I feel privileged to have learnt the importance of a comprehensive neuro exam when working as an OT with both Professors Harry Reef and Viv Fritz. Throughout my career as both a clinician and educator, I must have sounded like a broken record by insisting that one cannot fully understand a patient's areas of difficulty if merely relying on test results, heresay and text books
My recently retired neuro would do a THOROUGH physical neuro exam 3x a year, each lasting a solid 45min. His much younger replacement only does very cursory (5 min) physical exams, and mainly asks questions. I prefer the longer and more frequent physical exams done by my retired doc. He touched EVERY part of my body with vibration, sharp vs dull pokes, cognitive tests, visual. I think the longer and more detailed physical neuro exam done well can track a patient's progression MUCH better than a patient self reporting.
Impossible to diagnose in neuro- ophthalmology without examining the patient. For example ptosis and fatiguability , variability of diplopia etc. warm regards Gavin from our days at the joburg Gen.
I feel privileged to have learnt the importance of a comprehensive neuro exam when working as an OT with both Professors Harry Reef and Viv Fritz. Throughout my career as both a clinician and educator, I must have sounded like a broken record by insisting that one cannot fully understand a patient's areas of difficulty if merely relying on test results, heresay and text books
My recently retired neuro would do a THOROUGH physical neuro exam 3x a year, each lasting a solid 45min. His much younger replacement only does very cursory (5 min) physical exams, and mainly asks questions. I prefer the longer and more frequent physical exams done by my retired doc. He touched EVERY part of my body with vibration, sharp vs dull pokes, cognitive tests, visual. I think the longer and more detailed physical neuro exam done well can track a patient's progression MUCH better than a patient self reporting.
Impossible to diagnose in neuro- ophthalmology without examining the patient. For example ptosis and fatiguability , variability of diplopia etc. warm regards Gavin from our days at the joburg Gen.
Objective variable ptosis is a good one. Mary Walker challenge and objective worsening. Cold pack test. Cheers!