Neuro Assessment

Enables therapist to Understand nature & extent of patients difficulties Abilities of the patient Plan and decide the treatment approach
Key points to remember before assessing

Not possible to make full assessment in one session Day to day variations are possible Assessment should go hand-in-hand with treatment Initial assessment and final assessment prior to discharge is must and should be recorded. Subjective details: Name Age Sex Occupation Address Handedness Marital status Chief complain

HISTORY TAKING: History of present illness Date and mode of onset (sudden/gradual) Associated symptoms (headache, nausea, vomiting) Progression of symptoms (onset to day of assessment) Past medical history:General health prior to the onset of present illness History of DM, hypertension etc 1

Prognosis of past illness if any Medications Hospitalizations and operations Physiotherapy treatment

Personal history:o o o o Type of personality Personal habits Marital history In terms of both abilities and disabilities

Family history:o Family history of any risk factor o Family and care giver resources Economical history:o o o o Occupation income Bread winners of the family - Expense of the family Source of income Whether able to cope up with the treatment financially

Educational history:Patient Spouse Educational History Family members 2

Whether able to understand the nature of disease &importance of the treatment Environmental history:Home and work place Accessibility No. of rooms Width of passage Type and condition of flooring Position of lights, switches, power points etc. Staircase details Location and type of toilet Kitchen arrangements To find out the barriers for the patient in his environment Easy to get details from readmitted patients Therapist anticipates the environment disability based on patients impairment and ability Occupational history:Type of work Intensity and duration Access to job place To know whether patient can continue the job or require a change Vital signs:Temperature Blood pressure Heart rate Respiratory rate 3

Vital Signs to know whether there is any contraindication Observation:Built Mode of ventilation Type of respiration Pattern of respiration Posture Head (rotation to any side) Trunk (listing phenomenon) Face (drooping/ deviation of angle of mouth) Eyes (deviation to lesion side) Attitude of limbs Upper limb Lower limb Trophic changes Pressure sores External appliances Urinary catheter IV lines Splints / sling Dressings Drainage tubes To take precautions while giving treatment 4

 Palpation Spasm Tightness Status of muscle Local temperature Trigger point Tenderness Scar Examination Temperature Blood pressure Heart rate Respiratory rate Higher mental function Level of consciousness GCS Orientation place, person, time Cognition Memory- immediate, long Cranial nerve examination 5

 Sensory examination Superficial touch, pain, temperature, pressure Deep proprioception, movement sense, vibration Combined cortical barognosis, steriognosis,graphesthesia,tectile localization,2 point discrimination Motor examination Muscle tone ROM MMT / Voluntary control grading Contracture/tightness/deformity Reflexes- superficial/Deep Balance- static/ Dynamic Co ordination examination Gait examination Functional assessment FIM / Barthel index Investigations x ray, CT, MRI, blood, CSF, EMG, NCV etc. Differential diagnosis Provisional diagnosis Problem list Aims and means Follow up 6