chat says he will send my letter to my doctor for my next lot of tablets.
Forgot to say I suffer from really bad myclonic jerks which are changing daily and are more aggresive.
Thank You for any advice.
If you are diagnosed with MS, then a neuro won’t do another clinical exam unless there has been a major change (and even then, probably not - more likely to send you for a new MRI).
If you haven’t been diagnosed, then a neuro should do a thorough clinical exam on first meeting you. Thereafter I am not sure - I guess it depends on what you tell them and what symptoms you are having.
It is crazy to be getting prescriptions, but not have anyone trying to find out why you need them though.
If I were you, I wasn’t diagnosed and hadn’t had a proper clinical exam since developing significant symptoms, I would push very hard for a second opinion.
Kx
That cerebellum discription is exactly me! Good link which has answered my query, thank you.