welcome to the clinic let's get started with your neuro examination,
are you having any problems at all?
all right
okay i have all the equipment here, i think we're good to go
so the first test is following this small red target both eyes open
okay do you see any double vision?
and again you see one or two?
follow the target with both eyes open again head steady
do you see one or two?
one or two?
any double vision?
and there? and then into the corners
one or two? and one or two? excellent cover your right eye,
look into this eye, tell me when the object appears in your peripheral vision
okay let's get on eye line there
so
okay cover the other one you're now looking into this eye
keep going
peripheral vision seems okay there
cover your left eye again, are the letters clearer on the red or the green please?
now cover the other eye, are we clearer on the red or the green? red or green?
okay cover your left nostril, a simple smell test
inhale, what you're picking up there?
and
cover the other nostril please
inhale
and once again please
okay and relax
now cover your left eye, i'm going to check the right eye vision,
a series of pictures here so what you see at this distance?
and if you're unsure take a guess
cover the other eye
and now here please
both eyes open now i have some letters for you to identify
right just look towards my forehead
simple light coming
okay looking here
okay look directly into the light
follow this light source please just with the eyes, looking at the corneal reflexes now
okay looking into this eye please
to this one
right look towards my forehead
just look up to the ceiling ever so slight, check the sensitivity there
okay i'm going to check the desensitivity now, i'm going to pop some oxybuprocaine
aesthetic into the eyes, look up slightly very slightly
let's give that a few seconds
okay just while you're waiting what do you see there please?
and what do you see there?
okay looking up again
that's fine
okay we're going to do a facial sensations test, this is the soft contact
and this is what we'll call sharp, close your eyes tell me what you feel please
okay raise your eyebrows for me, show me your teeth, grit your teeth, give me a smile,
okay stick your tongue out, tongue back now, relax, turn your head to the left,
turn to the right, head to shoulder, head to other shoulder, head forwards
and backwards okay head steady, don't let me move your head
this side, excellent
close your eyes, open your mouth
okay what are you detecting there?
keep the eyes closed
final sample please for the taste test
what are you picking up there? excellent
right to cover your left eye, we're going to do some colour vision
okay do any of the spots look different in colour there? here? one here? and what about there?
there?
and this one? any different?
okay which colour closely matches the centre circle there from the other four?
and on this plate?
targets are a little bit smaller here, just match please
two more
okay cover the other eye now
any colours different here? and there? here? and here?
starting with this one, the next one
bottom left and bottom right
and this one, this one here, and here
all right i'm going to do the matching again, pick one of the outer that closely matches the middle
this one excellent
the smaller ones now
which one? this one here, good
and
so we have two more
and there please
okay just stand up straight and relax, let's have a look at you
arms to the side don't let me push them down
arms like this, don't let me pull them towards me, don't let me push them towards you
okay do this with your right hand, don't let me break the link
and here
okay i want you to touch your nose and the target
in different locations please, i'll start with the nose and the target
excellent
all right let's have a little look the optic nerve
a little bit closer now just look straight ahead please
all right so we're looking at the head of the optic nerve there
so we're looking at the definition, the colour
and for any abnormal features which is no swelling or haemorrhaging,
look at the cd ratio, rule out any notching or bayonneting on the optic nerve, look up slightly
look into the light
okay just look straight
it's about a medium height, well defined, no evidence of ppa, haemorrhaging or drusen, 0.4
vessels look fine at the crossings, looking pink there, look up slightly, good
now look into the light
blink and there's a nice foveal light reflex there
okay relax, stand up straight can you hear this here?
and do you hear this here? any difference between
the two? cover the ear with the palm, just repeat what i whisper six, 72
93
7
21 okay cover the other side, repeat what i say, or whisper 9
26
48 32
29
75
excellent that completes the examination very good