Page 97 Guide to Pain Management in Low-Resource Settings

Physical Examination: Neurology 85

• Finger-nose test: a test for coordination, and the
patient trying to touch his nose with his index
fi nger in a uninterrupted ample movement with
his eyes closed
• Romberg test: the patient should be able to stand
stable with eyes closed, feet together, arms ex-
tended 90° to the front
• Use a simple body scheme to document the
pain reported from the patient and your fi nd-
ings (see Fig. 1)

References

[1] Campbell WW. Pocket guide and toolkit to Dejong’s neurologic exami-
nation. Lippincott, Williams and Wilkins; 2007.
[2] Cruccu G, Anand P, Attal N, Garcia-Larrea L, Haanpää M, Jørum E,
Serra J, Jensen TS. EFNS guidelines on neuropathic pain assessment.
Eur J Neurol 2004;3:153–62.
[3] Weisberg LA, Garcia C, Stub R. Essentials of clinical neurology: neurol-
ogy history and examination. Available at: www.psychneuro.tulane.edu/
neurolect.

Websites

http://www.brooksidepress.org/Products/OperationalMedicine/DATA/
operationalmed/Manuals/SeaBee/clinicalsection/Neurology.pdf
http://library.med.utah.edu/neurologicexam/html/home_exam.html
Fig. 1. A neurological body scheme, useful for diff erentiating and lo-
calizing radicular and nonradicular pain with the patient’s subjective http://www.neuroexam.com
reports and the results from the physical examination. http://edinfo.med.nyu.edu/courseware/neurosurgery
http://meded.ucsd.edu/clinicalmed/neuro2.htm
• Refl ex testing: biceps = C5–6, triceps = C6–7, fi n-
ger II + III fl exion (“Trömner”) = C7–T1, patellar
ligament = L2–4, and Achilles tendon = L5–S2