How is a neurological evaluation performed?

How is a neurological evaluation performed?

It's a combination of getting the history, listening to what the patient has to say, putting those pieces together, knowing the nervous system so that you can figure out roughly what's happening, what's normal and what isn't, trying to sort it out from psychiatric overlay and all the things that are going on in the patient's life, etc., and figuring the patient's age, how long it's been going on, family history of things, and so forth. And then when you examine the patient, if you find specific abnormalities, being able to say, "Well that seems to be in this region of the brain, this seems to be peripheral nervous system versus central nervous system," etc. And then you run diagnostic tests to confirm your impression. So, I'll give you an example in MS: Our major tool for confirming diagnosis is the MRI. But initially, about 10% of MS patients have normal MRI's. So therefore, we want to look at spinal fluid in that patient. If they have an abnormal spinal fluid and they have a history that's consistent with MS, we'll make the diagnosis even though there's a normal MRI.