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THE ESSENTIAL NEUROLOGICAL EXAMINATION FOR ACUTE PHYSICIANS
  1. Matthew Jones
  1. Salford Royal Foundation Trust

Abstract

Background Up to 20% of acute hospital admissions are for neurological symptoms. Acute and general physicians initially assess such patients and many will never see a neurologist. It is therefore important that physicians in acute medicine have a sound grasp of the principles of clinical neurological assessment. However, recent audits suggest that many patients presenting with neurological symptoms are not adequately examined.

Method We used a questionnaire to to assess which components of the neurological examination a group of general physicians felt were important. We compared their responses to the answers from a group of consultant neurologists. We then implemented an intensive one-day training course and re-surveyed the group of general physicians afterwards.

Results In the initial survey the general physicians rated 12 components of the neurological examination as being necessary to perform more then 80% of the time. This contrasted with the neurology consultants who rated 25 components as being similarly important. After one day of training the general physicians rated 20 components as being important and these items closely matched those selected by the neurologists.

Conclusion General physicians may not appreciate which elements of the neurological examination are essential. Clinically focused training can help to improve this.

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